Three-dimensional printing and virtual reconstruction in surgical planning of double-outlet right ventricle repair

Article Article scientifique Article Three-dimensional printing and virtual reconstruction in surgical planning of double-outlet right ventricle repair eng 2022-11-26 2023-02 author Ponchant Kevin Cardiovascular Radiology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. 822926 author Nguyen Duy-Anh Pediatric Cardiology Unit, Children's University Hospital, Geneva, Switzerland. 946496 author Prsa Milan Division of Pediatric Cardiology, Woman-Mother-Child Department, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique, Geneva University Hospitals/Lausanne University Hospital, Geneva/Lausanne, Switzerland. author Beghetti Maurice Pediatric Cardiology Unit, Children's University Hospital, Geneva, Switzerland.,Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique, Geneva University Hospitals/Lausanne University Hospital, Geneva/Lausanne, Switzerland. 31865 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Sologashvili Tornike Centre Universitaire Romand de Cardiologie et Chirurgie Cardiaque Pédiatrique, Geneva University Hospitals/Lausanne University Hospital, Geneva/Lausanne, Switzerland.,Division of Cardiac Surgery, Geneva University Hospitals, Geneva, Switzerland. 807807 Département de chirurgie (CHIRU) author Vallée Jean-Paul 0000-0001-7546-2013 Cardiovascular Radiology Unit, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. 29185 Département de radiologie et informatique médicale (RADIO) 138-150 10.1016/j.xjtc.2022.11.005 36820361 2666-2507 PMC9938382 https://www.sciencedirect.com/science/article/pii/S2666250722005855 Objectives: For more than a decade, 3-dimensional (3D) printing has been identified as an innovative tool for the surgical planning of double-outlet right ventricle (DORV). Nevertheless, lack of evidence concerning its benefits encourages us to identify valuable criteria for future prospective trials. Methods: We conducted a retrospective study involving 10 patients with DORV operated between 2015 and 2019 in our center. During a preoperative multidisciplinary heart team meeting, we harvested surgical decisions following a 3-increment step process: (1) multimodal imaging; (2) 3D virtual valvular reconstruction (3DVVR); and (3) 3D-printed heart model (3DPHM). The primary outcome was the proportion of predicted surgical strategy following each of the 3 steps, compared with the institutional retrospective surgical strategy. The secondary outcome was the change of surgical strategy through 3D modalities compared with multimodal imaging. The incremental benefit of the 3DVVR and 3DPHM over multimodal imaging was then assessed. Results: The operative strategy was predicted in 5 cases after multimodal imaging, in 9 cases after 3DVVR, and the 10 cases after 3DPHM. Compared with multimodal imaging, 3DVVR modified the strategy for 4 cases. One case was correctly predicted only after 3DPHM inspection. Conclusions: 3DVVR and 3DPHM improved multimodal imaging in the surgical planning of patients with DORV. 3DVVR allowed a better appreciation of the relationships between great vessels, valves, and ventricular septal defects. 3DPHM offers a realistic preoperative view at patient scale and enhances the evaluation of outflow tract obstruction. Our retrospective study demonstrates benefits of preoperative 3D modalities and supports future prospective trials to assess their impact on postoperative outcomes. 3D modality in surgical planning 3D printed heart model 3D printing 3D virtual valvular reconstruction 3D, 3-dimensional 3DPHM, 3D-printed heart model 3DVVR, 3D virtual valvular annulus reconstruction CTA, computed tomography angiogram DORV, double-outlet right ventricle LV, left ventricle PA, pulmonary artery PV, pulmonary valve TGA, transposition of the great arteries TTE, transthoracic echocardiography VSD, ventricular septal defect Double-outlet right ventricle Dewey 616.0757 Dewey 617 Dewey 618 58 Département de pédiatrie, gynécologie et obstétrique 223 62 Département de radiologie et informatique médicale 227 57 Département de chirurgie 222 false 179 L'hypertension pulmonaire (pédiatrie) 228 286 Imagerie cardiaque fonctionnelle 541 JTCVS techniques 17 cf9bdab2-b678-451d-840f-2b49407c5d2f Article (Published version) Public PIIS2666250722005855.pdf 2877384 application/pdf CC BY-4.0 32a2a9b5f5f449d7e3d2feda0a96f6b08684bd0d87f26fb46220cf60efc21b3d openAccess Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Ponchant, Kevin