Advancing Surgical Arrhythmia Ablation: Novel Insights on 3D Printing Applications and Two Biocompatible Materials
 
Advancing Surgical Arrhythmia Ablation: Novel Insights on 3D Printing Applications and Two Biocompatible Materials 
 
Cinzia Monaco, Cinzia Monaco, Rani Kronenberger, Rani Kronenberger, Giacomo Talevi, Giacomo Talevi, Luigi Pannone, Luigi Pannone, Ida Anna Cappello, Ida Anna Cappello, Mara Candelari, Mara Candelari, Robbert Ramak, Robbert Ramak, Domenico Giovanni Della Rocca, Domenico Giovanni Della Rocca, Edoardo Bori, Edoardo Bori, Herman Terryn, Herman Terryn, Kitty Baert, Kitty Baert, Priya Laha, Priya Laha, Ahmet Krasniqi, Ahmet Krasniqi, Ali Gharaviri, Ali Gharaviri, Gezim Bala, Gezim Bala, Gian Battista Chierchia, Gian Battista Chierchia, Mark La Meir, Mark La Meir, Bernardo Innocenti, Bernardo Innocenti, Carlo de Asmundis, Carlo de Asmundis
 
Abstract 

To date, studies assessing the safety profile of 3D printing materials for application in cardiac ablation are sparse. Our aim is to evaluate the safety and feasibility of two biocompatible 3D printing materials, investigating their potential use for intra-procedural guides to navigate surgical cardiac arrhythmia ablation. Herein, we 3D printed various prototypes in varying thicknesses (0.8 mm-3 mm) using a resin (MED625FLX) and a thermoplastic polyurethane elastomer (TPU95A). Geometrical testing was performed to assess the material properties pre- and post-sterilization. Furthermore, we investigated the thermal propagation behavior beneath the 3D printing materials during cryo-energy and radiofrequency ablation using an in vitro wet-lab setup. Moreover, electron microscopy and Raman spectroscopy were performed on biological tissue that had been exposed to the 3D printing materials to assess microparticle release. Post-sterilization assessments revealed that MED625FLX at thicknesses of 1 mm, 2.5 mm, and 3 mm, along with TPU95A at 1 mm and 2.5 mm, maintained geometrical integrity. Thermal analysis revealed that material type, energy source, and their factorial combination with distance from the energy source significantly influenced the temperatures beneath the 3D-printed material. Electron microscopy revealed traces of nitrogen and sulfur underneath the MED625FLX prints (1 mm, 2.5 mm) after cryo-ablation exposure. The other samples were uncontaminated. While Raman spectroscopy did not detect material release, further research is warranted to better understand these findings for application in clinical settings.