The practical clinical value of three-dimensional models of complex congenitally malformed hearts.
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.
Riesenkampff
Eugénie
E
Unit of Cardiovascular Imaging, Department of Congenital Heart Disease and Pediatric Cardiology, Deutsches Herzzentrum Berlin, Berlin, Germany. riesenkampff@dhzb.de <
Rietdorf
Urte
U
Wolf
Ivo
I
Schnackenburg
Bernhard
B
Ewert
Peter
P
Huebler
Michael
M
Alexi-Meskishvili
Vladimir
V
Anderson
Robert H
RH
Engel
Nicole
N
Meinzer
Hans-Peter
HP
Hetzer
Roland
R
Berger
Felix
F
Kuehne
Titus
T
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