Impact of 3D Printouts in Optimizing Surgical Results for Complex Congenital Heart Disease

2019 ◽  
Vol 10 (5) ◽  
pp. 533-538 ◽  
Author(s):  
Frank Han ◽  
Jennifer Co-Vu ◽  
Dalia Lopez-Colon ◽  
John Forder ◽  
Mark Bleiweis ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Surgical Outcomes ◽  
Congenital Heart ◽  
Heart Defects ◽  
Statistical Significance ◽  
Three Dimensional ◽  
3D Models ◽  
Palliative Surgery ◽  
Complex Congenital Heart Disease

Planning corrective and palliative surgery for patients who have complex congenital heart disease often relies on the assessment of cardiac anatomy using two-dimensional noninvasive cardiac imaging modalities (echocardiography, cardiac magnetic resonance imaging, and computed tomography scan). Advances in cardiac noninvasive imaging now include the use of three-dimensional (3D) reconstruction tools that produce 3D images and 3D printouts. There is scant evidence available in the literature as to what effect the availability of 3D printouts of complex congenital heart defects has on surgical outcomes. Surgical outcomes of study subjects with a 3D cardiac printout available and their paired control subject without a 3D cardiac printout available were compared. We found a trend toward shorter surgical times in the study group who had the benefit of 3D models, but no statistical significance was found for bypass time, cross-clamp time, total time, length of stay, or respiratory support. These preliminary results support the proposal that 3D modeling be made readily available to congenital cardiac surgery teams, for use in patients with the most complex congenital heart disease.

scholarly journals Multiscale cardiac imaging to capture the whole heart and its internal cellular architecture, with applications to congenital heart disease

2020 ◽  
Author(s):  
Graham Rykiel ◽  
Claudia S. López ◽  
Jessica L. Riesterer ◽  
Ian Fries ◽  
Sanika Deosthali ◽  
...  
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Heart Defects ◽  
Three Dimensional ◽  
Morphological Structure ◽  
Cardiac Contraction ◽  
Micro Computed Tomography ◽  
Correlative Imaging ◽  
Whole Heart

AbstractEfficient cardiac pumping depends on the morphological structure of the heart, but also on its sub-cellular (ultrastructural) architecture, which enables cardiac contraction. In cases of congenital heart defects, localized sub-cellular disruptions in architecture that increase the risk of heart failure are only starting to be discovered. This is in part due to a lack of technologies that can image the three dimensional (3D) heart structure, assessing malformations; and its ultrastructure, assessing disruptions. We present here a multiscale, correlative imaging procedure that achieves high-resolution images of the whole heart, using 3D micro-computed tomography (micro-CT); and its ultrastructure, using 3D scanning electron microscopy (SEM). This combination of technologies has not been possible before in imaging the same cardiac sample due to the heart large size, even when studying small fetal and neonatal animal models (~5×5×5mm3). Here, we achieved uniform fixation and staining of the whole heart, without losing ultrastructural preservation (at the nm resolution range). Our approach enables multiscale studies of cardiac architecture in models of congenital heart disease and beyond.

scholarly journals Outcomes of the Surgical Management of Atrial Isomerism and Functional Single Ventricle: A Single-Centered Cohort From China

2021 ◽  
Vol 8 ◽  
Author(s):  
Ming-Hui Zou ◽  
Fan Cao ◽  
Li Ma ◽  
Wei-Dan Chen ◽  
Wen-Lei Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Palliative Surgery ◽  
Complex Congenital Heart Disease ◽  
Atrioventricular Valve Regurgitation ◽  
Independent Risk Factors ◽  
Atrial Isomerism ◽  
Anomalous Pulmonary Venous Connection

Objectives: The management of atrial isomerism with complex congenital heart disease remains challenging. Experience has been largely obtained in advanced countries. The clinical diversity is greater in China. We evaluated the early- and medium-term outcomes of surgical treatment of these patients.Methods: We reviewed 86 patients of atrial isomerism with complex congenital heart disease undergoing varied surgeries in our center in 2008–2020. Cox regression models were used to analyze the risk factors for mortality.Results: There were 75 cases of right and 11 of left atrial isomerism. Eighty-three (96.5%) patients underwent single-ventricle staged palliation approach, with 10 early and 7 late deaths. The overall 1-, 5-, and 10-year survival rates were 84.7, 79.3, and 79.3%, respectively. Thirty-six (43.4%) patients completed the Fontan procedure with median age of 48 months and freedom from death or Fontan failure at 1-, 5-, and 8-years were 94.4, 87.4, and 80.7%, respectively. Concomitant total anomalous pulmonary venous connection [hazard ratio (HR): 5.15 (1.95–12.94), p = 0.008], more than moderate atrioventricular valve regurgitation [HR: 4.82 (2.42–6.79), p = 0.003], and the need for first-stage palliative surgery [HR: 4.58 (1.64–10.76), p = 0.015] were independent risk factors for mortality.Conclusions: Despite even greater clinical diversity, the surgical outcomes of atrial isomerism with complex congenital heart disease are improving in China. The early and intermediate outcomes are comparable to many previous reports. Concomitant total anomalous pulmonary venous connection, moderate or severe atrioventricular valve regurgitation, and the need for a first-stage palliative surgery are still independent risk factors for mortality.

Volumetric analysis of the right ventricle in children with congenital heart defects: comparison of biplane angiography and transthoracic 3-dimensional echocardiography

1999 ◽  
Vol 9 (6) ◽  
pp. 577-584 ◽  
Author(s):  
A. Heusch ◽  
J. Rübo ◽  
O. N. Krogmann ◽  
M. Bourgeois
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Right Ventricular ◽  
Congenital Heart ◽  
Heart Defects ◽  
Three Dimensional ◽  
Ventricular Volume ◽  
Right Ventricular Volume ◽  
3 Dimensional ◽  
Dimensional Echocardiography

AbstractBackgroundThree-dimensional echocardiography is a non-invasive imaging technique. The fact that it permits volumetric analyses independently of geometrical assumptions makes it a putatively useful method for the precise measurement of the volumes of the irregularly shaped right ventricles in children. The aim of this study was to assess the feasibility of this method and its agreement with angiocardiography based estimates of right ventricular volume in children with congenital heart disease.MethodsWe studied 102 children with congenital heart disease. The angiocardiographic right ventricular volumetry was performed using a biplanar technique using Simpson's rule and corrected with Lange's correction factors. The echo data sets were registered trans-thoracically with a rotating transmitter. Volumes were calculated after manual planimetry by adding the volumes of the individual slices.ResultsCalculation of right ventricular volume echocardiographically was possible only in 34% of patients, mostly infants and toddlers. In comparison to angiocardiography, the measured volumes were 1.1 ±6.9 ml (19.5 ±34.1%) or 6.3±9.4ml (42.5±33.6%) smaller during systole or diastole, respectively. The limits of agreement were −12.5 and 13.6ml, or 12.45 and 25.15ml during systole or diastole, respectively. When plotted to a logarithmical scale, the correlation coefficients r2 were 0.70 for systolic and 0.79 for diastolic measurements.ConclusionTransthoracic 3-dimensional echocardiography with a rotating transmitter is feasible for volumetry only in small children. The volumes measured were significantly smaller than the ones calculated from the angiocardiographic images. The correlation between the two methods is moderate.

Three‐dimensional printing for surgical planning in complex congenital heart disease

2019 ◽  
Vol 34 (11) ◽  
pp. 1363-1369 ◽  
Author(s):  
Joseph J. Vettukattil ◽  
Bassel Mohammad Nijres ◽  
Jordan M. Gosnell ◽  
Bennett P. Samuel ◽  
Marcus P. Haw
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Congenital Heart ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Complex Congenital Heart Disease ◽  
Three Dimensional Printing ◽  
Dimensional Printing
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