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Wang, Dee Dee; Qian, Zhen; Vukicevic, Marija; Engelhardt, Sandy; Kheradvar, Arash; Zhang, Chuck; Little, Stephen H.; Verjans, Johan; Comaniciu, Dorin; O’Neill, William W.; Vannan, Mani A.
JACC. Cardiovascular imaging, January 2021, 2021-01-00, 20210101, Volume: 14, Issue: 1Journal Article
Structural heart disease (SHD) is a new field within cardiovascular medicine. Traditional imaging modalities fall short in supporting the needs of SHD interventions, as they have been constructed around the concept of disease diagnosis. SHD interventions disrupt traditional concepts of imaging in requiring imaging to plan, simulate, and predict intraprocedural outcomes. In transcatheter SHD interventions, the absence of a gold-standard open cavity surgical field deprives physicians of the opportunity for tactile feedback and visual confirmation of cardiac anatomy. Hence, dependency on imaging in periprocedural guidance has led to evolution of a new generation of procedural skillsets, concept of a visual field, and technologies in the periprocedural planning period to accelerate preclinical device development, physician, and patient education. Adaptation of 3-dimensional (3D) printing in clinical care and procedural planning has demonstrated a reduction in early-operator learning curve for transcatheter interventions. Integration of computation modeling to 3D printing has accelerated research and development understanding of fluid mechanics within device testing. Application of 3D printing, computational modeling, and ultimately incorporation of artificial intelligence is changing the landscape of physician training and delivery of patient-centric care. Transcatheter structural heart interventions are requiring in-depth periprocedural understanding of cardiac pathophysiology and device interactions not afforded by traditional imaging metrics. Display omitted •Structural heart interventions require in-depth understanding of cardiac pathophysiology.•3D printing can decrease the early-operator learning curve for new technology adaptation.•Computational fluid modeling has potential to emulate dynamic physical and physiological properties of cardiac pathophysiology.•Application of AI has potential for patient-specific anatomic replica procedural simulation training.
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