New technologyModeling Tool for Rapid Virtual Planning of the Intracardiac Baffle in Double-Outlet Right Ventricle
Section snippets
Patient Selection and Image Acquisition
An existing institutional database of patients who had undergone CMR and segmentation for 3D printing for the planning of surgical repair of DORV was queried, and 3 representative studies were identified. The CMR studies had been performed on a 1.5-Tesla scanner (Magnetom Avento, Siemens Healthcare, Erlangen, Germany) by using ferumoxytol, an iron-based contrast agent. A navigated cardiac-gated inversion recovery FLASH sequence was performed to assess the vascular anatomy. The Institutional
Study Design
Baffles were created in preoperative CMR-based models of 3 patients for demonstration and exploration of planning (Figure 5, Videos 1 to 3). Patients’ demographics are shown in Table 1.
Results
The baffle planning tool allowed simpler and faster interaction and refinement of baffles within 3D models compared with segmentation-based tools historically used to design baffles in 2D views. The average baffle placement time with the new tool was 2 minutes. In addition, baffles could be easily altered and
Comment
This freely available, open-source dedicated software modeling workflow is designed for the rapid creation of baffles for the planning of biventricular repair of DORV. On the basis of our initial clinical experience, we assert 3 main findings: (1) preoperative image-based virtual modeling holds promise for improved planning of surgical repair of DORV, (2) baffle planning is faster and requires less user experience with this dedicated tool relative to segmentation and commercially available
Disclosures and Freedom of Investigation
This work was supported by a Children’s Hospital of Philadelphia (CHOP) Cardiac Center Innovation Grant, a CHOP Cardiac Center Research Grant, a CHOP Frontier Grant, National Institutes of Health grants R01 HL153166 and T32GM008562, and CANARIE’s Research Software Program. Dr Pinter is employed by Pixel Medical and served as a contracted software developer for parts of this work. All other authors declare no relevant conflicts of interest or disclosures. No commercial entity provided any direct
Disclaimer
The Society of Thoracic Surgeons, The Southern Thoracic Surgical Association, and The Annals of Thoracic Surgery neither endorse nor discourage the use of the new technology described in this article.
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