Disharmonious Ventricular Relationship and Topology for the Given Atrioventricular Connections. Contemporary Diagnostic Approach Using 3D Modeling and Printing

Abstract

In the last issue, two case reports separately present examples of the extremely rare and complex congenital heart diseases that show concordant atrioventricular connections to the L-looped ventricles in the presence of situs solitus. Both cases highlight that the relationship between the two ventricles within the ventricular mass is not always harmonious with the given atrioventricular connection. Such disharmony between the connections and relationships requires careful assessment of the three basic facets of cardiac building blocks, namely their morphology, the relationship of their component parts, and their connections with the adjacent segments. 3D imaging and printing can now facilitate an otherwise difficult diagnosis in such complex situations. Rotation of either the 3D images or the models permit accurate assessment of the ventricular topologic pattern by creating the right ventricular en-face septal view, thus facilitating placement of the observer’s hands. As we now emphasize, an alternative approach, which might prove more attractive to imagers, is to rotate the ventricular mass to provide the ventricular apical view, thus permitting determination of the ventricular relationship without using the hands.