• J. Cardiothorac. Vasc. Anesth. · Oct 2016

    Review

    Hemodynamic Testing of Patient-Specific Mitral Valves Using a Pulse Duplicator: A Clinical Application of Three-Dimensional Printing.

    • Azad Mashari, Ziyad Knio, Jelliffe Jeganathan, Mario Montealegre-Gallegos, Lu Yeh, Yannis Amador, Robina Matyal, Rabya Saraf, Kamal Khabbaz, and Feroze Mahmood.
    • Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada.
    • J. Cardiothorac. Vasc. Anesth. 2016 Oct 1; 30 (5): 1278-85.

    ObjectiveTo evaluate the feasibility of obtaining hemodynamic metrics of echocardiographically derived 3-dimensional printed mitral valve models deployed in a pulse-duplicator chamber.DesignExploratory study.SettingTertiary-care university hospital.ParticipantsPercutaneous MitraClip procedure patient.InterventionsThree-dimensional R-wave gated, full-volume transesophageal echocardiography images were obtained after deployment of the MitraClip device. A high-quality diastolic frame of the mitral valve was segmented using Mimics Innovation Suite and merged with a flange. The data were exported as a stereolithography (.stl) file, and a rigid 3-dimensional model was printed using a MakerBot Replicator 2 printer. A flexible silicone cast then was created and deployed in the pulse-duplicator chamber filled with a blood-mimicking fluid.Measurements And Main ResultsThe authors were able to obtain continuous-wave Doppler tracings of the valve inflow with a transesophageal echocardiography transducer. They also were able to generate diastolic ventricular and atrial pressure tracings. Pressure half-time and mitral valve area were computed from these measurements.ConclusionThis pulse duplicator shows promising applications in hemodynamic testing of patient-specific anatomy. Future modifications to the system may allow for visualization and data collection of gradients across the aortic valve.Copyright © 2016 Elsevier Inc. All rights reserved.

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