Diagnostic and Interventional Radiology
Cardiovascular Imaging - Original Article

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

1.

Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey

2.

Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey

3.

Department of Biomedical Engineering, Koç University, Istanbul, Turkey

Diagn Interv Radiol 2021; 27: 488-496
DOI: 10.5152/dir.2021.20163
Read: 486 Downloads: 97 Published: 29 June 2021

PURPOSE 
This study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries.

METHODS
From July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (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 corrected transposition 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 were used to gather additional data about cardiac anatomy for presurgical decision-making.

RESULTS
All 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 obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation.

CONCLUSION
3D cardiac models accurately reveal the patient’s anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy.

You may cite this article as: Yıldız O, Köse B, Tanıdır İC, Pekkan K, Güzeltaş A, Haydin S. Single-center experience with routine clinical use of 3D technologies in surgical planning for pediatric patients with complex congenital heart disease. Diagn Interv Radiol 2021; 27:488-496

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