Optimizing surgical outcomes with 3D models in Double Outlet Right Ventricle (DORV) cases

Dr. Ala Al-Lawati, Head of the Cardiac Surgery Department at the National Heart Centre of the Royal Hospital in the Sultanate of Oman, uses Axial3D solutions in the field of paediatric cardiac surgery.

Case
A patient diagnosed with Double Outlet Right Ventricle (DORV) and multiple Ventricular Septal Defects (VSDs) presented a challenging scenario for surgical intervention. The decision to pursue biventricular repair given having at least two VSDs in two different planes requires the construction of accurate and unobstructed complex baffle routing the left ventricle to the aorta without having a residual VSD. These were critical decision making issues in surgical planning which Dr. Ala Al-Lawati had to answer. The complexity of multiple VSDs further complicated the decision-making process, making an accurate visualization of the heart's anatomy essential.

Solution

Dr. Ala Al-Lawati encountered significant challenges when making vital surgical decisions using conventional diagnostic tools like Echo or CT scans. The introduction of 3D visualization and anatomical models allowed for a detailed study of the patient's heart, offering insights that were previously unattainable. While it still required time to analyze the intricate anatomy, the 3D model proved invaluable. 3D solutions revealed two VSDs in perpendicular plains, an uncommon occurrence. This insight enabled Dr. Ala Al-Lawati to plan accurate surgical decisions and effectively communicate with the patient’s family.

‘Occasionally, slight disparities arise between echocardiograms and CT scans interpretation. The 3D anatomical model helped to determine the accurate surgical approach for the patient. In these instances, surgical precision is crucial due to the wide spectrum of patients falling under DORV diagnosis.’

– Dr. Ala Al-Lawati

Differing from a comparable case managed in the past without the assistance of a 3D anatomical model, in which a Ventricular Septal Defect (VSD) was unintentionally overlooked due to its intricate orientation, this patient's surgical procedure was enhanced through the utilization of the 3D solutions. The 3D model illuminated the spatial relationships between the VSDs and aorta, allowing the surgeon to confidently perform the necessary repairs during a single surgery, preventing the need for a subsequent procedure. Not only it streamlined surgical planning but also reduced surgery time and the potential for complications.

‘3D models help us in obtaining consent from the family, as we can now visually display the hearts of their infants instead of relying on drawings, diagrams, or charts. We're able to make a direct comparison to a healthy heart and effectively explain how we intend to address the case.’

– Dr. Ala Al-Lawati

This case highlights the transformative impact of 3D visualization and 3D anatomical models in enhancing surgical precision and patient outcomes in complex congenital heart defect cases.

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Disclaimer: Details of Axial3D's regulatory clearance for diagnostic use cases are outlined here. For all other uses of Axial3D solutions, they should be used for demonstration and education purposes only.