Assessment of post-infarct ventricular septal defects through 3D printing and statistical shape analysis

Ashar Asif; Andrew Iu Shearn; Mark S Turner; Maria V Ordoñez; Froso Sophocleous; Ana Mendez-Santos; Israel Valverde; Gianni D Angelini; Massimo Caputo; Mark Ck Hamilton; Giovanni Biglino

doi:10.2217/3dp-2022-0012

Assessment of post-infarct ventricular septal defects through 3D printing and statistical shape analysis

J 3D Print Med. 2023 Mar;7(1):3DP3. doi: 10.2217/3dp-2022-0012. Epub 2023 Jan 18.

Authors

Ashar Asif¹, Andrew Iu Shearn^{1

2}, Mark S Turner², Maria V Ordoñez^{1

2}, Froso Sophocleous^{1

2}, Ana Mendez-Santos³, Israel Valverde^{3

4}, Gianni D Angelini^{1

2}, Massimo Caputo^{1

2}, Mark Ck Hamilton⁵, Giovanni Biglino^{1

2

6}

Affiliations

¹ Bristol Medical School, University of Bristol, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK.
² Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK.
³ Pediatric Cardiology Unit, Hospital Virgen del Rocio and Institute of Biomedicine of Seville (IBIS), Seville, E-41013, Spain.
⁴ School of Biomedical Engineering and Imaging Sciences, King's College London, King's Health Partners, St Thomas' Hospital, SE1 7EH, UK.
⁵ Department of Clinical Radiology, Bristol Royal Infirmary, Upper Maudlin St, Bristol, BS2 8HW, UK.
⁶ National Heart and Lung Institute, Guy Scadding Building, Imperial College London, London, SW3 6LY, UK.

Abstract

Background: Post-infarct ventricular septal defect (PIVSD) is a serious complication of myocardial infarction. We evaluated 3D-printing models in PIVSD clinical assessment and the feasibility of statistical shape modeling for morphological analysis of the defects.

Methods: Models (n = 15) reconstructed from computed tomography data were evaluated by clinicians (n = 8). Statistical shape modeling was performed on 3D meshes to calculate the mean morphological configuration of the defects.

Results: Clinicians' evaluation highlighted the models' utility in displaying defects for interventional/surgical planning, education/training and device development. However, models lack dynamic representation. Morphological analysis was feasible and revealed oval-shaped (n = 12) and complex channel-like (n = 3) defects.

Conclusion: 3D-PIVSD models can complement imaging data for teaching and procedural planning. Statistical shape modeling is feasible in this scenario.

Keywords: 3D printing; myocardial infarction; statistical shape modeling; ventricular septal defect.

Plain language summary

Following heart attacks, the heart muscle becomes scarred and weaker, making it prone to tearing under high pressures. These tears are known as ‘post-infarct ventricular septal defects’. Their shape varies greatly as the heart beats. The approach to fixing these can range from plugging them with a device or patching them by open heart surgery. We created 15 3D-printed models of hearts with these kinds of defects and made digital reconstructions of the tears to see the different sizes/shapes that they can have. Doctors agreed that 3D-printed models could help in planning repairs and training other doctors. The digital reconstructions of the tears showed that many were round, but some had irregular shapes which would mean devices used to fix them may not fit.