The University of Louisville Alumni Magazine: for alumni, faculty, staff, students and anyone that is a UofL Cardinal fan.
Issue link: https://louisville.epubxp.com/i/339710
3 2 | L O U I S V I L L E . E D U W hen 14-month-old Roland Lian Cung Bawi needed surgery to repair complex connections within his tiny heart, doctors knew it would be a difficult process. The best option for planning the complicated procedure depended on heart surgeon Erle Austin, MD, Department of Cardiovascular and Thoracic Surgery, piecing together several two-dimen- sional images of the toddler's heart to create a 3D picture in his mind. However, even with the best technology available, Austin received conflicting ideas on how to proceed when consulting other surgeons. When Roland's physicians looked beyond their usual circle of experts, they found the perfect way to repair Roland's heart. Austin and Philip Dydynski, MD, chief radiologist at Kosair Children's Hospital, toured UofL's Rapid Prototyping Center and consulted with engineer and manager Tim Gornet about the possibility of creating a three-dimensional model of the child's heart and all its congenital defects. "I was aware that 3D printing had been going on for a number of years, and I knew that if we could get a set of data that could accurately describe a 3D object, we could print anything," said Austin. Dydynski found a way to put the CT data into a format the machine could read, while Gornet found a polymer known as "Ninja Fle" that closely mimicked the texture of heart muscle. "To be honest, I did not know the printed model would be as accurate and helpful as it turned out to be," said Dydynski. "It's exciting and encouraging that we were able to merge medicine and engineering to help improve patient care. I am confident we will apply this technology in the future for our most complex congenital heart patients where additional help is needed for surgical planning." After 20 hours in the printing process, the 3D model of Roland's heart was complete — estimated at a total of $600 in labor and materials. Made in three sections and twice the size of the toddler's heart, this new plastic replica gave Austin a better, more true-to-life view of the heart, providing valuable perspectives of the intricate internal anatomy. "I had to operate and the 3D heart model enabled me to plan the operation without making multiple incisions in the walls of the heart to visualize the exact location of the hole and surrounding structures. Essentially, I was able to plan the optimal operation and perform it in the shortest period of time with minimal injury to the heart," said Austin of his pre-surgery planning experience with the heart model. On February 10, 2014, Austin and his team were able to successfully operate on Roland's heart. The model — which was the first use of 3D printing for a pediatric heart patient in Kentucky — also enabled a quicker recovery time for Roland. "He was discharged on his fourth post-operative day without any medications," said pediatric cardiologist Smitha Bullock, MD, Department of Pediatrics. "His mother was very grateful for this technology, which allowed the surgeon to pursue a technique that doesn't necessitate future operations and he was taken off of all the medications he was on prior to the procedure for his heart failure." In the future, Austin, Dydynski and Gornet plan to use 3D printing technology to plan the surgeries of additional pediatric patients with congenital heart defects. "With congenital heart defects in children, they are all unique and must be navigated on a case-by-case basis," said Gornet. He is already receiving calls from other institutions that want to employ the technology and plans to create more 3D heart models as new cases become available through the university. Because 3D printed models offer a distinct advantage over 2D images when planning a complex surgery, the technology shows great promise in helping more patients like Roland avoid additional trauma to the heart, with more precise planning that can prevent repeat procedures and accelerate recovery time. "We have great faculty both on the clinical and engineering side to execute these unique, patient-centered, bioengineering projects," said Brad Keller, MD, Kosair Charities Chair in Pediatric Heart Surgery Research and director of the Kosair Charities Pediatric Heart Research Center at the UofL Cardiovas- cular Innovation Institute. "Innovation by multidisciplinary teams remains a key factor in providing the best outcomes for patients with complex congenital heart defects." A SIMPLIFIED SURGERY "The 3D heart model enabled me to plan the operation without making multiple incisions. " ÑErle Austin, MD U L _ 3 2 3 2 UL_32 32 6 / 2 3 / 1 4 9 : 4 7 A M 6/23/14 9:47 AM