Surgical Planning and 3D Printed Hearts

Alistair Phillips, MD, who is the Co-Chair for the American College of Cardiology, Surgeons Section tells about some of the impacts he has personally experienced using 3D printing in surgical settings as his participation in the 3DHEART program:

“The clinical trial is particularly exciting as it targets specific cases in which understanding of the anatomy will greatly enhance the surgical approach. A 3D printed replica of a patient’s heart will be created as part of the inclusion criteria to be in the study.Using 3D printing gave a better understanding of the Hybrid procedure, and allowed us to perform pulmonary valve replacement with a minimally invasive approach avoiding conventional method that required open-heart surgery. After coming to Cedars-Sinai we refined the pre-ventricular approach by utilizing a 3D printed models of patients’ hearts. We were able to simulate the implant into the right ventricular outflow tract.

Every surgeon is different. The education, experience, aptitudes, and attitude we bring to each equally nuanced and varied patient span an almost limitless spectrum and inform how we may utilize 3D printing for the benefit of our patients. The elegance of 3D printing is that it can create the individualized tools spanning this spectrum.

That said, however, what is not negotiable is the veracity of the models that we are receiving. Various materials and their corresponding colouring or rigidity may serve different functions in the hands of different surgeons, but ultimately we must have the utmost confidence in the fidelity of the models we are utilizing for pre-surgical planning. The more realistic the model is both in anatomical and textural preciousness will greatly enhance the application.

In all honesty, I would advise each hospital to start by really understanding the value proposition 3D printing offers across all specialities and, the culture of their institution. The best way to get answers to these very nebulous, complicated, nuanced directives is by retaining an outside vendor to provide as much of the services as possible, from the proverbial soup to nuts.

The excitement around the 3DHEART clinical trial is so great because it is the first organized, large-scale attempt to collect evidence of the efficacies of 3D printing in the practice of medicine and delivery of healthcare, not only in terms of optimized patient outcomes but also with respect to lower costs. If we can get reimbursement for 3D models, it is without a doubt a game-changer in terms of the practice of medicine, and a life-changer for many of our patients.”

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Flow Testing Dynamic Systems with 3D Printed Patient-Specific Heart Models

Without the 3D printed models, we wouldn’t have been able to come up with a way to do the procedure in advance.

—C. HUIE LIN, M.D
Adult congenital and interventional cardiologist.

3D Print Bureau of Texas has partnered with physicians at Houston Methodist Hospital to create cardiac models for applications such as assessing the size and attachment site of a right atrial malignancy. Accurate physical replications of patient anatomy can even undergo testing in a dynamic system such as replicating the severity of aortic stenosis using flow testing.

3D Print Bureau of Texas also worked with Houston Methodist DeBakey Heart and Vascular Center on a complex case involving a young patient born with a wide-open leaking pulmonary valve. The patient could not take blood transfusions and have been turned down by two medical centres concerned she would not make it through surgery.

With a 3D printed model of the patient’s heart, Lin devised a plan that required very little blood loss, which resulted in a successful operation for the little patient.

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