We read the recent case report by Gaia et al. with great interest [1]. In their paper the authors reported off-label use Amplatzer Vascular Plug II device for closure of a prosthetic mitral valve perivalvular leak [1].
Due to the lack of commercially available devices customized for different cardiac lesions, interventionalists use the most appropriate/potentially suitable ones already labelled for other indications. But results are not always encouraging as reported by the authors and sometimes because of device-lesion mismatch, patient loses the chance of a percutaneous treatment.
At this point three-dimensional (3D) printers remodel our future practice. Today 3D printers are being used by surgeons to simulate analogue 3D anatomical models of complex heart diseases to facilitate the planning and execution of the surgical procedure. Individual dental implants produced by 3D printers have been used by dentists nearly for a decade. Use of 3D printers during catheter-based interventions is also promising. Sodian et al. reported a case of 3D-printing model to fabricate a custom-made occlusion device for coil embolization of an anastomotic leak after aortic arch replacement [2]. There are reports in the literature describing the use of models in the treatment of valve diseases [3].
In conclusion 3D printers can assist with diagnosis, surgical and catheter-based intervention planning, patient communication, and prosthesis design in fields ranging from maxillofacial surgery to cardiology. With this technology the off-label term will leave its place to the term 'individualized medicine'; a concept implying diagnosis and treatment tailored according to the patient's unique features and requirements.
Conflict of interest: none declared.
References
- 1.Gaia DF, Breda JR, Fischer CH, Palma JH. Off-pump transapical closure of a mitral periprosthetic leak: a new approach to a difficult problem. Interact CardioVasc Thorac 2013;17:1048–50 [DOI] [PMC free article] [PubMed] [Google Scholar]
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