Apr 11, 2016 | By Kira
A 5-day-old baby boy was rushed to the St. Petersburg State Paediatric University Hospital in Russia with a life-threatening congenital heart defect known as Taussig-Bing malformation. The rare and complex condition requires specialized patient information to understand and plan the surgery, however due to the complexity of this case, the standard CT scans were not detailed enough to allow the surgeons to confidently prepare and execute a plan.
They thus turned to 3D printing technology, provided by Swiss startup 3D Medical Printing AG, to create a patient-specific 3D printed heart model. Not only did the 3D printed heart serve as a pre-operational guide in two separate surgeries, but it also helped the baby’s understandably anxious parents fully understand their child’s condition and become more involved in his medical care.
In Taussig-Bing malformation, rather than the aorta being connected to the left ventricle, both the aorta and the pulmonary artery are connected to the right ventricle. In addition, the baby, born in August 2015, showed signs of an aortic arch obstruction.
“A variety of operations have been used to manage such patients with double-outlet right ventricle and subpulmonary ventricular septal defect,” explained Dr. Sergey Marchenko, the assigned surgeon. However, he continued, “hospital mortality is still high.”
Under normal circumstances, doctors would study the patient’s intracardiac and extracardiac flow using standard echo and computed tomography (CT) scans. However, these traditional medical imaging technologies have their limitations.
“Before the surgery, there was a discrepancy in clinical pictures and echocardiography,” explained Dr. Marchenko. “Despite of the good visualization by echo, it was difficult to understand particular pattern of mixing of the oxygenated and non-oxygenated blood inside of the heart.”
Due to this discrepancy, the doctors were not comfortable moving forward with the procedure until a clearer picture could be obtained.
As we have seen in the past, 3D printed medical models are invaluable, life-saving tools in precisely these circumstances. A physical, three-dimensional model showing the exact positions of arteries, muscles and other anatomical features provides doctors the most complete image possible, and allows them to practice and plan the exact surgical procedure before the patient even enters the operating theatre.
“Entering an operating room for a complex case having full understanding of all the steps of operation is the main advantage of 3D printing,” said Dr. Marchenko. “A 3D model is the only option in such a case to clarify the pattern of flow inside the heart and enhance visualization in order to plan for the most appropriate surgical approach.”
3D Medical Printing AG, a Swiss startup headed by CEO Frank Ehrsam provided the 3D printed heart model. Using this patient-specific, 3D printed guide, alongside the echo and CT scans, the surgeons confidently decided to reconstruct the arch, remove the coarctation, and postpone the intracardiac operation. A second surgery when the child was 6 months old was also successfully performed using information from the 3D printed model.
Beyond helping the doctors confidently plan and execute the operation, the 3D printed model also gave the baby’s parents invaluable insight into their child’s condition, giving them the confidence they needed to get through the emotionally trying procedure.
“The 3D printed heart model allowed the surgeons to explain the baby’s condition and their plan,” said the father. “By seeing the model and understanding what needed to be done and why, in two surgeries I have become as confident as the surgical team. 3D model allowed me to understand and support the doctors in their decision-making. Despite two surgeries, finally our son recovered completely. Thanks to the heart team, baby is on his way to a healthy life!”
This heart-warming case study is just the latest example of how 3D printed medical solutions are already saving lives. In the past, 3D printed medical models have been used to save a 6-month-old girl with a brain tumor, and a 9-month-old baby in China, and these are really just the beginning.
According to Dr. Paul Vogt, specialist in cardiac and thoracic vascular surgery at the Heart Vascular Center in Zurich, 3D printing in the medical field is the absolute way forward: “After the successful result, it’s hard to imagine entering an operating room for another complex case without the aid of a 3D printed model. It’s definitely going to be standard of care in the future.”
3D Medical Printing AG has said that they will continue to collaborate with the St. Petersburg State paediatric University to further develop 3D neonatal cardiac surgery solutions, one of the most difficult areas in cardiovascular medicine.
Posted in 3D Printing Application
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