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315 downloadsThese congenital heart defect STL files demonstrate Partial Anomalous Pulmonary Venous Return (PAPVR). In PAPVR, one or two of the pulmonary veins returns blood to the right atrium instead of the left atrium. This causes oxygen-rich blood to flow back to the lungs instead of on to the rest of the body. Because some oxygen-rich blood is continually flowing between the lungs and the right atrium, the right chambers of the heart may become dilated. Over time, this may cause an abnormal heart rhythm (arrhythmia). In addition, too much blood flow to the lungs may increase the pressure in the lung's blood vessels, leading to a condition called pulmonary hypertension. If only one of the pulmonary veins is affected by the disorder, there may not be any symptoms. If two of the veins are affected, there may be shortness of breath during heavy exercise. Aortic coarctation is also present. Coarctation of the aorta is a narrowing of the aorta, the main blood vessel carrying oxygen-rich blood from the left ventricle of the heart to all of the organs of the body. Coarctation occurs most commonly in a short segment of the aorta just beyond where the arteries to the head and arms take off, as the aorta arches inferiorly toward the chest and abdomen. There are three STL files for 3D printing this model in slices. A whole model STL file is also available for 3D printing. Demonstrated is a bicuspid aortic valve and history of coarctation repair within the first week of life by end to end anastomosis. MRI obtained for evaluation of distal arch. MRI findings: • PAPVR of left upper lobe to innominate vein: Qp:Qs of 1.4:1 • Mild residual narrowing of second transverse segment of the aortic arch. • Moderate post-stenotic dilation of aorta MRI images obtained at end-systole due to tachycardic heart rate during exam. RV End-systolic volume is 36.3 ml. LV End-systolic volume is 30.06 ml. MRI methods: A GE 1.5T HDxt system was used for the 3D HEART sequence which used a 3D respiratory-navigated balanced SSFP (steady state free precession) multi-slab sequence with T2 preparation that provides whole heart coverage with high contrast-to-noise ratio between vessels and myocardium. Due to the relatively fast heart rate of 122 bpm, the fat saturation was turned off to decrease the time needed for the prepatory pulse brining the acquisition window earlier into the cardiac cycle so that it could be centered on the quiescent stage of end systole. The sequence was run with the following parameters: TR 3.4, TE 1.4, Freq 224, Phase 160, RR 8, and fat sat off. Learning: The MRI identified previously un-diagnosed partial anomalous pulmonary venous return. However, the Qp:Qs fell within acceptable left to right shunting of < 1.5:1 and there was insignificant RV, RA enlargement. The MRI evaluation of the coarctation repair revealed a good repair with only mild narrowing, which appeared more severe by echo due to the post-stenotic dilation. Disclaimer: The available model has been validated to demonstrate the case’s pathologic features on a Z450 3D printer, (3DSystems, Circle Rock Hill, South Carolina)(or other printer as appropriate). While the mask applied to the original DICOM images accurately represents the anatomic features, some anatomic detail may be lost due to thin walled structures or inadequate supporting architecture; while other anatomic detail may be added due to similar limitations resulting in bleeding of modeling materials into small negative spaces. However, intracardiac structures, relationships, and pathologic features represent anatomic findings to scale and in high detail. Credit: The model is provided for distribution on Embodi3D with the permission of the author, pediatric cardiologist Dr. Matthew Bramlet, MD, and is part of the Congenital Heart Defects library. We thank Dr. Bramlet and all others who are working to help children with congenital heart problems lead normal and happy lives. It is distributed by Dr. Bramlet under the Creative Commons license Attribution-NonCommercial-NoDerivs. Please respect the terms of the licensing agreement.