Abstract 18738: Using 3D Printing With Virtual Surgery to Identify Residual Transverse Arch Obstruction in Coarctation Correction
Introduction: Transverse arch (tArch) hypoplasia often accompanies coarctation of the aorta (CoA), causing residual arch obstruction after repair. We propose a novel technique for surgical planning using 3D printing and a pulsatile flow phantom in patients with tArch hypoplasia, in order to preoperatively assess the potential correction and quantify residual tArch obstruction.
Methods: Rendered aortic volumes were created by segmentation of two CoA patients with tArch hypoplasia using Mimics and edited in 3-matic (Materialise, Leuven, Belgium). The CoA was virtually repaired but the tArch was not repaired. A rigid-walled 3D model was printed and connected to an MRI-compatible pump programmed to match the patients’ aortic waveform delivered flow of a 40% glycerin-aqueous solution. Descending aorta (dAo) flow was tuned to match the patient-measured inferior vena cava flow. 4D flow MRI sequences were acquired and time-elapse flow pathlines were calculated. Pressures were measured in the ascending aorta, just distal to the tArch, and dAo.
Results: Flow patterns revealed acceleration in the tArch and dAo of both phantoms. Peak tArch velocities were measured to be 2.5 and 3.5 m/s in the mild and moderate hypoplasia (figure) cases, respectively with significant flow skewing in both cases. Pressure gradients were less than 5 mmHg for the mild case and significant (39 mmHg) for the moderate case with some pressure recovery in the dAo (25 mmHg) in the moderate case.
Conclusion: We demonstrate a method using 3D printing to investigate the potential results of a CoA repair in the setting of tArch hypoplasia. Further study is needed to determine the predictive quality of these results.
Author Disclosures: K.K. Whitehead: None. K.A. Gralewski: None. Y. Dori: None.
- © 2016 by American Heart Association, Inc.