Rotational angiography (RA) has proven to be an excellent method for evaluating congenital disease (CHD) in the cardiac cath lab, permitting acquisition of 3D datasets with superior spatial resolution. This technique has not been routinely implemented for 3D printing in CHD. We describe our case series of models printed from RA and validate our technique. All patients with models printed from RA were selected. RA acquisitions from a Toshiba Infinix-I system were postprocessed and printed with a Stratasys Eden 260. Two independent observers measured 5–10 points of interest on both the RA and the 3D model. Bland Altman plot was used to compare the measurements on rotational angiography to the printed model. Models were printed from RA in 5 patients (age 2 months–1 year). Diagnoses included (a) coronary artery aneurysm, (b) Glenn shunt, (c) coarctation of the aorta, (d) tetralogy of Fallot with MAPCAs, and (e) pulmonary artery stenosis. There was no significant measurement difference between RA and the printed model (r = 0.990, p < 0.01, Bland Altman p = 0.987). There was also no significant inter-observer variability. The MAPCAs model was referenced by the surgeon intraoperatively and was accurate. Rotational angiography can generate highly accurate 3D models in congenital heart disease, including in small vascular structures. These models can be extremely useful in patient evaluation and management.
Rotational angiography 3D printing Cardiac catheterization Computer modeling
This is a preview of subscription content, log in to check access.
Funding was provided by Saint Louis University (US).
Compliance with Ethical Standards
Conflict of interest
The authors declare they have no conflict of interest.
Hoyek N et al (2009) Enhancement of mental rotation abilities and its effect on anatomy learning. Teach Learn Med 21(3):201–206CrossRefPubMedGoogle Scholar
Noecker AM et al (2006) Development of patient-specific three-dimensional pediatric cardiac models. ASAIO J 52(3):349–353CrossRefPubMedGoogle Scholar
Jacobs S et al (2008) 3D-Imaging of cardiac structures using 3D heart models for planning in heart surgery: a preliminary study. Interact Cardiovasc Thorac Surg 7(1):6–9CrossRefPubMedGoogle Scholar
Riesenkampff E et al (2009) The practical clinical value of three-dimensional models of complex congenitally malformed hearts. J Thorac Cardiovasc Surg 138(3):571–580CrossRefPubMedGoogle Scholar
Kiraly L et al (2016) Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair. Interact Cardiovasc Thorac Surg 22(2):238–240CrossRefPubMedGoogle Scholar
Sodian R et al (2008) Three-dimensional printing creates models for surgical planning of aortic valve replacement after previous coronary bypass grafting. Ann Thorac Surg 85(6):2105–2108CrossRefPubMedGoogle Scholar
Sodian R et al (2007) Stereolithographic models for surgical planning in congenital heart surgery. Ann Thorac Surg 83(5):1854–1857CrossRefPubMedGoogle Scholar
Guarino J et al (2007) Rapid prototyping technology for surgeries of the pediatric spine and pelvis: benefits analysis. J Pediatr Orthop 27(8):955–960CrossRefPubMedGoogle Scholar
Lu S et al (2009) A novel patient-specific navigational template for cervical pedicle screw placement. Spine (Phila Pa 1976) 34(26):E959–E966CrossRefGoogle Scholar
Lim CG et al (2015) A case series of rapid prototyping and intraoperative imaging in orbital reconstruction. Craniomaxillofac Trauma Reconstr 8(2):105–110PubMedGoogle Scholar
Shengwei H et al (2014) Combined use of an anterolateral thigh flap and rapid prototype modeling to reconstruct maxillary oncologic resections and midface defects. J Craniofac Surg 25(4):1147–1149CrossRefPubMedGoogle Scholar
Yim HW, Nguyen A, Kim YK (2015) Facial contouring surgery with custom silicone implants based on a 3D prototype model and CT-scan: a preliminary study. Aesthetic Plast Surg 39(3):418–424CrossRefPubMedGoogle Scholar
Biglino G et al (2015) 3D-manufactured patient-specific models of congenital heart defects for communication in clinical practice: feasibility and acceptability. BMJ Open 5(4):e007165CrossRefPubMedPubMedCentralGoogle Scholar
Mottl-Link S et al (2008) Physical models aiding in complex congenital heart surgery. Ann Thorac Surg 86(1):273–277CrossRefPubMedGoogle Scholar
Kim MS, Hansgen AR, Carroll JD (2008) Use of rapid prototyping in the care of patients with structural heart disease. Trends Cardiovasc Med 18(6):210–216CrossRefPubMedGoogle Scholar
Ngan EM et al (2006) The rapid prototyping of anatomic models in pulmonary atresia. J Thorac Cardiovasc Surg 132(2):264–269CrossRefPubMedGoogle Scholar
Schmauss D et al (2015) Three-dimensional printing in cardiac surgery and interventional cardiology: a single-centre experience. Eur J Cardiothorac Surg 47(6):1044–1052CrossRefPubMedGoogle Scholar
Voskuil M, Sievert H, Arslan F (2017) Guidance of interventions in structural heart disease; three-dimensional techniques are here to stay. Neth Heart J 25(2):63–64CrossRefPubMedPubMedCentralGoogle Scholar
Schievano S et al (2007) Percutaneous pulmonary valve implantation based on rapid prototyping of right ventricular outflow tract and pulmonary trunk from MR data. Radiology 242(2):490–497CrossRefPubMedGoogle Scholar
Hochmuth A, Spetzger U, Schumacher M (2002) Comparison of three-dimensional rotational angiography with digital subtraction angiography in the assessment of ruptured cerebral aneurysms. AJNR Am J Neuroradiol 23(7):1199–1205PubMedGoogle Scholar
Schafer D et al (2006) Motion-compensated and gated cone beam filtered back-projection for 3-D rotational X-ray angiography. IEEE Trans Med Imaging 25(7):898–906CrossRefPubMedGoogle Scholar
Hu Y et al (2010) ECG gated tomographic reconstruction for 3-D rotational coronary angiography. Conf Proc IEEE Eng Med Biol Soc 2010:3614–3617PubMedGoogle Scholar