利用多模态成像和三维打印模型指导复杂先天性双心室修复的决策

Q4 Medicine

JACC. Case reports Pub Date : 2025-06-25 DOI:10.1016/j.jaccas.2025.103884

Sukran Erdem MD , Munes Fares MD , Felipe Murguia MD , Jay Moore RDCS , Gregory Sturgeon RDCS , Catherine M. Ikemba MD , Gerald Greil MD, PhD , Tarique Hussain MD, PhD , Nicholas D. Andersen MD , Qing Zou PhD

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引用次数: 0

摘要

背景：利用传统的二维经胸超声心动图（TTE）和横断面成像（包括心脏磁共振（CMR）和计算机断层扫描）确定复杂先天性心脏病（CHD）的最佳手术入路是具有挑战性的。一例11个月大的女性患者，表现为异位综合征、右心、双出口右心室和复杂的肺动脉瓣狭窄。胎儿超声心动图和产后TTE确立了心脏解剖的复杂性，并引发了多学科讨论，以计划复杂的分阶段心脏修复。三维（3D）打印和虚拟心脏模型，以及CMR血管造影，提供了详细的解剖可视化和空间概念化，这有助于评估分阶段双心室修复的可行性。术后CMR指导后续手术，评估新创建的结构，如挡板，并确定并发症。本病例强调了多模式成像的关键作用，包括先进的虚拟成像和3D打印建模，在复杂冠心病患者的手术计划中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.

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