Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease

Özet

PURPOSEThis study was planned to assess the application of three-dimensional (3D) cardiac modelingin preoperative evaluation for complex congenital heart surgeries.METHODSFrom July 2015 to September 2019, 18 children diagnosed with complex congenital heartdiseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients,complex types of transposition of the great arteries in six patients, congenitally correctedtransposition of the great arteries in two patients, and univentricular heart in one patient).The patients’ age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT)data. Using each patient’s data, a virtual computer model (3D mesh) and stereolithographic(SLA) file that would be printed as a 3D model were generated. These 3D cardiac models wereused to gather additional data about cardiac anatomy for presurgical decision-making.RESULTSAll 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases(33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstructionremoval and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defectand great vessels, and they help surgeons identify risk structures more clearly for detailedplanning of surgery. There was a strong correlation between the models of the patients andthe anatomy encountered during the operation.CONCLUSION3D cardiac models accurately reveal the patient’s anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy.