Abstract 12917: Incremental Utility of 3D Printing to Guide the Surgical Management of Cardiac Sarcoma

Abstract

Background: Intimal sarcoma is an extremely rare and aggressive malignancy that originates in the heart and major vessels. Due to its rarity, ambiguous clinical presentation, and rapid progression, diagnosing and treating this neoplasm presents significant challenges. Case presentation: A 61-year-old female with a history of left atrial sarcoma underwent mass excision in 2019 and 2020, along with several rounds of chemotherapy and immunotherapy. A follow-up cardiac MRI revealed a concerning lesion in the posterior left atrium with evidence of interval size progression on a subsequent CT, suggestive of a recurrence (Panel A). To aid in surgical planning, 3D segmentation of the patient's CT scan was performed, and a 3D model of her heart and lesion were printed (Panel B). This was particularly valuable as it was her third redo surgery, and there were concerns about the surrounding anatomy. Upon reviewing the multimodality imaging and 3D model, the patient was deemed a suitable candidate for a redo surgery. She underwent left atrial sarcoma resection with left atrial floor reconstruction using a bovine pericardial patch and left inferior pulmonary vein reimplantation (Panel C). Histological studies were consistent with recurrent intimal sarcoma (Panel D). The patient is currently in remission. Conclusion: Multimodality imaging was crucial in diagnosing the recurrence of the sarcoma. However, 3D printing of the heart and lesion with detailed segmentation of the left atrium and surrounding structures played a significant role in surgical planning. This highlights the growing use of 3D printing in cardiac surgery planning.