Clinical 3D modeling to guide pediatric cardiothoracic surgery and intervention using 3D printed anatomic models, computer aided design and virtual reality

• Published in: 3D printing in medicine Vol. 8; no. 1; p. 11
• Main Authors: Ghosh, Reena M., Jolley, Matthew A., Mascio, Christopher E., Chen, Jonathan M., Fuller, Stephanie, Rome, Jonathan J., Silvestro, Elizabeth, Whitehead, Kevin K.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 21-04-2022; Springer Nature B.V; BMC
• Subjects: 3D printing; Biomaterials; Biomedical Engineering and Bioengineering; CAD; Cardiovascular disease; Computer aided design; Congenital diseases; Congenital heart disease; Imaging; Magnetic resonance imaging; Medicine; Medicine & Public Health; Pediatrics; Radiology; Surgery; Surgical planning; Virtual reality; Cardiac catheterization; Magnetic resonance imaging; Imaging; Virtual reality; Pediatric cardiology; Cardiothoracic surgery; Congenital heart disease; Surgical planning; 3D printing; Computer aided design
• ISSN: 2365-6271; 2365-6271
• DOI: 10.1186/s41205-022-00137-9

Background
Surgical and catheter-based interventions for congenital heart disease require precise understanding of complex anatomy. The use of three-dimensional (3D) printing and virtual reality to enhance visuospatial understanding has been well documented, but integration of these methods into routine clinical practice has not been well described. We review the growth and development of a clinical 3D modeling service to inform procedural planning within a high-volume pediatric heart center.
Methods
Clinical 3D modeling was performed using cardiac magnetic resonance (CMR) or computed tomography (CT) derived data. Image segmentation and post-processing was performed using FDA-approved software. Patient-specific anatomy was visualized using 3D printed models, digital flat screen models and virtual reality. Surgical repair options were digitally designed using proprietary and open-source computer aided design (CAD) based modeling tools.
Results
From 2018 to 2020 there were 112 individual 3D modeling cases performed, 16 for educational purposes and 96 clinically utilized for procedural planning. Over the 3-year period, demand for clinical modeling tripled and in 2020, 3D modeling was requested in more than one-quarter of STAT category 3, 4 and 5 cases. The most common indications for modeling were complex biventricular repair (
n
 = 30, 31%) and repair of multiple ventricular septal defects (VSD) (
n
 = 11, 12%).
Conclusions
Using a multidisciplinary approach, clinical application of 3D modeling can be seamlessly integrated into pre-procedural care for patients with congenital heart disease. Rapid expansion and increased demand for utilization of these tools within a high-volume center demonstrate the high value conferred on these techniques by surgeons and interventionalists alike.