title: Three-dimensional ultrasound-derived physical mitral valve modeling.
abstract: OBJECTIVE
  Advances in mitral valve repair and adoption have been partly attributed to improvements in echocardiographic imaging technology. To educate and guide repair surgery further, we have developed a methodology for fast production of physical models of the valve using novel three-dimensional (3D) echocardiographic imaging software in combination with stereolithographic printing.
  
  
  METHODS
  Quantitative virtual mitral valve shape models were developed from 3D transesophageal echocardiographic images using software based on semiautomated image segmentation and continuous medial representation algorithms. These quantitative virtual shape models were then used as input to a commercially available stereolithographic printer to generate a physical model of the each valve at end systole and end diastole.
  
  
  RESULTS
  Physical models of normal and diseased valves (ischemic mitral regurgitation and myxomatous degeneration) were constructed. There was good correspondence between the virtual shape models and physical models.
  
  
  CONCLUSIONS
  It was feasible to create a physical model of mitral valve geometry under normal, ischemic, and myxomatous valve conditions using 3D printing of 3D echocardiographic data. Printed valves have the potential to guide surgical therapy for mitral valve disease.
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Walter R T
authors.initials: WR
authors.lastname: Witschey
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania; Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Pouch
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: McGarvey
authors.affiliation: School of Design, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Kaori
authors.initials: K
authors.lastname: Ikeuchi
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania; Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Francisco
authors.initials: F
authors.lastname: Contijoch
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Levack
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Yushkevick
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Chandra M
authors.initials: CM
authors.lastname: Sehgal
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Jackson
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Gorman
authors.affiliation: Gorman Cardiovascular Research Group University of Pennsylvania, Philadelphia, Pennsylvania; Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: gormanj@uphs.upenn.edu.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Gorman
mesh_terms: D019560:Echocardiography, Three-Dimensional; D006338:Heart Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008943:Mitral Valve / Q000033:anatomy & histology* / Q000000981:diagnostic imaging* / Q000473:pathology; D008944:Mitral Valve Insufficiency / Q000473:pathology; D008955:Models, Cardiovascular; D009232:Myxoma / Q000000981:diagnostic imaging / Q000473:pathology; D011327:Printing
references.citation: J Thorac Cardiovasc Surg. 2007 Sep;134(3):644-8
references.pmid: 17723812
references.citation: Ann Thorac Surg. 2010 Dec;90(6):1904-11; discussion 1912
references.pmid: 21095334
references.citation: Ann Thorac Surg. 1995 Sep;60(3):499-503; discussion 503-4
references.pmid: 7677471
references.citation: Ann Thorac Surg. 2011 Jan;91(1):157-64
references.pmid: 21172506
references.citation: J Biomech. 2012 Mar 15;45(5):903-7
references.pmid: 22281408
references.citation: Circulation. 2006 Aug 1;114(5):e84-231
references.pmid: 16880336
references.citation: J Thorac Cardiovasc Surg. 1995 Apr;109(4):676-82; discussion 682-3
references.pmid: 7715214
references.citation: Ann Thorac Surg. 2007 Aug;84(2):553-9
references.pmid: 17643634
references.citation: Med Phys. 2012 Feb;39(2):933-50
references.pmid: 22320803
references.citation: Ann Thorac Surg. 1995 Nov;60(5):1177-85; discussion 1185-6
references.pmid: 8526596