Department of Pediatric Cardiovascular Surgery, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
Department of Pediatric Cardiology, Mehmet Akif Ersoy Cardiovascular Research and Training Hospital, Istanbul, Turkey.
Diagn Interv Radiol. 2021 Jul;27(4):488-496. doi: 10.5152/dir.2021.20163.
This study was planned to assess the application of three-dimensional (3D) cardiac modeling in preoperative evaluation for complex congenital heart surgeries.
From July 2015 to September 2019, 18 children diagnosed with complex congenital heart diseases (CHDs) were enrolled in this study (double outlet right ventricle in nine patients, complex types of transposition of the great arteries in six patients, congenitally corrected transposition of the great arteries in two patients, and univentricular heart in one patient). The patients' age ranged from 7 months to 19 years (median age, 14 months). Before the operation, 3D patient-specific cardiac models were created based on computed tomography (CT) data. Using each patient's data, a virtual computer model (3D mesh) and stereolithographic (SLA) file that would be printed as a 3D model were generated. These 3D cardiac models were used to gather additional data about cardiac anatomy for presurgical decision-making.
All 18 patients successfully underwent surgeries, and there were no mortalities. The 3D patient-specific cardiac models led to a change from the initial surgical plans in 6 of 18 cases (33%), and biventricular repair was considered feasible. Moreover, the models helped to modify the planned biventricular repair in five cases, for left ventricular outflow tract obstruction removal and ventricular septal defect enlargement. 3D cardiac models enable pediatric cardiologists to better understand the spatial relationships between the ventricular septal defect and great vessels, and they help surgeons identify risk structures more clearly for detailed planning of surgery. There was a strong correlation between the models of the patients and the anatomy encountered during the operation.
3D cardiac models accurately reveal the patient's anatomy in detail and are therefore beneficial for planning surgery in patients with complex intracardiac anatomy.
本研究旨在评估三维（3D）心脏建模在复杂先天性心脏病手术术前评估中的应用。
本研究纳入了 2015 年 7 月至 2019 年 9 月期间 18 例被诊断为复杂先天性心脏病（CHD）的患儿（右心室双出口 9 例，复杂大动脉转位 6 例，矫正型大动脉转位 2 例，单心室 1 例）。患者年龄 7 个月至 19 岁（中位数 14 个月）。在手术前，根据 CT 数据创建了 3D 患者特定的心脏模型。利用每位患者的数据，生成了一个虚拟计算机模型（3D 网格）和立体光刻（SLA）文件，该文件将被打印成 3D 模型。这些 3D 心脏模型用于收集更多有关心脏解剖结构的信息，以便进行术前决策。
18 例患者均成功接受手术，无死亡病例。3D 患者特定的心脏模型导致 18 例中的 6 例（33%）初始手术计划发生改变，认为可行双心室修复。此外，模型有助于修改 5 例计划的双心室修复，包括左心室流出道梗阻的消除和室间隔缺损的扩大。3D 心脏模型使儿科心脏病专家能够更好地理解室间隔缺损和大血管之间的空间关系，并帮助外科医生更清楚地识别风险结构，以便更详细地规划手术。患者模型与手术中遇到的解剖结构之间具有很强的相关性。
3D 心脏模型能够准确地详细揭示患者的解剖结构，因此有利于计划复杂心内解剖结构患者的手术。
