Using Multimodality Imaging and 3-Dimensional Printed Models to Guide Decision-Making for Complex Congenital Biventricular Repair.

BACKGROUND

Determining the optimal surgical approach for complex congenital heart disease (CHD) can be challenging using conventional 2-dimensional transthoracic echocardiography (TTE) and cross-sectional imaging, including cardiac magnetic resonance (CMR) and computed tomography.

CASE SUMMARY: An 11-month-old female patient presented with heterotaxy syndrome, dextrocardia, double-outlet right ventricle, and complex pulmonary valve stenosis. Fetal echocardiography and postnatal TTE established the complexity of the cardiac anatomy and led to a multidisciplinary discussion to plan a complex staged cardiac repair.

DISCUSSION: Three-dimensional (3D) printed and virtual heart models, along with CMR angiography, provided detailed anatomical visualization and spatial conceptualization, which aided in assessing the feasibility of a staged biventricular repair. Postoperative CMR guided subsequent surgical procedures, evaluated newly created structures such as baffles, and identified complications.

TAKE-HOME MESSAGE: This case highlights the critical role of multimodality imaging, including advanced imaging with virtual and 3D printed modeling, in surgical planning in a patient with complex CHD.