title: The practical clinical value of three-dimensional models of complex congenitally malformed hearts.
abstract: OBJECTIVE
  Detailed 3-dimensional anatomic information is essential when planning strategies of surgical treatment for patients with complex congenitally malformed hearts. Current imaging techniques, however, do not always provide all the necessary anatomic information in a user-friendly fashion. We sought to assess the practical clinical value of realistic 3-dimensional models of complex congenitally malformed hearts.
  
  
  METHODS
  In 11 patients, aged from 0.8 to 27 years, all with complex congenitally malformed hearts, an unequivocal decision regarding the optimum surgical strategy had not been reached when using standard diagnostic tools. Therefore, we constructed 3-dimensional virtual computer and printed cast models of the heart on the basis of high-resolution whole-heart or cine magnetic resonance imaging or computed tomography. Anatomic descriptions were compared with intraoperative findings when surgery was performed.
  
  
  RESULTS
  Independently of age-related factors, images acquired in all patients using magnetic resonance imaging and computed tomography proved to be of sufficient quality for producing the models without major differences in the postprocessing and revealing the anatomy in an unequivocal 3-dimensional context. Examination of the models provided invaluable additional information that supported the surgical decision-making. The anatomy as shown in the models was confirmed during surgery. Biventricular corrective surgery was achieved in 5 patients, palliative surgery was achieved in 3 patients, and lack of suitable surgical options was confirmed in the remaining 3 patients.
  
  
  CONCLUSIONS
  Realistic 3-dimensional modeling of the heart provides a new means for the assessment of complex intracardiac anatomy. We expect this method to change current diagnostic approaches and facilitate preoperative planning.
authors.affiliation: Unit of Cardiovascular Imaging, Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. riesenkampff@dhzb.de <
authors.forename: Eugénie
authors.initials: E
authors.lastname: Riesenkampff
authors.forename: Urte
authors.initials: U
authors.lastname: Rietdorf
authors.forename: Ivo
authors.initials: I
authors.lastname: Wolf
authors.forename: Bernhard
authors.initials: B
authors.lastname: Schnackenburg
authors.forename: Peter
authors.initials: P
authors.lastname: Ewert
authors.forename: Michael
authors.initials: M
authors.lastname: Huebler
authors.forename: Vladimir
authors.initials: V
authors.lastname: Alexi-Meskishvili
authors.forename: Robert H
authors.initials: RH
authors.lastname: Anderson
authors.forename: Nicole
authors.initials: N
authors.lastname: Engel
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Meinzer
authors.forename: Roland
authors.initials: R
authors.lastname: Hetzer
authors.forename: Felix
authors.initials: F
authors.lastname: Berger
authors.forename: Titus
authors.initials: T
authors.lastname: Kuehne
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003198:Computer Simulation; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008955:Models, Cardiovascular; D010934:Planning Techniques; D055815:Young Adult