3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study

TLDR

The study aimed to produce anatomically accurate 3D rapid‑prototyping models for patients with complex cardiac geometry to aid surgical planning and execution. Using CT and MRI data segmented in Mimics 9.0, the target volumes were converted to STL files and printed with a Z™ 510 3‑D printer, producing patient‑specific models for planning left‑ventricular aneurysm and right‑ventricular tumor resections. The printed models enabled surgeons to identify risk structures, delineate optimal resection lines, and confirm residual ventricular shape, thereby improving planning, orientation, and LV volume preservation during aneurysm and tumor resections.

Abstract

The aim of the study was to create an anatomical correct 3D rapid prototyping model (RPT) for patients with complex heart disease and altered geometry of the atria or ventricles to facilitate planning and execution of the surgical procedure. Based on computer tomography (CT) and magnetic resonance imaging (MRI) images, regions of interest were segmented using the Mimics 9.0 software (Materialise, Leuven, Belgium). The segmented regions were the target volume and structures at risk. After generating an STL-file (StereoLithography file) out of the patient's data set, the 3D printer Z™ 510 (4D Concepts, Gross-Gerau, Germany) created a 3D plaster model. The patient individual 3D printed RPT-models were used to plan the resection of a left ventricular aneurysm and right ventricular tumor. The surgeon was able to identify risk structures, assess the ideal resection lines and determine the residual shape after a reconstructive procedure (LV remodelling, infiltrating tumor resection). Using a 3D-print of the LV-aneurysm, reshaping of the left ventricle ensuring sufficient LV volume was easily accomplished. The use of the 3D rapid prototyping model (RPT-model) during resection of ventricular aneurysm and malignant cardiac tumors may facilitate the surgical procedure due to better planning and improved orientation.