Surgical simulation – a new tool to evaluate surgical incisions in congenital heart disease?

We introduce a new concept for preoperative planning and surgical education in congenital heart disease: surgical simulation. Recent advances in three-dimensional image acquisition have provided a new means to virtually reconstruct accurate morphological models while computer visualisation hardware now allows simulation of elastic tissue deformations interactively. Incision simulation is performed in two patients with complex congenital heart disease to preoperatively evaluate potential corrective surgical strategies. The relevant cardiac morphology was correctly depicted by the virtual models on which arbitrary incisions could be performed. By visualising the morphology in respect to each incision, different surgical strategies could be evaluated pre-operatively. We have taken the first step towards a clinically useful incision simulator for procedures in congenital heart disease and made an initial evaluation. With further developments it is likely that new tools for patient-specific preoperative planning and surgical training will emerge based on the presented ideas.