title: Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair.
abstract: Three-dimensional (3D) printed prototypes of malformed hearts have been used for education, communication, presurgical planning and simulation. We present a case of a 5-month old infant with complex obstruction at the neoaortic to transverse arch and descending aortic junction following the neonatal modified Norwood-1 procedure for hypoplastic left heart syndrome. Digital 3D models were created from a routine 64-slice CT dataset; then life-size solid and magnified hollow models were printed with a 3D printer. The solid model provided further insights into details of the anatomy, whereas the surgical approach and steps of the operation were simulated on the hollow model. Intraoperative assessment confirmed the anatomical accuracy of the 3D models. The operation was performed in accordance with preoperative simulation: sliding autologous flaps achieved relief of the obstruction without additional patching. Knowledge gained from the models fundamentally contributed to successful outcome and improved patient safety. This case study presents an effective use of 3D models in exploring complex spatial relationship at the aortic arch and in simulation-based planning of the operative procedure.
authors.affiliation: Pediatric Cardiac Surgery, Sheikh Khalifa Medical City managed by Cleveland Clinic, Institute of Cardiac Sciences, Abu Dhabi, United Arab Emirates laszlokir@gmail.com.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kiraly
authors.affiliation: Pediatric Cardiology, Sheikh Khalifa Medical City managed by Cleveland Clinic, Institute of Cardiac Sciences, Abu Dhabi, United Arab Emirates.
authors.forename: Magdi
authors.initials: M
authors.lastname: Tofeig
authors.affiliation: Pediatric Cardiac Surgery, Sheikh Khalifa Medical City managed by Cleveland Clinic, Institute of Cardiac Sciences, Abu Dhabi, United Arab Emirates.
authors.forename: Neerod Kumar
authors.initials: NK
authors.lastname: Jha
authors.affiliation: Pediatric Cardiology, Sheikh Khalifa Medical City managed by Cleveland Clinic, Institute of Cardiac Sciences, Abu Dhabi, United Arab Emirates.
authors.forename: Haitham
authors.initials: H
authors.lastname: Talo
mesh_terms: D001013:Aorta, Thoracic / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D001015:Aortic Arch Syndromes / Q000175:diagnosis / Q000601:surgery*; D000072226:Computed Tomography Angiography; D003198:Computer Simulation; D004452:Echocardiography; D006801:Humans; D007223:Infant; D008955:Models, Cardiovascular; D061330:Multidetector Computed Tomography; D058327:Norwood Procedures / Q000379:methods*; D057234:Preoperative Period; D066330:Printing, Three-Dimensional
keywords: 3D printing; Aortic arch obstruction; Congenital cardiac surgery; Rapid prototyping; Redo surgery