Three-dimensional printed models for surgical planning of complex congenital heart defects: An international multicentre study

Israel Valverde*, Gorka Gomez-Ciriza, Tarique Hussain, Cristina Suarez-Mejias, Maria N. Velasco-Forte, Nicholas Byrne, Antonio Ordoñez, Antonio Gonzalez-Calle, David Anderson, Mark G. Hazekamp, Arno A.W. Roest, Jose Rivas-Gonzalez, Sergio Uribe, Issam El-Rassi, John Simpson, Owen Miller, Enrique Ruiz, Ignacio Zabala, Ana Mendez, Begoña MansoPastora Gallego, Freddy Prada, Massimiliano Cantinotti, Lamia Ait-Ali, Carlos Merino, Andrew Parry, Nancy Poirier, Gerald Greil, Reza Razavi, Tomas Gomez-Cia, Amir Reza Hosseinpour

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

113 Citations (Scopus)

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

Original languageEnglish
Pages (from-to)1139-1148
Number of pages10
JournalEuropean Journal of Cardio-thoracic Surgery
Volume52
Issue number6
DOIs
Publication statusPublished - Dec 2017
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Keywords

  • 3D printing
  • Congenital heart defects
  • Imaging
  • Medical computer-aided design
  • Surgery

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