In pediatric complex CHD, VR modeling showed superior utility over CT alone for coronary assessment and strong inter-operator agreement.

This retrospective bi-center feasibility study assessed the technical feasibility and clinical utility of patient-specific three-dimensional (3D) reconstruction and virtual reality (VR) modeling for pre-procedural planning. The study population consisted of 19 pediatric patients who underwent evaluation for right ventricle-to-pulmonary artery (RV-PA) conduit dilation and stenting at Sheba and Wolfson Medical Centers in Israel. The primary comparison was against CT imaging alone.

The main results indicated that VR modeling was significantly superior to CT alone for delineating coronary trajectories and assessing compression risk, with mean scores of 4.58 versus 3.78, respectively. Additionally, strong inter-operator agreement was observed across most parameters, with an intraclass correlation coefficient greater than 0.7. No specific p-values or confidence intervals were reported for these comparisons.

Safety and tolerability data were not reported in this study. The investigation was limited by its retrospective design, small sample size of 19 patients, and lack of reported follow-up. Consequently, the certainty of the findings is low, and the results reflect feasibility rather than established clinical efficacy.

While the study suggests VR may offer advantages in anatomical visualization and risk assessment for complex congenital heart disease, the absence of reported adverse events, discontinuations, or funding conflicts limits a comprehensive safety profile. These results should be interpreted with caution until confirmed in larger, prospective trials.