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In vitro bench testing using patient-specific 3D models for percutaneous pulmonary valve implantation with Venus P-valve

In vitro bench testing using patient-specific 3D models for percutaneous pulmonary valve implantation with Venus P-valve

摘要Background::Due to the wide variety of morphology, size, and dynamics, selecting an optimal valve size and location poses great difficulty in percutaneous pulmonary valve implantation (PPVI). This study aimed to report our experience with in vitro bench testing using patient-specific three-dimensional (3D)-printed models for planning PPVI with the Venus P-valve. Methods::Patient-specific 3D soft models were generated using PolyJet printing with a compliant synthetic material in 15 patients scheduled to undergo PPVI between July 2018 and July 2020 in Central China Fuwai Hospital of Zhengzhou University.Results::3D model bench testing altered treatment strategy in all patients (100%). One patient was referred for surgery because testing revealed that even the largest Venus P-valve would not anchor properly. In the remaining 14 patients, valve size and/or implantation location was altered to avoid valve migration and/or compression coronary artery. In four patients, it was decided to change the point anchoring because of inverted cone-shaped right ventricular outflow tract (RVOT) ( n = 2) or risk of compression coronary artery ( n = 2). Concerning sizing, we found that an oversize of 2-5 mm suffices. Anchoring of the valve was dictated by the flaring of the in- and outflow portion in the pulmonary artery. PPVI was successful in all 14 patients (absence of valve migration, no coronary compression, and none-to-mild residual pulmonary regurgitation [PR]). The diameter of the Venus P-valve in the 3D simulation group was significantly smaller than that of the conventional planning group (36 [2] vs. 32 [4], Z = -3.77, P <0.001). Conclusions::In vitro testing indicated no need to oversize the Venus P-valve to the degree recommended by the balloon-sizing technique, as 2-5 mm sufficed.

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abstractsBackground::Due to the wide variety of morphology, size, and dynamics, selecting an optimal valve size and location poses great difficulty in percutaneous pulmonary valve implantation (PPVI). This study aimed to report our experience with in vitro bench testing using patient-specific three-dimensional (3D)-printed models for planning PPVI with the Venus P-valve. Methods::Patient-specific 3D soft models were generated using PolyJet printing with a compliant synthetic material in 15 patients scheduled to undergo PPVI between July 2018 and July 2020 in Central China Fuwai Hospital of Zhengzhou University.Results::3D model bench testing altered treatment strategy in all patients (100%). One patient was referred for surgery because testing revealed that even the largest Venus P-valve would not anchor properly. In the remaining 14 patients, valve size and/or implantation location was altered to avoid valve migration and/or compression coronary artery. In four patients, it was decided to change the point anchoring because of inverted cone-shaped right ventricular outflow tract (RVOT) ( n = 2) or risk of compression coronary artery ( n = 2). Concerning sizing, we found that an oversize of 2-5 mm suffices. Anchoring of the valve was dictated by the flaring of the in- and outflow portion in the pulmonary artery. PPVI was successful in all 14 patients (absence of valve migration, no coronary compression, and none-to-mild residual pulmonary regurgitation [PR]). The diameter of the Venus P-valve in the 3D simulation group was significantly smaller than that of the conventional planning group (36 [2] vs. 32 [4], Z = -3.77, P <0.001). Conclusions::In vitro testing indicated no need to oversize the Venus P-valve to the degree recommended by the balloon-sizing technique, as 2-5 mm sufficed.

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作者 Han Yu [1] Shao Zehua [2] Sun Zirui [1] Han Yan [1] Xu Hongdang [3] Song Shubo [2] Pan Xiangbin [4] de Jaegere Peter P. T. [5] Fan Taibing [2] Zhang Gejun [1] 学术成果认领
作者单位 Department of Structure Heart Disease, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan 451460, China [1] Children’s Heart Center, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan 451460, China [2] Department of Anesthesiology, Central China Fuwai Hospital of Zhengzhou University, Zhengzhou, Henan 451460, China [3] Department of Structure Heart Disease, Fuwai Hospital Chinese Academy of Medical Sciences, Beijing 100037, China [4] Department of Cardiology, Erasmus MC, Rotterdam 3015 GD, Netherlands [5]
栏目名称 Original Article
DOI 10.1097/CM9.0000000000002793
发布时间 2025-02-25
基金项目
Henan Province health science and technology innovation talents training project
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中华医学杂志英文版

中华医学杂志英文版

2024年137卷8期

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