Objective: To investigate the feasibility of trans-catheter closure of multiple atrial septal defects (ASD) monitored by trans-thoracic echocardiography (TTE) under the guidance of 3D printing heart model. Methods: Between April and August 2016, a total of 21 patients (8 male and 13 female) with multiple ASD in Fuwai Hospital of Chinese Academy of Medical Sciences underwent CT scan and 3-dimensional echocardiography for heart disease model produced by 3D printing technique. The best occlusion program was determined through the simulation test on the model. Percutaneous device closure of multiple ASD was performed follow the predetermined program guided by TTE. Clinical follow-up including electrocardiogram and TTE was arranged at 1 month after the procedure. Results: The trans-catheter procedure was successful in all 21 patients using a single atrial septal occluder. Mild residual shunt was found in 5 patient in the immediate postoperative period, 3 of them were disappeared during postoperative follow-up. There was no death, vascular damage, arrhythmia, device migration, thromboembolism, valvular dysfunction during the follow-up period. Conclusion: The use of 3D printing heart model provides a useful reference for transcatheter device closure of multiple ASD achieving through ultrasound-guided intervention technique, which appears to be safe and feasible with good outcomes of short-term follow-up.
目的： 探讨利用3D打印心脏模型帮助超声引导多发房间隔缺损(ASD)封堵治疗的可行性。 方法： 2016年4至8月，中国医学科学院阜外医院21例多发ASD患者经采集CT和三维超声图像，通过3D打印技术制作心脏疾病模型。利用模型进行模拟封堵测试，确定最佳封堵方案。在经胸超声心动图引导下行ASD经皮封堵术，并于术后1个月随访复查心电图和超声心动图。 结果： 共21例患者，男8例，女13例，均成功实施封堵治疗，其中5例患者存在少量残余分流，该5例患者中3例术后1个月残余分流消失，住院及随访期间无死亡、血管损伤、心律失常、封堵器脱落、血栓形成、瓣膜功能障碍等并发症。 结论： 应用3D打印心脏模型进行模拟测试有助于制定多发ASD封堵方案，经超声引导的经皮介入技术可以实现预定方案，且短期随访结果良好。.
Keywords: 3D printing; Heart septal defects, atrial; Septal occluder device; Ultrasonography, interventional.