Computed Tomography–Derived 3D Modeling to Guide Sizing and Planning of Transcatheter Mitral Valve Interventions

• Published in: JACC. Cardiovascular imaging Vol. 14; no. 8; pp. 1644 - 1658
• Main Authors: Ooms, Joris F., Wang, Dee Dee, Rajani, Ronak, Redwood, Simon, Little, Stephen H., Chuang, Michael L., Popma, Jeffrey J., Dahle, Gry, Pfeiffer, Michael, Kanda, Brinder, Minet, Magali, Hirsch, Alexander, Budde, Ricardo P., De Jaegere, Peter P., Prendergast, Bernard, O’Neill, William, Van Mieghem, Nicolas M.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2021
• Subjects: 3D printing; computational modeling; mitral annular calcification; multidetector computed tomography; paravalvular leakage closure; transcatheter mitral valve replacement; 3DCM; THV; PVL; LV; LVOT; MDCT; MAC; mitral annular calcification; paravalvular leakage closure; transcatheter mitral valve replacement; 3D; TMVR; LA; multidetector computed tomography; LVOTO; computational modeling; 3D printing; 3Dp
• ISSN: 1936-878X; 1876-7591; 1876-7591
• DOI: 10.1016/j.jcmg.2020.12.034

A plethora of catheter-based strategies have been developed to treat mitral valve disease. Evolving 3-dimensional (3D) multidetector computed tomography (MDCT) technology can accurately reconstruct the mitral valve by means of 3-dimensional computational modeling (3DCM) to allow virtual implantation of catheter-based devices. 3D printing complements computational modeling and offers implanting physician teams the opportunity to evaluate devices in life-size replicas of patient-specific cardiac anatomy. MDCT-derived 3D computational and 3D-printed modeling provides unprecedented insights to facilitate hands-on procedural planning, device training, and retrospective procedural evaluation. This overview summarizes current concepts and provides insight into the application of MDCT-derived 3DCM and 3D printing for the planning of transcatheter mitral valve replacement and closure of paravalvular leaks. Additionally, future directions in the development of 3DCM will be discussed. [Display omitted] •Catheter-based interventions for complex defects of the mitral valve apparatus are evolving.•MDCT-derived 3D computational modeling and 3D printing enhance risk evaluation and planning of complex transcatheter procedures.•Incorporation of multiple cardiac phases, tissue/device properties, and hemodynamics should optimize 3D modeling.