3D Printing in Cardiology: Innovation for Treatment

It is an immensely exciting time to be alive. Today’s cardiologists and cardiothoracic surgeons are more qualified than ever more thanks to the discoveries and innovation in the world of medicine. One of the newest methods of enhancing patient treatment being researched is 3D printing of the heart. Applying machine learning and incorporating various imaging processes has allowed for accurate 3D images of the heart. Innovatively, doctors are using 3D printing technology to physically touch and see the patient’s anatomy without surgical procedures.

Imaging Methods

Cardiology requires an abundance of tests and imaging in order to properly diagnose and treat patients. Several ways to read the heart have been developed over the course of history, which have been remarkably helpful for diagnosis.

• Computed Tomography

-A CT scan is primarily used to determine if there are any blockages or other abnormalities in the coronary arteries. It is a combination of many X- rays from different angles that provide an accurate reading of the heart’s functions. At the University of Chicago, the cardiac CT team uses an advanced scanner that takes several high-quality images, at the lowest-possible radiation dose, to recreate a multidimensional (3D) image of the beating heart.

• Echocardiogram

-An echocardiogram is essentially an ultrasound of the heart. It is a noninvasive way to obtain a live image of the beating heart as it uses sound waves bouncing off of the tissue to create an image of all the chambers of the heart (right atrium, right ventricle, left atrium, and left ventricle). It allows the cardiologist to look at the heart from different angles. Recent advancements have made it possible for a 3D echocardiogram for more accurate treatment and diagnosis.

• Angiogram

-An angiogram is a type of X-ray used to examine blood vessels. A dye (iodine) is injected into the bloodstream to inspect blood flow to the heart. The iodine highlights the blood vessels as it travels through them.

• Magnetic Resonance Imaging

-MRIs are often used for reconstruction of cardiac masses and studying congenital heart defects. In short, cardiac MRIs use magnetic fields and radiofrequency waves to create a detailed image of the heart with different cross sections. It is usually the second step after an echocardiogram in the process of diagnosing a patient as it provides a much clearer picture.

The Process of Printing

There are essentially two steps to bringing a patient’s heart into a 3D form. First, imaging data from all the aforementioned imaging methods must be pooled together to be converted into a printable form. After gathering all of the necessary imaging, specific areas of interest are selected in the process known as image segmentation. In recent times, AI is being developed to carry out image segmentation in order to cut effort, costs, and time. The second step emphasizes the availability and feasibility of 3D printing technology. There are 3D visualization softwares that allow cardiologists to study a digital 3D image of the heart before printing it. Once the digital image is produced, specialized triangulated surface meshes are generated in order to define an enclosed volume for the print. Softwares such as MeshLab have found recent success in editing and modifying mesh in order to yield the most accurate 3D image.

Various steps involved in 3D visualization

Applications

The applications of 3D heart printing have revolutionized the field of medicine, offering groundbreaking opportunities for diagnosis, treatment, research, and education. One of the most significant uses is in patient-specific preoperative planning. Surgeons can now use 3D-printed models of a patient's heart to gain valuable insights into the organ's unique anatomical features before complex procedures, such as heart valve replacements or congenital defect repairs, reducing surgery risks and improving outcomes. Additionally, 3D heart printing has facilitated the development of personalized cardiac implants and prosthetics, tailored to fit individual patients, enhancing their overall quality of life. Moreover, researchers can employ these printed hearts to even practice surgical skills before the actual surgery to familiarize themselves with the specific patient’s heart in order to minimize errors and time spent on surgery. Medical students and professionals also benefit from 3D-printed hearts as educational tools, offering an immersive and hands-on learning experience. Overall, 3D heart printing's multifaceted applications showcase its potential to reshape cardiovascular medicine and foster better patient care worldwide.

Successfully printed 3D heart model used to plan surgery at Duke University