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A case of total anomalous pulmonary venous return plus univentricular heart
“Thanks to the ability to handle a 3-D model of a patient’s heart, we’re now able to do intracardiac repairs in cases of complex congenital heart disease that we couldn’t even contemplate before,” says Hani Najm, MD, Chair of Pediatric and Congenital Heart Surgery at Cleveland Clinic.
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Dr. Najm proves his point in this one-minute captioned video in which he demonstrates how the 3-D-printed heart replica he’s holding confirmed the feasibility of an extracardiac Fontan procedure in a 5-year-old born with total anomalous pulmonary venous return and a univentricular heart who underwent pulmonary vein stenting and a sutureless repair of the pulmonary veins.
Watch the video above or read the transcript below.
This patient is a 5-year-old patient who was born with total anomalous pulmonary venous drainage plus a univentricular heart that needed to have pulmonary vein stenting in addition to the repair of the total anomalous pulmonary venous drainage. And if we look inside the heart here, you will see this heart stent in the pulmonary vein, which, at this point in the patient’s care, was fine. But the question to us was, because of the type of repair which was done, were we able to do an extracardiac Fontan to complete the univentricular circuit?
With the aid of this 3-D printing, we were able to decide that this is doable. Therefore, we took the patient and routed this IVC into the pulmonary artery. We stayed away from the pulmonary veins, and the patient underwent a completion Fontan procedure based on this 3-D printing.
For other cases in which 3-D printing has assisted the surgical team in planning, see this case of a 10-year-old boy who needed a double switch procedure, or this newborn girl who needed a two-stage repair.
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