Diagnosis And Treatment Of 3D Printing Technology In Complex Congenital Heart Disease With Double Outlet Right Ventricle

ObjectiveTo manufacture three-dimensional(3D)cardiac models of double outlet right ventricle(DORV)in patients with complex congenital heart disease by 3D printing technology and to evaluate the value of 3D printing modes in diagnosis,preoperative evaluation and surgical strategies of DORV.MethodsRetrospective assessment the data of 32 patients with DORV in Henan Provincial People's Hospital from September 2015 to December 2017.All patients were divided into 4 groups according to the position of ventricular septal defect(VSD).8 subaortic VSD type of DORV cases,5 patients had the subpulmonary VSD,6 patients had the doubly committed VSD,and 13 patients had the remoted VSD.All patients underwent echocardiography and cardiac CT angiography(CTA)scan.The CTA image data were reconstructed and then input into a 3D printer to manufacture 3D printed heart models at a 1:1 scale.The accuracy of the 3D printing model was evaluated by comparing the size of the VSD,the diameter of the aorta,the diameter of the pulmonary artery and its branches in the 3D printing model with the data in the CTA data by a Pearson coefficient analysis,and the results was compared with intraoperative findings.Making the preoperative diagnosis,preoperative assessment,and the surgical strategies according to the two-dimensional(2D)imaging data and the 3D-printed heart model,respectively.The results were compared with postoperative diagnoses and final surgical strategies to assess the value of 3D printed cardiac model in the diagnosis and treatment of DORV.Results1.The accuracy of 3D printing models: There was good correlation between 3D printed models and CTA data with a Pearson correlation coefficient of 0.972.2.The diagnosis of DORV: Both the two-dimensional imaging and 3D printed models were effective in the diagnosis in all groups(P>0.05).32 cases of DORV patients were successfully produced 3D printing models which diagnoses were all consistent with postoperative diagnoses.28 patients were consistent with postoperative diagnosis in the 2D imaging data,4 cases were inconsistent including 1 case of subaortic VSD type of DORV and 3 patients of remoted VSD type of DORV.3.Surgical results: For patients in subaortic VSD type,subpulmonary VSD type,and doubly committed VSD type of DORV,2D imaging and 3D printed models were effective in the designing of surgical strategies(P>0.05).For patients with remoted VSD,3D printed models were more accurate in the designing of surgical strategies(P=0.02).According to the 3D printing cardiac model,31 patients were consistent with the final operation,a case of remoted VSD type of DORV was inconsistent with the final operation.According to the 2D imaging data to develop surgical plans,22 cases were consistent with the final operation,including a case of subaortic VSD,one patient of doubly committed VSD and 8 cases remoted VSD of type of DORV were inconsistent with the final operation.ConclusionThe 3D model of DORV can be used to demonstrate the complex spatial structure clearly and has guidance meaning for the diagnosis,preoperative evaluation and surgical strategies making in DORV,and may save operating time,shorten the recovery time.