Key result
Half-scaled 3D printed anatomic models accurately predicted the optimal intercostal space in 100% of cases and provided measurements that corresponded well with intraoperative findings, saving an estimated 40 minutes of operating room time.
Why the study?
Does pre-procedural planning with 50% scaled 3D printed anatomic models improve anatomic measurement accuracy and save operating room time in patients undergoing MIDCAB?
Cohort (n=12)
No
Does pre-procedural planning with 50% scaled 3D printed anatomic models improve anatomic measurement accuracy and save operating room time in patients undergoing MIDCAB?
Half-scaled 3D printed anatomic models are dimensionally accurate for MIDCAB pre-surgical planning, accurately predicting the optimal intercostal space and potentially saving operating room time.
May aid MIDCAB planning in small cohorts; hypothesis-generating and requires prospective validation before adoption.
Background: Three-dimensional (3D) printing technology has impacted many clinical applications across medicine. However, 3D printing for Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) has not yet been reported in the peer-reviewed literature. The current observational cohort study aimed to evaluate the impact of half scaled (50% scale) 3DP anatomic models in the pre-procedural planning of MIDCAB. Methods: Retrospective analysis included 12 patients who underwent MIDCAB using 50% scale 3DP between March and July 2020 (10 males, 2 females). Distances measured from CT scans and 3DP anatomic models were correlated with Operating Room (OR) measurements. The measurements were compared statistically using Tukey’s test. The correspondence between the predicted (3DP & CT) and observed best InterCostal Space (ICS) in the OR was recorded. Likert surveys from the 3D printing registry were provided to the surgeon to assess the utility of the model. The OR time saved by planning the procedure using 3D printed anatomic models was estimated. Results: All 12 patients were successfully grafted. The 3DP model predicted the optimal ICS in all cases (100%). The distances measured on the 3DP model corresponded well to the distances measured in OR. The measurements were significantly different between the CT and 3DP (p < 0.05) as well as CT and OR (p < 0.05) groups, but not the 3DP and OR group. The Likert responses suggested high clinical utility of 3D printing. The mean estimated OR time saved was 40 minutes. Conclusion: The 50% scaled 3DP anatomic models demonstrated high utility for MIDCAB and saved OR time while being resource efficient. The subjective benefits over routine care that used 3D visualization for surgical planning warrants further investigation.
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Ravi et al. (2023) conducted a cohort in Minimally Invasive Direct Coronary Artery Bypass (MIDCAB) (n=12). 50% scale 3D printed anatomic models vs. CT imaging / Operating Room measurements was evaluated on Prediction of optimal intercostal space (ICS). Half-scaled 3D printed anatomic models accurately predicted the optimal intercostal space in 100% of cases and provided measurements that corresponded well with intraoperative findings, saving an estimated 40 minutes of operating room time.
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