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Utility and Scope of Rapid Prototyping in Patients with Complex Muscular Ventricular Septal Defects or Double-Outlet Right Ventricle: Does it Alter Management Decisions?

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Abstract

Rapid prototyping facilitates comprehension of complex cardiac anatomy. However, determining when this additional information proves instrumental in patient management remains a challenge. We describe our experience with patient-specific anatomic models created using rapid prototyping from various imaging modalities, suggesting their utility in surgical and interventional planning in congenital heart disease (CHD). Virtual and physical 3-dimensional (3D) models were generated from CT or MRI data, using commercially available software for patients with complex muscular ventricular septal defects (CMVSD) and double-outlet right ventricle (DORV). Six patients with complex anatomy and uncertainty of the optimal management strategy were included in this study. The models were subsequently used to guide management decisions, and the outcomes reviewed. 3D models clearly demonstrated the complex intra-cardiac anatomy in all six patients and were utilized to guide management decisions. In the three patients with CMVSD, one underwent successful endovascular device closure following a prior failed attempt at transcatheter closure, and the other two underwent successful primary surgical closure with the aid of 3D models. In all three cases of DORV, the models provided better anatomic delineation and additional information that altered or confirmed the surgical plan. Patient-specific 3D heart models show promise in accurately defining intra-cardiac anatomy in CHD, specifically CMVSD and DORV. We believe these models improve understanding of the complex anatomical spatial relationships in these defects and provide additional insight for pre/intra-interventional management and surgical planning.

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Authors and Affiliations

  1. Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA

    Puneet Bhatla, Justin T. Tretter, Achi Ludomirsky, Michael Argilla, Sujata Chakravarti & Doff B. McElhinney

  2. Department of Radiology, New York University Langone Medical Center, New York, NY, USA

    Puneet Bhatla & Larry A. Latson Jr.

  3. Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA

    Piers C. Barker

  4. Department of Radiology, The Hospital of Sick Children, Toronto, Canada

    Shi-Joon Yoo

  5. Lucille Packard Children’s Hospital Stanford Heart Center Clinical and Translational Research Program, Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA

    Doff B. McElhinney

  6. Department of Radiology, Center for Advanced Imaging Innovation and Research, Bernard and Irene Schwartz Center for Biomedical Imaging, New York University Langone Medical Center, New York, NY, USA

    Nicole Wake

  7. Department of Cardiac Surgery, New York University Langone Medical Center, New York, NY, USA

    Ralph S. Mosca

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  1. Puneet Bhatla
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  2. Justin T. Tretter
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  3. Achi Ludomirsky
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  4. Michael Argilla
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  6. Sujata Chakravarti
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  7. Piers C. Barker
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  8. Shi-Joon Yoo
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Correspondence to Puneet Bhatla.

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Bhatla, P., Tretter, J.T., Ludomirsky, A. 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 38, 103–114 (2017). https://doi.org/10.1007/s00246-016-1489-1

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  • DOI: https://doi.org/10.1007/s00246-016-1489-1

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