three-dimensional modelling and three-dimensional printing in pediatric and congenital cardiac surgery laszlo kiraly论文.pdf

该【three-dimensional modelling and three-dimensional printing in pediatric and congenital cardiac surgery laszlo kiraly论文 】是由【小舍儿】上传分享，文档一共【11】页，该文档可以免费在线阅读，需要了解更多关于【three-dimensional modelling and three-dimensional printing in pediatric and congenital cardiac surgery laszlo kiraly论文 】的内容，可以使用淘豆网的站内搜索功能，选择自己适合的文档，以下文字是截取该文章内的部分文字，如需要获得完整电子版，请下载此文档到您的设备，方便您编辑和打印。:..138ReviewArticleThree-dimensionalmodellingandthree-dimensionalprintinginpediatricandcongenitalcardiacsurgeryLaszloKiralyardiacSurgery,CardiacSciences,SheikhKhalifaMedicalCity,AbuDhabi,UnitedArabEmiratesCorrespondenceto:,MD,PhD,,CardiacSciences,SheikhKhalifaMedicalCity,AlKaramahStreet,POB51900,AbuDhabi,:******@.Abstract:Three-dimensional(3D),personalizedimagingand3Dmodellingpresentswitharangeofadvantages,.,plexanatomy,interactivityandhands-onapproach,possibilityforpreoperativesurgicalplanningandvirtualsurgery,abilitytoassessexpectedresults,,controlledrandomizedtrials,however,-scenario,priorknowledge,preparednessandpossibilityofemulationareindispensableinraisingpatient-(COE).Policymakers,researchscientists,clinicians,aswellashealthcarefinancersandlocalentrepreneursshouldmunicatealongalegalframeworkandestablishedscientificguidelinesfortheclinicalbenefitofpatients,-specificanatomicalmodels,3Dprintingwillhaveamajorroleinpediatricandcongenitalcardiacsurgerybyprovidingindividuallycustomizedimplantsandprostheses,:Three-dimensionalprinting(3Dprinting);congenitalheartdisease;surgicalstimulation;surgicaltrainingSubmittedNov30,,:.:http://dx./.‘modatetoallechocardiography/ultrasound,3Drotationalangiography,ourideas’—-tomography(CT)icresonance(MR)(3).ImagedataintegrationofthesemodalitiesAdvancesinanatomypavedthewayformodernmedicinebywillenhance3Dmultimodalitymodellingwithgrosslyabstractingfeaturesofindividualanatomicrepresentationsimprovedreliability,accuracyandresolution(4).However,intogeneralrules(1).Anatomicaldemonstrationswereasimagesarecurrentlynotacquiredinrealtime,threemostlyhelpedbythree-dimensional(3D)exvivospecimenslimitationspersist:(I)anychangeinthepositionofpatientaswellastwo-dimensional(2D)diagrams(2).Nowadays,orequipmentcancausemisalignmentoftheregistration;3Dimagingmethodsgreatlysupportthedevelopmentof(II);and(III)3Dmodelsarestillprojecteddomain,theseimagingtechnologiesinclude3Din2Dplaneofthevisualscreen(5).Understandingofthe?;7(2):129-138:..:theyAnatomicmodelsfordemonstration,surgicalplanningandemulationsreplicateexactpatientmorphology3Dprintedpatient-puterCustomized/personalizedimplantsaideddesign(CAD)tocreatenewly-,,’sheartremainstatic,butarereviewedbinocularly,3Dprintingconsistsofconsecutivestepsofdigitaldatatheyalsoofferinteractivityandhands-,post-processing[segmentation,conversionofdataintostereolithography(STL)file],productionthebrainasvision,thusneuralresponsesaremodulated(actualstereolithographicprinting,additivemanufacturing)bysensoryinputfromothermodalities(6).Multisensoryandpost-production(processessimilartochisellingandconvergenceenhancesvisualprocessingandhapticinputrefinementinsculpture)(please,alsoseeSupplementI)significantlycontributestothefine-tuningofthevisual(Figure1).First,digitaldatafromimagingsourcesinformation(7).3Dprintedmodelsarenottoreplace(CT-angiography,MRIandechocardiography)-gatedbreath-heldcontrast-,–,.,better3Dsoftware(Mimics?,Materialise,Leuven,Belgium)andplexanatomy,apossibilityforbetterarotatabledigital(virtual)3Dmodelissegmented(11).preoperativeplanningandvirtualsurgery,pletenessofintraoperativeaidsandprostheses,abilityofassessandclarityofrawdataandappropriateselectionofexpectedresult,(8-10).areexposedwhileothers(temporarily)’ssurfacebyauser-,manufacturingofpatient-intimateknowledgeofanatomy,thusclose-cooperationspecificprototypesbetweentheclinicalengineerandclinician/surgeonisTechnologicaldevelopmentbrought3Dmodellingandadvised;segmentationisalsotime-consuming,laboriousprintingfromtheresearchlaboratoriesintofactoriesandand—atpresent—itisnotfeasibleforautomation(9).thenintopeople’:itmedicaldevicesisquick,-sectionsatanyplaneanddepthTherearetwotypesof3Dprintedobjectsinhealthcare:(I)canrevealintricatedetailsofanatomy(Figure2).The3Dprintedanatomicalmodelsofanindividualpatient—anactualprintingprocessisrapidprototypingandadditiveapplicationthisarticlefocuseson;and(II)patient-specificmanufacturing,:areallife-sized,(CAD)—customized/personalizedimplants,prostheses,blood-volumesolidmodelprovidesexactdimensionsoftheexternalfixators,splints,surgicalinstrumentationandanatomicalstructures;anotherhollowmodel(wallmodel?;7(2):129-138:..TranslationalPediatrics,Vol7,No2April2018131safetyandshortenedoperatingtime,e(13).Amongthemultiplebenefitsof3Dprintedmodelsaremunicationwithinthemultidisciplinaryclinicalteamandpatient/familyeducation(14).Feasibilityofnewsurgicalproceduresand/orcatheterinterventionscouldbeexperimentedwithpatient-specificmorphologicalcharacteristics(15).Virtualsurgerycanalsobeperformed(16,17).Besideslistedanddocumentedadvantages,3Dprintingpresentswithpossibledownsides:labour—andtechnologyintensivemanufacturingpresentswithadditionalcosts,needsextrapersonnelandinfrastructure(.,3Dprintingfacility)(18).Accordingtoameta-analysisof158paperson3Dprintinginsurgery,%;%(19).Applicationsof3Dmodellingandprintinginardiacsurgeryardiacsurgerydealswithawiderangeofpatientsofage(fromneonataltoadultcongenital),ofacuity(fromemergenciestoelectiveand/orstagedreoperations),,ourspecialtystillcarriessignificantrisks(20).(CT-angiography,MRI)embracenewmodalitiesinthepursuitofpatient-safetyandundergopost-processingalsoknownassegmentationtocreateahighquality-of-,,(10).ardiacsurgeryisalsoadisciplinewhereindividualdecision-makingisthebasisoftheplanningforendocardialandepicardialsurfacerepresentation),bloodloss,postoperativelength-tissueproperties(Young’;?3?3?1of-stay,etc.(21).××10mmHg).–×,,-fidelity(12)(Figure3).cardiacmalformations,[1869–1940],foundermodels(Figure4).Prototypingcontributestoimprovedpatientofpathomorphologyforcongenitalheartdisease,began?;7(2):129-138:..(LCA)isflattenedandobstructedbyagrosslydilatedrightpulmonaryartery(RPA).LCAismuchsmallerthantherightcoronaryartery(RCA).Right-sidedstructures(SVCandRV)areblue;left-sidedstructures(LV,RUPV,LUPV),aorta;LUPV,leftupperpulmonaryvein;LV,leftventricle;RUPV,rightupperpulmonaryvein;RV,rightventricle;SVC,superiorvenacava.‘museumdemonstrations’epartmethodswith3D(virtual)modelsandprintedprototypesofthemedicalschoolcurriculum(22,23).Inrecentyears,(clinicalcasescenariosandspecimens)eelimitedthesedifficultiesandmeetthedemandsofmorphologicalduetostiffeneddataprotectionregulations(24),-onapproachisnumberofautopsies,naturalattritionofspecimensandthefoundationinmoderndaymedicalandpostgraduatemostimportantly,patientswithcongenitalheartdiseaseeducation(30).Medicaleducationrangesfrommedicalsurvive(25).,trainees,themultidisciplinaryclinicalteamTransferofspecimensinthemorphologicalarchivesontoandtowardspatients/(26).First,specimensinput,improvedspatialawareness,betterunderstandingarescannedwithhigh-municationandsimulationtomography(itcanachievearesolutionof10micrometres)toolforsurgicalandinterventionalcasesleadingtobetter(27,28).Next,digitalinformationissegmentedtocreate3Dpre-operativeplanningarethecorebenefits(14).’sconditionstranslatingintomoreAvirtualmuseumoffersinnumerableopportunitiesforrealisticexpectations,andtherefore,fortablewithtrainingandeducation,pre-,patient-familyeducation,etc.(29).benefits,.,reductioninintraoperativetimeandcost,Introductionof2Dechocardiographyenhancedtheanaesthesiatime,infectionrate,radiationandcontrast,plicationsandhospitalstayneedtobevalidatedinhatisfurtheremphasizedbynewerimaging