北京生物医学工程

应用三维打印技术构建心脏瓣膜病术前主动脉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：马连彩刘坤张茗卉崔跃张宝祥李君涛吕滨

单位：有研医疗器械（北京）有限公司（北京102299）<p>中国人民解放军总医院第一附属医院肝胆胰脾外科（北京 100048）</p><p>中国医学科学院/北京协和医学院阜外医院超声诊断中心（北京 100037）</p>

关键词：计算机断层成像；主动脉瓣病；经心尖主动脉瓣置换术；三维打印

分类号：R318.04

出版年·卷·期（页码）：2019·38·1（7-14）

摘要：

目的探讨应用三维(three dimensional，3D)打印技术构建心脏瓣膜病术前主动脉根部模型的可行性,为临床应用提供思路。方法前瞻性入选术前接受CT检查且拟行主动脉瓣置换术的患者8例，其中6例的主动脉疾病手术指征为主动脉瓣重度狭窄（2例合并主动脉瓣二叶式畸形），1例为人工生物瓣置入术后瓣膜失功能，1例为主动脉根部瘤合并主动脉瓣反流。CT扫描均使用前瞻性心电门控采集，将患者收缩期CT图像导入Mimics?、3-matic、Magics?、Freeform?等医学三维图像建模及编辑软件，逐一进行疾病三维模型的构建，并打印出实物模型。结果 8例患者的主动脉疾病模型均成功构建，模型质量满意，有3例模型得到了手术验证。患者中位年龄为74岁（52~ 82岁），三维建模的中位耗时为4.5 h（3.0~5.5 h），3D打印的中位耗时为5 h（5~9 h），中位材料成本为3050元（2600~9700元）。结论应用3D打印技术构建心脏瓣膜病术前主动脉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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