Evaluation of multiple ventricular septal defects using three-dimensional reconstruction models†.

Objectives: Although there has been rapid development in the field of three-dimensional morphological analyses of congenital heart disease, with the three-dimensional volume-rendered images providing visualization of the external vascular anatomy, the precise reproduction of 'Swiss-cheese' ventricular septum is not well established. We created three-dimensional printed models and computer graphics based on multi-slice computed tomography of patients with complex multiple ventricular septal defects for surgical decision planning of this difficult cardiac defect.

Methods: Seven patients with complex multiple ventricular septal defects were evaluated preoperatively using 3-dimensional printed models and computer graphics to plan therapeutic interventions.

Results: The three-dimensional printed models detected muscular VSDs in 9 out of 15 (60%) regions. On the other hand, 3-dimensional computer graphics detected 10 out of 15 (67%) regions. The 3-dimensional printed models and computer graphics allowed the evaluation of the muscular ventricular septal defects from both the left and right ventricular aspects of the septum.

Conclusions: Our preliminary experiences suggest that three-dimensional printed models and computer graphics can help plan surgery in patients with complex multiple ventricular septal defects. Three-dimensional printed models allowed surgeons to understand the three-dimensional positioning of complex multiple ventricular septal defects preoperatively. High-quality three-dimensional computer graphics provided precise information about the size, shape and localization of muscular ventricular septal defects especially from the left ventricular side.