title: Echocardiography derived three-dimensional printing of normal and abnormal mitral annuli.
abstract: OBJECTIVE
  The objective of this study was to assess the clinical feasibility of using echocardiographic data to generate three-dimensional models of normal and pathologic mitral valve annuli before and after repair procedures.
  
  
  METHODS
  High-resolution transesophageal echocardiographic data from five patients was analyzed to delineate and track the mitral annulus (MA) using Tom Tec Image-Arena software. Coordinates representing the annulus were imported into Solidworks software for constructing solid models. These solid models were converted to stereolithographic (STL) file format and three-dimensionally printed by a commercially available Maker Bot Replicator 2 three-dimensional printer. Total time from image acquisition to printing was approximately 30 min.
  
  
  RESULTS
  Models created were highly reflective of known geometry, shape and size of normal and pathologic mitral annuli. Post-repair models also closely resembled shapes of the rings they were implanted with. Compared to echocardiographic images of annuli seen on a computer screen, physical models were able to convey clinical information more comprehensively, making them helpful in appreciating pathology, as well as post-repair changes.
  
  
  CONCLUSIONS
  Three-dimensional printing of the MA is possible and clinically feasible using routinely obtained echocardiographic images. Given the short turn-around time and the lack of need for additional imaging, a technique we describe here has the potential for rapid integration into clinical practice to assist with surgical education, planning and decision-making.
authors.affiliation: Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
authors.forename: Feroze
authors.initials: F
authors.lastname: Mahmood
authors.forename: Khurram
authors.initials: K
authors.lastname: Owais
authors.forename: Mario
authors.initials: M
authors.lastname: Montealegre-Gallegos
authors.forename: Robina
authors.initials: R
authors.lastname: Matyal
authors.forename: Peter
authors.initials: P
authors.lastname: Panzica
authors.forename: Andrew
authors.initials: A
authors.lastname: Maslow
authors.forename: Kamal R
authors.initials: KR
authors.lastname: Khabbaz
mesh_terms: D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005240:Feasibility Studies; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008943:Mitral Valve / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D066330:Printing, Three-Dimensional; D012984:Software