北京生物醫(yī)學(xué)工程

應(yīng)用三維打印技術(shù)構(gòu)建心臟瓣膜病術(shù)前主動(dòng)脈根部模型的可行性研究

Feasibility of 3D printing of aortic valve disease models before transapical aortic valve implantation

作者：馬連彩劉坤張茗卉崔躍張寶祥李君濤呂濱

單位：有研醫(yī)療器械（北京）有限公司（北京102299）<p>中國(guó)人民解放軍總醫(yī)院第一附屬醫(yī)院肝膽胰脾外科（北京 100048）</p><p>中國(guó)醫(yī)學(xué)科學(xué)院/北京協(xié)和醫(yī)學(xué)院阜外醫(yī)院超聲診斷中心（北京 100037）</p>

關(guān)鍵詞：計(jì)算機(jī)斷層成像；主動(dòng)脈瓣病；經(jīng)心尖主動(dòng)脈瓣置換術(shù)；三維打印

分類(lèi)號(hào)：R318.04

出版年·卷·期（頁(yè)碼）：2019·38·1（7-14）

摘要：

目的探討應(yīng)用三維(three dimensional，3D)打印技術(shù)構(gòu)建心臟瓣膜病術(shù)前主動(dòng)脈根部模型的可行性,為臨床應(yīng)用提供思路。方法前瞻性入選術(shù)前接受CT檢查且擬行主動(dòng)脈瓣置換術(shù)的患者8例，其中6例的主動(dòng)脈疾病手術(shù)指征為主動(dòng)脈瓣重度狹窄（2例合并主動(dòng)脈瓣二葉式畸形），1例為人工生物瓣置入術(shù)后瓣膜失功能，1例為主動(dòng)脈根部瘤合并主動(dòng)脈瓣反流。CT掃描均使用前瞻性心電門(mén)控采集，將患者收縮期CT圖像導(dǎo)入Mimics?、3-matic、Magics?、Freeform?等醫(yī)學(xué)三維圖像建模及編輯軟件，逐一進(jìn)行疾病三維模型的構(gòu)建，并打印出實(shí)物模型。結(jié)果 8例患者的主動(dòng)脈疾病模型均成功構(gòu)建，模型質(zhì)量滿(mǎn)意，有3例模型得到了手術(shù)驗(yàn)證。患者中位年齡為74歲（52~ 82歲），三維建模的中位耗時(shí)為4.5 h（3.0~5.5 h），3D打印的中位耗時(shí)為5 h（5~9 h），中位材料成本為3050元（2600~9700元）。結(jié)論應(yīng)用3D打印技術(shù)構(gòu)建心臟瓣膜病術(shù)前主動(dòng)脈根部模型具有可行性。

Objective To investigate the feasibility of three dimensional (3D) model printing of aortic root before aortic valve disease surgery. Methods Eight patients undergoing CT examination who would undergone cardiac aortic valve replacement were prospectively enrolled. Six patients’ aortic disease indicated for severe aortic stenosis (two patients were with bicuspid aortic valve deformity),one patient was with artificial bioprosthetic valve dysfunction after implantation, one patient was with main artery root aneurysm and aortic regurgitation.Prospective ECG gated acquisition was used for CT scan. The CT images of systolic were imported into Mimics?、3-matic、Magics?、 Freeform? and other 3D modeling and editing software, then the 3D models of disease were built one by one, and physical models were printed. Results Models of aortic valve disease of all eight cases were successfully constructed, with good qualities, three of which were confirmed by open surgery. The median age was 74 years (the age range of 52-82 years). The median time cost of three-dimensional modeling was 4.5 hours (the time range of 3.0-5.5 hours), and the median time cost of 3D model printing was 5 hours (the time range of 5-9 hours), and the median material cost was ￥3050 (the cost range of ￥2600-9700). Conclusions 3D model printing of aortic valve disease before operation is feasible.

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