Michael S. Kim, Adam R. Hansgen, John D. Carroll 

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Use of Rapid Prototyping in the Care of Patients with Structural Heart Disease  Michael S. Kim, Adam R. Hansgen, John D. Carroll  Trends in Cardiovascular Medicine  Volume 18, Issue 6, Pages 210-216 (August 2008) DOI: 10.1016/j.tcm.2008.11.001 Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 1 Distinguishing between true structures and artifact in image postprocessing. (A) Digital 3D surface model illustrates the challenge in deciphering atrial septal defect (arrowhead) rims and surrounding contrast artifact (arrow). (B) Final processed 3D surface model demonstrating clear atrail septal defect (arrowhead) rims after deletion of the surrounding contrast artifact. Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 2 Sample integrated image-processing environment with overlay of a digital 3D surface model onto the standard 2D planes. (A) Combined three-axis. (B) Sagital axis. (C) Axial axis. (D) Coronal axis. Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 3 Sample full-color physical models printed on a ZPrinter 450 (Z Corporation, Burlington, MA). (A) View into the left atrium of a fenestrated ASD (arrows). (B) View into the left atrium of a large secundum atrial septal defect (arrows). (C) View through the right atrium into the right ventricle of a post-myocardial infarction ventricular septal defect (arrow). (D) Cross-sectional view of the left ventricle of rheumatic mitral stenosis (arrow = mitral valve). Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 4 Physical model illustrating strategically placed cutaways and viewing windows of a prosthetic mitral paravalvular leak. (A) Cutaway view toward the left atrium demonstrating mechanical mitral (right arrowhead) and aortic (left arrowhead) valves and a mitral paravalvular leak (arrow). (B) View through the left atrial free wall toward the prosthetic mitral valve (arrowhead) and mitral paravalvular leak (arrow). Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 5 Physical model printed in PolyJet Tango Plus. (A) Lateral view with the left ventricular and left atrial free walls removed illustrating a secundum atrail septal defect. (B) Demonstration of the flexibility of the Tango Plus material. Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 6 Full-color physical models of CHD pathologies. (A) Anterior view of the surgical repair of tetrology of Fallot with a right ventricle-pulmonary artery conduit (arrows) and a persistent left superior vena cava (white arrowhead). (B)-(C) Anterior (B) and posterior (C) sided views of a 1-month-old with a ventricular septal defect (arrow) and pulmonary atresia (arrowhead = right ventricular outflow tract). Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 7 Schematic of the proposed hands-on training simulation. Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 8 Lesion specific physical models illustrating the variability in secundum atrial septal defect size and morphology. Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions

Figure 9 Use of physical models in preprocedure planning. (A) View into the left atrium of a full-color model of rheumatic mitral stenosis. (B) Inoue balloon advanced across a transseptal puncture (arrow) through the rheumatic mitral valve (arrowheads). (C) Posterior view of a full-color model of a secundum atrial septal defect with a J-tipped wire and multipurpose catheter advanced across the defect into the left upper pulmonary vein. (D) View through the right atrial free wall of a deployed Amplatzer Septal Occluder (AGA medical). Trends in Cardiovascular Medicine 2008 18, 210-216DOI: (10.1016/j.tcm.2008.11.001) Copyright © 2008 Elsevier Inc. Terms and Conditions