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Background <p>Given the established and reproducible benefit of 3D-printed models in complex congenital heart disease (CHD) surgical planning, the focus has shifted from validating their utility to refining anatomical fidelity through enhanced imaging integration. The purpose of this study is to evaluate the perceived clinical utility of multimodality fusion 3D-printed cardiac models and to determine whether inclusion of valve structures confers incremental benefit over conventional single-modality 3D models in enhancing anatomical understanding and preoperative surgical planning among pediatric cardiac surgeons and imaging cardiologists in complex CHD.</p> Methods <p>In this feasibility study, multimodality fusion 3D models were successfully generated by integrating cross-sectional imaging (cardiac computed tomography and magnetic resonance) with 3D echocardiographic datasets to reproduce atrioventricular valve apparatus and subvalvular structures in 10 pediatric patients with complex CHD. Ten faculty members (7 pediatric cardiologists with advanced imaging expertise and 3 pediatric cardiothoracic surgeons) evaluated 10 patient-specific models using a structured Likert questionnaire.</p> Results <p>Surgeons assigned significantly higher ratings than imagers for anatomical understanding (median 5 vs 4; <i>p</i> = 0.002) and surgical planning (<i>p</i> &lt; 0.001). Participants agreed that multimodality models are most valuable in complex congenital heart disease, particularly in cases requiring ventricular septal defect patching or intraventricular baffle repair involving the subvalvular apparatus.</p> Conclusion <p>Multimodality imaging fusion for 3D printing is technically feasible and produces high-quality models with strong intraoperative correlation. Incorporation of atrioventricular valve anatomy provides meaningful incremental benefit—particularly for surgeons—enhancing operative planning in complex CHD.</p> Graphical Abstract <p></p>

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Feasibility of 3D echocardiography–CT/CMR fusion to create atrioventricular valve–integrated 3D printed heart models in complex congenital heart disease: greater incremental benefit for surgeons than cardiac imagers

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月6日

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  • Jose Carlos Villalobos-Lizardi,
  • Shi-Joon Yoo,
  • Brandon Peel,
  • Francesco Bertelli,
  • Andreea Dragulescu,
  • Nick Arbic,
  • David Barron,
  • Osami Honjo,
  • Christopher Haller,
  • Carmel Daskalo,
  • Luc Mertens,
  • Israel Valverde

摘要

Background

Given the established and reproducible benefit of 3D-printed models in complex congenital heart disease (CHD) surgical planning, the focus has shifted from validating their utility to refining anatomical fidelity through enhanced imaging integration. The purpose of this study is to evaluate the perceived clinical utility of multimodality fusion 3D-printed cardiac models and to determine whether inclusion of valve structures confers incremental benefit over conventional single-modality 3D models in enhancing anatomical understanding and preoperative surgical planning among pediatric cardiac surgeons and imaging cardiologists in complex CHD.

Methods

In this feasibility study, multimodality fusion 3D models were successfully generated by integrating cross-sectional imaging (cardiac computed tomography and magnetic resonance) with 3D echocardiographic datasets to reproduce atrioventricular valve apparatus and subvalvular structures in 10 pediatric patients with complex CHD. Ten faculty members (7 pediatric cardiologists with advanced imaging expertise and 3 pediatric cardiothoracic surgeons) evaluated 10 patient-specific models using a structured Likert questionnaire.

Results

Surgeons assigned significantly higher ratings than imagers for anatomical understanding (median 5 vs 4; p = 0.002) and surgical planning (p < 0.001). Participants agreed that multimodality models are most valuable in complex congenital heart disease, particularly in cases requiring ventricular septal defect patching or intraventricular baffle repair involving the subvalvular apparatus.

Conclusion

Multimodality imaging fusion for 3D printing is technically feasible and produces high-quality models with strong intraoperative correlation. Incorporation of atrioventricular valve anatomy provides meaningful incremental benefit—particularly for surgeons—enhancing operative planning in complex CHD.

Graphical Abstract