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3D Modeling of Pediatric Hearts with Congenital Defects
Anthony Gonnella, Depts. of Mechanical Engineering and Mathematics, with Dr. Joao Soares, Depts. of Mechanical and Nuclear Engineering
Introduction: The anatomic complexity and variability of congenital heart disease (CHD) presents unique challenges in three dimensional visualizations between the multiple specialists that can be involved in surgical planning. Gold standard imaging (conventional 2 dimensional echocardiography) requires each team member mentally integrate multiple images to complete one’s own mental model. We hypothesize that 3D printed models improve preoperative planning and shared team understanding, Materials and Methods: Standard CT and MRI scans were performed on patients at the Children’s Hospital of Richmond (CHoR) as part of their standard of care. Anonymized DICOM files were segmented with 3D Slicer open-source software. Using the threshold by intensity and paintbrush tools, the blood cavities were modeled. Incorrect features in the automated segmentations were manually edited. Subsequently, the myocardium was segmented to obtain wall thickness and a virtual 3D model created. The digital models are then sliced at orientations that best highlighted each congenital defect and converted to an STL file for 3D printing. Results and Discussion: Our method confirms the feasibility of creating patient specific 3D printed models that not only integrated the anatomic complexity of a specific patient but also provide the managing team and the family a conceptually clear picture of the anatomy and a springboard to discuss planned surgery. One of the 3D-printed CHD models was presented at the Pediatric Cardiology Conference and was able to help guide the surgical team to plan and pick the most appropriate surgical procedure (with the highest likelihood of a positive outcome) among several different possibilities. Conclusion: Our 3D-printed models of CHD improved surgical understanding, perspective, and approach in one patient. This potentially improved the outcome of the surgery, reduced the child’s risks, minimized hospital costs, and hopefully eased some of the parent’s concerns. The use of 3D-printed models should be explored in other complex CHDs. In addition, it seems to be an extremely elucidative educational tool for the team.
Joao Soares, Ph.D.
Thomas Yeh, M.D., Ph.D.
Virginia Commonwealth University. Undergraduate Research Opportunities Program
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