Three-dimensional configuration of the right ventricular outflow tract (RVOT) based on analysis of the centroids of...

The right ventricular outflow tract (RVOT) exhibits complex morphology and spatial orientation, posing challenges for accurate anatomical assessment. Detailed characterization of this region has become increasingly important in interventional cardiology, where the success of lead placement and catheter ablation depends on precise knowledge of RVOT geometry.

In this study, 60 adult human hearts were examined and subsequently stratified into three age groups: young adults (18-40 years), middle-aged adults (41-60 years), and older adults (61-85 years). Silicone RVOT casts were prepared and digitized using photogrammetry to generate three-dimensional models. Secondary cross-sections were derived, and the centroids were determined. The resulting coordinates and their distances from the central RVOT axis were analyzed using a custom MATLAB algorithm. Intergroup comparisons were performed using appropriate statistical tests.

Centroid positions varied across all age groups. Significant differences in x-coordinate values were identified only in hearts from older adults (p < 0.001), reflecting greater displacement in the mid-RVOT segment. The most pronounced shifts occurred in cross-section no. 3, corresponding to the central portion of the RVOT. Deviations from the central axis demonstrated that the mid-RVOT consistently deflects away from this axis across all age groups, suggesting a rotational configuration.

Age-related displacement of RVOT centroids, particularly in older individuals, may have direct implications for procedural planning in catheter ablation and device implantation. Three-dimensional modeling with spatial analysis enables high-fidelity reconstruction of RVOT anatomy, supporting individualized therapeutic strategies and potentially improving procedural outcomes.