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Congenital Heart Surgeons' Society

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The Impact Of 3D Printing And 3D Interactive Visualization On The Ability To Repair Previously Palliated Complex Congenital Heart Disease
Marcus P. Haw, MBBS, MS, FRCS, FECTS, Giedrius Baliulis, MD, FRCS(CT), Neal D. Hillman, MD, Jordan M. Gosnell, BS, RDCS (AE PE), FASE, Bennett P. Samuel, MHA, BSN, RN, John L. Byl, MPH, RDCS (AE PE), Joseph J. Vettukattil, MBBS, MD, DNB, CCST, FRCPCH, FRSM, FRCP.
Spectrum Health Helen DeVos Children's Hospital, Grand Rapids, MI, USA.

AbstractObjective: To review the utility of 3D printing, and of novel interactive 3D visualisation (I3DV), in clinical decision making and surgical planning in complex congenital heart disease. Methods: We reviewed a series of seven surgical patients. In six cases bi-ventricular repair was previously considered inappropriate. Using interactive 3D printing, and also interactive 3D visualisation software (Echopixel), 7 patients aged 3-21 years underwent corrective surgery. Previous attempts at treatment had resulted in complications such that palliation or no surgery had been preferred. All patients had significant symptoms. Results: 3D printing and I3DV review was performed in all 7 patients. I3DV was superior to 3D printing in 4 cases and critical for surgical planning in 5 cases. There was no mortality and bi-ventricular repair was possible in all cases. (Table).

Transplant PossiblePrevious
Sternotomies
AgeInteractive 3D VisualizationPalliative Care
Heterotaxy, Dextrocardia, Bilateral SVC, TAPVR
AVSD, DORV, PA. Palliation with BD Glenn, PV occlusion
NoX33Critical to decision and planYes
Heterotaxy, Dextrocardia, TAPVR, AVSD,DORV, PV stenosis and occlusion, PAHNoX211Critical decision and planYes
TGA, PS
post Rastelli, conduit compression
YesX314Critical to surgical planNo
Univentricular Heart, ASD
post PAB
YesX17Critical to decision and to planNo
DORV, PA, Dextrocardia, crisscross heart, post bilateral Glenn shuntsYesX19Not Critical to decision or planNo
Heterotaxy, TGA, DORV, straddling Mitral valve, previous Fontan, HOCM, failed subaortic resectionNoX310Critical to decision and to planAlmost
PA, IVS, failing atrio-pulmonary Fontan, Low cardiac output stateNoX321Not Critical to decision or planNo

Conclusions: 3D printing and I3DV were highly effective in the decision to treat and in planning the appropriate surgical technique. Surgical techniques and repair strategies were altered based on the new technologies. 3D printing and I3DV should be considered in some patients with complex CHD prior to finalising management plans.