The heart of the newborn child can weigh 20 grams and fit on a human’s palm. It’s easy to see why surgical procedures on such a small organ bring many difficulties.
When the heart has only one abnormality most doctors can refer to their experience or to methods like CT scan and MRI to create an image of the impairment. The real challenge starts when the heart is tiny, the heart disease rare, or it differs from other, typical cases. In all of those examples, even sub-millimeters can make a life-or-death difference. To increase the chance of survival, surgeons decided to 3D print the abnormal heart with laser sintering desktop 3d printer.
Kordian, a 3-week old infant from Poland was suffering from the heart disease called traumatic aortic rupture.
– The problem was that the aorta, the biggest vessel that is coming out of the heart was suddenly interrupted – says Jarosław Meyer-Szary MD from the Department of Pediatric Cardiology and Congenital Heart Defect, University Clinical Center in Gdańsk, Poland.
This condition can be fatal. Doctors along with his mother, a person who didn’t have any knowledge about the disease, had to decide quickly about undertaking the procedure. Dr. Meyer-Szary decided to use a 3d printed model of Kordian’s heart in the original size as a support.
3d printing is becoming a popular approach in many hospitals. Cardiologists can print every heart and see the abnormality closely. Doctors can even do a mock-up surgery before the real procedure. Unfortunately, while the most common FDM 3D printers are good enough for everyday use, this time that technology couldn’t help. Doctors needed a solution that would provide surgical precision. They had to imitate every little vein and artery that surrounds the heart. For FDMs, veins were either too thin to print or, because of the needed supports, could be easily torn apart during post-processing.
As it turned out, selective laser sintering (SLS) 3D technology meets all the requirements. SLS 3D-printed models can be used both for planning the cardiac surgery and also for interventional procedures, especially in complex and rare congenital heart diseases when the anatomy always varies from patient to patient.
Medical doctors are not the only beneficiaries, it is also important for the patients and in this case, parents to understand the situation and give the permission to operate.
– As a head of Department I have to talk to parents, students and explain sometimes very complicated congenital heart defects to the people who are not doctors, not professionals in this area – says Joanna Kwiatkowska MD Ph.D, Associate Professor and Head of the Department of Pediatric Cardiology and Congenital Heart Defect, University Clinical Center in Gdańsk, Poland.
Operations, where doctors practiced on 3D printed hearts have a higher rate of success, which is leading to a better life of the patient.
Seeing the model made it easier for Kordian’s mother to understand how serious his condition was, and how the procedure would proceed.
– I learned about the disease, traumatic aortic rupture, when Kordian was three weeks old – says child’s mother. This model of the heart helped us a lot because I didn’t understand this heart defect while seeing it on the screen. Touching this printed model helped me realize the seriousness of my child’s disease. Having this model in front of me, I could get it. The doctor showed me where the rapture is, presented me the defect and showed how he would connect it – she adds
Surgeons decided to print Kordian’s heart to better plan an operation. With the rapture clearly visible on the SLS 3D printed model, the minimal size of the heart wasn’t a problem. It helped to prepare for the complicated operation. They connected raptured fragments of the aorta.
Today Kordian is 18 months old. His happy face and positive attitude toward new people don’t reveal that over a year ago this boy could not live.
Model of the heart was printed on the Sinterit Lisa, a desktop-size selective laser sintering 3D printer.
In July 2018 Sinterit is launching a new, even more reliable generation of Lisa. Now with increased printing size in the Y-axis, the overall diagonal dimension of the printing area rose from 227 to 245 mm. Recent hardware enhancements resulted in better temperature management and boosted the reliability of prints.