TY - JOUR
T1 - Three-dimensional printed models for surgical planning of complex congenital heart defects
T2 - An international multicentre study
AU - Valverde, Israel
AU - Gomez-Ciriza, Gorka
AU - Hussain, Tarique
AU - Suarez-Mejias, Cristina
AU - Velasco-Forte, Maria N.
AU - Byrne, Nicholas
AU - Ordoñez, Antonio
AU - Gonzalez-Calle, Antonio
AU - Anderson, David
AU - Hazekamp, Mark G.
AU - Roest, Arno A.W.
AU - Rivas-Gonzalez, Jose
AU - Uribe, Sergio
AU - El-Rassi, Issam
AU - Simpson, John
AU - Miller, Owen
AU - Ruiz, Enrique
AU - Zabala, Ignacio
AU - Mendez, Ana
AU - Manso, Begoña
AU - Gallego, Pastora
AU - Prada, Freddy
AU - Cantinotti, Massimiliano
AU - Ait-Ali, Lamia
AU - Merino, Carlos
AU - Parry, Andrew
AU - Poirier, Nancy
AU - Greil, Gerald
AU - Razavi, Reza
AU - Gomez-Cia, Tomas
AU - Hosseinpour, Amir Reza
N1 - Publisher Copyright:
© The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
PY - 2017/12
Y1 - 2017/12
N2 - 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).
AB - 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).
KW - 3D printing
KW - Congenital heart defects
KW - Imaging
KW - Medical computer-aided design
KW - Surgery
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U2 - 10.1093/EJCTS/EZX208
DO - 10.1093/EJCTS/EZX208
M3 - Article
C2 - 28977423
AN - SCOPUS:85040394194
SN - 1010-7940
VL - 52
SP - 1139
EP - 1148
JO - European Journal of Cardio-thoracic Surgery
JF - European Journal of Cardio-thoracic Surgery
IS - 6
ER -