(Fig.3 A)
In another case, which was the biforate ASD and had 6mm apart between
the two holes, the defects were closed by a single occluder device. The
maximal diameter of the two defects and the whole size that measured
from the 3D printed ASD model was 16.09mm, 6.68mm and 21.28mm, the
minimum diameter of each hole and the whole size was 10.00mm, 5.17mm and
18.47mm, respectively. During simulation operation, occlusion was
simulated in vitro using the 3D biforate ASD model to inform the closure
plan, including the determination of target defect and size selection of
the device. After the failure attempt with a 30mm occluder, a 34mm ASO
was finally selected to cover all the defects successfully with the
bigger defect as the optimal target defect. (Fig3 C )
In the other three cases, the size of the ASO devices selected in
simulation operation according to 3D printed ASD models were identical
with that applied in actual surgical procedure obtained by checking the
medical records retrospectively. Moreover, simulation operation in 3D
printed ASD model all showed no device replacement and occlusion-related
complications such as residual leaks or device migration immediately
after the in vitro simulation. (Fig.3 )