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婴儿期主-肺动脉侧支动脉(MAPCAs)与固有肺动脉的单源化——3D打印和虚拟现实的应用

Unifocalization of Major Aortopulmonary Collateral Arteries (MAPCAs) and Native Pulmonary Arteries in Infancy-Application of 3D Printing and Virtual Reality.

作者信息

Kolcz Jacek, Rudek-Budzynska Anna, Grandys Krzysztof

机构信息

Jagiellonian University, Collegium Medicum, Department of Pediatric Cardiac Surgery, 31-007 Krakow, Poland.

Department of Anesthesiology, University Children's Hospital, 30-663 Krakow, Poland.

出版信息

J Cardiovasc Dev Dis. 2024 Dec 13;11(12):403. doi: 10.3390/jcdd11120403.

Abstract

BACKGROUND

Major aortopulmonary collateral arteries (MAPCAs) are rare remnants of pulmonary circulation embryological development usually associated with complex congenital anomalies of the right ventricular outflow tract and pulmonary arteries. Effective management requires surgical unifocalization of MAPCAs and native pulmonary arteries (NPAs). Traditional imaging may lack the spatial clarity needed for precise surgical planning.

AIM

This study evaluated the feasibility of integrating three-dimensional (3D) printing and virtual reality (VR) into preoperative planning to improve surgical precision, team communication, and parental understanding. In a prospective cohort study, nine infants undergoing MAPCA unifocalization were included. Four patients underwent conventional imaging-based planning (control), while five were additionally assessed using VR and 3D-printed models (intervention). The outcomes measured included operative times, team confidence, collaboration, and parental satisfaction. Statistical analysis was performed using standard tests.

RESULTS

The intervention group had shorter operative and cardiopulmonary bypass times compared to the control group. Intraoperative complications were absent in the VR/3D group but occurred in the control group. Medical staff in the VR/3D group reported significantly improved understanding of anatomy, surgical preparedness, and team collaboration ( < 0.05). Parents also expressed higher satisfaction, with better comprehension of their child's anatomy and surgical plan.

CONCLUSIONS

VR and 3D printing enhanced preoperative planning, surgical precision, and communication, proving valuable for complex congenital heart surgery. These technologies offer promising potential to improve clinical outcomes and patient-family experiences, meriting further investigation in larger studies.

摘要

背景

主-肺动脉侧支动脉(MAPCAs)是肺循环胚胎发育的罕见残余物,通常与右心室流出道和肺动脉的复杂先天性异常相关。有效的治疗需要对MAPCAs和天然肺动脉(NPAs)进行手术单灶化。传统成像可能缺乏精确手术规划所需的空间清晰度。

目的

本研究评估了将三维(3D)打印和虚拟现实(VR)整合到术前规划中以提高手术精度、团队沟通和家长理解的可行性。在一项前瞻性队列研究中,纳入了9名接受MAPCA单灶化的婴儿。4名患者接受基于传统成像的规划(对照组),而另外5名患者使用VR和3D打印模型进行额外评估(干预组)。测量的结果包括手术时间、团队信心、协作和家长满意度。使用标准测试进行统计分析。

结果

与对照组相比,干预组的手术和体外循环时间更短。VR/3D组术中无并发症发生,而对照组有并发症发生。VR/3D组的医务人员报告对解剖结构、手术准备和团队协作的理解有显著改善(<0.05)。家长也表达了更高的满意度,对孩子的解剖结构和手术计划有更好的理解。

结论

VR和3D打印增强了术前规划、手术精度和沟通,对复杂先天性心脏病手术具有重要价值。这些技术具有改善临床结果和患者-家庭体验的潜力,值得在更大规模的研究中进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/06e1/11678195/ffd3915aeb8e/jcdd-11-00403-g001.jpg

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