Background: 3D printing is a rapidly evolving new technology with various applications within
cardiac surgery. It is mainly applied for individual operational planning in complex
congenital heart disease. Its impact on procedural understanding of the patient has
not yet been evaluated in a structured manner. This is the first randomized cohort
trial to evaluate the value of patient-specific 3D printed models on procedural understanding
in patients for elective aortic surgery.
Methods: The study was planned in collaboration with the Institute of Epidemiology and Social
Medicine and approved by the local ethics committee. Between April 2020 and June 2022
41 patients (21 females) for elective aortic procedures were included and an intermediate
analysis in accordance with the previously defined power (>0.8) was performed. After
randomization, patients were informed with either conventional forms or with individual
3D models of their own aorta using a commercially available 3D printer. Beside other
factors, procedural understanding and localization of aortic pathology were evaluated
using a validated scoring system (based on the illness perception questionnaire).
General demographic data as well as the educational and socio-economic background
were surveyed separately. The t-test was applied for comparison of means while the Mann-Whitney U-test was applied
for comparison of independent ordinal-scaled variables using SPSS version 22.0 (IBM
Corp, Armonk, NY).
Results: This is the first structured approach evaluating the (additional) value of 3D printing
on procedural understanding in aortic surgery patients. Mean age of the patients in
the 3D and conventional group was 63.6 years and 60.5 years respectively. Patients
informed with a 3D model of their aortic pathology showed a significantly better understanding
regarding their disease (p < .001), operative procedure (p < 0.001) and localization of their pathology (p = 0.015). The added value of the 3D model is independent of the patient’s gender,
age, level of education or socio-economic background.
Conclusion: Within cardiac surgery, 3D printing has so far been mainly used for procedure planning
in complex (congenital) cases. However, this study shows the potentials of this innovation
for broader applications beyond the single-case mentality. This is the first prospective
randomized cohort trial to show a clear benefit of individualized 3D printed models
on patient illness and procedural perception in aortic pathologies.
