Added Value of Practicing Cardiac Interventions Under Fluoroscopy Using Patient-Specific 3D Printed Cardiac Models

Background: 3D printing technology has been used to practice cardiac structural interventions in a benchtop setting. We hypothesized that practice on such models under fluoroscopy using standard access and deployment techniques would be feasible and create more realistic simulations. Methods: Computed Tomography Angiography data was segmented with commercial software and models exported for 3D printing. The resulting models were fixed to a catheterization table and the planned procedures attempted under fluoroscopy. Operator success and failures were noted and compared with actual case outcomes. Results: Three cases investigating left atrial appendage ligation and paravalvular leak closure were successfully simulated, with associated outcomes in the actual cases paralleling the simulated experiences. Conclusion: Patient-specific 3D printed cardiac models are easily visualized under fluoroscopy, with an anatomic fidelity sufficient to permit simulation and practice of structural interventions. Further work is needed to prove the value of this technology for improving patient outcomes and optimizing the training of future operators.