Operationalizing low-cost three-dimensional printing in planning for complex congenital cardiac interventions

Objectives: This study aims to evaluate the feasibility and efficacy of commercially available 3-D printing technology for anatomical modeling. Background: Additive manufacturing has been widely talked about in the context of personalized medical care and interventional and surgical planning for the past decade. Early studies have shown reduction in procedure time and optimization of device deployment by improving anticipation of potential obstacles by bench testing reconstructed models. However, commercially printed 3-D models are costly, ranging between $ 1,500-$ 3500 per model. Our goal is to produce heart models of acceptable quality for as low as $ 1-$ 20 and to demonstrate their utility in planning and carrying out complex congenital heart interventions. Methods: Low-and mid-tier fused deposition modeling (FDM) printers able to utilize flexible filament along with a sophisticated modeling software were used in our practice to create congenital heart models for bench testing. For cases that required softer and more stretchable material than the available flexible filaments offered, molding and casting with dissolvable filament and silicone was carried out. Results: 15 models were constructed and 13 were bench tested (8 commercial models), preliminary data gathered by questionnaires completed by treating physicians before and after obtaining the 3D models show equal improvement in pre-procedure planning and increased confidence about the procedure with both model types. Conclusions: The use of commercially available reasonably priced 3-D printing technology is feasible for printing complex congenital heart disease models in a cost-effective manner. These models were not deemed to be inferior to commercially printed models that are up to 100 times more expensive.