Hemodynamic Testing of Patient-Specific Mitral Valves Using a Pulse Duplicator: A Clinical Application of Three-Dimensional Printing

J Cardiothorac Vasc Anesth. 2016 Oct;30(5):1278-85. doi: 10.1053/j.jvca.2016.01.013. Epub 2016 Jan 12.

Abstract

Objective: To evaluate the feasibility of obtaining hemodynamic metrics of echocardiographically derived 3-dimensional printed mitral valve models deployed in a pulse-duplicator chamber.

Design: Exploratory study.

Setting: Tertiary-care university hospital.

Participants: Percutaneous MitraClip procedure patient.

Interventions: Three-dimensional R-wave gated, full-volume transesophageal echocardiography images were obtained after deployment of the MitraClip device. A high-quality diastolic frame of the mitral valve was segmented using Mimics Innovation Suite and merged with a flange. The data were exported as a stereolithography (.stl) file, and a rigid 3-dimensional model was printed using a MakerBot Replicator 2 printer. A flexible silicone cast then was created and deployed in the pulse-duplicator chamber filled with a blood-mimicking fluid.

Measurements and main results: The authors were able to obtain continuous-wave Doppler tracings of the valve inflow with a transesophageal echocardiography transducer. They also were able to generate diastolic ventricular and atrial pressure tracings. Pressure half-time and mitral valve area were computed from these measurements.

Conclusion: This pulse duplicator shows promising applications in hemodynamic testing of patient-specific anatomy. Future modifications to the system may allow for visualization and data collection of gradients across the aortic valve.

Keywords: 3D printing; hemodynamics; mitral valve; pulse duplicator; transesophageal echocardiography.

Publication types

  • Review

MeSH terms

  • Echocardiography, Doppler, Color / methods
  • Echocardiography, Transesophageal / methods
  • Feasibility Studies
  • Hemodynamics
  • Humans
  • Mitral Valve / diagnostic imaging*
  • Mitral Valve / surgery*
  • Models, Biological*
  • Monitoring, Intraoperative / instrumentation*
  • Monitoring, Intraoperative / methods*
  • Printing, Three-Dimensional / instrumentation*