Abstract 4367150: Utilizing Virtual Reality for Pre-Transplant Planning in Patients with Congenital Heart Disease

Abstract

Backround: Virtual reality (VR) has emerged as a powerful tool in the pre-procedural planning of complex congenital heart disease (CHD), enabling enhanced visualization of anatomy beyond traditional imaging. This technology allows for immersive, patient-specific simulations that support surgical decision-making and procedural strategy, particularly in high-risk transplant cases. This case focuses on a 17-year-old Jehovah’s Witness with complex congenital anatomy undergoing evaluation for bloodless heart transplantation, highlighting how VR was integrated into the planning process. Research Question: How can VR segmentation and simulation enhance surgical planning and team readiness in pediatric heart transplants, particularly for patients with complex anatomy or prior surgeries? Methods: The patient’s history includes heterotaxy syndrome with right atrial isomerism, right-dominant complete AV canal defect and D-transposition of the great arteries, who is s/p staged Fontan palliation. His venous anatomy consisted of a right-sided SVC with bidirectional cavopulmonary anastomosis to the right pulmonary artery, left-sided IVC to the Fontan conduit and all pulmonary veins draining to a left atrium. Additionally, he underwent stent placement in the LPA and the Fontan conduit for stenosis. Cardiac CT and CTA abdomen/pelvis were acquired for transplant evaluation. 3D segmentation was performed by FDA-approved Elucis software and analyzed in a VR environment using a Meta Pro VR headset. In collaboration with the surgical team, virtual heart transplantation was performed with baffling of the left sided IVC to a ‘normal’ donor heart of appropriate size. Results: The patient successfully underwent cardiac transplant. VR simulated virtual transplant enabled a thorough pre-operative assessment of complex intracardiac and extracardiac anatomy and allowed for patient specific planning. These tools helped identify potential surgical challenges in advance and aided in the development of a detailed operative roadmap. The team reported improved procedural confidence and more robust interdepartmental communication during planning. Conclusion: The application of VR segmentation and simulation provided critical insights that shaped surgical planning for a bloodless pediatric heart transplant. Incorporating virtual 3D modeling into transplant evaluation enhances decision-making and outcomes in complex cases, supporting its broader use in congenital cardiac surgery.