Expanding the use of 3D printing in congenital heart surgery.

Three-dimensional (3D) printing has evolved the way patients with complex congenital heart disease are managed. The main applications of 3D printing in congenital heart surgery are (I) clinical decision making/surgical planning; (II) practice/simulation; (III) education. This paper explores these applications and how they can benefit clinicians involved in the care of patients with complex congenital heart disease. 3D printing is particularly useful in clinical decision making for patients with complex diseases, especially when there is ambiguity over whether a biventricular repair is possible versus univentricular palliation. This paper provides a summary of the evidence that supports its use and in which subset of patients this technology is most beneficial. Beyond surgical planning, 3D models support the safe development and rehearsal of novel surgical techniques and provide a platform for simulation-based training. Studies have shown that simulation using 3D models improves technical performance and procedural efficiency, supporting their integration into training curricula, particularly in resource-limited settings. Furthermore, 3D models enhance education for medical professionals and aid communication with patients and families, facilitating shared decision-making. Although high-quality evidence supporting 3D printing is limited, in the clinical management of patients with complex congenital heart disease, 3D printing should be considered in complex cases. This clinical benefit is being supported by the availability of reimbursement codes in some countries. As the technology advances, 3D printing may become a core component in congenital heart surgery. While further evidence is needed to fully quantify its clinical benefit, current data and global experience strongly support its integration into care pathways for selected patients, training programs, and education strategies.