Patient-Specific 3D Printing of Mitral Para-valvular Leaks Derived from 3D Transesophageal Echocardiography: A Narrative Review

Abstract

Paravalvular leak (PVL) of the mitral prosthetic valve is a significant postoperative complication that arises when there is incomplete sealing between the prosthetic valve and the native annular tissue. Depending on the severity, it may lead to heart failure symptoms, haemolysis, and increased morbidity. Therefore, precise anatomical assessment is necessary for the best possible care. Since three-dimensional transoesophageal echocardiography (3D TEE) offers comprehensive details about the defects, including their location, geometry, size, and spatial relationship to neighbouring cardiac structures, it has emerged as the ideal imaging method for evaluating mitral PVL.Recent developments in three-dimensional printing technology have enabled the transformation of 3D TEE imaging datasets into patient-specific physical models. These models provide a realistic representation of complex paravalvular anatomy, allowing clinicians to better understand defect morphology and plan interventions more effectively. The use of 3D-printed models has demonstrated particular value in pre-procedural planning for transcatheter paravalvular leak closure, facilitating device selection, procedural simulation, and anticipation of technical challenges. In addition, these models enhance multidisciplinary communication and support patient counselling.Despite its potential, the widespread adoption of 3D printing is still constrained by issues including cost, processing time, and a lack of established standards. This narrative review highlights the role of 3D TEE in imaging mitral PVL, outlines the workflow for converting imaging data into printable models, and discusses the clinical benefits, current limitations, and future directions of 3D printing in the management of mitral paravalvular leaks.