Three-Dimensional Printing Model in Double-Outlet Right Ventricle to Simplify Intraventricular Repair

pp.200-204

Abstract

Introduction: Three-dimensional (3D) printing of anatomical structures is gaining interest in congenital heart surgery. We report the case of a 6 year-old boy with double-outlet right ventricle, tetralogy of Fallot subtype, who underwent surgical repair with intracardiac patch. This procedure was  performed with the support of two 3D printed models: one of the heart and another of the tunnel patch.

Materials and Methods: Transthoracic color Doppler echocardiography, cardiac catheterization, and multi-detector row computed tomography angiography with 3D reconstruction were performed as preoperative evaluation. The 3D models of the heart and the patch –virtually designed to create the intracardiac tunnel– were printed to evaluate possibilities and strategies during the repair. Both 3D models were sterilized for intraoperative use.

Results: The 3D heart accurately showed the position of the ventricular septal defect regarding adjacent structures, including the pulmonary, tricuspid, and aortic valves. The virtual planning, simulation, and 3D-printed patch model were useful for making the sutured patch for the tunnel. Postoperative color Doppler echocardiography revealed an effective repair with no residual obstruction.

Conclusions: Three-dimensional printing models of the intracardiac anatomy, together with simulation and patch printing, using multi-detector row computed tomography angiography, could provide valuable information for preoperative planning in patients with double-outlet right ventricle, tetralogy of Fallot subtype. The 3D-printed patch models could also be useful to simplify and increase the efficacy of complex procedures.