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J Thorac Cardiovasc Surg 2006;132:264-269
© 2006 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease

The rapid prototyping of anatomic models in pulmonary atresia

Elizabeth M. Ngan, MD, MSc a , * , Ivan M. Rebeyka, MD, FRCSC b , David B. Ross, MD, FRCSC b , Mohamed Hirji, MB ChB, FRCPC a , Johan F. Wolfaardt, BDS, MDent, PhD c , e , Rosemary Seelaus, MAMS d , e , Andrew Grosvenor, MIMPT, LCGI, RDT e , Michelle L. Noga, MD, FRCPC a

a Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada
b Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
c Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
d Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
e COMPRU, Misericordia Community Hospital, Caritas Health Group, Edmonton, Alberta, Canada

Received for publication September 23, 2005; revisions received December 20, 2005; accepted for publication February 3, 2006.

* Address for reprints: Elizabeth Ngan, MD, MSc, 2A2.41 Walter C. Mackenzie Health Sciences Centre, 8440-112 St, Edmonton, Alberta, Canada T6G 2B7 (Email: ema2{at}ualberta.ca).

OBJECTIVE: The goal of this study was to assess the utility and accuracy of solid anatomic models constructed with rapid prototyping technology for surgical planning in patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries.

METHODS: In 6 patients with pulmonary atresia with ventricular septal defect and major aortopulmonary collateral arteries, anatomic models of the pulmonary vasculature were rapid prototyped from computed tomographic angiographic data. The surgeons used the models for preoperative and intraoperative planning. The models' accuracy and utility were assessed with a postoperative questionnaire completed by the surgeons. An independent cardiac radiologist also assessed each model for accuracy of major aortopulmonary collateral artery origin, course, and caliber relative to conventional angiography.

RESULTS: Of the major aortopulmonary collateral arteries identified during surgery and conventional angiography, 96% and 93%, respectively, were accurately represented by the models. The surgeons found the models to be very useful in visualizing the vascular anatomy.

CONCLUSION: This study presents the novel vascular application of rapid prototyping to pediatric congenital heart disease. Anatomic models are an intuitive means of communicating complex imaging data, such as the pulmonary vascular tree, which can be referenced intraoperatively.

Abbreviations and Acronyms 3D = 3-dimensional; CT = computed tomography; MAPCA = major aortopulmonary collateral artery; MR = magnetic resonance; VSD = ventricular septal defect




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