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3D to the rescue of the heart

Innovative procedure of the heart valve repair took place at the Centre for Cardiovascular Research and Development of American Heart of Poland in Bielsko-Biała, where the team of specialists used a model of the patient’s heart prepared in 3D technology. A Three-dimensional, actual model of the organ is a revolution that significantly improves preparation for the surgical procedure of heart structural defects and increases patient safety.

Heart valve diseases, especially congenital heart defects, may lead to significant changes in its anatomy. To prepare properly for the procedure - not only for a surgical one, but also for a percutaneous one - physicians must take into consideration all details regarding pathological changes in the heart structure. Visualization of three-dimensional interrelations of changed structures is crucial for physicians and provides them with high precision of movements that extremely increases chances for the success.

Imaging techniques have been functioning in cardiology for some time. However, despite their development, they are still imperfect – so far, they have been providing images that are only virtual reconstructions. It is different in case of 3D technology. It supports creating actual, physical models of organs, and that neutralize imperfections of imaging techniques, said Professor Paweł Buszman, specialist who led the procedure in Bielsko-Biała.

 

It is as if we were able not only to see the heart of a patient in details including all its defects, literally from all sides, before the procedure, but we also can touch it. For me, as a physician, comfort of such preparation for the procedure using 3D printing, especially in case of such severe defects as the valve insufficiency, is exceptional

sums up Professor Paweł Buszman, AHP Group Chief Executive Officer.

In order to create an individual three-dimensional model of the patient’s heart, images of the organ obtained with the use of multislice computed tomography, performed about one week before the procedure, were used. Based on analysis of the blood volume there was prepared a virtual three-dimensional model including the internal surface of the left ventricle, the left atrium and an initial segment of the aorta. In addition, the data were modified in such manner that suitable thickness of the wall was added. All of these data were processed by special software and were sent to Belgium and printed in 3D technology. Within two days, the three-dimensional model of heart came to the CCRD AHP in Bielsko-Biała.

The heart copied in 3D technique was used during preparation for an innovative procedure of percutaneous mitral valve annuloplasty. This procedure should be used in patients with severe heart failure, usually after myocardial infarctions, with large cicatrix, who cannot undergo classic cardiac surgery because the high level of risk. It includes femoral artery puncture and installation of special polymer implants via a catheter. To simplify it we can say that these implants work like a staples. Then, they are tightened in order to decrease the circumference of the mitral valve annulus in the heart – the valve insufficiency. Each stage of the procedure was additionally controlled by 3D transesophageal echocardiography.

Individual heart model prepared in 3D technology allows for perfect matching to a particular patient. The procedure required insertion of the guiding catheter to the left ventricle through the aorta and placement of its tip between papillary muscles around the valve annulus. Based on the heart model, we were able to select the size of the guiding catheter to ensure free manoeuvring inside the ventricle. We had also a chance to determine optimum location of the guidewires that were going through the valve annulus and check the possibility of proper placement of the catheter, said Professor Paweł Buszman. The effect is a maximum precision, which consequently translates into the maximum level of safety for the patient.

The procedure performed at the CCRD AHP in Bielsko-Biała was a part of our clinical studies. The first conclusions drawn by the physicians directly after the procedure state that individual model of the patient’s heart created in the three-dimensional printing technique is an extremely helpful tool used at the stage of preparation for percutaneous procedures in cardiology.

The CCRD AHP is the only one private center in Poland that conducts preclinical and clinical studies within the scope of cardiovascular diseases. The facility has modern treatment rooms and operating rooms, including one of the cutting-edge hybrid room, where cardiology procedures and cardiac surgeries are performed. The purpose of our studies within the scope of preclinical and clinical studies is to introduce the most modern technologies and treatment methods into clinical practice.

The CCRD AHP research work led to multiple successful outcomes. The list of completed projects includes more than 18 trials. As a result of our studies into the clinical practice were introduced: the first Polish coronary stent made of stainless steel, the coronary stent made of cobalt-chrome alloy “KOS” and one of the first in the world a drug-eluting stent releasing antiproliferative drug from the surface of biodegradable polymer.

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