Swati Garekar1, Alpa Bharati2, Manish Chokhandre3, Shivaji Mali3, Bhadra Trivedi3, Vishal P Changela3, Narayan Solanki4, Sarang Gaikwad3, Vijay Agarwal3. 1. Division of Pediatric Cardiology, Fortis Child Heart Mission, Fortis Hospital, Mumbai, India swatigar@gmail.com swati.garekar@fortishealthcare.com. 2. Department of Radiology, LTMG Hospital, Sion, Mumbai, India Department of Radiology, NM Medical Centre, Mumbai, India. 3. Division of Pediatric Cardiology, Fortis Child Heart Mission, Fortis Hospital, Mumbai, India. 4. Department of Radiology, LTMG Hospital, Sion, Mumbai, India.
Abstract
BACKGROUND: Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventricular septal defect (VSD) may present a therapeutic challenge. Echocardiographic imaging of such complex cases does not always provide all of the information required to decide on an operative approach (biventricular or univentricular) and to design an intracardiac baffle to direct left ventricular outflow through the VSD and to the aorta for biventricular repair. A three dimensional (3D) printed model of the heart based upon data derived from computed tomography (CT) or magnetic resonance imaging (MRI) may contribute to a more complete appreciation of the intracardiac anatomy. METHODS: From April to September 2015, six consecutive patients with DORV and remote VSD underwent CT/MRI scans. Data sets from these studies were used to generate life-size 3D models using a 3D printer. We compared the assessment of 3D printed heart model findings with information obtained from echocardiography, CT, or cardiac MRI and with details of the surgeon's intraoperative direct observations when available. Quantification of the information provided by the 3D model was achieved using a unique scale that was created for the purpose of this study. The accuracy and utility of information derived preoperatively from the models were assessed. RESULTS: Six data sets from six patients were analyzed. Five data sets could be successfully used to create sandstone models using 3D printing. The five patients ranged from 7 months to 11 years of age and weighed 6.7 to 26 kg. The spatial orientation of the heart in the thorax, the relationships of the great arteries and the semilunar valves, the size and location of the VSD were well appreciated in all models, as were the anticipated dimensions and orientation of a surgically planned interventricular baffle. Three of the five patients underwent successful biventricular repair. CONCLUSION: The 3D printed models scored higher than conventional imaging, with respect to most aspects of the surface spatial orientation and intracardiac anatomy. The models are a useful adjunct in preoperative assessment of complex DORV. The unique scale helps quantify the advantages and limitations of the 3D heart models.
BACKGROUND: Double outlet right ventricle (DORV) with two well-developed ventricles and with a remote ventricular septal defect (VSD) may present a therapeutic challenge. Echocardiographic imaging of such complex cases does not always provide all of the information required to decide on an operative approach (biventricular or univentricular) and to design an intracardiac baffle to direct left ventricular outflow through the VSD and to the aorta for biventricular repair. A three dimensional (3D) printed model of the heart based upon data derived from computed tomography (CT) or magnetic resonance imaging (MRI) may contribute to a more complete appreciation of the intracardiac anatomy. METHODS: From April to September 2015, six consecutive patients with DORV and remote VSD underwent CT/MRI scans. Data sets from these studies were used to generate life-size 3D models using a 3D printer. We compared the assessment of 3D printed heart model findings with information obtained from echocardiography, CT, or cardiac MRI and with details of the surgeon's intraoperative direct observations when available. Quantification of the information provided by the 3D model was achieved using a unique scale that was created for the purpose of this study. The accuracy and utility of information derived preoperatively from the models were assessed. RESULTS: Six data sets from six patients were analyzed. Five data sets could be successfully used to create sandstone models using 3D printing. The five patients ranged from 7 months to 11 years of age and weighed 6.7 to 26 kg. The spatial orientation of the heart in the thorax, the relationships of the great arteries and the semilunar valves, the size and location of the VSD were well appreciated in all models, as were the anticipated dimensions and orientation of a surgically planned interventricular baffle. Three of the five patients underwent successful biventricular repair. CONCLUSION: The 3D printed models scored higher than conventional imaging, with respect to most aspects of the surface spatial orientation and intracardiac anatomy. The models are a useful adjunct in preoperative assessment of complex DORV. The unique scale helps quantify the advantages and limitations of the 3D heart models.
Authors: Abdallah El Sabbagh; Mackram F Eleid; Mohammed Al-Hijji; Nandan S Anavekar; David R Holmes; Vuyisile T Nkomo; Gustavo S Oderich; Stephen D Cassivi; Sameh M Said; Charanjit S Rihal; Jane M Matsumoto; Thomas A Foley Journal: Curr Cardiol Rep Date: 2018-05-10 Impact factor: 2.931
Authors: Ramtin Gharleghi; Claire A Dessalles; Ronil Lal; Sinead McCraith; Kiran Sarathy; Nigel Jepson; James Otton; Abdul I Barakat; Susann Beier Journal: Ann Biomed Eng Date: 2021-05-17 Impact factor: 3.934