Effect of 3D-printed heart model on congenital heart disease education: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

BI Siwei ¹ , ZHOU Yannan ² , GU Jun ³ ,  WU Zhong ³

1. Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, 610041, P. R. China;
3. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China;

Corresponding author：

WU Zhong, Email: wuzhong71@scu.edu.cn

Keywords：

3D printing; heart model; education effect; congenital heart disease; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202304004

Video：

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Objective To evaluate the effect of the 3D-printed heart model on congenital heart disease (CHD) education through systematic review and meta-analysis. Methods The literature about the application of the 3D-printed heart model in CHD education was systematically searched by computer from PubMed, Web of Science, and EMbase from inception to November 10, 2022. The two researchers independently screened the literature, extracted data and evaluated the quality of the literature. Cochrane literature evaluation standard was used to evaluate the quality of randomized controlled trials, and JBI evaluation scale was used for cross-sectional and cohort studies. Results After screening, 23 literatures were included, including 7 randomized controlled trials, 15 cross-sectional studies and 1 cohort study. Randomized controlled trials were all at low-risk, cross-sectional studies and and the cohort study had potential bias. There were 4 literatures comparing 3D printing heart model with 2D image teaching and the meta-analysis result showed that the effect of 3D printing heart model on theoretical achievement was more significant compared with 2D image teaching (SMD=0.31, 95%CI –0.28 to 0.91, P=0.05). Conclusion The application of the 3D-printed heart model in CHD education can be beneficial. But more randomized controlled trials are still needed to verify this result.

Citation： BI Siwei, ZHOU Yannan, GU Jun, WU Zhong. Effect of 3D-printed heart model on congenital heart disease education: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2024, 31(8): 1101-1108. doi: 10.7507/1007-4848.202304004 Copy

1.	van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis. J Am Coll Cardiol, 2011, 58(21): 2241-2247.
2.	Zhao QM, Liu F, Wu L, et al. Prevalence of congenital heart disease at live birth in China. J Pediatr, 2019, 204: 53-58.
3.	Pan F, Li J, Lou H, et al. Geographical and socioeconomic factors influence the birth prevalence of congenital heart disease: A population-based cross-sectional study in eastern China. Curr Probl Cardiol, 2022, 47(11): 101341.
4.	Tack P, Victor J, Gemmel P, et al. 3D-printing techniques in a medical setting: A systematic literature review. Biomed Eng Online, 2016, 15(1): 115.
5.	Vukicevic M, Mosadegh B, Min JK, et al. Cardiac 3D printing and its future directions. JACC Cardiovasc Imaging, 2017, 10(2): 171-184.
6.	El Sabbagh A, Eleid MF, Al-Hijji M, et al. The various applications of 3D printing in cardiovascular diseases. Curr Cardiol Rep, 2018, 20(6): 47.
7.	Su W, Xiao Y, He S, et al. Three-dimensional printing models in congenital heart disease education for medical students: A controlled comparative study. BMC Med Educ, 2018, 18(1): 178.
8.	Lee C, Lee JY. Utility of three-dimensional printed heart models for education on complex congenital heart diseases. Cardiol Young, 2020, 30(11): 1637-1642.
9.	Li Q, Hussein N, Zhang Y, et al. Clinical translation of surgical simulated closure of a ventricular septum defect. Interact Cardiovasc Thorac Surg, 2022, 35(3): ivac122.
10.	Jones TW, Seckeler MD. Use of 3D models of vascular rings and slings to improve resident education. Congenit Heart Dis, 2017, 12(5): 578-582.
11.	Loke YH, Harahsheh AS, Krieger A, et al. Usage of 3D models of tetralogy of Fallot for medical education: Impact on learning congenital heart disease. BMC Med Educ, 2017, 17(1): 54.
12.	White SC, Sedler J, Jones TW, et al. Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects. Congenit Heart Dis, 2018, 13(6): 1045-1049.
13.	Tan H, Huang E, Deng X, et al. Application of 3D printing technology combined with PBL teaching model in teaching clinical nursing in congenital heart surgery: A case-control study. Medicine (Baltimore), 2021, 100(20): e25918.
14.	Karsenty C, Guitarte A, Dulac Y, et al. The usefulness of 3D printed heart models for medical student education in congenital heart disease. BMC Med Educ, 2021, 21(1): 480.
15.	Wang Z, Liu Y, Luo H, et al. Is a Three-dimensional printing model better than a traditional cardiac model for medical education? A pilot randomized controlled study. Acta Cardiol Sin, 2017, 33(6): 664-669.
16.	Lau I, Sun Z. The role of 3D printed heart models in immediate and long-term knowledge acquisition in medical education. Rev Cardiovasc Med, 2022, 23(1): 22.
17.	Costello JP, Olivieri LJ, Krieger A, et al. 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, 5(3): 421-426.
18.	Costello JP, Olivieri LJ, Su L, et al. Incorporating three-dimensional printing into a simulation-based congenital heart disease and critical care training curriculum for resident physicians. Congenit Heart Dis, 2015, 10(2): 185-190.
19.	Olivieri LJ, Su L, Hynes CF, et al. "Just-in-time" simulation training using 3-D printed cardiac models after congenital cardiac surgery. World J Pediatr Congenit Heart Surg, 2016, 7(2): 164-168.
20.	Biglino G, Capelli C, Wray J, et al. 3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: Feasibility and acceptability. BMJ Open, 2015, 5(4): e007165.
21.	Yoo SJ, Spray T, Austin EH, et al. Hands-on surgical training of congenital heart surgery using 3-dimensional print models. J Thorac Cardiovasc Surg, 2017, 153(6): 1530-1540.
22.	Lau IWW, Liu D, Xu L, et al. Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments. PLoS One, 2018, 13(3): e0194333.
23.	Smerling J, Marboe CC, Lefkowitch JH, et al. Utility of 3D printed cardiac models for medical student education in congenital heart disease: Across a spectrum of disease severity. Pediatr Cardiol, 2019, 40(6): 1258-1265.
24.	Hussein N, Honjo O, Haller C, et al. Quantitative assessment of technical performance during hands-on surgical training of the arterial switch operation using 3-dimensional printed heart models. J Thorac Cardiovasc Surg, 2020, 160(4): 1035-1042.
25.	Awori J, Friedman SD, Chan T, et al. 3D models improve understanding of congenital heart disease. 3D Print Med, 2021, 7(1): 26.
26.	Hon NWL, Hussein N, Honjo O, et al. Evaluating the impact of medical student inclusion into hands-on surgical simulation in congenital heart surgery. J Surg Educ, 2021, 78(1): 207-213.
27.	Nam JG, Lee W, Jeong B, et al. Three-dimensional printing of congenital heart disease models for cardiac surgery simulation: Evaluation of surgical skill improvement among inexperienced cardiothoracic surgeons. Korean J Radiol, 2021, 22(5): 706-713.
28.	Valverde I, Gomez G, Byrne N, et al. Criss-cross heart three-dimensional printed models in medical education: A multicenter study on their value as a supporting tool to conventional imaging. Anat Sci Educ, 2022, 15(4): 719-730.
29.	Brunner BS, Thierij A, Jakob A, et al. 3D-printed heart models for hands-on training in pediatric cardiology—The future of modern learning and teaching? GMS J Med Educ, 2022, 39(2): Doc23.
30.	Alsuwaidi L, Kristensen J, Hk A, et al. Use of simulation in teaching haematological aspects to undergraduate medical students improves student's knowledge related to the taught theoretical underpinnings. BMC Med Educ, 2021, 21(1): 271.
31.	Wang S, Ren X, Ye J, et al. Exploration of simulation-based medical education for undergraduate students. Medicine (Baltimore), 2021, 100(20): e25982.
32.	Yu JH, Chang HJ, Kim SS, et al. Effects of high-fidelity simulation education on medical students' anxiety and confidence. PLoS One, 2021, 16(5): e0251078.
33.	Valverde I. Three-dimensional printed cardiac models: Applications in the field of medical education, cardiovascular surgery, and structural heart interventions. Rev Esp Cardiol (Engl Ed), 2017, 70(4): 282-291.

1. van der Linde D, Konings EE, Slager MA, et al. Birth prevalence of congenital heart disease worldwide: A systematic review and meta-analysis. J Am Coll Cardiol, 2011, 58(21): 2241-2247.
2. Zhao QM, Liu F, Wu L, et al. Prevalence of congenital heart disease at live birth in China. J Pediatr, 2019, 204: 53-58.
3. Pan F, Li J, Lou H, et al. Geographical and socioeconomic factors influence the birth prevalence of congenital heart disease: A population-based cross-sectional study in eastern China. Curr Probl Cardiol, 2022, 47(11): 101341.
4. Tack P, Victor J, Gemmel P, et al. 3D-printing techniques in a medical setting: A systematic literature review. Biomed Eng Online, 2016, 15(1): 115.
5. Vukicevic M, Mosadegh B, Min JK, et al. Cardiac 3D printing and its future directions. JACC Cardiovasc Imaging, 2017, 10(2): 171-184.
6. El Sabbagh A, Eleid MF, Al-Hijji M, et al. The various applications of 3D printing in cardiovascular diseases. Curr Cardiol Rep, 2018, 20(6): 47.
7. Su W, Xiao Y, He S, et al. Three-dimensional printing models in congenital heart disease education for medical students: A controlled comparative study. BMC Med Educ, 2018, 18(1): 178.
8. Lee C, Lee JY. Utility of three-dimensional printed heart models for education on complex congenital heart diseases. Cardiol Young, 2020, 30(11): 1637-1642.
9. Li Q, Hussein N, Zhang Y, et al. Clinical translation of surgical simulated closure of a ventricular septum defect. Interact Cardiovasc Thorac Surg, 2022, 35(3): ivac122.
10. Jones TW, Seckeler MD. Use of 3D models of vascular rings and slings to improve resident education. Congenit Heart Dis, 2017, 12(5): 578-582.
11. Loke YH, Harahsheh AS, Krieger A, et al. Usage of 3D models of tetralogy of Fallot for medical education: Impact on learning congenital heart disease. BMC Med Educ, 2017, 17(1): 54.
12. White SC, Sedler J, Jones TW, et al. Utility of three-dimensional models in resident education on simple and complex intracardiac congenital heart defects. Congenit Heart Dis, 2018, 13(6): 1045-1049.
13. Tan H, Huang E, Deng X, et al. Application of 3D printing technology combined with PBL teaching model in teaching clinical nursing in congenital heart surgery: A case-control study. Medicine (Baltimore), 2021, 100(20): e25918.
14. Karsenty C, Guitarte A, Dulac Y, et al. The usefulness of 3D printed heart models for medical student education in congenital heart disease. BMC Med Educ, 2021, 21(1): 480.
15. Wang Z, Liu Y, Luo H, et al. Is a Three-dimensional printing model better than a traditional cardiac model for medical education? A pilot randomized controlled study. Acta Cardiol Sin, 2017, 33(6): 664-669.
16. Lau I, Sun Z. The role of 3D printed heart models in immediate and long-term knowledge acquisition in medical education. Rev Cardiovasc Med, 2022, 23(1): 22.
17. Costello JP, Olivieri LJ, Krieger A, et al. 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, 5(3): 421-426.
18. Costello JP, Olivieri LJ, Su L, et al. Incorporating three-dimensional printing into a simulation-based congenital heart disease and critical care training curriculum for resident physicians. Congenit Heart Dis, 2015, 10(2): 185-190.
19. Olivieri LJ, Su L, Hynes CF, et al. "Just-in-time" simulation training using 3-D printed cardiac models after congenital cardiac surgery. World J Pediatr Congenit Heart Surg, 2016, 7(2): 164-168.
20. Biglino G, Capelli C, Wray J, et al. 3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: Feasibility and acceptability. BMJ Open, 2015, 5(4): e007165.
21. Yoo SJ, Spray T, Austin EH, et al. Hands-on surgical training of congenital heart surgery using 3-dimensional print models. J Thorac Cardiovasc Surg, 2017, 153(6): 1530-1540.
22. Lau IWW, Liu D, Xu L, et al. Clinical value of patient-specific three-dimensional printing of congenital heart disease: Quantitative and qualitative assessments. PLoS One, 2018, 13(3): e0194333.
23. Smerling J, Marboe CC, Lefkowitch JH, et al. Utility of 3D printed cardiac models for medical student education in congenital heart disease: Across a spectrum of disease severity. Pediatr Cardiol, 2019, 40(6): 1258-1265.
24. Hussein N, Honjo O, Haller C, et al. Quantitative assessment of technical performance during hands-on surgical training of the arterial switch operation using 3-dimensional printed heart models. J Thorac Cardiovasc Surg, 2020, 160(4): 1035-1042.
25. Awori J, Friedman SD, Chan T, et al. 3D models improve understanding of congenital heart disease. 3D Print Med, 2021, 7(1): 26.
26. Hon NWL, Hussein N, Honjo O, et al. Evaluating the impact of medical student inclusion into hands-on surgical simulation in congenital heart surgery. J Surg Educ, 2021, 78(1): 207-213.
27. Nam JG, Lee W, Jeong B, et al. Three-dimensional printing of congenital heart disease models for cardiac surgery simulation: Evaluation of surgical skill improvement among inexperienced cardiothoracic surgeons. Korean J Radiol, 2021, 22(5): 706-713.
28. Valverde I, Gomez G, Byrne N, et al. Criss-cross heart three-dimensional printed models in medical education: A multicenter study on their value as a supporting tool to conventional imaging. Anat Sci Educ, 2022, 15(4): 719-730.
29. Brunner BS, Thierij A, Jakob A, et al. 3D-printed heart models for hands-on training in pediatric cardiology—The future of modern learning and teaching? GMS J Med Educ, 2022, 39(2): Doc23.
30. Alsuwaidi L, Kristensen J, Hk A, et al. Use of simulation in teaching haematological aspects to undergraduate medical students improves student's knowledge related to the taught theoretical underpinnings. BMC Med Educ, 2021, 21(1): 271.
31. Wang S, Ren X, Ye J, et al. Exploration of simulation-based medical education for undergraduate students. Medicine (Baltimore), 2021, 100(20): e25982.
32. Yu JH, Chang HJ, Kim SS, et al. Effects of high-fidelity simulation education on medical students' anxiety and confidence. PLoS One, 2021, 16(5): e0251078.
33. Valverde I. Three-dimensional printed cardiac models: Applications in the field of medical education, cardiovascular surgery, and structural heart interventions. Rev Esp Cardiol (Engl Ed), 2017, 70(4): 282-291.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of 3D-printed heart model on congenital heart disease education: A systematic review and meta-analysis

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