Three-dimensional (3D) printing is an emerging technology aiding diagnostics, education, and interventional, and surgical planning in congenital heart disease (CHD). Three-dimensional printing has been derived from computed tomography, cardiac magnetic resonance, and 3D echocardiography. However, individually the imaging modalities may not provide adequate visualization of complex CHD. The integration of the strengths of two or more imaging modalities has the potential to enhance visualization of cardiac pathomorphology. We describe the feasibility of hybrid 3D printing from two imaging modalities in a patient with congenitally corrected transposition of the great arteries (L-TGA). Hybrid 3D printing may be useful as an additional tool for cardiologists and cardiothoracic surgeons in planning interventions in children and adults with CHD.
Sinus venosus atrial septal defect (SVASD) accounts for 5-10% of all ASDs. Partial anomalous pulmonary venous connection (PAPVC) and pulmonary hypertension (PH) in patients with SVASD increases the risk for surgical or transcatheter intervention. Closure is preferred over medical therapy. Transcatheter closure is challenging due to complex anatomy, difficulty in evaluating suitability for intervention, and lack of dedicated devices. We present a systematic approach using multimodality imaging and 3D printing for transcatheter closure of superior SVASD with PAPVC using a custom-made CP Stent®. A 53-year-old with history of drug abuse presented with NYHA Class III symptoms, hypoxemia, atrial flutter, and PH (MPAP of 30 mmHg) requiring multidrug therapy. Echocardiogram raised suspicion of superior SVASD, confirmed by cardiac CT and CMR. Multidisciplinary team ruled out surgery due to high risk and recommended transcatheter closure, if feasible. CT and CMR demonstrated a 20 × 18 mm superior SVASD with PAPVC: right upper (RUPV) and middle pulmonary veins draining into the superior vena cava (SVC). To understand spatial relationships, a 3D model was printed with 1.5-mm transparent and flexible walls to deploy a nonsterile prototype of the stent in the SVC. Rotational angiogram was performed to test feasibility of in-vivo deployment in view of stent foreshortening (from 110 to 70 mm) and differential widening of the SVC: 23 mm at the junction of the innominate vein; 35 mm at the atrial end. Transcatheter closure of superior SVASD with PAPVC in patients with PH is feasible in suitable cases using a systematic approach with multi-modality imaging and 3D printing.A 53-year-old presented to the emergency department with NYHA Class III symptoms, hypoxemia, new onset atrial flutter, ventricular dysfunction, and pulmonary hypertension (PH). Echocardiogram with agitated saline raised suspicion of superior sinus venous atrial septal defect (SVASD) with venous return directly entering the left atrium (LA) and
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.