Systematic review and meta-analysis of 3D cardiac simulations for congenital heart disease surgery3D heart models help surgeons plan better operations for children with heart defects

Open heart Published May 26, 2026 Study authors: Arero Godana, Jarsso Godana, Wako Abdinasir, Fekadu Desalegn, Mardasa Kibiru, Godana Honey PubMed ↗ DOI ↗ Editorial oversight: Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

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Key Takeaway

Consider that 3D cardiac simulations may improve surgical planning and outcomes in congenital heart disease, but evidence is non-experimental.

This is a systematic review and meta-analysis of patient-centred 3D cardiac simulations, including 3D-printed or virtual heart models, versus conventional imaging for patients undergoing operation for congenital cardiac disease. The analysis pooled data from 1842 patients. The authors synthesized findings on surgical plan modification, operative time, postoperative complications, re-operation, hospital stay, and surgeon confidence. Compared to conventional imaging, 3D simulations were associated with more frequent surgical plan modifications (RR 1.42; 95% CI 1.21 to 1.67), reduced operative time (MD -18.4 min; 95% CI -27.6 to -9.2), lower postoperative complications (RR 0.74; 95% CI 0.56 to 0.98), reduced re-operation (RR 0.52; 95% CI 0.31 to 0.86), shortened hospital stay (MD 1.8 days; 95% CI -3.0 to -0.6), and improved surgeon confidence (SMD 0.88; 95% CI 0.60 to 1.15). The authors acknowledge limitations, including non-experimental research design and variability across studies. They note that statistics for conclusive diagnosis results remain restricted and mainly experiential, and data on medical effects are unpredictable and uneven. The certainty of the evidence is rated as modest to small. Practice relevance is not reported, and the findings should be interpreted cautiously.

Surgeons face tough choices when operating on children born with heart defects. They often rely on standard images that can be hard to fully understand. A large review looked at using 3D heart models to help these teams. These models can be printed or shown on screens to show the heart clearly before the operation starts. The study looked at 1,842 patients who had surgery for congenital heart disease. This is a serious condition present from birth that requires skilled repair. The review found that using these models changed the surgical plan more often than usual methods. It also helped surgeons feel more confident about their approach. Patients who used these models had fewer complications after surgery. They also spent less time in the hospital and needed fewer repeat operations. The time spent in the operating room was shorter too. However, the research combined many different studies. This means the results varied because each hospital used different techniques. The data for some specific outcomes was limited and not fully conclusive. Despite these gaps, the benefits for patient care look promising.

What this means for you:

3D heart models improved surgical planning and reduced complications for children with heart defects.

Study Details

Study typeMeta analysis

Sample sizen = 1,842

EvidenceLevel 1

PublishedMay 2026

PMID42185024

View Original Abstract ↓

BACKGROUND: Congenital heart disease surgery includes intricate structures that are perhaps hard to completely understand by traditional two-dimensional shapes. Individualised, centre-based three-dimensional (3D) heart models may enhance structural imaging and surgical preparation, while data on their medical effect continue to be unpredictable and uneven. This systematic review and meta-analysis assessed the impact of 3D heart simulations on surgical preparation and outcomes in congenital cardiac disease. OBJECTIVE: To assess the successful outcomes of patient-centred 3D cardiac simulations in medical preparation, intraoperative execution and surgical results in patients experiencing operation for congenital cardiac disease. OBJECTIVE: To evaluate the impact of patient-specific 3D heart models on surgical planning precision and preoperative outcomes in congenital heart disease surgery. METHODS: A systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards and prospectively registered in PROSPERO (CRD42024211985). PubMed, Embase, Scopus and Cochrane CENTRAL were searched through March 2025 for comparative studies evaluating 3D-printed or virtual heart models versus conventional imaging. Outcomes were harmonised and pooled as risk ratios (RRs), mean differences (MDs) or standardised MDs (SMDs) with 95% CIs using random-effects models. RESULTS: 32 studies (n=1842) met inclusion criteria. The use of 3D models was associated with more frequent surgical plan modification (RR 1.42; 95% CI 1.21 to 1.67), reduced operative time (MD -18.4 min; 95% CI -27.6 to -9.2), lower postoperative complications (RR 0.74; 95% CI 0.56 to 0.98) and reduced re-operation (RR 0.52; 95% CI 0.31 to 0.86). Hospital stay was shortened (MD: 1.8 days; 95% CI -3.0 to -0.6), and surgeon confidence improved (SMD 0.88; 95% CI 0.60 to 1.15). The confidence of indication extended from modest to small because of non-experimental research and variability. CONCLUSION: Individualised-centred 3D heart stimulation improves structural imaging and medical preparation in congenital cardiac disease, chiefly for intricate lacerations and can increase preoperative competence, while statistics for conclusive diagnosis results continue to be restricted and mainly experiential. Upcoming potential, large-scale investigator-led research with consistent result events are required to ratify their medical success.

Systematic review and meta-analysis of 3D cardiac simulations for congenital heart disease surgery3D heart models help surgeons plan better operations for children with heart defects

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Systematic review and meta-analysis of 3D cardiac simulations for congenital heart disease surgery3D heart models help surgeons plan better operations for children with heart defects

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