Apical Muscular Ventricular Septal Defects: Surgical Strategy Using Three-Dimensional Printed Model

Area of Science:

• Cardiology
• Medical Imaging
• 3D Printing Technology

Background:

• Complex congenital heart disease, such as multiple ventricular septal defects (VSDs), poses significant surgical planning challenges.
• Accurate anatomical understanding is crucial for successful VSD closure, especially in intricate cases like Swiss-cheese septum.

Observation:

• A 3-month-old infant presented with multiple apical VSDs, perimembranous VSD, and atrial septal defect, leading to congestive heart failure.
• Preoperative imaging lacked definitive clarity on the exact number, openings, and locations of the apical VSDs, raising concerns about the optimal surgical strategy.

Findings:

• A 3D printed model, created from CT scans, precisely identified all VSDs, their origins/exits, and guided optimal patch selection and size.
• The 3D model facilitated surgical simulation, enabling the determination of minimal septal band resection and ensuring adequate right ventricular (RV) cavity size post-closure.

Implications:

• Utilizing 3D printed models in surgical planning for complex VSD cases can optimize surgical approach, patch selection, and potentially reduce complications and residual defects.
• This technology offers a valuable tool for enhancing surgical decision-making and improving patient outcomes in pediatric cardiac surgery.