3D printed cardiovascular models for surgical planning in complex congenital heart diseases

Abstract

Purpose: To explore the use of 3D patient-specific cardiovascular models using rapid prototyping techniques to avoid unexpected findings and improve surgical planning in patients with complex congenital heart disease Methods: This European prospective multi center (7 institutions) study included 21 patients with complex congenital heart diseases. Magnetic resonance imaging (MRI) and computed tomography (CT) were used to acquire 3D cardiovascular anatomy. Fused deposition technique using polylactic acid was used. A Bland-Altman analysis was used to evaluate the diameters measurement agreement between the 3D printed model and the patient's MRI and CT. 3D-models were used to plan the surgery. After the procedure, surgeons involved filled a questionnaire form to evaluate the usefulness of the 3D printed model. Results: The Bland-Altman analysis showed accurate agreement in the diameter between medical images and 3D-models (-0.20±1.70 mm). 3D-models showed the spatial relationships between the VSD and great vessels in 10 patients with DORV and 3 patients with TGA and pulmonary stenosis, re-appraisal for biventricular repair in 2 cases, planning of lateral tunnel Font an completion in 2 cases, re-opening of a restrictive VSD in 1 case, evaluation of MAPCA's in 1 case and evaluation of criss-cross heart anatomy in 2 cases. Surgeons found the 3D models to be very useful for surgical planning and avoiding complications with an overall level of satisfaction of 8.5 out of 10. Conclusions: 3D-printed cardiovascular models accurately replicate the patient's anatomy and are extremely helpful for planning surgery in complex congenital heart disease. They may potentially reduce operative time and morbi-mortality. (Figure Presented).