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. 2022 Apr 19;9(5):179.
doi: 10.3390/bioengineering9050179.

3D Printed Surgical Guide for Coronary Artery Bypass Graft: Workflow from Computed Tomography to Prototype

Ida Anna Cappello  1 , Mara Candelari  1 , Luigi Pannone  1 , Cinzia Monaco  1 , Edoardo Bori  2 , Giacomo Talevi  1 , Robbert Ramak  1 , Mark La Meir  3 , Ali Gharaviri  1 , Gian Battista Chierchia  1 , Bernardo Innocenti  2 , Carlo de Asmundis  1
Affiliations

3D Printed Surgical Guide for Coronary Artery Bypass Graft: Workflow from Computed Tomography to Prototype

Ida Anna Cappello et al. Bioengineering (Basel). .

Abstract

Patient-specific three-dimensional (3D) printed models have been increasingly used in many medical fields, including cardiac surgery for which they are used as planning and communication tools. To locate and plan the correct region of interest for the bypass placement during coronary artery bypass graft (CABG) surgery, cardiac surgeons can pre-operatively rely on different medical images. This article aims to present a workflow for the production of a patient-specific 3D-printed surgical guide, from data acquisition and image segmentation to final prototyping. The aim of this surgical guide is to help visualize the region of interest for bypass placement during the operation, through the use of dedicated surgical holes. The results showed the feasibility of this surgical guide in terms of design and fitting to the phantom. Further studies are needed to assess material biocompatibility and technical properties.

Keywords: 3D printing; image processing; pre-operative planning; segmentation.

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Conflict of interest statement

M.L.M. is consultant for Atricure. G.C. received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Boston Scientific, Acutus Medical. C.d.A. receives research grants on behalf of the center from Biotronik, Medtronic, Abbott, LivaNova, Boston Scientific, AtriCure, Philips, and Acutus; C.d.A. received compensation for teaching purposes and proctoring from Medtronic, Abbott, Biotronik, Livanova, Boston Scientific, Atricure, Acutus Medical Daiichi Sankyo. The remaining authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Workflow from the stack of medical images to the surgical guide.
Figure 2
Figure 2
Heart model segmented: (A) First stage segmentation of whole heart without coronary artery tree; (B) Second stage segmentation as a combination of whole heart and coronary arteries; (C) Final segmentation stage.
Figure 3
Figure 3
Heart model with selected region of interest.
Figure 4
Figure 4
3D surgical guide in three views: (A) Lateral view; (B) Frontal view; (C) Posterior view.
Figure 5
Figure 5
Post-printing steps: (A) Removal of the prototype from the 3D printer plate; (B) Cleaning of support material using a high-pressure water jet.
Figure 6
Figure 6
Printed and cleaned surgical guide: (A) Above view; (B) Left lateral view; (C) Frontal view.
Figure 7
Figure 7
Fitting test of the surgical guide on the phantom heart: (A) Above view; (B) Right lateral view; (C) Frontal view.
See this image and copyright information in PMC

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