3D printing technology and computer modeling have been successfully utilized to study and predict paravalvular leaks (PVL) in patients who are receiving a transcatheter aortic valve replacement (TAVR). One of the common worries and risks for TAVR patients is a poorly fitted valve because it often leads to PVL. The new study focused on using 3D printing techniques to help find any leaks.

3D printed heart valve. Source: Yael L. Maxwell, TCTMD

TAVR is used in patients who are intermediate, high-risk, inoperable heart valve disease patients who have severe narrowing aortic valves where a prosthetic valve is implanted. TAVR is a less invasive procedure that replaces the heart’s aortic valve. TAVR patients can experience paravalvular leaks, which lead to a high mortality rate. Doctors have been searching for a way to prevent the leaks for a few years. 3D printing is growing in the medical industry for many uses and researchers found that it can be a useful tool to prevent fix and foresee errors in any procedures.

In the TAVR 3D printing study, six TAVR patients — who had severe calcific aortic stenosis and are risks for paravalvular leaks — had pre-procedure CT scans. The CT scans gave a 360-degree view of the location where calcium had built up and identified the location to segment for the printing of 3D models. The 3D models let the researchers further evaluate the ill-fitting valves. The 3D aortic root models were then implanted with the valve to find out if they were the right size and show where the calcium composites would be. In the final step of the study, the 3D models were scanned, evaluated and then compared to the in vivo implanted TAVR echocardiograms.

All of the leaks the 3D models showed were confirmed by the CT scans. The 3D models allow researchers to use prototypes to personalize valve placement for each patient’s needs, like size and location, to prevent leaks and calcium build up.

"We are very encouraged to see such positive outcomes for the feasibility of 3D printing in patients with heart valve disease. These patients are at a high risk of developing a leak after TAVR, and anything we can do to identify and prevent these leaks from happening is certainly helpful," said lead author Sergey Gurevich, MD, and Cardiovascular Fellow at the University of Minnesota in Minneapolis. "Like any other new technology, as 3D printing evolves, we hope to see an increase in accessibility and opportunity for the use of this technology to help improve patient care."

The paper on this research was presented at the Society for Cardiovascular Angiography and Interventions (SCAI) Scientific Sessions.