Background3D printing is an ideal manufacturing process for creating patient-matched models (anatomical models) for surgical and interventional planning. Cardiac anatomical models have been described in numerous case studies and journal publications. However, few studies attempt to describe wider impact of the novel planning augmentation tool. The work here presents the evolution of an institution’s first 3 full years of 3D prints following consistent integration of the technology into clinical workflow (2012–2014) - a center which produced 79 models for surgical planning (within that time frame). Patient outcomes and technology acceptance following implementation of 3D printing were reviewed.MethodsA retrospective analysis was designed to investigate the anatomical model’s impact on time-based surgical metrics. A contemporaneous cohort of standard-of-care pre-procedural planning (no anatomical models) was identified for comparative analysis. A post-surgery technology acceptance assessment was also employed in a smaller subset to measure perceived efficacy of the anatomical models. The data was examined.ResultsWithin the timeframe of the study, 928 primary-case cardiothoracic surgeries (encompassing both CHD and non-CHD surgeries) took place at the practicing pediatric hospital. One hundred sixty four anatomical models had been generated for various purposes. An inclusion criterion based on lesion type limited those with anatomic models to 33; there were 113 cases matching the same criterion that received no anatomical model. Time-based metrics such as case length-of-time showed a mean reduction in overall time for anatomical models. These reductions were not statistically significant. The technology acceptance survey did demonstrate strong perceived efficacy. Anecdotal vignettes further support the technology acceptance.Discussion & conclusionThe anatomical models demonstrate trends for reduced operating room and case length of time when compared with similar surgeries in the same time-period; in turn, these reductions could have significant impact on patient outcomes and operating room economics. While analysis did not yield robust statistical powering, strong Cohen’s d values suggest poor powering may be more related to sample size than non-ideal outcomes. The utility of planning with an anatomical model is further supported by the technology acceptance study which demonstrated that surgeons perceive the anatomical models to be an effective tool in surgical planning for a complex CHD repair. A prospective multi-center trial is currently in progress to further validate or reject these findings.
Purpose -The purpose of this study was to develop and apply new physical heart defect models (PHDMs) that are patient-specific and color-coded with an optimized map. Design/methodology/approach -Heart defect anatomies were segmented from medical images and reconstructed to form virtual models, which were then color-coded and rapid prototyped. The resulting PHDMs were used in a medical educational study to evaluate their pedagogical efficacy and in clinical case studies to investigate their utility in surgical planning. Findings -A growing library of 36 PHDMs (including the most common defects) was generated. Results from the educational study showed that the PHDMs enabled uniquely effective learning, and the clinical case studies indicated that the models added value as surgical planning aids. Research limitations/implications -The education study involved a limited number of students, so future work should consider a larger sample size. The clinical case studies favored use of the PHDMs in surgical planning, but provided only qualitative support. Practical implications -Workflow optimization is critical for PHDMs to be used effectively in surgical planning because some operations must be performed in emergently. Social implications -Because PHDMs have potential to influence surgeons' actions as surgical planning aids, their use in that context must be thoroughly vetted. Originality/value -The proposed models represent the first PHDMs that are patient-specific and fully color-coded with a standardized map optimized for the human visual system. The models enhanced medical education and facilitated effective surgical planning in this study.
Anomalous origin of one pulmonary artery from the aorta, or hemitruncus, is a rare cardiac malformation. We report a case of left hemitruncus (aortic origin of the left pulmonary artery) associated with tetralogy of Fallot diagnosed in utero. To the authors' knowledge, this is the first such case diagnosed by fetal echocardiography to be described in the literature. The condition was documented by postnatal echocardiogram and cardiac computed tomography. Prompt recognition of this lesion is essential for early repair to improve outcome.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.