Abstract
Our goal was to construct three-dimensional (3D) virtual models to allow simultaneous visualization of the ventricles, ventricular septal defect (VSD) and great arteries in patients with complex intracardiac anatomy to aid in surgical planning. We also sought to correlate measurements from the source cardiac magnetic resonance (CMR) image dataset and the 3D model. Complicated ventriculo-arterial relationships in patients with complex conotruncal malformations make preoperative assessment of possible repair pathways difficult. Patients were chosen with double outlet right ventricle for the complexity of intracardiac anatomy and potential for better delineation of anatomic spatial relationships. Virtual 3D models were generated from CMR 3D datasets. Measurements were made on the source CMR as well as the 3D model for the following structures: aortic diameter in orthogonal planes, VSD diameter in orthogonal planes and long axis of right ventricle. A total of six patients were identified for inclusion. The path from the ventricles to each respective outflow tract and the location of the VSD with respect to each great vessel was visualized clearly in all patients. Measurements on the virtual model showed excellent correlation with the source CMR when all measurements were included by Pearson coefficient, r = 0.99 as well as for each individual structure. Construction of virtual 3D models in patients with complex conotruncal defects from 3D CMR datasets allows for simultaneous visualization of anatomic relationships relevant for surgical repair. The availability of these models may allow for a more informed preoperative evaluation in these patients.
Similar content being viewed by others
References
Bash SE, Huhta JC, Vick GWI, Gutgesell HP, Ott DA (1986) Hypoplastic left heart syndrome: is echocardiography accurate enough to guide surgical palliation? J Am Coll Cardiol 7:610–616
Huhta JC, Glasow P, Murphy DJJ et al (1987) Surgery without catheterization for congenital heart defects: management of 100 patients. J Am Coll Cardiol 9:823–829
Pfammatter JP, Berdat P, Hammerli M, Carrel T (2000) Pediatric cardiac surgery after exclusively echocardiography-based diagnostic work-up. Int J Cardiol 74:185–190
Sharma S, Anand R, Kanter KR et al (1992) The usefulness of echocardiography in the surgical management of infants with congenital heart disease. Clin Cardiol 15:891–897
Tworetzky W, McElhinney DB, Brook MM, Reddy VM, Hanley FL, Silverman NH (1999) Echocardiographic diagnosis alone for the complete repair of major congenital heart defects. J Am Coll Cardiol 33:228–233
Van Praagh R (1977) Terminology of congenital heart disease. Gloss Comment Circ 56(2):139–143
Serraf A, Nakamura T, Lacour-Gayet F et al (1996) Surgical approaches for double-outlet right ventricle or transposition of the great arteries associated with straddling atrioventricular valves. J Thorac Cardiovasc Surg 111(3):527–535
Bradley TJ, Karamlou T, Kulik A et al (2007) Determinants of repair type, reintervention, and mortality in 393 children with double-outlet right ventricle. J Thorac Cardiovasc Surg 134(4):967–973
Brown JW, Ruzmetov M, Okada Y, Vijay P, Turrentine MW (2001) Surgical results in patients with double outlet right ventricle: a 20-year experience. Ann Thorac Surg 72(5):1630–1635
Sodian R, Weber S, Markert M et al (2007) Stereolithographic models for surgical planning in congenital heart surgery. Ann Thorac Surg 83(5):1854–1857
Binder TM, Moertl D, Mundigler G et al (2000) Stereolithographic biomodeling to create tangible hard copies of cardiac structures from echocardiographic data: in vitro and in vivo validation. J Am Coll Cardiol 35(1):230–237
Jacobs S, Grunert R, Mohr FW, Falk V (2008) 3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact CardioVasc Thorac Surg 7(1):6–9
Kim MS, Hansgen AR, Wink O, Quaife RA, Carroll JD (2008) Rapid prototyping: a new tool in understanding and treating structural heart disease. Circulation 117(18):2388–2394
Noecker AM, Chen JF, Zhou Q, White RD, Kopcak MW, Arruda MJ et al (2006) Development of patient-specific three-dimensional pediatric cardiac models. ASAIO J 52(3):349–353
Mottl-Link S, Hübler M, Kühne T et al (2008) Physical models aiding in complex congenital heart surgery. Ann Thorac Surg 86(1):273–277
Ngan EM, Rebeyka IM, Ross DB et al (2006) The rapid prototyping of anatomic models in pulmonary atresia. J Thorac Cardiovasc Surg 132(2):264–269
Sodian R, Weber S, Markert M et al (2008) Pediatric cardiac transplantation: three-dimensional printing of anatomic models for surgical planning of heart transplantation in patients with univentricular heart. J Thorac Cardiovasc Surg 136(4):1098–1099
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to disclose.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Videoclip 1. Demonstration of ability of 3D model to be manipulated using 3D model from patient 1. The full model is rotated in order to demonstrate the anatomy from different perspectives. The cropped model is then revealed demonstrating the intracardiac anatomy. (MOV 58035 kb)
Rights and permissions
About this article
Cite this article
Farooqi, K.M., Uppu, S.C., Nguyen, K. et al. Application of Virtual Three-Dimensional Models for Simultaneous Visualization of Intracardiac Anatomic Relationships in Double Outlet Right Ventricle. Pediatr Cardiol 37, 90–98 (2016). https://doi.org/10.1007/s00246-015-1244-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00246-015-1244-z