Evaluation of multiple ventricular septal defects using three-dimensional reconstruction models†

Although there has been rapid development in the field of three-dimensional morphological analyses of congenital heart disease, with the three-dimensional volume-rendered images providing visualization of the external vascular anatomy, the precise reproduction of 'Swiss-cheese' ventricular septum is not well established. We created three-dimensional printed models and computer graphics based on multi-slice computed tomography of patients with complex multiple ventricular septal defects for surgical decision planning of this difficult cardiac defect.

Seven patients with complex multiple ventricular septal defects were evaluated preoperatively using 3-dimensional printed models and computer graphics to plan therapeutic interventions.

The three-dimensional printed models detected muscular VSDs in 9 out of 15 (60%) regions. On the other hand, 3-dimensional computer graphics detected 10 out of 15 (67%) regions. The 3-dimensional printed models and computer graphics allowed the evaluation of the muscular ventricular septal defects from both the left and right ventricular aspects of the septum.

Our preliminary experiences suggest that three-dimensional printed models and computer graphics can help plan surgery in patients with complex multiple ventricular septal defects. Three-dimensional printed models allowed surgeons to understand the three-dimensional positioning of complex multiple ventricular septal defects preoperatively. High-quality three-dimensional computer graphics provided precise information about the size, shape and localization of muscular ventricular septal defects especially from the left ventricular side.