3D打印主动脉根部模型在经导管主动脉瓣置换术前评估中的应用

马五艳; 李辉; 刘子君

doi:10.11659/jjssx.04E025025

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3D打印主动脉根部模型在经导管主动脉瓣置换术前评估中的应用

心血管外科专栏 | 更新时间：2026-03-09

- 3D打印主动脉根部模型在经导管主动脉瓣置换术前评估中的应用
- Application of 3D-printed aortic root model in preoperative evaluation of transcatheter aortic valve replacement surgery
- 局解手术学杂志 2026年35卷第2期页码：115-119
- 作者机构：
  
  1.临汾市人民医院影像科，山西临汾 041000
  2.临汾市人民医院心脏大血管外科，山西临汾 041000
  3.临汾市人民医院心内科，山西临汾 041000
- 作者简介：
  
  李辉，E-mail： 18903579747@163.com
- 基金信息：
  
  山西省高等学校科技创新计划项目(2022L217)
- DOI：10.11659/jjssx.04E025025
  中图分类号： R654.2
- 收稿：2025-04-07，
  
  纸质出版：2026-02-25
- 稿件说明：
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马五艳,李辉,刘子君.3D打印主动脉根部模型在经导管主动脉瓣置换术前评估中的应用[J].局解手术学杂志,2026,35(02):115-119.

MA Wu-yan,LI Hui,LIU Zi-jun.Application of 3D-printed aortic root model in preoperative evaluation of transcatheter aortic valve replacement surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):115-119.
马五艳,李辉,刘子君.3D打印主动脉根部模型在经导管主动脉瓣置换术前评估中的应用[J].局解手术学杂志,2026,35(02):115-119. DOI： 10.11659/jjssx.04E025025.

MA Wu-yan,LI Hui,LIU Zi-jun.Application of 3D-printed aortic root model in preoperative evaluation of transcatheter aortic valve replacement surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2026,35(02):115-119. DOI： 10.11659/jjssx.04E025025.

摘要

目的

构建基于CTA的主动脉根部3D打印模型，并探讨其在经导管主动脉瓣置换术（TAVR）前评估中的应用价值。

方法

选择临汾市人民医院21例主动脉瓣病变患者，入院后行主动脉+冠状动脉CTA扫描，利用Mimics医学三维建模软件对主动脉根部进行三维建模和3D打印，测量3D打印模型和CTA上的主动脉瓣环，主动脉窦和窦管交界处的最长径、最短径，主动脉瓣面积、周长，左右冠状动脉开口-瓣环距离等数据，并对2组数据进行统计学分析。在3D打印模型上测量瓣环及冠状动脉开口参数、评估钙化情况及血管入路情况等，并基于上述评估情况进行术前规划以规避手术风险。比较手术前后心脏超声、心电图等数据。

结果

所有患者在CTA和3D打印模型上测量的主动脉瓣环直径、主动脉瓣面积、主动脉瓣周长、左右冠状动脉开口-瓣环距离、主动脉窦和窦管交界处的各项数据比较，差异无统计学意义（

0.05）。21例患者中，经TAVR治疗18例，TAVR+冠状动脉介入治疗3例，术前根据3D打印模型预判高风险冠状动脉阻塞5例，在术中对冠状动脉进行保护，术中未发生冠状动脉阻塞并发症。根据3D打印模型预选瓣膜型号尺寸与术中实际置入瓣膜型号尺寸相符率90.5%（19/21），围术期无瓣周漏发生。术后3个月、6个月、12个月患者主动脉瓣跨瓣压差、左室射血分数（LVEF）、左室舒末期内径、纽约心脏协会（NYHA）心功能分级Ⅳ级比例与术前相比，差异具有统计学意义（

0.05）。

结论

基于CTA构建的主动脉根部3D打印模型可较好地还原主动脉根部结构。基于3D打印模型进行术前规划，可以有效减少术中冠状动脉阻塞风险及术后瓣周漏的发生率。

Abstract

Objective

To construct 3D-printed models of the aortic root based on contrast-enhanced CT angiography （CTA） data and to explore their application value in the preoperative evaluation of transcatheter aortic valve replacement （TAVR）.

Methods

Twenty-one patients with aortic valve disease were enrolled from Linfen People's Hospital.All patients underwent CTA of the aorta and coronary arteries.The aortic root was reconstructed using Mimics medical imaging software and subsequently printed into 3D models. Parameters including the aortic annulus maximum and minimum diameters of junction of the aortic sinus and the sinus canal，as well as the aortic valve area and perimeter，and the distance from the coronary ostia to the annulus，were measured on both the CTA images and the 3D-printed models.Statistical analysis was performed to compare the two sets of measurements. The parameters of the aortic annulus and coronary ostia were measured and the calcification and vascular access conditions were evaluated on the 3D-printed model，and preoperative planning was carried out based on the above evaluation results to avoid surgical risks.Echocardiographic and electrocardiographic data before and after surgery were compared.

Results

There were no statistically significant differences in terms of the diameter of the aortic annulus，the aortic valve area and perimeter，the distance from the coronary ostia to the annulus，or the diameter of junction of the aortic sinus and the sinus canal between CTA and 3D-printed models （

0.05）. Among the 21 patients， 18 cases underwent TAVR alone， while 3 cases received TAVR combined with coronary intervention. Based on the 3D-printed models， high risk of coronary obstruction was predicted in 5 cases， and protective measures were successfully implemented during surgery， with no coronary obstruction occurring. The agreement rate between the valve size preselected using the 3D-printed models and the size actually implanted was 90.5% （19/21）， no perivalvular leakage occurred during the perioperative period.There were significant differences in the transvalvular pressure gradient， left v

entricular ejection fraction （LVEF）， left ventricular end-diastolic diameter， and the proportion of patients with NYHA cardiac function classification Ⅳ 3 months，6 months，12 months after surgery compared with those before surgery （

0.05）.

Conclusion

3D-printed model of the aortic root constructed based on CTA can accurately replicate aortic root anatomy.Preoperative planning utilizing these models can effectively reduce the risk of intraoperative coronary obstruction and the incidence of postoperative paravalvular leakage.

关键词

Keywords

references

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