A new study presented at the Society for Cardiovascular Angiography and Interventions (SCAI) Scientific Sessions illuminates the effectiveness of using 3D printed models to determine the risk of paravalvular leak (PVL) in patients undergoing transcatheter aortic valve replacement (TAVR) operations.
TAVR is a procedure employed for treating intermediate, high-risk and inoperable patients suffering from narrowing of the aortic valve. The process consists of implanting a prosthetic valve to replace the damaged one. And though the procedure itself is less invasive than other treatments, TAVR does bring with it the risk of paravalvular leak (leaking around the new valve), which can lead to higher mortality rates.
In an effort to better understand and prevent PVL, scientists and clinicians are increasingly turning to 3D printing technologies. 3D printed models based off of patient CT scans are enabling medical professionals to predict whether an implant valve will be ill-fitting or not. More than that, the 3D printed models also help doctors to visualize where the leak will take place and find solutions for the patient in question.
In the recently presented retrospective study, six patients undergoing TAVR for calcific stenosis who had the risk of PVL were subjected to pre-procedure computed tomography (CT) scans. These images were then analyzed and segmented before being sent to a 3D printer for manufacturing. With both the CT images and the 3D printed models, the researchers were able to identify the location of calcium buildup and explore options for ill-fitting valves.
Additionally, the researchers used the 3D printed aortic root models to test the valve size, which provided valuable insight into where the calcium deposits would be. From there, the 3D models were scanned and further analyzed before being compared to in-vivo implanted TAVR echocardiograms.
As the study showed, the leaks found in the 3D printed models were confirmed in the patients’ CT scans and the 3D models ultimately helped the researchers to personalize valve placement, size and location to precent leaks and lower calcium build up.
“We are very encouraged to see such positive outcomes for the feasibility of 3D printing in patients with heart valve disease. These patients are at a high risk of developing a leak after TAVR, and anything we can do to identify and prevent these leaks from happening is certainly helpful. Like any other new technology, as 3D printing evolves, we hope to see an increase in accessibility and opportunity for the use of this technology to help improve patient care.”
Sergey Gurevich, MD, lead author and Cardiovascular Fellow at the University of Minnesota.
With over five million Americans diagnosed with heart valve disease each year, advancements in treatments are in high demand. As the retrospective study (entitled “Poster Session III: 3D Printing and Computer Modeling to Predict Paravalvular Leak in Transcatheter Aortic Valve Replacement”) has shown, additive manufacturing could play a critical role in improving TAVR procedures.