Purpose Given the multitude of challenges surgeons face during mitral valve repair surgery, they should have a high confidence in handling of instruments and in the application of surgical techniques before they enter the operating room. Unfortunately, opportunities for surgical training of minimally invasive repair are very limited, leading to a situation where most surgeons undergo a steep learning curve while operating the first patients.
In a very recent medical review, @cite_17 describe a general guidance for creation of dynamic valve models usable in a flow simulator. The authors provide an overview of the production pipeline (imaging, segmentation, 3D printing, material casting) and discuss viable options for each step. Moreover, they present an approach, for which two interesting points shall be highlighted: They just printed the lower impression of the valve and not a full mold. Silicone was painted on the printed surface in a thin layer, which then cured to the shape of the valve. Furthermore, they incorporated braided nylon fishing line strings into the leaflets to mimic some strings of the chordae tendineae. With the mentioned steps, it seems to be difficult to obtain results of the same quality when multiple valves are produced from the same mold (e.g. two models could have different thicknesses or varying chordae attachments). The phantoms do not seem to include papillary muscles.
@cite_17
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Medical imaging has advanced enormously over the last few decades, revolutionizing patient diagnostics and care. At the same time, additive manufacturing has emerged as a means of reproducing physical shapes and models previously not possible. In combination, they have given rise to 3-dimensional (3D) modeling, an entirely new technology for physicians. In an era in which 3D imaging has become a standard for aiding in the diagnosis and treatment of cardiac disease, this visualization now can be taken further by bringing the patient’s anatomy into physical reality as a model. The authors describe the generalized process of creating a model of cardiac anatomy from patient images and their experience creating patient-specific dynamic mitral valve models. This involves a combination of image processing software and 3D printing technology. In this article, the complexity of 3D modeling is described and the decision-making process for cardiac anesthesiologists is summarized. The management of cardiac disease has been altered with the emergence of 3D echocardiography, and 3D modeling represents the next paradigm shift.