The 3D printed cardiac model; a potential tool in transcatheter complex ASD closure – A case report study

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Secundum atrial septal defects (ASDs) with absent inferior-posterior rim (n=1). Intervention: 3D printed cardiac model-guided percutaneous closure. Primary outcome: Procedural success and symptom resolution.

Jelle Nieuwendijk; Abby Geerlings; Jan Baan; Berto Bouma; Maik J D Grundeken

doi:10.1093/ehjcr/ytag596

August 10, 2026European Heart Journal - Case ReportsOpen Access

The 3D printed cardiac model; a potential tool in transcatheter complex ASD closure – A case report study

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Key result

3D-printed model simulation enables successful percutaneous closure of 2 complex ASDs lacking an inferior-posterior rim.

n=1

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Why the study?

Transcatheter closure of atrial septum defects can be complicated by inferior-posterior rim deficiency, requiring detailed pre-procedural imaging.

Key Points

To assess the feasibility and value of using a patient-specific 3D printed cardiac model for pre-procedural planning and simulation in transcatheter closure of complex atrial septal defects with rim deficiency.
Coronary computed tomography angiography from a 66-year-old female with two secundum atrial septal defects (ASDs) was segmented and printed into a patient-specific physical model using soft photopolymer resin.
Pre-procedural bench simulations were performed on the 3D model to test different occluder types and sizes to assess device stability, positioning, and overall procedural feasibility.
Under transoesophageal echocardiogram (TOE) and fluoroscopic guidance, percutaneous closure was performed on the inferior 21 mm defect using a 22 mm Amplatzer septal occluder, followed by the superior 11 mm defect using a 13 mm occluder.
Bench simulations on the 3D printed model confirmed adequate rim anchoring and device stability despite an absent inferior-posterior rim, confirming percutaneous closure was feasible.
Both occluders were successfully placed without device luxation, venous obstruction, or residual shunt visible on intra-procedural transoesophageal echocardiography.
Follow-up contrast-enhanced cardiac CT performed 1 day post-procedure identified remaining contrast flow from the left atrium to the right atrium and inferior vena cava, indicating a suspected small residual shunt.

Study Design

Type

Case Report (n=1)

Multicenter

No

Structured PICO

P

Population

A 66-year-old female with two secundum ASDs and an absent inferior-posterior rim, followed for 3 months after percutaneous closure.

I

Intervention

Pre-procedural simulation using a patient-specific 3D printed cardiac model based on CT imaging to guide transcatheter closure, followed by percutaneous closure using a 22 mm septal occluder for the inferior defect and a 13 mm septal occluder for the anterior-superior defect.

O

Outcome

Procedural feasibility and success of transcatheter closure, and symptom resolution at follow-up.

Patient-specific 3D printed cardiac models can facilitate the successful transcatheter closure of complex atrial septal defects with deficient rims by allowing detailed anatomical assessment and pre-procedural simulation.

Limitations

Need for long-term follow-up to monitor for late complications such as residual shunt

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Implication

May aid planning for complex ASD closure; hypothesis-generating and requires prospective validation before broader adoption.

Abstract

Background The transcatheter closure of atrial septum defects (ASDs) can be complicated by inferior-posterior rim deficiency. Percutaneous closure is possible but demands detailed pre-procedural imaging. Case summary In this case, we present a successful percutaneous closure of two secundum ASDs complicated by the absence of the inferior-posterior rim. Pre-procedural simulations were conducted on a printed cardiac three dimensional model based on cardiac CT imaging. Discussion ASDs with an inferior-posterior rim deficiency/absence are associated with an increased risk of device failure in percutaneous closure. Creating a 3D model offers improved understanding of the complex anatomy of the defects and allows pre-procedural simulation of the procedure, which may contribute to successful closure.

Discussion

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Cite This Study

Nieuwendijk et al. (2026) conducted a case report in Secundum atrial septal defects (ASDs) with absent inferior-posterior rim (n=1). 3D printed cardiac model-guided percutaneous closure was evaluated on Procedural success and symptom resolution. Pre-procedural simulation using a 3D printed cardiac model enabled the successful percutaneous closure of two complex secundum ASDs with an absent inferior-posterior rim.

synapsesocial.com/papers/6a7d76412b0e0cff3f63f76a https://doi.org/10.1093/ehjcr/ytag596

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The 3D printed cardiac model; a potential tool in transcatheter complex ASD closure – A case report study

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

The 3D printed cardiac model; a potential tool in transcatheter complex ASD closure – A case report study

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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