PATIENT-SPECIFIC SIMULATOR FOR PREOPERATIVE PLANNING IN CARDIOVASCULAR INTERVENTIONS

Objectives: The clinical use of 3D printing has gained success in preoperative surgical planning, allowing clinicians to perform surgical treatments in a safe, realistic, and controlled environment. Therefore, the use of patient-specific simulators for preoperative training plays a key role in defining customized solutions for patients, increasing treatment efficiency and accuracy, and reducing surgical risks. In this work, we present the design and manufacturing of a 3D-printed patient-specific thoracic simulator equipped with modular and interchangeable components for multiple surgical procedures. Specifically, the thoracic simulator has been validated by the hands-on implantation of an innovative ventricular remodeling device for the treatment of tricuspid functional regurgitation (FTR). Methods: A patient-specific thoracic simulator composed of ventricles, septum, atria, mammary arteries, aorta, lungs, diaphragm, and rib cage, was developed starting from CT images of an 86-year-old male with moderate FTR. To obtain a modular simulator, mesh models of anatomical structures were processed in Meshmixer and design solutions were implemented in Fusion 360. Anatomical structures were 3D-printed with PLA and connected via pin connectors, allowing them to be disconnected and interchanged with other anatomies. Furthermore, by integrating disposable silicone patches into 3D components, the simulation of the procedure can be performed multiple times. The simulator's usability was tested and validated by experienced cardiac surgeons. Results: The usability test demonstrated the feasibility of using the thoracic simulator during preoperative planning. Specifically, surgeons were able to test different strategies to identify the optimal surgical treatment for the specific anatomy of the patient represented in the model. Conclusions: The developed simulator has shown potential in preoperative planning of the device implantation procedure. Moreover, the simulator's modularity makes it versatile and adaptable to replicate different medical procedures by incorporating interchangeable and disposable anatomical components. Future developments could lead to the introduction of fluid dynamics by integration with a pulsatile flow mock loop.