Department of Anesthesia and Critical Care, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
School of Computing, Queen's University, Kingston, Ontario, Canada.
Ann Thorac Surg. 2021 Jun;111(6):2078-2083. doi: 10.1016/j.athoracsur.2021.02.058. Epub 2021 Mar 6.
Biventricular repair of double-outlet right ventricle (DORV) necessitates the creation of a complex intracardiac baffle. Creation of the optimal baffle design and placement thereof can be challenging to conceptualize, even with 2-dimensional and 3-dimensional images. This report describes a recently developed methodology for creating virtual baffles to inform intraoperative repair.
A total of 3 heart models of DORV were created from cardiac magnetic resonance images. Baffles were created and visualized using custom software.
This report demonstrates application of the tool to virtual planning of the baffle for repair of DORV in 3 cases. Models were examined by a multidisciplinary team, on screen and in virtual reality. Baffles could be rapidly created and revised to facilitate planning of the surgical procedure.
Virtual modeling of the baffle pathway by using cardiac magnetic resonance, creation of physical templates for the baffle, and visualization in virtual reality are feasible and may be beneficial for preoperative planning of complex biventricular repairs in DORV. Further work is needed to demonstrate clinical benefit or improvement in outcomes.
双出口右心室（DORV）的双心室修复需要创建一个复杂的心脏内分流器。即使使用二维和三维图像，也很难对最佳分流器设计及其放置进行概念化。本报告介绍了一种新开发的创建虚拟分流器以指导术中修复的方法。
使用心脏磁共振图像创建了 3 个 DORV 心脏模型。使用定制软件创建并可视化了分流器。
本报告通过 3 例 DORV 修复的虚拟规划应用该工具进行了演示。通过屏幕和虚拟现实，多学科团队对模型进行了检查。可以快速创建和修改分流器，以方便手术程序的规划。
使用心脏磁共振对分流器路径进行虚拟建模，创建分流器的物理模板，并在虚拟现实中可视化，这是可行的，可能有助于 DORV 复杂双心室修复的术前规划。需要进一步的工作来证明临床获益或改善结局。
