Background

Single-stage unifocalisation for pulmonary atresia (PA) with ventricular septal defect (VSD) and major aortopulmonary collateral arteries (MAPCA) requires a high degree of three-dimensional (3D) anatomical imagination. A previous study has reported the application of a 3D-printed heart model with virtual reality (VR) or mixed reality (MR). However, few studies have evaluated the surgical outcomes of the 3D model with VR or MR in PA/VSD patients.

Methods

Three-dimensional (3D) heart models of five selected PA/VSD patients were derived from traditional imageology of their hearts. Using VR glasses, the 3D models were also visualised in the operating room. Both the 3D-printed heart models and preoperative evaluation by VR were used in the five selected patients for surgical simulation and better anatomical understanding. Mixed reality holograms were used as perioperative assistive tools. Surgical outcomes were assessed, including in-hospital and early follow-up clinical data.

Results

The use of these three new technologies had favourable feedback from the surgeons on intraoperative judgment. There were no in-hospital or early deaths. No reintervention was required until the last follow-up. Three (3) patients developed postoperative complications: one had right bundle branch block and ST-segment change, one had chest drainage >7 days (>40 mL/day) and one had pneumonia.

Conclusion

The preoperative application of a 3D-printed heart model with VR or MR helped in aligning the surgical field. These technologies improved the understanding of complicated cardiac anatomy and achieved acceptable surgical outcomes as guiding surgical planning.

中文翻译：

---

肺动脉闭锁的三维打印，虚拟现实和混合现实：早期手术结果评估

背景

具有心室间隔缺损（VSD）和主肺上支副动脉（MAPCA）的肺动脉闭锁（PA）的单阶段单焦点治疗需要高度的三维（3D）解剖学想象力。先前的研究报告了带有虚拟现实（VR）或混合现实（MR）的3D打印心脏模型的应用。但是，很少有研究评估PA / VSD患者使用VR或MR的3D模型的手术效果。

方法

五名选定的PA / VSD患者的三维（3D）心脏模型是从他们心脏的传统影像学得出的。使用VR眼镜，还可以在手术室中看到3D模型。在5名选定的患者中，使用了3D打印的心脏模型和VR术前评估，以进行手术模拟和更好的解剖学理解。混合现实全息图被用作围手术期的辅助工具。评估手术结局，包括医院内和早期随访的临床数据。

结果

这三种新技术的使用在手术过程中获得了外科医生的良好反馈。没有住院或早期死亡。直到最后一次随访才需要再次干预。三（3）例患者出现了术后并发症：一例患有右束支传导阻滞和ST段改变，一例胸腔引流> 7天（> 40 mL /天），另一例患有肺炎。

结论

带有VR或MR的3D打印心脏模型的术前应用有助于对齐手术区域。这些技术增进了对复杂心脏解剖结构的理解，并获得了可接受的手术结果作为指导手术计划。