Physical models aiding in complex congenital heart surgery

Purpose. Our aim was to improve spatial imagination of complex congenital cardiac abnormalities for subsequent surgical intervention. Description. Magnetic resonance imaging data of a patient with complex congenital heart malformations was post-processed with software developed at our institution. The resulting virtual surface data sets were printed out three-dimensionally by rapid prototyping techniques. Evaluation. We present the first patient operated on with intraoperative use of physical models representing the intracardiac volumes (RepliCast) or muscle and vessel walls (RepliCardio). The courses of the coronary arteries were visible on the RepliCast, whereas the RepliCardio showed intracardiac views a surgeon could never obtain intraoperatively in the relaxed heart. Other than on virtual reconstructions presented on computer screens, physical models vastly improve the spatial imagination and give precise information regarding localization and actual size of abnormal structures. The self-explanatory utility of these models shortened preparation and expedited orientation on the open heart. Conclusions. The additional spatial information provided by RepliCast and RepliCardio models may enable even high-risk correction procedures in patients with complex congenital heart disease.