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Title: Three-dimensional virtual and printed prototypes in complex congenital and pediatric cardiac surgery—a multidisciplinary team-learning experience
Authors: Kiraly, Laszlo 
Shah, Nishant C.
Abdullah, Osama
Al-Ketan, Oraib
Rowshan, Reza
Keywords: Congenital heart disease
Congenital heart surgery
Hands-on surgical training
Surgical simulation
Surgical training
Three-dimensional printing
Issue Date: 16-Nov-2021
Publisher: MDPI
Citation: Kiraly, Laszlo, Shah, Nishant C., Abdullah, Osama, Al-Ketan, Oraib, Rowshan, Reza (2021-11-16). Three-dimensional virtual and printed prototypes in complex congenital and pediatric cardiac surgery—a multidisciplinary team-learning experience. Biomolecules 11 (11) : 1703. ScholarBank@NUS Repository.
Rights: Attribution 4.0 International
Abstract: Three-dimensional (3D) virtual modeling and printing advances individualized medicine and surgery. In congenital cardiac surgery, 3D virtual models and printed prototypes offer advantages of better understanding of complex anatomy, hands-on preoperative surgical planning and emulation, and improved communication within the multidisciplinary team and to patients. We report our single center team-learning experience about the realization and validation of possible clinical benefits of 3D-printed models in surgical planning of complex congenital cardiac surgery. CT-angiography raw data were segmented into 3D-virtual models of the heart-great vessels. Prototypes were 3D-printed as rigid “blood-volume” and flexible “hollow”. The accuracy of the models was evaluated intraoperatively. Production steps were realized in the framework of a clinical/research partnership. We produced 3D prototypes of the heart-great vessels for 15 case scenarios (nine males, median age: 11 months) undergoing complex intracardiac repairs. Parity between 3D models and intraoperative structures was within 1 mm range. Models refined diagnostics in 13/15, provided new anatomic information in 9/15. As a team-learning experience, all complex staged redo-operations (13/15; Aristotle-score mean: 10.64 ± 1.95) were rehearsed on the 3D models preoperatively. 3D-printed prototypes significantly contributed to an improved/alternative operative plan on the surgical approach, modification of intracardiac repair in 13/15. No operative morbidity/mortality occurred. Our clinical/research partnership provided coverage for the extra time/labor and material/machinery not financed by insurance. 3D-printed models provided a team-learning experience and contributed to the safety of complex congenital cardiac surgeries. A clinical/research partnership may open avenues for bioprinting of patient-specific implants. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
Source Title: Biomolecules
ISSN: 2218-273X
DOI: 10.3390/biom11111703
Rights: Attribution 4.0 International
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