Author + information
- Abdallah El Sabbagh,
- Mackram Eleid,
- Sameh Said,
- Vuyisile Nkomo,
- Charanjit Rihal and
- Thomas Foley
Background: 3 dimensional (3D) printing is a novel technique used to fabricate physical models from digital objects allowing visual assessment of the cardiac anatomy including mitral annular apparatus and simulation of percutaneous interventions.
Methods: 8 patients with severe mitral annular calcification underwent transcatheter mitral valve replacement (TMVR). 3D digital images from the pre-procedure computed tomography were created. A digital model of the SAPIEN prosthesis was added to the mitral annulus to assess prosthesis matching, peri-valvular gaps, and left ventricular outflow tract (LVOT) obstruction. Models were printed. Post procedure imaging was then retrospectively compared to the 3D simulation model to determine how closely the achieved result mirrored that which was modeled.
Results: 3D simulated models predicted LVOT obstruction in 4 patients; 2 patients underwent transatrial approach with anterior mitral leaflet resection and 1 patient underwent alcohol septal ablation prior to TMVR. It also predicted valve sizing in 5 patients. Mean MV gradient decreased from 12 mmHg to 5 mmHg (Figure 1). 2 patients had severe perivalvular leak not predicted by 3D simulation, likely due to anterior mitral valve resection offsetting the pre-procedure measurements.
Conclusions: 3D technology for TMVR simulation in severe MAC is feasible and shows promise. More studies are required to demonstrate the incremental value of 3D printing as compared to other imaging modalities.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Structural Heart Interventions: Focus on Mitral Valve, Left Atrial Appendage and HOCM
Abstract Category: 24. Interventional Cardiology: Mitral and Structural Heart Disease
Presentation Number: 1156-183
- 2017 American College of Cardiology Foundation