A clinical trial to outline the benefits of using 3-D printed hearts for surgery was recently funded by the nonprofit organization Matthew’s Hearts of Hope. Read more about this on our sister blog, Vector.
Jason Ayres, a family doctor in Alabama, was speechless as he held his adopted son’s heart in his hands — well, a replica of his son’s heart, an exact replica, 3-D printed before the three-year-old boy had lifesaving open-heart surgery.
Patrick Ayres was one of the Boston Children’s Hospital’s first beneficiaries of 3-D printing, which in 2015 helped open a new frontier in pediatric cardiac surgery.
Patrick was born with numerous cardiac problems; in addition to double outlet right ventricle (DORV) and a complete atrioventricular canal defect, his heart lay backwards in his chest. DORV is a complex congenital defect in which the blood pumped from the heart to the body lacks adequate oxygen. Complete atrioventricular canal defect is a combination of issues related to holes in the heart and/or ineffective heart valves.
“There were a lot of things wrong with his heart,” says Jason. “We knew early on that he’d need complex surgery to survive.”
Open-heart surgery: Planning and pre-planning
Finely detailed, 3-D printed models of Patrick’s heart created by the Simulator Program at Boston Children’s gave his cardiac surgeon Dr. Sitaram Emani an up-close-and-personal look at his complex cardiac anatomy.
Emani, who directs the Complex Biventricular Repair Program at the Heart Center, says it can take anywhere between 30 minutes and an hour in the operating room to sort through a patient’s cardiac anatomy. That’s all extra time the child is on cardiopulmonary bypass and anesthesia — precious time that the 3-D models can save.
“Not only can we eliminate this planning time in the operating room,” says Emani, “but we believe surgical techniques and outcomes will also improve due to that pre-planning.”
Patrick is one of eight Ayres children: four biological and four adopted. His parents knew Patrick had congenital heart disease before they brought him home from China.
“When you fill out adoption paperwork,” Jason explains, “you can indicate which medical conditions you will consent to manage. The first time I adopted, I didn’t check off congenital heart disease (CHD), because I thought the likelihood someone with CHD could have a normal life was essentially zero. But now I know that’s not true.”
After seeking care locally, it became clear to the family that Patrick needed extremely complex care, and they decided to make the trip to Boston. Jason had heard from friends about cardiologist Dr. Gerald Marx and called him directly. Soon, the Ayres were in Boston meeting with Marx and discussing the plan for Patrick’s open-heart surgery with Emani.
“When [Emani] asked if we wanted to have a 3-D printed model of Patrick’s heart, it was kind of a no-brainer,” says Jason, a self-described geek. “It couldn’t hurt, and it would be kind of cool to have.”
Patrick’s open-heart surgery
Patrick was in the operating room for nearly seven hours. The 3-D printed heart allowed his surgeons to make the most of that time and operate with confidence. “Technology has assisted to give these kids a much longer life expectancy as well as quality of life,” Jason says. “We should be doing anything we can to make these things easier and take less time [in the OR] for these kids.”
After his successful surgery, Patrick now runs around playing with his seven brothers and sisters like nothing ever happened.
And as for the 3-D heart, “They let us keep it!” says Jason. “I have it in my office now, and when people ask how Patrick did, I show them the heart.”
That highlights an additional benefit to the printed hearts: better patient education. “We can model every possible type of heart disease to show a family exactly what their child has,” says Emani. “It’s taking something complex and making it simple.” Most importantly, when these children grow older and start asking questions about their heart conditions, they can hold the answers in their hands — and marvel at how far they’ve come.
Learn more about the Boston Children’s Department of Cardiac Surgery.