Skip to main content

Making three-dimensional echocardiography more tangible: a workflow for three-dimensional printing with echocardiographic data

Abstract

Three-dimensional (3D) printing is a rapidly evolving technology with several potential applications in the diagnosis and management of cardiac disease. Recently, 3D printing (i.e. rapid prototyping) derived from 3D transesophageal echocardiography (TEE) has become possible. Due to the multiple steps involved and the specific equipment required for each step, it might be difficult to start implementing echocardiography-derived 3D printing in a clinical setting. In this review, we provide an overview of this process, including its logistics and organization of tools and materials, 3D TEE image acquisition strategies, data export, format conversion, segmentation, and printing. Generation of patient-specific models of cardiac anatomy from echocardiographic data is a feasible, practical application of 3D printing technology.

References

  1. Kijima Y, Akagi T, Nakagawa K, Takaya Y, Oe H, Ito H 2014 Three-dimensional echocardiography guided closure of complex multiple atrial septal defects. Echocardiography 31 E304–E306. (doi:10.1111/echo.12731)

    Article  Google Scholar 

  2. Wunderlich NC, Beigel R, Swaans MJ, Ho SY, Siegel RJ 2015 Percutaneous interventions for left atrial appendage exclusion: options, assessment, and imaging using 2D and 3D echocardiography. JACC Cardiovascular Imaging 8 472–488. (doi:10.1016/j.jcmg.2015.02.002)

    Article  Google Scholar 

  3. Mahmood F, Jeganathan J, Saraf R, Shahul S, Swaminathan M, Mackensen GB, Knio Z, Matyal R 2016 A practical approach to an intraoperative three-dimensional transesophageal echocardiography examination. Journal of Cardiothoracic and Vascular Anesthesia 30 470–490. (doi:10.1053/j.jvca.2015.10.014)

    Article  Google Scholar 

  4. Hahn RT, Abraham T, Adams MS, Bruce CJ, Glas KE, Lang RM, Reeves ST, Shanewise JS, Siu SC, Stewart W 2014 Guidelines for performing a comprehensive transesophageal echocardiographic examination: recommendations from the American Society of Echocardiography and the Society of Cardiovascular Anesthesiologists. Anesthesia & Analgesia 118 21–68. (doi:10.1213/ane.0000000000000016)

    Article  Google Scholar 

  5. Montealegre-Gallegos M, Mahmood F 2014 Intraoperative transesophageal echocardiography: Monere to Decidere. Journal of Cardiothoracic and Vascular Anesthesia 28 1700–1701. (doi:10.1053/j.jvca.2014.08.007)

    Article  Google Scholar 

  6. Marro A, Bandukwala T, Mak W 2016 Three-dimensional printing and medical imaging: a review of the methods and applications. Current Problems in Diagnostic Radiology 45 2–9 (doi:10.1067/j.cpradiol.2015.07.009)

    Article  Google Scholar 

  7. Schmauss D, Haeberle S, Hagl C, Sodian R 2015 Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience. European Journal of Cardio-Thoracic Surgery 47 1044–1052. (doi:10.1093/ejcts/ezu310)

    Article  Google Scholar 

  8. Tam MD, Laycock SD, Brown JR, Jakeways M 2013 3D printing of an aortic aneurysm to facilitate decision making and device selection for endovascular aneurysm repair in complex neck anatomy. Journal of Endovascular Therapy 20 863–867. (doi:10.1583/13-4450MR.1)

    Article  Google Scholar 

  9. Noecker AM, Chen J-F, Zhou Q, White RD, Kopcak MW, Arruda MJ, Duncan BW 2006 Development of patient-specific three-dimensional pediatric cardiac models. ASAIO Journal 52 349–353. (doi:10.1097/01.mat.0000217962.98619.ab)

    Article  Google Scholar 

  10. Sodian R, Weber S, Markert M, Loeff M, Lueth T, Weis FC, Daebritz S, Malec E, Schmitz C, Reichart B 2008 Pediatric cardiac transplantation: three-dimensional printing of anatomic models for surgical planning of heart transplantation in patients with univentricular heart. Journal of Thoracic and Cardiovascular Surgery 136 1098–1099. (doi:10.1016/j.jtcvs.2008.03.055)

    Article  Google Scholar 

  11. Farooqi KM, Sengupta PP 2015 Echocardiography and three-dimensional printing: sound ideas to touch a heart. Journal of the American Society of Echocardiography 28 398–403. (doi:10.1016/j.echo.2015.02.005)

    Article  Google Scholar 

  12. Owais K, Pal A, Matyal R, Montealegre-Gallegos M, Khabbaz KR, Maslow A, Panzica P, Mahmood F 2014 Three-dimensional printing of the mitral annulus using echocardiographic data: science fiction or in the operating room next door? Journal of Cardiothoracic and Vascular Anesthesia 28 1393–1396. (doi:10.1053/j.jvca.2014.04.001)

    Article  Google Scholar 

  13. Malik HH, Darwood ARJ, Shaunak S, Kulatilake P, El-Hilly AA, Mulki O, Baskaradas A 2015 Three-dimensional printing in surgery: a review of current surgical applications. Journal of Surgical Research 199 512–522. (doi:10.1016/j.jss.2015.06.051)

    Article  Google Scholar 

  14. Mahmood F, Owais K, Montealegre-Gallegos M, Matyal R, Panzica P, Maslow A, Khabbaz KR 2014 Echocardiography derived three-dimensional printing of normal and abnormal mitral annuli. Annals of Cardiac Anaesthesia 17 279–283. (doi:10.4103/0971-9784.142062)

    Article  Google Scholar 

  15. Mahmood F, Owais K, Taylor C, Montealegre-Gallegos M, Manning W, Matyal R, Khabbaz KR 2015 Three-dimensional printing of mitral valve using echocardiographic data. JACC Cardiovascular Imaging 8 227–229. (doi:10.1016/j.jcmg.2014.06.020)

    Article  Google Scholar 

  16. Olivieri LJ, Krieger A, Loke Y-H, Nath DS, Kim PCW, Sable CA 2015 Three-dimensional printing of intracardiac defects from three-dimensional echocardiographic images: feasibility and relative accuracy. Journal of the American Society of Echocardiography 28 392–397. (doi:10.1016/j.echo.2014.12.016)

    Article  Google Scholar 

  17. Sardari Nia P, Heuts S, Daemen J, Luyten P, Vainer J, Hoorntje J, Cheriex E, Maessen J 2016 Preoperative planning with three-dimensional reconstruction of patient’s anatomy, rapid prototyping and simulation for endoscopic mitral valve repair. Interactive Cardiovascular and Thoracic Surgery [in press]. (doi:10.1093/icvts/ivw308)

    Google Scholar 

  18. Vukicevic M, Puperi DS, Jane Grande-Allen K, Little SH 2016 3D printed modeling of the mitral valve for catheter-based structural interventions. Annals of Biomedical Engineering [in press]. (doi:10.1007/s10439-016-1676-5)

    Google Scholar 

  19. Evangelista A, Flachskampf F, Lancellotti P, Badano L, Aguilar R, Monaghan M, Zamorano J, Nihoyannopoulos P European Association of Echocardiography 2008 European Association of Echocardiography recommendations for standardization of performance, digital storage and reporting of echocardiographic studies. European Journal of Echocardiography 9 438–448. (doi:10.1093/ejechocard/jen174)

    Article  Google Scholar 

  20. Pouch AM, Wang H, Takabe M, Jackson BM, Gorman JH, Gorman RC, Yushkevich PA, Sehgal CM 2014 Fully automatic segmentation of the mitral leaflets in 3D transesophageal echocardiographic images using multi-atlas joint label fusion and deformable medial modeling. Medical Image Analysis 18 118–129. (doi:10.1016/j.media.2013.10.001)

    Article  CAS  Google Scholar 

  21. Huotilainen E, Jaanimets R, Valášek J, Marcián P, Salmi M, Tuomi J, Mäkitie A, Wolff J 2014 Inaccuracies in additive manufactured medical skull models caused by the DICOM to STL conversion process. Journal of Cranio-Maxillofacial Surgery 42 e259–e265. (doi:10.1016/j.jcms.2013.10.001)

    Article  Google Scholar 

Download references

Acknowledgements

The authors thank Dr Mathew Jolley and the 3DSlicer development team for their assistance with this project.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mario Montealegre-Gallegos MD.

Rights and permissions

This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mashari, A., Montealegre-Gallegos, M., Knio, Z. et al. Making three-dimensional echocardiography more tangible: a workflow for three-dimensional printing with echocardiographic data. Echo Res Pract 3, R57–R64 (2016). https://doi.org/10.1530/ERP-16-0036

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1530/ERP-16-0036

Key Words