3D Modeling and Printing in Congenital Heart Surgery: Entering the Stage of Maturation

Abstract

3D printing allows the most realistic perception of the surgical anatomy of congenital heart diseases without the requirement of physical devices such as a computer screen or virtual headset. It is useful for surgical decision making and simulation, hands-on surgical training (HOST) and cardiovascular morphology teaching. 3D-printed models allow easy understanding of surgical morphology and preoperative surgical simulation. The most common indications for its clinical use include complex forms of double outlet right ventricle and transposition of the great arteries, anomalous systemic and pulmonary venous connections, and heterotaxy. Its utility in congenital heart surgery is indisputable, although it is hard to “scientifically” prove the impact of its use in surgery because of many confounding factors that contribute to the surgical outcome. 3D-printed models are valuable resources for morphology teaching. Educational models can be produced for almost all different variations of congenital heart diseases, and replicated in any number. HOST using 3D-printed models enables efficient education of surgeons in-training. Implementation of the HOST courses in congenital heart surgical training programs is not an option but an absolute necessity. In conclusion, 3D printing is entering the stage of maturation in its use for congenital heart surgery. It is now time for imagers and surgeons to find how to effectively utilize 3D printing and how to improve the quality of the products for improved patient outcomes and impact of education and training.

State-of-the-art silicone molded models for simulation of arterial switch operation: Innovation with parting-and-assembly strategy

“…The inclusion of silicone molded models that mimic both the anatomic reality and mechanical behavior of cardiac tissue into HOST programs for CHS will surpass traditional training on 3D printed models and continue to improve the acquisition of technical surgical skills in cardiovascular surgery trainees. Model material was realistic when passing a needle through the vessel 20…”

“…[17][18][19] However, the complexity of the cardiovascular anatomy has limited use of the silicone molding technique to modeling relatively simple structures, such as cardiac valves and vascular structures. [17][18][19][20] Here we describe the development and integration of silicone molded hearts into the HOST simulation program. We hypothesized that a silicone molded heart model of transposition of the great arteries (TGA) can be created using an injection molding technique with a "parting-and-assembly" strategy whereby the heart is divided into multiple parts and assembled using an adhesive agent.…”

One-Stage Correction with Intra- and Extraatrial Rerouting of Anomalous Systemic and Pulmonary Venous Return and Intraventricular Repair of Double Outlet Right Ventricle in a Patient with Heterotaxy Syndrome

“…In particular, the surgical treatment of congenital heart diseases benefits from the visualization of the individual morphology of the patient. Especially in the treatment of clinical conditions such as DORV, heterotaxy, anomalous systemic and pulmonary venous connections this technique is used [4]. The 3D reconstruction-virtual or in print-facilitates the visualization of the anatomy and thus offers new perspectives on the respective problem [9].…”

“…Interdisciplinary conferences and broad diagnostics are indispensable. Modern techniques such as 3D modelling may help to establish a profound understanding of morphological features [4].…”

Three-Dimensional Virtual and Printed Prototypes in Complex Congenital and Pediatric Cardiac Surgery—A Multidisciplinary Team-Learning Experience

“…Our experience replicates the reports by others [54,55] that building shared mental models and language promotes shared responsibilities, improved teamwork, and communication. The utilization of 3D-printed models remains a central element of the team experience [56].…”