Author + information
- Received April 5, 2018
- Revision received April 30, 2018
- Accepted May 3, 2018
- Published online October 1, 2018.
- Serge C. Harb, MDa,∗ (, )
- Leonardo L. Rodriguez, MDa,
- Lars G. Svensson, MD, PhDb,
- Bo Xu, MBBS (Hons)a,
- Haytham Elgharably, MDb,
- Ryan Klatte, BSBMEc,
- Amar Krishnaswamy, MDd,
- Richard A. Grimm, DOa,
- Brian P. Griffin, MDa,
- Samir R. Kapadia, MDd and
- Jose L. Navia, MDb
- aDepartment of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- bDepartment of Cardiovascular Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- cDepartment of Biomedical Engineering, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- dDepartment of Cardiovascular Intervention, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- ↵∗Address for correspondence:
Dr. Serge C. Harb, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Office J1-126, Cleveland, Ohio, 44195.
There is a recent rise in percutaneous therapies for the tricuspid valve. Due to the innovative nature of these procedures and the complex anatomy of the tricuspid valve, procedural planning often relies on 3-dimensional (3D) printing. Whereas contrast-enhanced 4-dimensional (4D) computed tomography is the imaging modality of choice to build models for printing, patients evaluated for percutaneous therapies for the tricuspid valve typically have multiple comorbidities and pose particular challenges for imaging. Here, we first present the steps involved in building a right-heart model for printing based on 4D computed tomography (Figure 1), and then illustrate tailored imaging approaches to overcome technical challenges in imaging, incorporating 3D transthoracic echocardiography, and cardiac magnetic resonance: imaging in the context of pacing leads (Figure 2); suboptimal visualization of the right-sided structures (Figures 3 and 4); and severe kidney dysfunction precluding contrast administration (Figures 5 and 6). The 3D printed models were helpful for procedural simulation (Online Figure 1).
Dr. Navia is the inventor on patents related to the device shown in Online Figure 1; and is a stakeholder of and a consultant to NaviGate Cardiac Structures. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received April 5, 2018.
- Revision received April 30, 2018.
- Accepted May 3, 2018.
- 2018 American College of Cardiology Foundation