In patients with congenital heart disease and heart failure, 3D printing can aid pre-surgical planning for ventricular assist device (VAD) implantation, a review suggested. Cost and accessibility, however, remain barriers to more widespread adoption.
Given the opportunity to "hold physical replicas of a patient's anatomy in our hand before entering the operating room," 3D printing is a "promising" technology, Kanwal M. Farooqi, MD, of Rutgers-New Jersey Medical School in Newark, and colleagues wrote online in JACC: Heart Failure.
But, 3D printing demands substantial logistical considerations in exchange for better device placement in complex anatomy, the authors noted.
Running up the cost of each 3D-printed model are factors such as post-processing software, personnel needed to perform the segmentation, the 3D printer, and material costs, Farooqi's group wrote, noting that the price of 3D printers typically runs the gamut from "a few hundred dollars" to more than $100,000 for industrial-size machinery.
In the authors' previous experiences, "the printer we used was the Mojo, a desktop printer which costs approximately $5,000. The material cost for this printer is typically about $5 per cubic inch for an acrylonitrile butadiene styrene plastic." The authors proposed creating models on a smaller scale to reduce material use, noting that their models were "33% of the full heart size and used a range of 0.4 to 0.7 in3 of material."
In addition, a source image dataset can be compiled via either cardiac CT or MRI, the group noted. At the crux of this decision is the tradeoff between faster scanning by CT and the lack of radiation when imaging by MRI.
Farooqi and colleagues ultimately suggested that while there is little doubt that 3D printing can be helpful in patients with congenital heart disease, the technology is still not quite ready for prime time.
"Considering that the overall response to this technology from the medical community, especially surgeons, has been positive, the main barriers to more widespread use are largely technical (i.e., access to post-processing software, knowledge of skillful post-processing, availability of good image datasets, access to a 3D printer)," they wrote.
"With the enthusiasm for this technology comes the need for standardization of technique, establishment of clinical utility, and increases in accessibility. These are hurdles that are not insignificant," the authors concluded.
Farooqi reported no relevant conflicts of interest.
Aucun commentaire:
Enregistrer un commentaire