Printed Models for Better Prediction of Surgery in Patients with Double Outlet Right Ventricle

The complex and variable anatomy of complex double outlet right ventricle makes it imperative to understand the spatial anatomic structures to determine whether it is feasible to repair the anomaly in a biventricular or univentricular fashion. Biventricular repair should be aimed for but is not always feasible. Choosing the correct surgical technique is of great importance in surgical planning of biventricular repair. Conventional imaging is typically insufficient to predict feasibility and technique of biventricular repair. The gap between virtual images and spatial reality can be filled using 3D prints. Retrospective observational study of all available imaging including 3D prints and operative reports in 13 patients. 3D-prints enabled accurate prediction of biventricular repair in 8 cases and of univentricular repair in 2 cases. In 2 patients, no precise prediction was possible. One 3D-print was created post repair. 3D-prints accurately predicted the optimal technique for achieving biventricular repair in 8 cases. Conventional imaging could not accurately predict biventricular repair of optimal surgical technique in any patient. In complex double outlet right ventricle, 3D-printing can predict feasibility of biventricular repair better than conventional imaging. Additionally, 3D-prints can predict the type of surgical technique better. 3D-printing is also helpful in preoperative discussion with parents, caretakers, and pediatric cardiologists. 3D-prints are strongly recommended in patients with complex double outlet right ventricle.