JCM | Free Full-Text | 3D-Printing to Plan Complex Transcatheter Paravalvular Leaks Closure

Background: Percutaneous closure of paravalvular leak (PVL) has emerged as a substitute to surgical administration in chosen instances. Achieving full PVL occlusion, whereas respecting prosthesis perform stays difficult. A multimodal imaging evaluation of PVL morphology earlier than and throughout the process is necessary to choose an acceptable machine. We intention to discover the extra worth of 3D printing in predicting machine associated opposed occasions together with mechanical valve leaflet blockade, threat of machine embolization and residual shunting. Methods: From the FFPP registries (NCT05089136 and NCT05117359), we included 11 transcatheter PVL closure procedures from three facilities for which 3D printed fashions have been produced. Cardiac CT was used for segmentation for 3D printed fashions (3D-heartmodeling, Caissargues, France). Technology used a laser to fuse very superb powders (TPU Thermoplastic polyurethane) right into a last part-laser sintering expertise (SLS) with an tailored elasticity. A simulation on 3D printed mannequin was carried out utilizing a set of occluders. Results: PVLs have been positioned round aortic prostheses in six instances, mitral prostheses in 4 instances and tricuspid ring in a single case. The machine chosen throughout the simulation on the 3D printed mannequin matched the one implanted in eight instances. In the three different instances, the same machine sort was chosen throughout the procedures however with a special dimension. A threat of prosthesis leaflet blockade was recognized on 3D printed fashions in 4 instances. During the process, the occluder was eliminated earlier than launch in a single case. In one other case the machine was efficiently repositioned and launched. In two sufferers, leaflet impingement was noticed post-operatively and surgical machine elimination had to be carried out. Conclusion: In a case-series of advanced transcatheter PVL closure procedures, hands-on simulation testing on 3D printed fashions proved its usefulness to plan and facilitate these difficult procedures.

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