title: Percutaneous Transcatheter Mitral Valve Replacement: Patient-specific Three-dimensional Computer-based Heart Model and Prototyping.
abstract: Mitral regurgitation is the most prevalent valvular heart disease worldwide. Despite the widespread availability of curative surgical intervention, a considerable proportion of patients with severe mitral regurgitation are not referred for treatment, largely due to the presence of left ventricular dysfunction, advanced age, and comorbid illnesses. Transcatheter mitral valve replacement is a promising therapeutic alternative to traditional surgical valve replacement. The complex anatomical and pathophysiological nature of the mitral valvular complex, however, presents significant challenges to the successful design and implementation of novel transcatheter mitral replacement devices. Patient-specific 3-dimensional computer-based models enable accurate assessment of the mitral valve anatomy and preprocedural simulations for transcatheter therapies. Such information may help refine the design features of novel transcatheter mitral devices and enhance procedural planning. Herein, we describe a novel medical image-based processing tool that facilitates accurate, noninvasive assessment of the mitral valvular complex, by creating precise three-dimensional heart models. The 3-dimensional computer reconstructions are then converted to a physical model using 3-dimensional printing technology, thereby enabling patient-specific assessment of the interaction between device and patient. It may provide new opportunities for a better understanding of the mitral anatomy-pathophysiology-device interaction, which is of critical importance for the advancement of transcatheter mitral valve replacement.
authors.affiliation: Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, Montreal, Québec, Canada; Department of Cardiology, Division of Interventional Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Electronic address: beavaquerizo@yahoo.es.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Vaquerizo
authors.affiliation: Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, Montreal, Québec, Canada.
authors.forename: Pascal
authors.initials: P
authors.lastname: Theriault-Lauzier
authors.affiliation: Department of Medicine, Division of Interventional Cardiology, McGill University Health Center, Montreal, Québec, Canada.
authors.forename: Nicolo
authors.initials: N
authors.lastname: Piazza
mesh_terms: D006328:Cardiac Catheterization / Q000379:methods*; D003198:Computer Simulation; D003194:Computer-Assisted Instruction; D005544:Forecasting; D006325:Heart Atria / Q000033:anatomy & histology; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000193:education / Q000379:methods*; D006352:Heart Ventricles / Q000033:anatomy & histology; D006801:Humans; D007318:Inservice Training; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000473:pathology / Q000601:surgery*; D008953:Models, Anatomic; D010210:Papillary Muscles / Q000033:anatomy & histology; D066330:Printing, Three-Dimensional; D011474:Prosthesis Design; D012984:Software
keywords: Insuficiencia mitral; Mitral regurgitation; Modelos informatizados tridimensionales; Percutaneous mitral valve replacement; Sustitución percutánea de válvula mitral; Tecnología de impresión tridimensional; Three-dimensional computer-based models; Three-dimensional printing technology