A twenty-nine-year-old (121 kg) male with history of double outlet right ventricle (DORV) underwent a two ventricle repair with a Rastelli procedure, ventricular septal defect (VSD) closure with baffling of left ventricle (LV) to aorta, and RV to pulmonary artery (PA) conduit placement in early life. He presented with exercise intolerance. Cardiac MRI showed complex LVOT obstruction, a small residual VSD, dilation of aortic root (sinus of Valsalva), and aortic regurgitation. A 3D model was printed to aid in surgical planning. Figure 11.1 shows complex obstruction under the aortic valve with muscle bundles in the LVOT. Note the small VSD and buckling of the VSD patch into the LVOT. A catheter crosses the VSD from the RV with the tip in the LV. A ridge of muscle crosses the LVOT. Figure 11.1b shows a second model, created to simulate the “surgeon’s view.” Corresponding anatomy from the operating room is shown in Fig. 11.1c.

A sixteen-year-old male with history of heterotaxy syndrome, single ventricle anatomy with a systemic RV, had undergone a total cavo-pulmonary connection (aka Fontan) palliation with an extracardiac fenestrated conduit. He subsequently underwent percutaneous device closure of the Fontan fenestration. A surveillance MRI was performed to evaluate single ventricle anatomy and physiology. A 3D model was printed for teaching purposes. The model (Fig. 11.2) shows a dilated and hypertrophied RV, the aorta as the only outflow from the functional single ventricle and the Fontan conduit and superior vena cava connecting to the pulmonary arteries. The fenestration occlusion device is shown in green.