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Josowitz R, Rogers LS. Double outlet right ventricle - the 50% rule has always been about the conus. Curr Opin Cardiol 2024; 39:348-355. [PMID: 38391276 DOI: 10.1097/hco.0000000000001131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE OF REVIEW There has been much variability in the definition of double outlet right ventricle (DORV) spanning the last century. Historically, emphasis has been placed on the assignment of the great arteries to the right ventricle as a definition of DORV. In this review, we aim to underscore the importance of conal muscle, rather than rules surrounding assignment of great arteries to ventricles. We will be outlining the variability in patient anatomy that results from variations in conal muscle development in DORV, which may not fit perfectly into predefined constructs. This anatomic variability directly determines physiology and surgical repair options. RECENT FINDINGS There is a growing appreciation of the utility of cross-sectional imaging in complex DORV, and the generation of patient-specific 3D models with virtual reality simulations for surgical planning. These models improve the prediction of candidacy for biventricular repair and allow the mapping of complex baffle pathways preoperatively. SUMMARY DORV is not a disease entity in itself, but rather a vast spectrum of disorders associated with maldevelopment of conal muscle and often abnormal expansion of one the great vessels. Patient-specific 3D models will be crucial for improved surgical planning and patient outcomes.
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Affiliation(s)
- Rebecca Josowitz
- The Cardiac Center, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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Isobe S, Katayama Y, Ozawa T, Fujii T. Intracardiac Three-Dimensional Image as Surgical Decision-Making Tool of Congenital Heart Disease. Pediatr Cardiol 2024; 45:351-360. [PMID: 38017199 DOI: 10.1007/s00246-023-03349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/07/2023] [Indexed: 11/30/2023]
Abstract
This study aimed to evaluate the anatomical reproducibility of a preoperative intracardiac 3D image (IC image) created using computed tomography, and to investigate its usefulness as a surgical decision-making tool. Between 2012 and 2022, ventricular septal defect (VSD) patients, and double outlet right ventricle (DORV) or transposition of the great arteries (TGA) with pulmonary stenosis (PS) patients who underwent cardiac surgery and had preoperative computed tomography were enrolled. SYNAPSE VINCENT® (Fujifilm) was used to create an IC image which was analyzed retrospectively. In 14 VSD patients, the diagnostic consistency rate in the Soto classification with intraoperative findings was 100% (14/14) for IC image versus 64% (9/14) for transthoracic echocardiography (P = 0.04). The defect size showed a higher correlation coefficient with IC image (0.837, P = 0.001) than with transthoracic echocardiography (0.567, P = 0.034). In 11 DORV/TGA with PS patients, the diagnostic consistency rate in the Lev classification was 100% (9/9) for IC image versus 77% (7/9) for transthoracic echocardiography (P = 0.47). The secondary interventricular foramen (SVF)/left ventricular outflow tract (LVOT) ratio by IC image was significantly smaller in the biventricular-repair group (median 0.71, IQR 0.67-1.06) than in the univentricular-repair group (median 1.79, IQR 1.53-2.42) (P = 0.006). An IC image is useful as a surgical decision-making tool for simple VSDs and complex congenital heart diseases such as DORV or TGA with pulmonary stenosis. The SVF/LVOT ratio determined from the IC image may be a useful indicator for avoiding LVOT obstruction.
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Affiliation(s)
- Sho Isobe
- Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi Ota-Ku, Tokyo, 143-8541, Japan
| | - Yuzo Katayama
- Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi Ota-Ku, Tokyo, 143-8541, Japan.
| | - Tsukasa Ozawa
- Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi Ota-Ku, Tokyo, 143-8541, Japan
| | - Takeshiro Fujii
- Division of Cardiovascular Surgery, Department of Surgery, Toho University Omori Medical Center, 6-11 Omori-Nishi Ota-Ku, Tokyo, 143-8541, Japan
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Priya S, La Russa D, Walling A, Goetz S, Hartig T, Khayat A, Gupta P, Nagpal P, Ashwath R. "From Vision to Reality: Virtual Reality's Impact on Baffle Planning in Congenital Heart Disease". Pediatr Cardiol 2024; 45:165-174. [PMID: 37932525 DOI: 10.1007/s00246-023-03323-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 10/04/2023] [Indexed: 11/08/2023]
Abstract
This study aims to evaluate the feasibility and utility of virtual reality (VR) for baffle planning in congenital heart disease (CHD), specifically by creating patient-specific 3D heart models and assessing a user-friendly VR interface. Patient-specific 3D heart models were created using high-resolution imaging data and a VR interface was developed for baffle planning. The process of model creation and the VR interface were assessed for their feasibility, usability, and clinical relevance. Collaborative and interactive planning within the VR space were also explored. The study findings demonstrate the feasibility and usefulness of VR in baffle planning for CHD. Patient-specific 3D heart models generated from imaging data provided valuable insights into complex spatial relationships. The developed VR interface allowed clinicians to interact with the models, simulate different baffle configurations, and assess their impact on blood flow. The VR space's collaborative and interactive planning enhanced the baffle planning process. This study highlights the potential of VR as a valuable tool in baffle planning for CHD. The findings demonstrate the feasibility of using patient-specific 3D heart models and a user-friendly VR interface to enhance surgical planning and patient outcomes. Further research and development in this field are warranted to harness the full benefits of VR technology in CHD surgical management.
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Affiliation(s)
- Sarv Priya
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA.
| | - Dan La Russa
- Realize Medical Inc., Ottawa, Canada
- Department of Radiology, Radiation Oncology and Medical Physics, University of Ottawa, Ottawa, Canada
| | - Abigail Walling
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Sawyer Goetz
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | - Tyler Hartig
- Department of Radiology, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52242, USA
| | | | - Pankaj Gupta
- Division of Pediatric Cardiology, The Royal Hospital for Children, Glasgow, UK
| | - Prashant Nagpal
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, USA
| | - Ravi Ashwath
- Division of Pediatric Cardiology, Department of Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Satsangi A, Prasad H, Murtaza SM, Devagourou V. Trans-aortic DORV repair. Indian J Thorac Cardiovasc Surg 2023; 39:622-625. [PMID: 37885932 PMCID: PMC10597895 DOI: 10.1007/s12055-023-01564-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/23/2023] [Accepted: 06/26/2023] [Indexed: 10/28/2023] Open
Abstract
Double-outlet right ventricle (DORV) is a group of complex ventriculoarterial connections. In the literature, there are reports of trans-aortic correction of tetralogy of Fallot, as well as ventricular septal defects and complex DORV without right ventricular outflow tract obstruction. However, a pure trans-aortic approach for DORV ventricular septal defect (VSD) right ventricular outflow tract obstruction repair is not reported in the literature. We present a case of pure trans-aortic repair of DORV VSD pulmonary stenosis (PS) in an adult. A 20-year-old male with a known case of DORV, VSD, and PS presented with cyanosis. A pure trans-aortic repair of DORV was done. Complete trans-aortic DORV VSD PS repair is yet to be reported in the literature. The trans-aortic approach avoids a right atriotomy, right ventriculotomy, and injury to coronary arteries in cases of complicated tetralogy of Fallot and avoids injury to the tricuspid valve. This approach can be used in selected patients for intracardiac repair. The advantages are excellent visualization of the defects and avoidance of injury to the aortic cusps and bundle of His. In addition, placement of the VSD patch on the left ventricular outflow side may prevent residual shunts after repair. Supplementary Information The online version contains supplementary material available at 10.1007/s12055-023-01564-x.
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Affiliation(s)
- Amitabh Satsangi
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 10029 India
| | - Hari Prasad
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 10029 India
| | - Sheikh Mohd Murtaza
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 10029 India
| | - V. Devagourou
- Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, New Delhi, 10029 India
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Holten-Andersen M, Lippert M, Holmstrøm H, Brun H, Døhlen G. Current outcomes of live-born children with double outlet right ventricle in Norway. Eur J Cardiothorac Surg 2022; 63:6874543. [PMID: 36472441 PMCID: PMC9762987 DOI: 10.1093/ejcts/ezac560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/29/2022] [Accepted: 12/06/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This population-based, comprehensive, retrospective study presented the clinical outcomes of all children born in Norway between 2003 and 2017 with double outlet right ventricle (DORV). METHODS All children born with DORV between 2003 and 2017 were identified in the Oslo University Hospital registry. Patients' characteristics, interventions, complications and deaths were recorded. Echocardiographic data were reviewed for classification according to current standards. We investigated time-dependent surgical reintervention and mortality using Kaplan-Meier analyses and determinants of treatment complications, reintervention and death using regression analyses. RESULTS Ninety-three children with DORV represented an annual median prevalence of 1.18 per 10 000 births in Norway. Six children received palliative care. With an intention to treat, a surgical route with the primary biventricular repair was followed for 62 children, staged biventricular repair for 15 and univentricular repair for 10 children. Major complications occurred in 1.0% and 6.2% of children following catheter or surgical intervention, respectively. No significant determinants of the complications were identified. Overall survival following treatment was 91.9%, 90.8%, 89.5% and 89.5% and corresponding freedom from surgical reintervention was 88.0%, 79.0%, 74.9% and 69.4% at 1, 2, 5 and 10 years, respectively. The presence of atrioventricular septal defect predicted an increased risk of mortality (hazard ratio: 7.16) but did not increase the risk of surgical reintervention. CONCLUSIONS In Norway, most children receive tailored treatment for DORV with low rates of complications, surgical reinterventions and mortality. However, atrioventricular septal defect remains a potential determinant of postoperative death.
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Affiliation(s)
- Mads Holten-Andersen
- Corresponding author. Department of Pediatrics, Lillehammer Hospital, Anders Sandvigsgate, 2609 Lillehammer, Norway. Tel:+47-61272013; e-mail: (M. Holten-Andersen)
| | - Matthias Lippert
- Institute of Clinical Medicine, Oslo University, Oslo, Norway,The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Henrik Holmstrøm
- Institute of Clinical Medicine, Oslo University, Oslo, Norway,Department of Pediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Henrik Brun
- The Intervention Centre, Oslo University Hospital, Oslo, Norway,Department of Pediatric Cardiology, Oslo University Hospital, Oslo, Norway
| | - Gaute Døhlen
- Department of Pediatric Cardiology, Oslo University Hospital, Oslo, Norway
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Karev E, Stovpyuk OF. Double outlet right ventricle in adults: Anatomic variability, surgical treatment, and late postoperative complications. JOURNAL OF CLINICAL ULTRASOUND : JCU 2022; 50:1151-1165. [PMID: 36218204 DOI: 10.1002/jcu.23319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
Double outlet right ventricle (DORV) is a highly complex congenital heart disease (CHD) entity, gaining increasing interest due to the rapid progress of cardiac surgery. The number of patients operated for this congenital defect has been growing since 1980s and over following decades with active transitioning of this cohort into the adult medicine. However, the diversity of initial anomaly and performed interventions makes challenging the management of these patients. This is particularly important in the regions where specialized adult CHD cardiology still remains underdeveloped. In this review, we observe the basic principles of DORV nomenclature, main types of the operations and possible late complications. The article focuses on adult patients and offers illustrations from clinical practice.
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Affiliation(s)
- Egor Karev
- The aorta and aortic valve pathology research laboratory, Federal State Budgetary Institution "V. A. Almazov National Medical Research Center" of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
| | - Oksana F Stovpyuk
- The aorta and aortic valve pathology research laboratory, Federal State Budgetary Institution "V. A. Almazov National Medical Research Center" of the Ministry of Health of the Russian Federation, Saint Petersburg, Russia
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Fernandez-Doblas J, Pamies-Catalan A, Dolader P, Ferrer Q, Abella RF. Usefulness of transaortic approach for a complex double-outlet right ventricle. Indian J Thorac Cardiovasc Surg 2022; 38:84-86. [PMID: 34898882 PMCID: PMC8630326 DOI: 10.1007/s12055-021-01261-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 01/03/2023] Open
Abstract
Surgical procedures for double-outlet right ventricle with ventricular septal defect are based on rerouting the blood flow of the left ventricle to the aorta through the ventricular septal defect (VSD) with an intraventricular baffle. The right atriotomy is the most common approach combined with a right ventriculotomy in some cases, particularly in pulmonary stenosis association. However, in complex cases, this standard operative strategy may not provide an adequate exposure. We describe the transaortic approach as an alternative procedure to repair a complex case of double-outlet right ventricle (DORV) with subaortic stenosis. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s12055-021-01261-7.
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Affiliation(s)
- Joaquín Fernandez-Doblas
- grid.411083.f0000 0001 0675 8654Pediatric Cardiac Surgery Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Antonio Pamies-Catalan
- grid.411083.f0000 0001 0675 8654Pediatric Cardiac Surgery Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Paola Dolader
- grid.411083.f0000 0001 0675 8654Pediatric Cardiology Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Queralt Ferrer
- grid.411083.f0000 0001 0675 8654Pediatric Cardiology Department, Vall Hebron University Hospital, Barcelona, Spain
| | - Raul F. Abella
- grid.411083.f0000 0001 0675 8654Pediatric Cardiac Surgery Department, Vall Hebron University Hospital, Barcelona, Spain
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Marathe SP, Piekarski B, Beroukhim RS, Gauvreau K, Baird CW, Emani SM, Del Nido PJ, Kaza AK. Super Glenn for staged biventricular repair: impact on left ventricular growth? Eur J Cardiothorac Surg 2021; 60:534-541. [PMID: 33718971 DOI: 10.1093/ejcts/ezab126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES The Super Glenn procedure involves targeted increased in blood flow to left sided heart structures with fenestrated atrial septation. The objective of this study was to examine the outcomes of patients who had this procedure as a part of biventricular staging and specifically evaluate the effect on dimensions of left heart structures. METHODS Data for patients who had this procedure between 2005 and 2019 were retrospectively identified. RESULTS Thirty-seven patients were identified. Most common diagnosis was hypoplastic left heart syndrome in 40% (n = 15). On echocardiography, the median mitral valve z score was -2.26. On cardiac magnetic resonance imaging, median indexed left ventricular end-diastolic volume was 31.5 ml/m2 and mitral/tricuspid inflow ratio was 0.35. The median age at Super Glenn was 2.3 years (interquartile range 1.5-3.6) while median weight was 12 kg (interquartile range 9.8-14). There were no early/hospital deaths. The median intensive care unit length of stay was 4 days, and median hospital length of stay was 10 days. Median follow-up for the entire cohort was 3 years (range 15 days to 13.2 years). There was a statistically significant increase in indexed left ventricular dimensions. There were 5 deaths (14%). Three patients (8%) underwent heart transplant. Freedom from death/transplant was 79% at 5 years. Seven patients (19%) needed a reoperation. Twenty-three patients (62%) underwent biventricular conversion after a median of 11.3 months after Super Glenn. CONCLUSIONS The Super Glenn procedure achieves consistent increase in left ventricular dimensions. This may be a useful strategy to help achieve a successful biventricular circulation in patients with borderline left ventricle. The superiority/non-inferiority of this approach over the conventional Fontan pathway is unclear.
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Affiliation(s)
- Supreet P Marathe
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Breanna Piekarski
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Rebecca S Beroukhim
- Harvard Medical School, Boston, MA, USA.,Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Kimberlee Gauvreau
- Harvard Medical School, Boston, MA, USA.,Department of Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Christopher W Baird
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sitaram M Emani
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Pedro J Del Nido
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Aditya K Kaza
- Department of Cardiac Surgery, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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Corno AF, Durairaj S, Skinner GJ. Narrative review of assessing the surgical options for double outlet right ventricle. Transl Pediatr 2021; 10:165-176. [PMID: 33633949 PMCID: PMC7882294 DOI: 10.21037/tp-20-227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The individualized surgical approach in individuals with both arterial trunks arising from the morphologically right ventricle is dictated by the extreme morphological variability encountered in this setting, with each patient being unique. An individualized surgical approach has been designed to take account of the morphological variations, identifying the anatomy with the preoperative three-dimensional CT scan reconstruction. The key features have been considered the distance between tricuspid and pulmonary valves, the size and location of the interventricular communication, and the relationship between the outflow tracts. The surgical approach is tailored, whenever feasible, to create a connection between left ventricle and aorta, but primarily to achieve biventricular repair. Account has been taken of all available surgical options already reported in the literature, identifying the most suitable to provide the best outcomes for each unique morphology. To date, meaningful comparison between different reported surgical series has been difficult because of the marked variation of individual intracardiac morphology, and the lack of reports of specific surgical approaches for well-categorized groups of patients. Our approach, being tailored to the individual cardiac morphology, can be offered to any patient with this ventriculo-arterial connection. Given the difficulties of diagnosis, and the multiple therapeutic indications, very close collaboration between cardiologists and surgeons is indispensable for further progress in the understanding and management of this complex congenital cardiac lesion.
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Affiliation(s)
- Antonio F Corno
- Houston Children's Heart Institute, Hermann Children's Hospital, University of Texas Health, McGovern Medical School, Houston, TX, USA
| | - Saravanan Durairaj
- East Midlands Congenital Heart Centre, University Hospitals of Leicester, Leicester, UK
| | - Gregory J Skinner
- East Midlands Congenital Heart Centre, University Hospitals of Leicester, Leicester, UK
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Illmann CF, Hosking M, Harris KC. Utility and Access to 3-Dimensional Printing in the Context of Congenital Heart Disease: An International Physician Survey Study. CJC Open 2020; 2:207-213. [PMID: 32695970 PMCID: PMC7365821 DOI: 10.1016/j.cjco.2020.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/23/2020] [Indexed: 11/26/2022] Open
Abstract
Background Three-dimensional (3D) printing is a new technology capable of producing patient-specific 3D cardiac models. Methods A cross-sectional survey of pediatric cardiologists was conducted. Members of the Canadian Pediatric Cardiology Association and Congenital Cardiac Interventional Study Consortium were invited to participate. A questionnaire was distributed using Research Electronic Data Capture between May and September 2019. Results were analyzed using descriptive statistics, Fisher exact test, and odds ratio. Results A total of 71 pediatric cardiologists responded. Some 85% (60/71) agreed that patient-specific 3D printed cardiac models are a beneficial tool in treating children with congenital heart disease (CHD); 80% of those (48/60) believe 3D models facilitate communication with colleagues; 49% (35/71) of respondents had access to 3D printing technology; and 77% (27/35) of those were using models for clinical care. Access differed according to geographic location (P = 0.004). Of respondents, Americans were 5.5 times more likely (confidence interval, 1.6-19.2) than Canadians to have access to 3D printing technology. The primary reason for lack of access was financial barriers (50%, 18/36). In clinical practice, surgical planning is the primary use of models (96%, 26/27), followed by interventional catheterization planning (52%, 14/27). Double outlet right ventricle was the most commonly modelled lesion (70%, 19/27). Conclusion 3D printing is a new technology that is beneficial in the care of children with CHD. Access to 3D printing varies by geographic location. In pediatric cardiology, 3D models are primarily used for procedural planning for CHD lesions with complex 3D spatial relationships.
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Affiliation(s)
- Caroline F Illmann
- Children's Heart Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Hosking
- Children's Heart Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kevin C Harris
- Children's Heart Centre, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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Beckerman Z, Mery CM. Commentary: Double-outlet right ventricle—Toward an individualized road map. J Thorac Cardiovasc Surg 2020. [DOI: 10.1016/j.jtcvs.2019.07.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Commentary: Double-outlet right ventricle: Complex solutions for a complex anomaly. J Thorac Cardiovasc Surg 2019; 159:266-267. [PMID: 31606170 DOI: 10.1016/j.jtcvs.2019.08.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 08/22/2019] [Accepted: 08/26/2019] [Indexed: 11/22/2022]
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13
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Commentary: Double-outlet right ventricle revisited. J Thorac Cardiovasc Surg 2019; 159:265. [PMID: 31587892 DOI: 10.1016/j.jtcvs.2019.07.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 11/22/2022]
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