Esta revisão sistemática foi conduzida de acordo com os itens do Preferred Reporting for Systematic Reviews e registrada no banco de dados Prospero (Registro Prospectivo Internacional de Revisão Sistemática) sob o número CRD42017059034. Foram utilizados os seguintes bancos de dados: PubMed, Embase, Scopus, Web of Science e Lilacs. Incluídos artigos com os termos de busca “Heart Valves”, “Heart Valve Prosthesis Implantation”, “Heart Valve Prosthesis”, “Printing, Three-Dimensional” e termos relacionados. Dois revisores independentes conduziram a extração dos dados e um terceiro (revisor) solucionou as discordâncias. Todas as tabelas usadas para a extração de dados estão disponibilizadas em site próprio. A ferramenta Cochraine Collaboration foi utilizada para avaliar o risco de viés na inclusão de estudos.

RESULTADOS:

Identificados 301 artigos e 13 relatos de casos e séries de casos que atenderam aos critérios de inclusão. A amostra envolveu 34 pacientes, com idade de 3 meses a 94 anos.

CONCLUSÃO:

Até o presente momento, não há estudos que contemplem um número considerável de pacientes. A impressão de um modelo 3D produzida a partir do protótipo do paciente permitirá ao cirurgião planejar a cirurgia, bem como escolher o melhor material, tamanho, formato e espessura da válvula a ser utilizada. Esse planejamento reduz o tempo de cirurgia, a exposição e, consequentemente, a redução do risco de infecção.

PALAVRAS-CHAVE:
Valvas cardíacas; Impressão tridimensional; Procedimentos cirúrgicos cardiovasculares

Study, Year	Country	Study design	Number of subjects	Age	Gender	Basic Diseases	Type of valve
Duan et al.¹¹11. Duan B, Hockaday LA, Kang KH, Butcher JT. 3D bioprinting of heterogeneous aortic valve conduits with alginate/gelatin hydrogels. J Biomed Mater Res A. 2013;101(5):1255-64./2013	USA	Case report	1	12	male	Congenital malformations	Aortic valve
Dankowski et al.¹²12. Dankowski R, Baszko A, Sutherland M, Firek L, Kałmucki P, Wróblewska K, et al. 3D heart model printing for preparation of percutaneous structural interventions: description of the technology and case report. Kardiol Pol. 2014;72(6):546-51./2014	Poland	Case study	1	41	male	Dilated cardiomyopathy	Mitral valve
Little et al.¹³13. Little SH, Vukicevic M, Avenatti E, Ramchandani M, Barker CM. 3D printed modeling for patient-specific mitral valve intervention: repair with a clip and a plug. JACC Cardiovasc Interv. 2016;9(9):973-5./2016	USA	Case report	1	62	male	Bacterial endocarditis	Mitral valve
Vukicevic et al.¹⁴14. Vukicevic M, Puperi DS, Jane Grande-Allen K, Little SH. 3D printed modeling of the mitral valve for catheter-based structural interventions. Ann Biomed Eng. 2017;45(2):508-19./2017	USA	Case report	2			1-Mitral valve regurgitation 2- Tissue infection	Mitral valve
Gallo et al.¹⁵15. Gallo M, D’Onofrio A, Tarantini G, Nocerino E, Remondino F, Gerosa G. 3D-printing model for complex aortic transcatheter valve treatment. Int J Cardiol. 2016;210:139-40./2016	Italy	Case report	1	79		Hypertension, diabetes mellitus, chronic kidney disease, dyslipidemia, atrial fibrillation, epilepsy, thalassemia minor, and monoclonal gammopathy	Aortic valve
Maragiannis et al.¹⁶16. Maragiannis D, Jackson MS, Igo SR, Schutt RC, Connell P, Grande-Allen J, et al. Replicating patient-specific severe aortic valve stenosis with functional 3D modeling. Circ Cardiovasc Imaging. 2016;8(10):e003626./2016	USA	Case report	8	84, 92, 94, 70, 91, 64, 81, 55	5- male 3- female	Severe degenerative aortic stenosis	6-Tricuspid and 2-Mitral valve
Sodian et al.¹⁷17. Sodian R, Schmauss D, Markert M, Weber S, Nikolaou K, Haeberle S, et al. Three-dimensional printing creates models for surgical planning of aortic valve replacement after previous coronary bypass grafting. Ann Thorac Surg. 2008;85(6):2105-8./2008	Germany	Case report	1	81	female	Aortic valve stenosis, after coronary artery bypass grafting (CABG)	Aortic valve
Bauch et al.¹⁸18. Bauch T, Vijayaraman P, Dandamudi G, Ellenbogen K. Three-dimensional printing for in vivo visualization of his bundle pacing leads. Am J Cardiol. 2015;116(3):485-6./2015	USA	Case report	2			Atrial fibrillation	Tricuspid valve
Schmauss et al.¹⁹19. Schmauss D, Haeberle S, Hagl C, Sodian R. Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience. Eur J Cardiothorac Surg. 2015;47(6):1044-52./2015	Germany	Case report	8	16, 3m, 2, 14, 81, 43, 50, 70	4- female, 4- male	1-Congenital malformations 2- Congenital malformations 3- Congenital malformations 4- Congenital malformations 5- Aortic stenosis 6- Heart insufficiency 7- HIV, a type A Aortic dissection 8- Aortic valve stenosis, calcified ascending aorta	Aortic valve
Fujita et al.²⁰20. Fujita T, Saito N, Minakata K, Imai M, Yamazaki K, Kimura T. Transfemoral transcatheter aortic valve implantation in the presence of a mechanical mitral valve prosthesis using a dedicated TAVI guidewire: utility of a patient-specific three-dimensional heart model. Cardiovasc Interv Ther. 2017;32(3):308-11./2017	Japan	Case report	1	82	female	Previously undergone mitral valve replacement	Aortic valve
Jacobs et al.²¹21. Jacobs S, Grunert R, Mohr FW, Falk V. 3D-imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg. 2008;7(1):6-9./ 2008	Germany	Case report	3	50, 81, 50	2- female, 1- male	Malignant tumor and ventricular aneurysm	Mitral and Tricuspid valve
Kim et al.²²22. Kim MS, Hansgen AR, Wink O, Quaife RA, Carroll JD. Rapid prototyping a new tool in understanding and treating structural heart disease. Circulation. 2008;117(18):2388-94./ 2008	USA	Case report	4	30, 50, 72, 69	1- female, 3- male	Congenital VSD Atrial septal aneurysm Periprosthetic valvular defect. Thoracic aortic pseudoaneurysm	Aortic and Mitral valve
Hadeed et al.²³23. Hadeed K, Dulac Y, Acar P. Three-dimensional printing of a complex CHD to plan surgical repair. Cardiol Young. 2016;26(7):1432-4./ 2016	France	Case report	1	5m		Congenital malformations (systolic heart murmur)

Study, Year	Imaging Modality / Technique	Printer details	Manufacturing material	Endpoints of printers
Duan et al.¹¹11. Duan B, Hockaday LA, Kang KH, Butcher JT. 3D bioprinting of heterogeneous aortic valve conduits with alginate/gelatin hydrogels. J Biomed Mater Res A. 2013;101(5):1255-64./2013	Computed tomography	Micro-CT (GE eXplore CT120; GE Health Care, Milwaukee, WI) at 100 μm resolution, 80keV, 30 mA, 800 angles, 30 ms exposure time, 30 gain, and 20 offset.30	Alginate/gelatin hydrogel	Living aortic valve conduits with anatomical resemblance to the native valve based on alginate/gelatin hydrogel system
Dankowski et al.¹²12. Dankowski R, Baszko A, Sutherland M, Firek L, Kałmucki P, Wróblewska K, et al. 3D heart model printing for preparation of percutaneous structural interventions: description of the technology and case report. Kardiol Pol. 2014;72(6):546-51./2014	Multi-slice computed tomography (MSCT)	3D printing as a clinically applicable heart modeling technology	Rubber-like urethane
Little et al.¹³13. Little SH, Vukicevic M, Avenatti E, Ramchandani M, Barker CM. 3D printed modeling for patient-specific mitral valve intervention: repair with a clip and a plug. JACC Cardiovasc Interv. 2016;9(9):973-5./ 2016	Echocardiography and tomography	A multimaterial patient-specific 3D model	Multimaterial TangoPlus	Replicate the mitral valve leaflet geometry, regional calcium deposition (yellow) and pathology.
Vukicevic et al.¹⁴14. Vukicevic M, Puperi DS, Jane Grande-Allen K, Little SH. 3D printed modeling of the mitral valve for catheter-based structural interventions. Ann Biomed Eng. 2017;45(2):508-19./2017	Clinical 3D transesophageal echocardiography and computed tomography	Multi-material 3D printing technology and addition 3D TEE	Multi-material, TangoPlus-Shore 3	Specific mitral leaflet geometry and the mitral valve apparatus can be digitally reconstructed from currently available clinical imaging tools
Gallo et al.¹⁵15. Gallo M, D’Onofrio A, Tarantini G, Nocerino E, Remondino F, Gerosa G. 3D-printing model for complex aortic transcatheter valve treatment. Int J Cardiol. 2016;210:139-40./2016	A 64-row multi-detector computed tomography (MDCT)	Three-dimensional (3D) model	Stereolithography	Was useful to rule out the risk of occlusion of the brachiocephalic trunk during the stent-valve deployment and is a useful tool to plan complex transcatheter
Maragiannis et al.¹⁶16. Maragiannis D, Jackson MS, Igo SR, Schutt RC, Connell P, Grande-Allen J, et al. Replicating patient-specific severe aortic valve stenosis with functional 3D modeling. Circ Cardiovasc Imaging. 2016;8(10):e003626./2016	ECG-gated and 64-slice multi-detector CT	Multimaterial 3D printed	The rubber-like material TangoPlus	Replicate the anatomic and functional properties of severe degenerative aortic valve stenosis.
Sodian et al.¹⁷17. Sodian R, Schmauss D, Markert M, Weber S, Nikolaou K, Haeberle S, et al. Three-dimensional printing creates models for surgical planning of aortic valve replacement after previous coronary bypass grafting. Ann Thorac Surg. 2008;85(6):2105-8./2008	128-slice computed tomography	3D printing techniques	Stereolithographic model, Stereolithographic prototyping	Proving benefit in complex anatomy
Bauch et al.¹⁸18. Bauch T, Vijayaraman P, Dandamudi G, Ellenbogen K. Three-dimensional printing for in vivo visualization of his bundle pacing leads. Am J Cardiol. 2015;116(3):485-6./2015	Computed tomography (CT)64 slice	Three- dimensional (3D) printing technology	Poly-actic acid filament	Research to minimize detrimental interactions between permanent pacing leads(His) and the tricuspid valve apparatus
Schmauss et al.¹⁹19. Schmauss D, Haeberle S, Hagl C, Sodian R. Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience. Eur J Cardiothorac Surg. 2015;47(6):1044-52./2015	CT 64 or 128 slices or MRI scans	3D printing models in collaboration with the Institute of Micro-Technology and Medical Device Technology,	A starch/cellulose powder (zp 15e) bound with polymer (zb 60). Using different types of material enables the production of rigid and flexible parts.	Perioperative planning and simulation in a variety of complex cases in pediatric and adult cardiac surgery
Fujita et al.²⁰20. Fujita T, Saito N, Minakata K, Imai M, Yamazaki K, Kimura T. Transfemoral transcatheter aortic valve implantation in the presence of a mechanical mitral valve prosthesis using a dedicated TAVI guidewire: utility of a patient-specific three-dimensional heart model. Cardiovasc Interv Ther. 2017;32(3):308-11./2017	Multislice computed tomography (MSCT)	3D reconstruction of computed tomography image.	Stereolithography	Simulation was performed using a patient-specific heart prototype to evaluate the safety and efficacy of TAVI guidewire use.
Jacobs et al.²¹21. Jacobs S, Grunert R, Mohr FW, Falk V. 3D-imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg. 2008;7(1):6-9./ 2008	Computer tomography (CT) and magnetic resonance imaging (MRI) images	3-dimensional (3D) printed multi-material	Plaster model	Planning and improved orientation to resection of ventricular aneurysm and malignant cardiac tumors may facilitate the surgical procedure due to better.
Kim et al.²²22. Kim MS, Hansgen AR, Wink O, Quaife RA, Carroll JD. Rapid prototyping a new tool in understanding and treating structural heart disease. Circulation. 2008;117(18):2388-94./ 2008	Multidetector CT	3D image processing software.	Polymerization of a photosensitive resin	Plan the operative approach for a 2.5-year-old child with single ventricle and single AV valve
Hadeed et al.²³23. Hadeed K, Dulac Y, Acar P. Three-dimensional printing of a complex CHD to plan surgical repair. Cardiol Young. 2016;26(7):1432-4./ 2016	Multi-detector-CT using 64-slice	Printed using a three-dimensional printer with HeartPrint® flex material (Materialise).	Flex material (Materialise)	Allows better understanding regard to size, position of ventricular septal defect, and its relationships with the great arteries.

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

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[1] CORRESPONDING AUTHOR: Silvia Goldmeier, Institute of Cardiology / University Foundation of Cardiology, Av. Princesa Isabel, 370 – Porto Alegre, RS / Brasil – Telephone and fax number: (51) 3230-3600 E-mail: silvia.gold@cardiologia.org.br