3D-printed models could predict leakage location, severity in TAVR

New manufacturing methods can further personalize medicine—and now 3D printing may offer cardiologists a method of testing transcatheter aortic valve replacements (TAVR) for leakage before implantation.

A team from the Georgia Institute of Technology and Piedmont Heart Institute produced models comparable to biological tissues via 3D printing. They then tried to develop a simulation platform for TAVR procedures that would allow for cardiologists to predict paravalvular leakage, which affects 26 to 67 percent of TAVR patients.

The results were published July 3 in JACC: Cardiovascular Imaging.

"Paravalvular leakage is an extremely important indicator in how well the patient will do long term with their new valve," said Zhen Qian, chief of cardiovascular imaging research at Georgia-based Piedmont Heart Institute. "The idea was, now that we can make a patient-specific model with this tissue-mimicking 3D printing technology, we can test how the prosthetic valves interact with the 3D printed models to learn whether we can predict leakage."

Researchers created heart valve models from cardiac CT scans for 18 individuals who had TAVR procedures. They then implanted prosthetics in the models.

The team then analyzed how the prosthetics interacted with the 3D-printed models. Any inconsistencies were measured according to a “bulge index” that ranked individuals who experience more leakage. The models could predict leakage and replicate the location and severity of such complications.

"Eventually, once a patient has a CT scan, we could create a model, try different kinds of valves in there, and tell the physician which one might work best," Qian said. "We could even predict that a patient would probably have moderate paravalvular leakage, but a balloon dilatation will solve it."

The research team hopes to conduct further testing in more patients to optimize design and production.