Due to advances in 3D printing technology , researchers may have found a way to improve the success rate of transcatheter aortic valve replacement (TAVR). In a new study published in JACC: Cardiovascular Imaging, the researchers said that the creation of a 3D printed model allows doctors to predict how artificial heart valves can better fit patients and reduce the likelihood of paravalvular leaks.
TAVR, also known as transcatheter aortic valve implantation, is a minimally invasive procedure. It involves inserting a replacement artificial aortic valve through the catheter into the injured aortic valve. Once inserted, the prosthetic valve expands and assumes the work of a healthy aortic valve.
One of the complications of TAVR is paravalvular leakage, where blood leaks from the artificial aortic valve and flows around it, rather than through it. This may increase the risk of endocarditis.
Peripheral leakage most often occurs when the prosthetic valve does not exactly match the patient's damaged aortic valve. Therefore, there is a need to find better ways to predict the suitability of prosthetic valves.
Zhen Qian, director of cardiovascular imaging research at the Piedmont Heart Institute in Atlanta, USA, and colleagues have developed a 3D heart valve model that they believe will meet this need.
Create a 3D heart valve model
To create the model, the researchers used cutting-edge 3D printing technology, which enabled them to simulate the physiological properties of heart valve tissue using a variety of different synthetic materials.
Chuck Zhang, a co-author and researcher at the Georgia Institute of Technology in the United States, said that the previous methods of using 3D printers and single materials to make human organ models were limited to the physiological properties of the materials used. Our approach to creating these models using metamaterial design and multi-material 3D printing takes into account the mechanical properties of the heart valve, simulating the softening of soft tissue from the interaction between elastin and collagen, two proteins found in heart valves. behavior.
The team's heart valve model was based on computed tomography (CT) images of 18 patients who underwent TAVR. Once built, the researchers arranged the model with radiopaque beads, which helped identify any misalignment of the heart valve to simulate tissue.
Expansion Index score
Next, the researchers determined the type and size of the prosthetic valve that 18 patients received during TAVR.
In a warm water environment, artificial valves of the same size and type are implanted into a 3D model in order to simulate human body temperature. The position of these valves simulates the position of the patient's prosthetic valve.
Using medical imaging and computer software, the team monitored the position of the radiopaque beads in a 3D model before and after prosthetic valve implantation. This allows them to identify any differences that indicate that the artificial valve is not suitable.
These differences are used to create an "expansion index." The researchers found that they could use the expansion index to predict the severity of paravalvular leaks after TAVR; the higher the expansion index score, the higher the severity of paravalvular leaks.
The researchers found that patients with impaired calcium accumulation in heart valves could also be used to predict the severity of paravalvular leaks, but they noted that in some cases, 3D printed models were more accurate.
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