Israel Valverde1,2,3,4, Gorka Gomez-Ciriza1, Tarique Hussain3,5, Cristina Suarez-Mejias1, Maria N Velasco-Forte3,4, Nicholas Byrne3, Antonio Ordoñez2, Antonio Gonzalez-Calle1, David Anderson3,4, Mark G Hazekamp6, Arno A W Roest6, Jose Rivas-Gonzalez1, Sergio Uribe7, Issam El-Rassi8, John Simpson3,4, Owen Miller3,4, Enrique Ruiz9, Ignacio Zabala9, Ana Mendez10, Begoña Manso1, Pastora Gallego1, Freddy Prada11, Massimiliano Cantinotti12, Lamia Ait-Ali12, Carlos Merino13, Andrew Parry14, Nancy Poirier10, Gerald Greil3,5, Reza Razavi3,4, Tomas Gomez-Cia1, Amir-Reza Hosseinpour1. 1. Paediatric Cardiology, Cardiothoracic Surgery and Technological Innovation Group, Hospital Virgen del Rocio, Seville, Spain. 2. Cardiovascular Pathology Unit, Institute of Biomedicine of Seville (IBIS), CIBER-CV, Hospital Virgen de Rocio/CSIC/University of Seville, Seville, Spain. 3. Division of Imaging Sciences and Biomedical Engineering, King's College London, The Rayne Institute, St. Thomas' Hospital, London, UK. 4. Department of Congenital Heart Disease, Evelina London Children's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK. 5. Children's Health CMC Dallas and UT Southwestern, Dallas, TX, USA. 6. Department of Paediatric Cardiology and Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands. 7. Radiology Department and Biomedical Imaging Center, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile. 8. Children's Heart Center, American University of Beirut AUBMC, Beirut, Lebanon. 9. Paediatric Cardiology Unit, Hospital Regional Universitario Malaga, Malaga, Spain. 10. Division of Paediatric Cardiology, Department of Paediatrics, Sainte-Justine University Hospital Center, Montreal, QC, Canada. 11. Paediatric Cardiology Unit, Hospital Sant Joan de Deu, Barcelona, Spain. 12. Fondazione G. Monasterio and Institute of Clinical Physiology, CNR-Regione Toscana, Pisa, Italy. 13. Paediatric Cardiology Unit, Hospital Reina Sofía, Córdoba, Spain. 14. Congenital Cardiac Surgery Unit, Bristol Children Hospital, Bristol, UK.
Abstract
OBJECTIVES: To evaluate the impact of 3D printed models (3D models) on surgical planning in complex congenital heart disease (CHD). METHODS: A prospective case-crossover study involving 10 international centres and 40 patients with complex CHD (median age 3 years, range 1 month-34 years) was conducted. Magnetic resonance imaging and computed tomography were used to acquire and segment the 3D cardiovascular anatomy. Models were fabricated by fused deposition modelling of polyurethane filament, and dimensions were compared with medical images. Decisions after the evaluation of routine clinical images were compared with those after inspection of the 3D model and intraoperative findings. Subjective satisfaction questionnaire was provided. RESULTS: 3D models accurately replicate anatomy with a mean bias of -0.27 ± 0.73 mm. Ninety-six percent of the surgeons agree or strongly agree that 3D models provided better understanding of CHD morphology and improved surgical planning. 3D models changed the surgical decision in 19 of the 40 cases. Consideration of a 3D model refined the planned biventricular repair, achieving an improved surgical correction in 8 cases. In 4 cases initially considered for conservative management or univentricular palliation, inspection of the 3D model enabled successful biventricular repair. CONCLUSIONS: 3D models are accurate replicas of the cardiovascular anatomy and improve the understanding of complex CHD. 3D models did not change the surgical decision in most of the cases (21 of 40 cases, 52.5% cases). However, in 19 of the 40 selected complex cases, 3D model helped redefining the surgical approach.
RCT Entities:
OBJECTIVES: To evaluate the impact of 3D printed models (3D models) on surgical planning in complex congenital heart disease (CHD). METHODS: A prospective case-crossover study involving 10 international centres and 40 patients with complex CHD (median age 3 years, range 1 month-34 years) was conducted. Magnetic resonance imaging and computed tomography were used to acquire and segment the 3D cardiovascular anatomy. Models were fabricated by fused deposition modelling of polyurethane filament, and dimensions were compared with medical images. Decisions after the evaluation of routine clinical images were compared with those after inspection of the 3D model and intraoperative findings. Subjective satisfaction questionnaire was provided. RESULTS: 3D models accurately replicate anatomy with a mean bias of -0.27 ± 0.73 mm. Ninety-six percent of the surgeons agree or strongly agree that 3D models provided better understanding of CHD morphology and improved surgical planning. 3D models changed the surgical decision in 19 of the 40 cases. Consideration of a 3D model refined the planned biventricular repair, achieving an improved surgical correction in 8 cases. In 4 cases initially considered for conservative management or univentricular palliation, inspection of the 3D model enabled successful biventricular repair. CONCLUSIONS: 3D models are accurate replicas of the cardiovascular anatomy and improve the understanding of complex CHD. 3D models did not change the surgical decision in most of the cases (21 of 40 cases, 52.5% cases). However, in 19 of the 40 selected complex cases, 3D model helped redefining the surgical approach.
Authors: Gorka Gomez; Montserrat Baeza; Juan Carlos Mateos; Jose Antonio Rivas; Florencio Javier Luis Simon; Diego Mesta Ortega; María de Los Ángeles Flores Carrión; Eleonor Rivin Del Campo; Tomas Gómez-Cía; Jose Luis Lopez Guerra Journal: Rep Pract Oncol Radiother Date: 2021-04-14
Authors: Gorka Gómez-Ciriza; Tomás Gómez-Cía; José Antonio Rivas-González; Mari Nieves Velasco Forte; Israel Valverde Journal: Front Cardiovasc Med Date: 2021-06-04