3D modeling and printing for complex biventricular repair of double outlet right ventricle
BackgroundDouble outlet right ventricle (DORV) describes a group of congenital heart defects where pulmonary artery and aorta originate completely or predominantly from the right ventricle. The individual anatomy of DORV patients varies widely with multiple subtypes classified. Although the majority...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Cardiovascular Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1024053/full |
| _version_ | 1811321206059565056 |
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| author | Jan Brüning Jan Brüning Peter Kramer Leonid Goubergrits Leonid Goubergrits Antonia Schulz Antonia Schulz Peter Murin Natalia Solowjowa Titus Kuehne Titus Kuehne Titus Kuehne Felix Berger Felix Berger Joachim Photiadis Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler |
| author_facet | Jan Brüning Jan Brüning Peter Kramer Leonid Goubergrits Leonid Goubergrits Antonia Schulz Antonia Schulz Peter Murin Natalia Solowjowa Titus Kuehne Titus Kuehne Titus Kuehne Felix Berger Felix Berger Joachim Photiadis Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler |
| author_sort | Jan Brüning |
| collection | DOAJ |
| description | BackgroundDouble outlet right ventricle (DORV) describes a group of congenital heart defects where pulmonary artery and aorta originate completely or predominantly from the right ventricle. The individual anatomy of DORV patients varies widely with multiple subtypes classified. Although the majority of morphologies is suitable for biventricular repair (BVR), complex DORV anatomy can render univentricular palliation (UVP) the only option. Thus, patient-specific decision-making is critical for optimal surgical treatment planning. The evolution of image processing and rapid prototyping techniques facilitate the generation of detailed virtual and physical 3D models of the patient-specific anatomy which can support this important decision process within the Heart Team.Materilas and methodsThe individual cardiovascular anatomy of nine patients with complex DORV, in whom surgical decision-making was not straightforward, was reconstructed from either computed tomography or magnetic resonance imaging data. 3D reconstructions were used to characterize the morphologic details of DORV, such as size and location of the ventricular septal defect (VSD), atrioventricular valve size, ventricular volumes, relationship between the great arteries and their spatial relation to the VSD, outflow tract obstructions, coronary artery anatomy, etc. Additionally, physical models were generated. Virtual and physical models were used in the preoperative assessment to determine surgical treatment strategy, either BVR vs. UVP.ResultsMedian age at operation was 13.2 months (IQR: 9.6-24.0). The DORV transposition subtype was present in six patients, three patients had a DORV-ventricular septal defect subtype. Patient-specific reconstruction was feasible for all patients despite heterogeneous image quality. Complex BVR was feasible in 5/9 patients (55%). Reasons for unsuitability for BVR were AV valve chordae interfering with potential intraventricular baffle creation, ventricular hypoplasia and non-committed VSD morphology. Evaluation in particular of qualitative data from 3D models was considered to support comprehension of complex anatomy.ConclusionImage-based 3D reconstruction of patient-specific intracardiac anatomy provides valuable additional information supporting decision-making processes and surgical planning in complex cardiac malformations. Further prospective studies are required to fully appreciate the benefits of 3D technology. |
| first_indexed | 2024-04-13T13:12:45Z |
| format | Article |
| id | doaj.art-51953b9b5d8b40689977eea94eafce43 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-04-13T13:12:45Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-51953b9b5d8b40689977eea94eafce432022-12-22T02:45:33ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2022-11-01910.3389/fcvm.2022.102405310240533D modeling and printing for complex biventricular repair of double outlet right ventricleJan Brüning0Jan Brüning1Peter Kramer2Leonid Goubergrits3Leonid Goubergrits4Antonia Schulz5Antonia Schulz6Peter Murin7Natalia Solowjowa8Titus Kuehne9Titus Kuehne10Titus Kuehne11Felix Berger12Felix Berger13Joachim Photiadis14Viktoria Heide-Marie Weixler15Viktoria Heide-Marie Weixler16Viktoria Heide-Marie Weixler17Institute for Cardiovascular Computer-Assisted Medicine, Charité – Universitätsmedizin Berlin, Berlin, GermanyPartner Site Berlin, German Center for Cardiovascular Research (DZHK), Berlin, GermanyDepartment of Congenital Heart Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, GermanyInstitute for Cardiovascular Computer-Assisted Medicine, Charité – Universitätsmedizin Berlin, Berlin, GermanyEinstein Center Digital Future, Berlin, GermanyDepartment of Congenital Heart Surgery and Pediatric Heart Surgery, German Heart Center Berlin, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyDepartment of Congenital Heart Surgery and Pediatric Heart Surgery, German Heart Center Berlin, Berlin, GermanyDepartment of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, GermanyInstitute for Cardiovascular Computer-Assisted Medicine, Charité – Universitätsmedizin Berlin, Berlin, GermanyPartner Site Berlin, German Center for Cardiovascular Research (DZHK), Berlin, GermanyDepartment of Congenital Heart Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, GermanyPartner Site Berlin, German Center for Cardiovascular Research (DZHK), Berlin, GermanyDepartment of Congenital Heart Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, GermanyDepartment of Congenital Heart Surgery and Pediatric Heart Surgery, German Heart Center Berlin, Berlin, GermanyPartner Site Berlin, German Center for Cardiovascular Research (DZHK), Berlin, GermanyDepartment of Congenital Heart Surgery and Pediatric Heart Surgery, German Heart Center Berlin, Berlin, GermanyBerlin Institute of Health (BIH), Berlin, GermanyBackgroundDouble outlet right ventricle (DORV) describes a group of congenital heart defects where pulmonary artery and aorta originate completely or predominantly from the right ventricle. The individual anatomy of DORV patients varies widely with multiple subtypes classified. Although the majority of morphologies is suitable for biventricular repair (BVR), complex DORV anatomy can render univentricular palliation (UVP) the only option. Thus, patient-specific decision-making is critical for optimal surgical treatment planning. The evolution of image processing and rapid prototyping techniques facilitate the generation of detailed virtual and physical 3D models of the patient-specific anatomy which can support this important decision process within the Heart Team.Materilas and methodsThe individual cardiovascular anatomy of nine patients with complex DORV, in whom surgical decision-making was not straightforward, was reconstructed from either computed tomography or magnetic resonance imaging data. 3D reconstructions were used to characterize the morphologic details of DORV, such as size and location of the ventricular septal defect (VSD), atrioventricular valve size, ventricular volumes, relationship between the great arteries and their spatial relation to the VSD, outflow tract obstructions, coronary artery anatomy, etc. Additionally, physical models were generated. Virtual and physical models were used in the preoperative assessment to determine surgical treatment strategy, either BVR vs. UVP.ResultsMedian age at operation was 13.2 months (IQR: 9.6-24.0). The DORV transposition subtype was present in six patients, three patients had a DORV-ventricular septal defect subtype. Patient-specific reconstruction was feasible for all patients despite heterogeneous image quality. Complex BVR was feasible in 5/9 patients (55%). Reasons for unsuitability for BVR were AV valve chordae interfering with potential intraventricular baffle creation, ventricular hypoplasia and non-committed VSD morphology. Evaluation in particular of qualitative data from 3D models was considered to support comprehension of complex anatomy.ConclusionImage-based 3D reconstruction of patient-specific intracardiac anatomy provides valuable additional information supporting decision-making processes and surgical planning in complex cardiac malformations. Further prospective studies are required to fully appreciate the benefits of 3D technology.https://www.frontiersin.org/articles/10.3389/fcvm.2022.1024053/fulldouble outlet right ventricle (DORV)biventricular repair3D printingcongenital heart diseaseimage reconstruction |
| spellingShingle | Jan Brüning Jan Brüning Peter Kramer Leonid Goubergrits Leonid Goubergrits Antonia Schulz Antonia Schulz Peter Murin Natalia Solowjowa Titus Kuehne Titus Kuehne Titus Kuehne Felix Berger Felix Berger Joachim Photiadis Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler Viktoria Heide-Marie Weixler 3D modeling and printing for complex biventricular repair of double outlet right ventricle Frontiers in Cardiovascular Medicine double outlet right ventricle (DORV) biventricular repair 3D printing congenital heart disease image reconstruction |
| title | 3D modeling and printing for complex biventricular repair of double outlet right ventricle |
| title_full | 3D modeling and printing for complex biventricular repair of double outlet right ventricle |
| title_fullStr | 3D modeling and printing for complex biventricular repair of double outlet right ventricle |
| title_full_unstemmed | 3D modeling and printing for complex biventricular repair of double outlet right ventricle |
| title_short | 3D modeling and printing for complex biventricular repair of double outlet right ventricle |
| title_sort | 3d modeling and printing for complex biventricular repair of double outlet right ventricle |
| topic | double outlet right ventricle (DORV) biventricular repair 3D printing congenital heart disease image reconstruction |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2022.1024053/full |
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