Abstract
Three‐dimensional (3D) printing has shown great promise in medicine with increasing reports in congenital heart disease (CHD). This systematic review aims to analyse the main clinical applications and accuracy of 3D printing in CHD, as well as to provide an overview of the software tools, time and costs associated with the generation of 3D printed heart models. A search of different databases was conducted to identify studies investigating the application of 3D printing in CHD. Studies based on patient's medical imaging datasets were included for analysis, while reports on in vitro phantom or review articles were excluded from the analysis. A total of 28 studies met selection criteria for inclusion in the review. More than half of the studies were based on isolated case reports with inclusion of 1–12 cases (61%), while 10 studies (36%) focused on the survey of opinion on the usefulness of 3D printing by healthcare professionals, patients, parents of patients and medical students, and the remaining one involved a multicentre study about the clinical value of 3D printed models in surgical planning of CHD. The analysis shows that patient‐specific 3D printed models accurately replicate complex cardiac anatomy, improve understanding and knowledge about congenital heart diseases and demonstrate value in preoperative planning and simulation of cardiac or interventional procedures, assist surgical decision‐making and intra‐operative orientation, and improve patient‐doctor communication and medical education. The cost of 3D printing ranges from USD 55 to USD 810. This systematic review shows the usefulness of 3D printed models in congenital heart disease with applications ranging from accurate replication of complex cardiac anatomy and pathology to medical education, preoperative planning and simulation. The additional cost and time required to manufacture the 3D printed models represent the limitations which need to be addressed in future studies.
Highlights
Congenital heart disease (CHD) is a complex pathology characterised by malformations in the heart and major blood vessels that are usually diverse and heterogeneous
The clinical applications of 3D printing in CHD can be summarised into five main areas: preoperative planning, pre-surgical simulation, intra-operative orientation, medical education and communication in medical practice
Diagnostic assessment and preoperative planning of CHD are based on two-dimensional (2D) and multi-planar viewing of the volumetric data such as echocardiography, magnetic resonance imaging (MRI) and computed tomography (CT).[8,33,44,45]
Summary
Congenital heart disease (CHD) is a complex pathology characterised by malformations in the heart and major blood vessels that are usually diverse and heterogeneous. It is the most common birth defects among newborns.[1,2,3,4,5] According to the AIHW report, the prevalence of CHD among the newborns in Australia is around 8 in every 1000.6 Due to the great diversity and variability in the cardiovascular morphology between individual patients, patient management of CHD, especially paediatric patients, can be very challenging.[7,8,9] It is crucial to have a comprehensive understanding of the dimensional and spatial relationship of the inter-cardiac anatomical structures, especially during preoperative planning or intra-operative orientation.[7].
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