Preliminary study of the application of transthoracic echocardiography-guided three-dimensional printing for the assessment of structural heart disease.

OBJECTIVE: To investigate the feasibility and diagnostic value of a preoperative transthoracic echocardiography-guided three-dimensional printed model (TTE-guided 3DPM) for the assessment of structural heart disease (SHD). METHODS: Fourty-four patients underwent cardiac surgery at Tianjin Chest Hospital. The patients were preoperatively assessed using TTE-guided 3DPM, which was compared to conventional three-dimensional transthoracic echocardiography (3DTTE) along with direct intraoperative findings, which were considered the "gold standard." Twelve patients had SHD, including four with mitral prolapse, two with partial endocardial cushion defects, two with secondary atrial septal defects, two with rheumatic mitral stenosis, one with tetralogy of Fallot, and one with a ventricular septal defect (VSD). Thirty-two patients who did not have SHDs were designated as the negative control group. RESULTS: The sensitivity and specificity of the TTE-guided 3DPM were greater than or equal to those of the 3DTTE. The P-value of the McNemar test of 3DTTE was >.05, which indicates that the difference was not statistically significant (Kappa = 0.745, P < .001). The P-value of the McNemar test of TTE-guided 3DPM was >.05, which indicates that the difference was not statistically significant (Kappa = 0.955, P < .001). A comparison of 3DTTE and TTE-guided 3DPM resulted in a P-value >.05, which indicates that the difference was not statistically significant (Kappa = 0.879, P < .001). TTE-guided 3DPM displayed the 3D structure of SHDs and cardiac lesions clearly and was consistent with the intra-operative findings. CONCLUSION: Transthoracic echocardiography-guided three-dimensional printed model (TTE-guided 3DPM) provides essential information for preoperative evaluation and decision making for patients with SHDs.

[Quantitative evaluation of aortic regurgitation by general imaging three-dimensional quantification].

OBJECTIVE: To investigate the feasibility and application value of AR-Vol measured by GI3DQ method directly. METHODS: One hundred and two patients with aortic regurgitation who underwent echocardiographic examination in Tianjin Chest Hospital from February 2014 to October 2014 were selected randomly and divided into two groups: the eccentric group included forty cases with eccentric aortic regurgitation; the central group included sixty and two cases with central aortic regurgitation. AR-Vol were directly measured by GI3DQ method, and then it was calculated by PISA method as the reference standard. RESULTS: (1) In the eccentric group, the AR-Vol measured by GI3DQ method and PISA method were respectively (44±11) ml and (48±10) ml. In the central group, the AR-Vol measured by GI3DQ method and PISA method were respectively (34±13) ml and (33±13) ml. (2) Paired t test analysis showed significant difference in two methods of the eccentric group (P<0.01); no significant difference was found in two methods of the central group (P=0.202). (3) The correlation coefficients of the AR-Vol measurement by GI3DQ method and PISA method are relatively in two groups: r=0.835, r=0.913; consistency analysis showed differences between the two methods of the eccentric group had statistical significance, and differences between the two methods of the central group had no statistical significance. CONCLUSION: In the central aortic regurgitation, AR-Vol measured by GI3DQ method is feasible and accurate compared with the PISA method, which can be used for routine application.