The Clinical Value Of Three Dimensional Printing In The Diagnosis And Treatment Of Atrial Septal Defect

Backgroud:3D printing technology is based on digital file, using different ways to discrete and stack raw materials to manufacturing models.3D printing technology, include digital modeling, mechanical and electrical control, information, materials science and chemistry technology, realized from flat printing to three-dimensional molding process. With medical development direction focusing on precision and individualization,3D printing technology has been used in many medical discipline, including cardiovascular disease, showed its unique value and broad application prospects.Objective:Application of 3D printing technology making atrial septal defects anatomical models, to investigate the clinical value of 3D printing models in diagnosis and treatment of atrial septal defects.Methods:Retrospective assessment the clinical data of 33 ASD patients in our hospital from October 2013 to March 2016. Cardiac CT were performed in them, all the CT data were processed with 3D medicine image prcessing software to get the modified 3D reconstruction pictures, then put these data in STL format into the 3D printer. According to 3D printing models to make appropriate interventional therapy. Measure the ASD diameter on the models and contrast with TTE, CT and POS measurement value to assess accuracy of 3D modelsResults:1. All the 3D printing models are produced successfully, including 6 central type of ASD cases (2 cases with ASA),7 multiple type of ASD cases (4 with ASA,1 with inferior sinus venosus type of ASD),6 superior sinus venosus type of ASD (all with partial anomalous pulmonary venous connection),14 inferior sinus venosus type of ASD cases. The diagnose on models are fitted with imaging examination.2. All the cases were analyzed on the models.We found PDA occluder fit the structure of inferior sinus venosus type of ASD very well. We invented three types of coverd stents based on 6 superior sinus venosus type of ASD models.3D models can directly show the location of defects and the relationship between defects and surrounding tissue, help to choose appropriate occluders before intervention therapy.3. By the guidance of models,16 cases were undergo intervention therapy,15 cases were success,1 case failed because the defect size was too large.4.11 cases (including 4 central type of ASD cases,7 inferior sinus venosus type of ASD cases)were not received intervention treatment for the too large size of defects or special structure.5. The accuracy of 3D models is good. There is a slightly positive correlation between 3D models measured value and imaging measured value, and the correlation coefficient (r) is 0.821 (P<0.001) with TTE measured value,0.835 (P<0.001) with CT measured value,0.902 (P<0.001) with POS.Conclusion:3D printing ASD models is feasible, it can improve operation successful rate and provide a new treatment idea by simulating intervention therapy on the models, it can provide great help for personal treatment of special case.