Craig M. Johnson MD, Presenter: Nothing to Disclose

Christopher Taylor BS, Abstract Co-Author: Nothing to Disclose

Christina R. Ferraro MD, Abstract Co-Author: Nothing to Disclose

Randy Ray Richardson MD, Abstract Co-Author: Nothing to Disclose

Justin Ryan BA, Abstract Co-Author: Nothing to Disclose

David Frakes PhD, Abstract Co-Author: Nothing to Disclose

Mitchell Ross, Abstract Co-Author: Nothing to Disclose

Kevin Brady, Abstract Co-Author: Nothing to Disclose

Hursh Naik, Abstract Co-Author: Nothing to Disclose

To assess the added value of 3D printing cardiac models of a patient’s anatomy from cardiac CTA reconstruction in the surgical planning of deployed bioprosthetic aortic valve size during TAVR.

An initial study group of five patients with ages ranging from 55-78 years of age diagnosed with severe, symptomatic aortic stenosis underwent cardiac CTA prior to TAVR procedure. The thoracic aorta and left ventricle were evaluated using cardiac CTA by a team of radiologists, cardiologists, and cardiothoracic surgeons for assessment of technical issues related to delivery and deployment of artificial valves. The area of the aortic root was measured and the coronary anatomy and calcifications were reviewed with the multidisciplinary team. A commercially available workstation was used to reconstruct images of the left ventricle and proximal aorta. These 3D reconstructed images were then post-processed and a negative of the images was 3D printed using a clear color photopolymer. Aortic root calcifications were 3D printed on the anatomic model using a yellow dye and coronary artery anatomy was printed using a red dye. Varying sizes of the devices approved for TAVR were deployed within the 3D printed aortic models and anatomic fit was assessed based on printed aortic root anatomy, coronary anatomy, and adjacent calcific plaque. The choice of valve type and size was compared after initial geometric assessment, after trial of deploying within the 3D printed model, and with the actual valve deployed intraoperatively.

From the initial study group of five patients who underwent TAVR procedure, geometric analysis on cardiac CTA using calculated aortic root area correctly predicted the actual deployed valve size in three out of five patients undergoing TAVR. Using 3D printed modeling of the patient’s anatomy and pre-surgical fitting of these models using bioprosthetic valves, the multidisciplinary team correctly predicted the eventual deployed size of the artificial valve in all five patients.

Supplemental 3D printing of aortic models prior to TAVR adds additional value to cardiac teams in addition to computer aided geometric assessment to correctly choose the correct bioprosthetic valve fit.

Radiologists can offer 3D printed models to cardiac teams based on a patient’s cardiac CTA as an additional tool for pre-operative assessment of bioprosthetic valve size to be deployed during TAVR.

Johnson, C, Taylor, C, Ferraro, C, Richardson, R, Ryan, J, Frakes, D, Ross, M, Brady, K, Naik, H, 3D Printing of Reconstructed Cardiac CT Angiography Models to Aid in Pre-operative Assessment of Implanted Bioprosthetic Valve Size before Transcatheter Aortic Valve Replacement (TAVR).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045478.html