Matthew Bramlet
3 yo female, 16.8 kg, 91.4 cm, 0.65 m^2; Complex perimembranous to muscular VSD with band dividing it into a large anterior component and smaller posterior component. There is a parallel RV muscle bundle that does not divide the RV inflow and outflow chambers and is at risk to be mistaken for the septum. A swiss cheese apical VSD is suspected. Educational Learning: Pulmonary artery band in good position. Qp:Qs of 0.82:1 consistent with balanced circulation. When true septal plane is utilized, normal LV size with borderline RV size at 39.7 ml/m^2, however, when parallel RV muscle bundle is utilized as septal plane, the RV size becomes hypoplastic at 28.9 ml/m^2. 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. Heart rate 90 bpm, Images obtained in diastole: The sequence was run with the following parameters: TR 3.98, TE 1.67, TD 486ms
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.
Magnets: http://www.rare-earth-magnets.com/magcraft-nsn0566/
