The necessity of applying 3D printing technique to the preoperative evaluation of transcatheter aortic valve replacement: Re-analysis of 4 death cases

Transcatheter aortic valve replacement (TAVR) has already been used as a standard treatment for patients with symptomatic severe aortic stenosis (AS). Pre-procedural cardiac computed tomography (CT) is required to simulate the annulus sizing. However, limitations of CT should be highlighted: 1. The valve annulus structure could only be measured through the certain plane, three-dimensional structure is not fully reflected; 2. It cannot assess the situation after implantation, such as relative movement of calcification and annulus, and the changes of the coronary ostium direction and height; and 3. It cannot predict intraoperative and postoperative complications accurately. Three-dimensional (3D) printing could establish individualized anatomy models for pre-operative planning. This study aimed at determining whether 3D printed models could be used for predicting the complications which other pre-procedural imaging techniques failed to.