World Journal of Pediatrics

, Volume 15, Issue 3, pp 246–254 | Cite as

Patient-specific three-dimensional printed heart models benefit preoperative planning for complex congenital heart disease

  • Jia-Jun Xu
  • Yu-Jia Luo
  • Jin-Hua Wang
  • Wei-Ze Xu
  • Zhuo Shi
  • Jian-Zhong Fu
  • Qiang ShuEmail author
Original Article



Preoperative planning for children with congenital heart diseases remains crucial and challenging. This study aimed to investigate the roles of three-dimensional printed patient-specific heart models in the presurgical planning for complex congenital heart disease.


From May 2017 to January 2018, 15 children diagnosed with complex congenital heart disease were included in this study. Heart models were printed based on computed tomography (CT) imaging reconstruction by a 3D printer with photosensitive resin using the stereolithography apparatus technology. Surgery options were first evaluated by a sophisticated cardiac surgery group using CT images only, and then surgical plans were also set up based on heart models.


Fifteen 3D printed heart models were successfully generated. According to the decisions based on CT, 13 cases were consistent with real options, while the other 2 were not. According to 3D printed heart models, all the 15 cases were consistent with real options. Unfortunately, one child diagnosed with complete transposition of great arteries combined with interruption of aortic arch (type A) died 5 days after operation due to postoperative low cardiac output syndrome. The cardiologists, especially the younger ones, considered that these 3D printed heart models with tangible, physical and comprehensive illustrations were beneficial for preoperative planning of complex congenital heart diseases.


3D printed heart models are beneficial and promising in preoperative planning for complex congenital heart diseases, and are able to help conform or even improve the surgery options.


Computed tomography Congenital heart disease Surgery Three-dimensional printing 


Author contributions

JJX contributed to the conception and design, collection and assembly of data, and data analysis and interpretation. YJL contributed to the conception and design. JHW contributed to the conception and design, and provision of study materials or patients. WZX and ZS contributed to provision of study materials or patients. JZF and QS contributed to the administrative support. All the authors contributed to the writing of the manuscript, and approved the final version to be published.


This study was funded by Science Technology Department of Zhejiang Province of China (Grant number: 2016C54006).

Compliance with ethical standards

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all of the families of individual participants included in the study.

Conflict of interest

The authors have no conflicts of interest to declare.


  1. 1.
    van der Bom T, Zomer AC, Zwinderman AH, Meijboom FJ, Bouma BJ, Mulder BJ. The changing epidemiology of congenital heart disease. Nat Rev Cardiol. 2011;8:50–60.CrossRefPubMedGoogle Scholar
  2. 2.
    Hu Z, Yuan X, Rao K, Zheng Z, Hu S. National trend in congenital heart disease mortality in China during 2003 to 2010: a population-based study. J Thorac Cardiovasc Surg. 2014;148:596–602.e1.CrossRefPubMedGoogle Scholar
  3. 3.
    Giannopoulos AA, Mitsouras D, Yoo SJ, Liu PP, Chatzizisis YS, Rybicki FJ. Applications of 3D printing in cardiovascular diseases. Nat Rev Cardiol. 2016;13:701–18.CrossRefPubMedGoogle Scholar
  4. 4.
    Vukicevic M, Mosadegh B, Min JK, Little SH. Cardiac 3D printing and its future directions. JACC Cardiovasc Imaging. 2017;10:171–84.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Cantinotti M, Valverde I, Kutty S. Three-dimensional printed models in congenital heart disease. Int J Cardiovasc Imaging. 2017;33:137–44.CrossRefPubMedGoogle Scholar
  6. 6.
    Bhatla P, Tretter JT, Ludomirsky A, Argilla M, Latson LA Jr, Chakravarti S, et al. Utility and scope of rapid prototyping in patients with complex muscular ventricular septal defects or double-outlet right ventricle: does it alter management decisions? Pediatr Cardiol. 2017;38:103–14.CrossRefPubMedGoogle Scholar
  7. 7.
    Ma XJ, Tao L, Chen X, Li W, Peng ZY, Chen Y, et al. Clinical application of three-dimensional reconstruction and rapid prototyping technology of multislice spiral computed tomography angiography for the repair of ventricular septal defect of tetralogy of Fallot. Genet Mol Res. 2015;14:1301–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Riesenkampff E, Rietdorf U, Wolf I, Schnackenburg B, Ewert P, Huebler M, et al. The practical clinical value of three-dimensional models of complex congenitally malformed hearts. J Thorac Cardiovasc Surg. 2009;138:571–80.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Armillotta A, Bonhoeffer P, Dubini G, Ferragina S, Migliavacca F, Sala G, et al. Use of rapid prototyping models in the planning of percutaneous pulmonary valved stent implantation. Proc Inst Mech Eng H. 2007;221:407–16.CrossRefPubMedGoogle Scholar
  10. 10.
    Valverde I, Gomez-Ciriza G, Hussain T, Suarez-Mejias C, Velasco-Forte MN, Byrne N, et al. Three-dimensional printed models for surgical planning of complex congenital heart defects: an international multicentre study. Eur J Cardiothorac Surg. 2017;52:1139–48.CrossRefPubMedGoogle Scholar
  11. 11.
    Anwar S, Singh GK, Varughese J, Nguyen H, Billadello JJ, Sheybani EF, et al. 3D printing in complex congenital heart disease: across a spectrum of age, pathology, and imaging techniques. JACC Cardiovasc Imaging. 2017;10:953–6.CrossRefPubMedGoogle Scholar
  12. 12.
    Farooqi KM, Saeed O, Zaidi A, Sanz J, Nielsen JC, Hsu DT, et al. 3D printing to guide ventricular assist device placement in adults with congenital heart disease and heart failure. JACC Heart Fail. 2016;4:301–11.CrossRefPubMedGoogle Scholar
  13. 13.
    Jacobs S, Grunert R, Mohr FW, Falk V. 3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg. 2008;7:6–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Olivieri L, Krieger A, Chen MY, Kim P, Kanter JP. 3D heart model guides complex stent angioplasty of pulmonary venous baffle obstruction in a Mustard repair of D-TGA. Int J Cardiol. 2014;172:e297–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Samuel BP, Pinto C, Pietila T, Vettukattil JJ. Ultrasound-derived three-dimensional printing in congenital heart disease. J Digit Imaging. 2015;28:459–61.CrossRefPubMedGoogle Scholar
  16. 16.
    Gosnell J, Pietila T, Samuel BP, Kurup HK, Haw MP, Vettukattil JJ. Integration of computed tomography and three-dimensional echocardiography for hybrid three-dimensional printing in congenital heart disease. J Digit Imaging. 2016;29:665–9.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Jacobs S, Grunert R, Mohr FW, Falk V. 3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg. 2008;7:6–9.CrossRefPubMedGoogle Scholar
  18. 18.
    Mottl-Link S, Hübler M, Kühne T, Rietdorf U, Krueger JJ, Schnackenburg B, et al. Physical models aiding in complex congenital heart surgery. Ann Thorac Surg. 2008;86:273–7.CrossRefPubMedGoogle Scholar
  19. 19.
    Farooqi KM, Nielsen JC, Uppu SC, Srivastava S, Parness IA, Sanz J, et al. Use of 3-dimensional printing to demonstrate complex intracardiac relationships in double-outlet right ventricle for surgical planning. Circ Cardiovasc Imaging. 2015;8:e003043.CrossRefPubMedGoogle Scholar
  20. 20.
    Garekar S, Bharati A, Chokhandre M, Mali S, Trivedi B, Changela VP, et al. Clinical application and multidisciplinary assessment of three dimensional printing in double outlet right ventricle with remote ventricular septal defect. World J Pediatr Congenit Heart Surg. 2016;7:344–50.CrossRefPubMedGoogle Scholar
  21. 21.
    Ghisiawan N, Herbert CE, Zussman M, Verigan A, Stapleton GE. The use of a three-dimensional print model of an aortic arch to plan a complex percutaneous intervention in a patient with coarctation of the aorta. Cardiol Young. 2016;26:1568–72.CrossRefPubMedGoogle Scholar
  22. 22.
    Lim KH, Loo ZY, Goldie SJ, Adams JW, McMenamin PG. Use of 3D printed models in medical education: a randomized control trial comparing 3D prints versus cadaveric materials for learning external cardiac anatomy. Anat Sci Educ. 2016;9:213–21.CrossRefPubMedGoogle Scholar
  23. 23.
    Biglino G, Koniordou D, Gasparini M, Capelli C, Leaver LK, Khambadkone S, et al. Piloting the use of patient-specific cardiac models as a novel tool to facilitate communication during clinical consultations. Pediatr Cardiol. 2017;38:813–8.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2019

Authors and Affiliations

  • Jia-Jun Xu
    • 1
    • 2
  • Yu-Jia Luo
    • 1
  • Jin-Hua Wang
    • 1
  • Wei-Ze Xu
    • 1
  • Zhuo Shi
    • 1
  • Jian-Zhong Fu
    • 2
  • Qiang Shu
    • 1
    Email author
  1. 1.Department of Heart Center, Children’s HospitalZhejiang University School of MedicineHangzhouChina
  2. 2.School of Mechanical EngineeringZhejiang UniversityHangzhouChina

Personalised recommendations