The development of a flexible heart model for simulation-based training.

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Simulation-based training has shown to be effective in training new surgical skills. The objective of this study is to develop a flexible 3-dimensional (3D)-printed heart model that can serve as a foundation for the simulation of multiple cardiovascular procedures.Using a pre-existing digital heart model, 3D transoesophageal echocardiography scans and a thoracic CT scan, a full volume new heart model was developed. The valves were removed from this model, and the internal structures were remodelled to make way for insertable patient-specific structures. Groves at the location of the coronaries were created using extrusion tools in a computer-modelling program. The heart was hollowed to create a more flexible model. A suitable material and thickness was determined using prior test prints. An aortic root and valve was built by segmenting the root from a thoracic CT scan and a valve from a transoesophageal echocardiogram. Segmentations were smoothed, small holes in the valves were filled and surrounding structures were removed to make the objects suitable for 3D printing.A hollow 3D-printed heart model with the wall thicknesses of 1.5 mm and spaces to insert coronary arteries, valves and aortic roots in various sizes was successfully printed in flexible material.A flexible 3D-printed model of the heart was developed onto which patient-specific cardiac structures can be attached to simulate multiple procedures. This model can be used as a platform for surgical simulation of various cardiovascular procedures.

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