Improved Functional Assessment of Ischemic Severity Using 3D Printed Models

Frontiers in Cardiovascular Medicine

article

Kranthi K. Kolli¹  Sun-Joo Jang¹  Abdul Zahid¹  Alexandre Caprio¹  Seyedhamidreza Alaie¹  Amir Ali Amiri Moghadam¹  Patricia Xu²  Robert Shepherd²  Bobak Mosadegh¹  Simon Dunham¹ 

[1] Department of Radiology, Dalio Institute of Cardiovascular Imaging, Weill Cornell Medical College;Department of Mechanical and Aerospace Engineering, Cornell University

关键词: CCTA;    radiology;    3D printing;    in vitro;    blood analog fluid;    fractional flow reserve;    catheterization;   

DOI  :  10.3389/fcvm.2022.909680

学科分类：地球科学(综合)

来源: Frontiers

【 摘 要 】

Objective To develop a novel in vitro method for evaluating coronary artery ischemia using a combination of non-invasive coronary CT angiograms (CCTA) and 3D printing (FFR 3D ). Methods Twenty eight patients with varying degrees of coronary artery disease who underwent non-invasive CCTA scans and invasive fractional flow reserve (FFR) of their epicardial coronary arteries were included in this study. Coronary arteries were segmented and reconstructed from CCTA scans using Mimics (Materialize). The segmented models were then 3D printed using a Carbon M1 3D printer with urethane methacrylate (UMA) family of rigid resins. Physiological coronary circulation was modeled in vitro as flow-dependent stenosis resistance in series with variable downstream resistance. A range of physiological flow rates (Q) were applied using a peristaltic steady flow pump and titrated with a flow sensor. The pressure drop (ΔP) and the pressure ratio (P d /P a ) were assessed for patient-specific aortic pressure (P a ) and differing flow rates (Q) to evaluate FFR 3D using the 3D printed model. Results There was a good positive correlation ( r = 0.87, p < 0.0001) between FFR 3D and invasive FFR. Bland-Altman analysis revealed a good concordance between the FFR 3D and invasive FFR values with a mean bias of 0.02 (limits of agreement: −0.14 to 0.18; p = 0.2). Conclusions 3D printed patient-specific models can be used in a non-invasive in vitro environment to quantify coronary artery ischemia with good correlation and concordance to that of invasive FFR.

【 授权许可】

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