From Printer to Patient

crnummdxeai6hlxThe human heart is an engineering marvel. A two-sided pump, it coordinates the flow of blood into the lungs to pick up oxygen, and then out into the body to deliver it. In adults, the heart pumps 1.5 gallons of blood each minute and 1.5 million gallons over a lifetime. But in rare cases, babies are born with hearts so malformed and the vessels within them so abnormally routed that they cannot properly pump blood at all. Confronting such tough cases, surgeons like Emile Bacha, MD, director of congenital and pediatric cardiac surgery at NewYork-Presbyterian Congenital Heart Center, have two options: Repair the baby’s heart by enlarging narrowed areas, closing errant holes, and realigning vessels, or conduct a palliative operation known as a Fontan procedure that leaves the infant with muchreduced heart function. The trouble is, a baby’s heart is difficult to image and the convolutions inside this pingpong ball-sized structure add to the complication. “You pretty much have to figure it out on the table,” Dr. Bacha says. When you do not know what you are getting into before you start, he adds, the chance for achieving a full repair is lessened.

Last summer, pediatric cardiologist Anjali Chelliah, MD, assistant professor of pediatrics, brought just such a case to Dr. Bacha, the Calvin F. Barber Professor of Surgery. Her patient, still unborn at 35 weeks of gestation, had a rare form of a congenital heart malformation called double outlet right ventricle. Based on the maze of holes and abnormally connected vessels within, Dr. Bacha doubted that he would be able to fully repair the baby boy’s heart.

Dr. Chelliah came bearing a solution, however: What if they could use a 3-D printer to generate a perfect model so that Dr. Bacha could literally hold the infant’s heart in his hand, study its ins and outs, make some test cuts, and design a clear plan for the procedure before the baby entered the operating room? That prospect could revolutionize the outcome for these babies, Dr. Bacha says. “The technology is such an obvious marriage with what we need.”

By Alla Katsnelson | Columbia University Medical Center

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