Apical Muscular Ventricular Septal Defects: Surgical Strategy Using Three-Dimensional Printed Model

Autor: Jose Rivas, Israel Valverde, Marie-Josée Raboisson, Gorka Gomez-Ciriza, Ana Mendez, Antonio Ordóñez, Nancy Poirier
Rok vydání: 2018
Předmět:
Pulmonary and Respiratory Medicine
Heart Septal Defects
Ventricular
Models
Anatomic
medicine.medical_specialty
Surgical strategy
0206 medical engineering
3d model
Computed tomography
02 engineering and technology
030204 cardiovascular system & hematology
Right atrial
03 medical and health sciences
0302 clinical medicine
Imaging
Three-Dimensional
medicine
Humans
Direct evaluation
Cardiac Surgical Procedures
medicine.diagnostic_test
business.industry
Models
Cardiovascular
Infant
General Medicine
medicine.disease
020601 biomedical engineering
Echocardiography
Doppler
Color
Trabecular septum
Treatment Outcome
Heart failure
Printing
Three-Dimensional
Radiographic Image Interpretation
Computer-Assisted
Surgery
Female
Radiology
Surgical simulation
Cardiology and Cardiovascular Medicine
business
Tomography
X-Ray Computed
Zdroj: Seminars in thoracic and cardiovascular surgery. 30(4)
ISSN: 1532-9488
Popis: To evaluate the utility of a three-dimensional printed model (3D-model) for surgical decision planning in a complex case of multiple ventricular septal defect (VSD) (so-called Swiss-cheese septum). A 3 month-old-girl with diagnosis of multiple apical VSDs in the trabecular septum, perimembranous VSD, and atrial septal defect that resulted in congestive heart failure was referred for surgical intervention. Due to inconclusive understanding of the total number, openings and locations of the apical VSDs, there were concerns regarding the best surgical approach. Using computed tomography images, a 3D-model was fabricated by fused deposition modeling of polyurethane filament. The 3D model helped identifying the total number of VSD, their origins and exits as well as the minimum number of septal bands to resect, the optimal patch size and morphology to completely close all VSDs without reducing significantly the RV cavity. The procedure was successfully replicated in the patient by right atrial approach, resulting in good RV cavity size, function and no residual VSDs evaluated by transesophageal echocardiography. Direct evaluation of the 3D printed replica anatomy and surgical simulation may help optimizing surgical approach, patch size and location and therefore it might reduce complications and residual defects.
Databáze: OpenAIRE
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