Erdem Sukran, Fares Munes, Murguia Felipe, Moore Jay, Sturgeon Gregory, Ikemba Catherine M, Greil Gerald, Hussain Tarique, Andersen Nicholas D, Zou Qing
Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Division of Pediatric Cardiology, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
JACC Case Rep. 2025 Jun 25;30(16):103884. doi: 10.1016/j.jaccas.2025.103884.
Determining the optimal surgical approach for complex congenital heart disease (CHD) can be challenging using conventional 2-dimensional transthoracic echocardiography (TTE) and cross-sectional imaging, including cardiac magnetic resonance (CMR) and computed tomography.
An 11-month-old female patient presented with heterotaxy syndrome, dextrocardia, double-outlet right ventricle, and complex pulmonary valve stenosis. Fetal echocardiography and postnatal TTE established the complexity of the cardiac anatomy and led to a multidisciplinary discussion to plan a complex staged cardiac repair.
Three-dimensional (3D) printed and virtual heart models, along with CMR angiography, provided detailed anatomical visualization and spatial conceptualization, which aided in assessing the feasibility of a staged biventricular repair. Postoperative CMR guided subsequent surgical procedures, evaluated newly created structures such as baffles, and identified complications.
TAKE-HOME MESSAGE: This case highlights the critical role of multimodality imaging, including advanced imaging with virtual and 3D printed modeling, in surgical planning in a patient with complex CHD.
使用传统的二维经胸超声心动图（TTE）以及包括心脏磁共振成像（CMR）和计算机断层扫描在内的横断面成像来确定复杂先天性心脏病（CHD）的最佳手术方法可能具有挑战性。
一名11个月大的女性患者患有内脏反位综合征、右位心、右心室双出口和复杂的肺动脉瓣狭窄。胎儿超声心动图和产后TTE确定了心脏解剖结构的复杂性，并引发了多学科讨论以规划复杂的分期心脏修复。
三维（3D）打印和虚拟心脏模型，以及CMR血管造影，提供了详细的解剖可视化和空间概念化，有助于评估分期双心室修复的可行性。术后CMR指导后续手术操作，评估新创建的结构如挡板，并识别并发症。
本病例突出了多模态成像，包括虚拟和3D打印建模的先进成像，在复杂CHD患者手术规划中的关键作用。
