**Recent Applications of Three Dimensional Printing in Cardiovascular Medicine**

**Chiara Gardin 1,2, Letizia Ferroni 1,2, Christian Latremouille 3, Juan Carlos Chachques 3, Dinko Mitreˇci´c <sup>4</sup> and Barbara Zavan 1,2,\***


Received: 30 January 2020; Accepted: 9 March 2020; Published: 17 March 2020

**Abstract:** Three dimensional (3D) printing, which consists in the conversion of digital images into a 3D physical model, is a promising and versatile field that, over the last decade, has experienced a rapid development in medicine. Cardiovascular medicine, in particular, is one of the fastest growing area for medical 3D printing. In this review, we firstly describe the major steps and the most common technologies used in the 3D printing process, then we present current applications of 3D printing with relevance to the cardiovascular field. The technology is more frequently used for the creation of anatomical 3D models useful for teaching, training, and procedural planning of complex surgical cases, as well as for facilitating communication with patients and their families. However, the most attractive and novel application of 3D printing in the last years is bioprinting, which holds the great potential to solve the ever-increasing crisis of organ shortage. In this review, we then present some of the 3D bioprinting strategies used for fabricating fully functional cardiovascular tissues, including myocardium, heart tissue patches, and heart valves. The implications of 3D bioprinting in drug discovery, development, and delivery systems are also briefly discussed, in terms of in vitro cardiovascular drug toxicity. Finally, we describe some applications of 3D printing in the development and testing of cardiovascular medical devices, and the current regulatory frameworks that apply to manufacturing and commercialization of 3D printed products.

**Keywords:** 3D printing; 3D model; bioprinting; cardiovascular medicine; heart; myocardium; heart valves
