**Introduction/Hypothesis:**
Differences in perspective, experience, and training can often lead to misunderstandings and conflicting approaches in caring for patients with congenital heart disease. Echocardiographers have a different perspective than CT/MRI images, and the surgical perspective in the operating room is totally unique. Two-dimensional representations in textbooks, 3D reconstructions of CT images, and 2D echo images all create false impressions of true 3D geometry. Bridging the gap of understanding between the operating room perspective and the various imaging modalities is of critical importance in accurate and successful patient care. We attempted to illustrate this issue with a series of case studies of complete atrioventricular canals (CAVC), contrasting various 2D images with 3D printed models printed to reflect what the surgeon sees in the operating room. In this study, we aim to create and print a suite of CAVC 3D models representing the most common AV valve repairs, utilize these models in medical education conferences for cardiologists, medical students, and cardiology/surgery trainees.

**Methods**
Utilizing Materialise Mimics and 3-Matic, CT scans of patients with AV canals were segmented and valves were reconstructed onto the patient models. Most of the patients had additional anatomic issues requiring CT scans (e.g. arch hypoplasia, coarctation of the aorta, or Tetralogy of Fallot with CAVC). The models were then 3D printed using Stratasys Digital Anatomy Printers™.

**Results**
We developed multiple 3D printed teaching models, with the utilization of both soft and hard materials and multiple colors to provide easily understandable models. These models duplicated exactly what the surgeon observes through the usual right atrial incision in a CAVC. They illustrated the profound differences between two-dimensional images and accurate patient-specific 3D printed models.

**Conclusion**
The models helped both attending physicians and trainees appreciate the differences in visualization and led to a far better understanding, for instance, of the relationship between the plane of the AV valves, the plane of the usual VSD, and the importance of the size of the primum atrial septal defect as seen by the surgeon. In the future, a 3D printing atlas covering different surgical views could be beneficial.



Utilizing 3D Printed Complete AV Canal Models for Professional Education