Utility of three-dimensional printing in preoperative planning for children with anomalous pulmonary venous connection: a single center experience

Abstract

Background: This study sought to assess the application of three-dimensional (3D) printing in preoperative planning for anomalous pulmonary venous connection (APVC).Methods: From November 2017 to January 2019, 17 children diagnosed with APVC were enrolled in this study (total APVC supracardiac type in 10 children, intracardiac type in 2 children, infracardiac type in 1 child, mixed type in 1 child, partial APVC in 3 children). The age was ranged 2 days to 20 months old (median age 1 m 5 d). Before operation, 3D-printed patient-specific heart models were created based on a cardiac computed tomography (CCT) data set with photosensitive resin materials in stereolithography (SLA) technology. These 3D models were used for presurgical decision making and navigation in the operation room. After surgery, the roles of the 3D models were evaluated with questionnaires.Results: All 17 children successfully underwent surgeries. 3D heart models accurately demonstrated the malformations, which were all confirmed consistent with surgery findings. The final surgery programs were in accord with presurgical planning. Modeling took 0.5-2 h, with an average of 0.9±0.4 h. Printing took 2-5 h, with an average of 3.4±1.2 h. All these children were discharged without adverse events. During follow-up, 2 children suspect of anastomotic stenosis were performed cardiac CT, and 3D printed heart models were created. Results confirmed there was no obvious anastomotic stenosis. Questionnaire results indicate that 3D printing is a promising technique in clinical practice.Conclusions: 3D printing is beneficial for preoperative planning and post-surgery follow-up in APVC.

Clinical Applications of Patient-Specific 3D Printed Models in Cardiovascular Disease: Current Status and Future Directions

“…Biomolecules 2020, 10, x 4 of 34 in particular in dealing with complex CHD cases such as double outlet right ventricle (DORV) ( Figure 3) [13]. Personalized therapeutic strategy can be achieved and the best surgery option can be made with the aid of patient-specific 3D printed models as reported by a recent study [41]. Another common application of 3D printing in CHD is about its usefulness in medical education.…”

“…The 3D printed models were found to assist surgeons define the best surgical approach, in particular in dealing with complex CHD cases such as double outlet right ventricle (DORV) ( Figure 3 ) [ 13 ]. Personalized therapeutic strategy can be achieved and the best surgery option can be made with the aid of patient-specific 3D printed models as reported by a recent study [ 41 ].…”

Comparison of blood pool and myocardial 3D printing in the diagnosis of types of congenital heart disease

“…However, in practical applications, the effectiveness, cost, and availability are important factors that restrict the large-scale application of 3D printing in CHD diagnosis 12 . Concerning the techniques used, SLA is a widely used, relatively low-cost, high-precision, and high-speed 13 , 14 technique for the fabrication of heart models used in the diagnosis of CHDs 15 , 16 . In order to get different virtual models, blood pool modeling and myocardial modeling are the common 3D reconstruction methods of cardiac CT or MRI 4 .…”

Blood-Pool or Myocardial 3D Printing, Which One is Better for the Diagnosis of Types of Congenital Heart Disease?

“…Concerning the techniques used, SLA is a widely used, relatively low-cost, highprecision, and high-speed 13,14 technique for the fabrication of heart models. Among existing 3D printing heart models, blood pool models 15,16 , myocardial models 7,11 , and their combination 4 have been used for diagnosis in different studies. There has been some comparison of rigid and exible models; rigid models provide a static representation of the anatomy, while exible models may be more suitable for surgical simulation 11,17 .…”

“…Matthew Lee et al 19 evaluated the feasibility of using rigid blood pool 3D-printed models in cases of coronary artery anomalies. Jiajun Xu et al 15 assessed the application of blood pool 3D printing in preoperative planning for the treatment of anomalous pulmonary venous connection (APVC) and investigated the roles of 3D-printed blood pool models using SLA technology in presurgical planning for the treatment of complex CHDs in 15 children with total anomalous pulmonary venous connection (TAPVC), complete transposition of the great arteries (TGA), patent ductus arteriosus (PDA), ventricular septal defect (VSD), and atrial septal defect (ASD) 18 . Existing studies have mainly focused on the feasibly of application in one or more cases, and a comparison of the applicability of blood pool and myocardial 3D printing in different CHDs is lacking.…”