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      Multimodality imaging and three‐dimensional printed model in patients with left ventricular outflow tract obstruction

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          Abstract

          Surgical treatment is an effective therapy and the gold standard for patients with left ventricular outflow tract obstruction (LVOTO) and drug‐refractory symptoms. However, it is difficult to arrange a concrete surgical plan due to the heterogenous and complex cardiac anatomy. Three‐dimensional (3D) printing is an emerging technology that is able to reproduce complex cardiac anatomy. Here, we present two patients with LVOTO in whom we created 3D printed models. In these two patients, we compared the 3D printed model and the intraoperative findings and confirmed that the 3D printed model we created could reproduce the complex cardiac anatomy including the interventricular septum, papillary muscles, and abnormally thickened chordae. By using 3D printed models, cardiologists and surgeons can comprehend the complex 3D cardiac structure and spatial positional relationship preoperatively and perform surgical rehearsal. 3D printing could be a valuable tool for the management of patients with LVOTO.

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          Most cited references5

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          Pharmacological treatment of hypertrophic cardiomyopathy: current practice and novel perspectives.

          Hypertrophic cardiomyopathy (HCM) is entering a phase of intense translational research that holds promise for major advances in disease-specific pharmacological therapy. For over 50 years, however, HCM has largely remained an orphan disease, and patients are still treated with old drugs developed for other conditions. While judicious use of the available armamentarium may control the clinical manifestations of HCM in most patients, specific experience is required in challenging situations, including deciding when not to treat. The present review revisits the time-honoured therapies available for HCM, in a practical perspective reflecting real-world scenarios. Specific agents are presented with doses, titration strategies, pros and cons. Peculiar HCM dilemmas such as treatment of dynamic outflow obstruction, heart failure caused by end-stage progression and prevention of atrial fibrillation and ventricular arrhythmias are assessed. In the near future, the field of HCM drug therapy will rapidly expand, based on ongoing efforts. Approaches such as myocardial metabolic modulation, late sodium current inhibition and allosteric myosin inhibition have moved from pre-clinical to clinical research, and reflect a surge of scientific as well as economic interest by academia and industry alike. These exciting developments, and their implications for future research, are discussed.
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            Simulative operation on congenital heart disease using rubber-like urethane stereolithographic biomodels based on 3D datasets of multislice computed tomography.

            Stereolithographic biomodelling is a technique where photosensitive liquid resin is polymerised with a pinpoint laser beam controlled by three-dimensional (3D) datasets. This study was designed to assess whether a stereolithographic biomodelling technique is applicable for precise anatomical diagnosis and simulation surgery of complicated congenital heart disease.
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              Scan, plan, print, practice, perform: Development and use of a patient-specific 3-dimensional printed model in adult cardiac surgery

              Static 3-dimensional printing is used for operative planning in cases that involve difficult anatomy. An interactive 3D print allowing deliberate surgical practice would represent an advance.
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                Author and article information

                Contributors
                izumi-ch@ncvc.go.jp
                Journal
                ESC Heart Fail
                ESC Heart Fail
                10.1002/(ISSN)2055-5822
                EHF2
                ESC Heart Failure
                John Wiley and Sons Inc. (Hoboken )
                2055-5822
                11 December 2019
                February 2020
                : 7
                : 1 ( doiID: 10.1002/ehf2.v7.1 )
                : 320-324
                Affiliations
                [ 1 ] Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Osaka Japan
                [ 2 ] Department of Cardiology, National Hospital Organization Kyoto Medical Center Kyoto Japan
                [ 3 ] Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center Osaka Japan
                [ 4 ] Department of Radiology, National Cerebral and Cardiovascular Center Osaka Japan
                [ 5 ] Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center Osaka Japan
                Author notes
                [*] [* ] Correspondence to: Chisato Izumi, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6‐1 Kishibe‐shinmachi, Suita, Osaka 564‐8565, Japan. Tel: (+81) 6 6170 1070. Email: izumi-ch@ 123456ncvc.go.jp

                Article
                EHF212566 ESCHF-19-00201
                10.1002/ehf2.12566
                7083429
                31825174
                0c05af00-33ed-40ad-8501-4f185af955fa
                © 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 31 July 2019
                : 28 September 2019
                : 04 November 2019
                Page count
                Figures: 2, Tables: 1, Pages: 5, Words: 1442
                Categories
                Case Report
                Case Report
                Custom metadata
                2.0
                February 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.7.8 mode:remove_FC converted:20.03.2020

                left ventricular outflow tract obstruction,multimodality imaging,three‐dimensional printing,surgery

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