Imaging-Based, Patient-Specific Three-Dimensional Printing to Plan, Train, and Guide Cardiovascular Interventions: A Systematic Review and Meta-Analysis.

Bernhard, Benedikt; Illi, Joël; Gloeckler, Martin; Pilgrim, Thomas; Praz, Fabien; Windecker, Stephan; Haeberlin, Andreas; Graeni, Christoph (2022). Imaging-Based, Patient-Specific Three-Dimensional Printing to Plan, Train, and Guide Cardiovascular Interventions: A Systematic Review and Meta-Analysis. Heart, lung & circulation, 31(9), pp. 1203-1218. Elsevier 10.1016/j.hlc.2022.04.052

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BACKGROUND

To tailor cardiovascular interventions, the use of three-dimensional (3D), patient-specific phantoms (3DPSP) encompasses patient education, training, simulation, procedure planning, and outcome-prediction.

AIM

This systematic review and meta-analysis aims to investigate the current and future perspective of 3D printing for cardiovascular interventions.

METHODS

We systematically screened articles on Medline and EMBASE reporting the prospective use of 3DPSP in cardiovascular interventions by using combined search terms. Studies that compared intervention time depending on 3DPSP utilisation were included into a meta-analysis.

RESULTS

We identified 107 studies that prospectively investigated a total of 814 3DPSP in cardiovascular interventions. Most common settings were congenital heart disease (CHD) (38 articles, 6 comparative studies), left atrial appendage (LAA) occlusion (11 articles, 5 comparative, 1 randomised controlled trial [RCT]), and aortic disease (10 articles). All authors described 3DPSP as helpful in assessing complex anatomic conditions, whereas poor tissue mimicry and the non-consideration of physiological properties were cited as limitations. Compared to controls, meta-analysis of six studies showed a significant reduction of intervention time in LAA occlusion (n=3 studies), and surgery due to CHD (n=3) if 3DPSPs were used (Cohen's d=0.54; 95% confidence interval, 0.13 to 0.95; p=0.001), however heterogeneity across studies should be taken into account.

CONCLUSIONS

3DPSP are helpful to plan, train, and guide interventions in patients with complex cardiovascular anatomy. Benefits for patients include reduced intervention time with the potential for lower radiation exposure and shorter mechanical ventilation times. More evidence and RCTs including clinical endpoints are needed to warrant adoption of 3DPSP into routine clinical practice.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Bernhard, Benedikt, Illi, Joël Alain, Glöckler, Martin, Pilgrim, Thomas, Praz, Fabien Daniel, Windecker, Stephan, Häberlin, Andreas David Heinrich, Gräni, Christoph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1444-2892

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

13 Jun 2022 08:46

Last Modified:

05 Dec 2022 16:20

Publisher DOI:

10.1016/j.hlc.2022.04.052

PubMed ID:

35680498

Uncontrolled Keywords:

3D printing Additive manufacturing Cardiovascular intervention Patient specific phantoms Personalized medicine

BORIS DOI:

10.48350/170595

URI:

https://boris.unibe.ch/id/eprint/170595

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