Skip to main content
Log in

Application of Virtual Three-Dimensional Models for Simultaneous Visualization of Intracardiac Anatomic Relationships in Double Outlet Right Ventricle

  • Original Article
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. 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

    Article  CAS  PubMed  Google Scholar 

  2. 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

    Article  CAS  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. 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

    Article  CAS  PubMed  Google Scholar 

  5. 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

    Article  CAS  PubMed  Google Scholar 

  6. Van Praagh R (1977) Terminology of congenital heart disease. Gloss Comment Circ 56(2):139–143

    Google Scholar 

  7. 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

    Article  CAS  PubMed  Google Scholar 

  8. 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

    Article  PubMed  Google Scholar 

  9. 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

    Article  CAS  PubMed  Google Scholar 

  10. 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

    Article  PubMed  Google Scholar 

  11. 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

    Article  CAS  PubMed  Google Scholar 

  12. 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

    Article  PubMed  Google Scholar 

  13. 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

    Article  PubMed  Google Scholar 

  14. 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

    Article  PubMed  Google Scholar 

  15. 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

    Article  PubMed  Google Scholar 

  16. 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

    Article  PubMed  Google Scholar 

  17. 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

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kanwal M. Farooqi.

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

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-015-1244-z

Keywords

Navigation