Preoperative evaluation of transcatheter aortic valve replacement with assistance of 3D printing technique: Reanalysis of 4 death cases

INTRODUCTION: Transcatheter aortic valve replacement (TAVR) can have some fatal complications during and after the operation. Until recently, pre-procedural imaging with cardiac computed tomography (CT), which is required to evaluate for TAVR, had its own imperfections. We aimed to determine whether 3D printed models can predict complications when other pre-procedural imaging techniques failed. METHODS: Vascular center patients with aortic valve stenosis, who died after TAVR between June 2011 and June 2016, were enrolled in this retrospective study. The CT datasets of the patients were imported into a three-dimensional (3D) construction software and then printed by flexible material. To predict complications during and after operations, we designed a release test using the non-valved stent mode that was consistent with the Edwards Sapien XT valve in size and radial support force. RESULT: The 3D model predicted the coronary obstruction and annular rupture in the in vitro release process, which was consistent with what happened in the actual operation. CONCLUSION: Three-dimensional modeling facilitates pre-operative assessment of patients receiving TAVR, with accurate simulation of intraoperative status.