A few months ago, as part of generating awareness of 3D printing applications in healthcare, USI3DT had arranged for me to meet with the staff of CIMS Hospital. That’s when I first met Dr. Shah. He patiently listened to my presentation, asked questions and carefully inspected the 3D printed anatomical parts that I produced from my backpack one by one.
On the 1st of July 2021, Dr. Dhiren Shah, along with paedriatic cardiac surgeon Dr. Shaunak Shah, performed a complex heart surgeory on a patient with an extremely rare heart condition. A 3D printed model of the patient’s heart proved to a crucial element in the successful operation.
It all started when a 15 year old boy with stunted growth was brought to Dr. Shah. His ECG had indicated some abnomality. Upon conducting a CT scan, he was diagnosed with a disease called Anomalous Left Coronary Artery from the Pulmonary Artery or ALCAPA. In children with ALCAPA, the left coronary artery arises from the pulmonary artery and carries blood without oxygen to the left side of the heart. When the heart doesn’t get enough oxygen, the heart muscle can weaken or die, similar to having a heart attack. The damaged heart muscle cannot pump effectively, leading to heart failure. ALCAPA is a very rare condition that may cause dangerously poor cardiac function in infancy. Surgery is needed to correct the defect. Without intervention, most babies don’t survive their first year. But with timely surgery, most babies do well and live a normal life.
But there was something very special about this boy. Although he had ALCAPA, he had managed to survive for 15 years. It turns out, nature had thrown him a lifeline. His heart had tiny passages called colaterals between his left and right sides which allowed him to survive. But his heart worked at 50% capacity and that was the reason for his stunted growth.
Dr. Shah had performed heart surgery on babies with ALCAPA several times. But this was the first time he was going to attempt the delicate operation on a 15 year old heart. In babies the heart tissue is soft and lends itself well to stretching, pulling and fixing operations. But a 15 year old heart would be much stronger. So it was critically important that both surgeons had a pretty good understanding of the patient’s anatomy before they started the operation. They had to plan and practice the surgery in advance. Even a small misunderstanding of the CT scan data of the patient’s heart could be a matter of life and death. This was the perfect use case for 3D printing.
The CT Scan data was sent to the healthcare specialists at Shree Rapid Technologies, a 3D Systems strategic partner in India. DICOM to Print, a medical image processing software was used to convert numerous greyscale CT scan images to a segmented 3D model. Geomagic Freeform, an organic modeling software was used to clean up the 3D model of the heart and highlight areas of interest. Finally the heart model was 3D printed using the Pro-BLK 10 material on a Figure 4 Standalone 3D printer and couriered overnight to CIMS Hospital.
Using the geometry and measurements of this 3D printed heart model the surgeons were able to figure out exactly what to do when they opened up the patient. They could decide in advance what kind of grafting operations they would need to perform. The element of uncertainity and surprise was greatly reduced. The end result was a successful operation.
Dr. Dhiren Shah tells me, “I want other surgeons to understand the kind of help 3D printing can offer in performing complex surgeries like this one. The 3D model doesn’t cost much, but can be the difference between success and failure.”
The boy will grow up to lead a normal and healthy life.