Clinical Impact of Rapid Prototyping 3D Models for Surgical Management

NCT ID: NCT04788082

Last Updated: 2021-03-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-01

Study Completion Date

2021-06-30

Brief Summary

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Patient-specific, 3D printed models have been utilized in preoperative planning for many years. Among researchers and clinicians, there is a perception that preoperative exposure to 3D printed models, derived from patient images (CT or MRI), aid in procedural planning. 3D printed models for heart surgery have the potential to improve a clinician's preparedness and therefore may reduce surgically-related morbidity and mortality. This randomized clinical trial aims to evaluate whether pre-procedural planning of surgeons exposed to a patient-specific 3D printed heart model will decrease cardiopulmonary bypass time, morbidity, and mortality.

Detailed Description

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3D imaging and rapid prototyping 3D printing technology have advanced to the point where it is feasible to marry the two to produce a patient-matched and accurate 3D model of congenital heart defects. The production of a 3D model of the heart may be particularly useful in anticipation of surgery such that the operator can plan and visualize the surgery prior to the surgical date with a physical heart he or she can manipulate in their hands.

Preliminary studies demonstrate potential for clinical impact of 3D models on patient care and patient outcomes. 3D models have long been shown to enhance education and communication of anatomy. In 2008 Kim et al reviewed 3D printed models as an emerging technology in management of congenital heart disease, and also suggests that physical models may also help enhance patients and physicians' understanding of congenital heart disease. Our group has also published on the clinical and educational value of these 3D heart models. To date, no systematic trial identifying the value of 3D models on procedural planning has been published.

Conditions

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Double Outlet Right Ventricle Transposition of the Great Arteries Truncus Arteriosus Congenitally Corrected Transposition of the Great Arteries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Control

Standard of care (not involving 3D printing)

Group Type NO_INTERVENTION

No interventions assigned to this group

3D Model

3D printed models (at least one rigid blood volume model and one flexible shell model) will be used for surgical planning.

Group Type EXPERIMENTAL

3D Printed Heart Model

Intervention Type DIAGNOSTIC_TEST

Prior to surgical intervention, the surgeon will be exposed to clinically-indicated images and a patient-specific 3D printed model of the subject's heart anatomy.

Interventions

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3D Printed Heart Model

Prior to surgical intervention, the surgeon will be exposed to clinically-indicated images and a patient-specific 3D printed model of the subject's heart anatomy.

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Rapid Prototyped Heart Model

Eligibility Criteria

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Inclusion Criteria

* Pediatric subjects undergoing primary complex two-ventricle repair of congenital heart defect, including but not limited to:

1. double outlet right ventricle (DORV),
2. transposition of the great arteries with ventricular septal defect and pulmonary stenosis (TGA/VSD/PS),
3. truncus arteriosus with ventricular septal defect (TA/VSD)
4. congenitally corrected transposition of the arteries with pulmonary stenosis (CCTGA/PS).
* Patient who will undergo preoperative cardiac MR or cardiac CT imaging

a. Images will be validated by the IRC prior to inclusion
* Written informed consent (and assent when applicable) and HIPAA authorization obtained from subject or subject's legal representative and ability for subject to comply with the requirements of the study.

Exclusion Criteria

* Complex defects involving atrioventricular valve anomalies

1. complete or transitional atrioventricular canal
2. double inlet left ventricle
3. tricuspid atresia
4. mitral atresia
* Defects with valve dysfunction requiring an extensive valvuloplasty
* Patients with a contraindication to MRI scanning will be excluded unless they are referred for a cardiac CT per clinical standard of practice. These contraindications include patients with the following devices:

1. Central nervous system aneurysm clips
2. Implanted neural stimulator
3. Implanted cardiac pacemaker or defibrillator which are not MR safe or MR conditional according to the manufacturer
4. Cochlear implant
5. Ocular foreign body (e.g. metal shavings)
6. Implanted Insulin pump
7. Metal shrapnel or bullet.
8. Any contraindications to receiving IV gadolinium contrast, determined clinically
* Subjects where MRI or CT images are acquired more than six months prior to the scheduled surgical date
* Subjects where date of scan to date of surgery is less than 10 calendar days
* Subjects where MRI or CT reconstruction is limited due to poor image acquisition as solely determined by the Image Reconstruction Center.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Phoenix Children's Hospital

OTHER

Sponsor Role collaborator

Children's Hospital of Philadelphia

OTHER

Sponsor Role collaborator

Children's National Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Laura Olivieri

Cardiologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Laura Olivieri, MD

Role: PRINCIPAL_INVESTIGATOR

Children's National Research Institute

Stephen Pophal, MD

Role: PRINCIPAL_INVESTIGATOR

Phoenix Children's Hospital

Yoav Dori, MD

Role: PRINCIPAL_INVESTIGATOR

Children's Hospital of Philadelphia

Locations

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Phoenix Children's Hospital

Phoenix, Arizona, United States

Site Status

Children's National Medical Center

Washington D.C., District of Columbia, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Countries

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United States

References

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Cardoen B, Demeulemeester E, Beliën J. Operating room planning and scheduling: A literature review. European Journal of Operational Research 201(3): 921-932, 2010.

Reference Type BACKGROUND

Costello JP, Olivieri LJ, Krieger A, Thabit O, Marshall MB, Yoo SJ, Kim PC, Jonas RA, Nath DS. Utilizing Three-Dimensional Printing Technology to Assess the Feasibility of High-Fidelity Synthetic Ventricular Septal Defect Models for Simulation in Medical Education. World J Pediatr Congenit Heart Surg. 2014 Jul;5(3):421-6. doi: 10.1177/2150135114528721.

Reference Type BACKGROUND
PMID: 24958045 (View on PubMed)

Costello JP, Olivieri LJ, Su L, Krieger A, Alfares F, Thabit O, Marshall MB, Yoo SJ, Kim PC, Jonas RA, Nath DS. Incorporating three-dimensional printing into a simulation-based congenital heart disease and critical care training curriculum for resident physicians. Congenit Heart Dis. 2015 Mar-Apr;10(2):185-90. doi: 10.1111/chd.12238. Epub 2014 Nov 11.

Reference Type BACKGROUND
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Reference Type BACKGROUND

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Reference Type BACKGROUND

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Reference Type BACKGROUND

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Reference Type BACKGROUND
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Kim MS, Hansgen AR, Wink O, Quaife RA, Carroll JD. Rapid prototyping: a new tool in understanding and treating structural heart disease. Circulation. 2008 May 6;117(18):2388-94. doi: 10.1161/CIRCULATIONAHA.107.740977.

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Related Links

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http://Cardiac3DPrintLab.com

Phoenix Children's Hospital's 3D Print Lab

http://childrensnational.org/

Children's National Medical Center

Other Identifiers

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15-090

Identifier Type: -

Identifier Source: org_study_id

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