title: Utility and Scope of Rapid Prototyping in Patients with Complex Muscular Ventricular Septal Defects or Double-Outlet Right Ventricle: Does it Alter Management Decisions?
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.
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA. puneet.bhatla@nyumc.org.|Department of Radiology, New York University Langone Medical Center, New York, NY, USA. puneet.bhatla@nyumc.org.
authors.forename: Puneet
authors.initials: P
authors.lastname: Bhatla
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA.
authors.forename: Justin T
authors.initials: JT
authors.lastname: Tretter
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA.
authors.forename: Achi
authors.initials: A
authors.lastname: Ludomirsky
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Argilla
authors.affiliation: Department of Radiology, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Larry A
authors.initials: LA
authors.lastname: Latson
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA.
authors.forename: Sujata
authors.initials: S
authors.lastname: Chakravarti
authors.affiliation: Division of Pediatric Cardiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Piers C
authors.initials: PC
authors.lastname: Barker
authors.affiliation: Department of Radiology, The Hospital of Sick Children, Toronto, Canada.
authors.forename: Shi-Joon
authors.initials: SJ
authors.lastname: Yoo
authors.affiliation: Division of Pediatric Cardiology, New York University Langone Medical Center, 401-403 East 34th Street, New York, NY, 10016, USA.|Lucille Packard Children's Hospital Stanford Heart Center Clinical and Translational Research Program, Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, USA.
authors.forename: Doff B
authors.initials: DB
authors.lastname: McElhinney
authors.affiliation: 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.
authors.forename: Nicole
authors.initials: N
authors.lastname: Wake
authors.affiliation: Department of Cardiac Surgery, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Ralph S
authors.initials: RS
authors.lastname: Mosca
mesh_terms: D006348:Cardiac Surgical Procedures / Q000379:methods; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004310:Double Outlet Right Ventricle / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D006321:Heart / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D006345:Heart Septal Defects, Ventricular / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008953:Models, Anatomic; D066330:Printing, Three-Dimensional; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: 3D printing; Computed tomography; Congenital heart disease; Double-outlet right ventricle; Magnetic resonance imaging; Rapid prototyping; Ventricular septal defect