3D-Printed Models for Surgical Planning in Complex Congenital Heart Diseases: A Systematic Review

Background: 3D technology support is an emerging technology in the field of congenital heart diseases (CHD). The goals of 3D printings or models is mainly a better analysis of complex anatomies to optimize the surgical repair or intervention planning. Method: We performed a systematic review to evaluate the accuracy and reliability of CHD modelization and 3D printing, as well as the proof of concept of the benefit of 3D printing in planning interventions. Results: Correlation studies showed good results with anatomical measurements. This technique can therefore be considered reliable with the limit of the operator's subjectivity in modelizing the defect. In cases series, the benefits of the 3D technology have been shown for describing the vessels anatomy and guiding the surgical approach. For intra-cardiac complex anatomy, 3D models have been shown helpful for the planification of intracardiac repair. However, there is still lack of evidence based approach for the usefulness of 3D models in CHD in changing outcomes after surgery or interventional procedures due to the difficulty to design a prospective study with comprehensive and clinically meaningful end-points. Conclusion: 3D technology can be used to improve the understanding of anatomy of complex CHD and to guide surgical strategy. However, there is a need to design clinical studies to identify the place of this approach in the current clinical practice.