Modeling great care

Six years ago, thanks to the support of donors, Cook Children's Heart Center added a new program: a 3D lab for the planning and printing of congenital heart disease (3D aPPROaCH Lab). The program is led by Steve Muyskens, M.D., who specializes in the field of pediatric cardiac MRI.

Cook Children's Cardiothoracic Surgery Medical Director Vincent Tam, M.D., is one of several surgeons who uses the 3D models created in this lab. The models help him create precise and personalized surgical plans for some of our most complex heart patients.

"As a surgeon, my job is to do the surgical repairs for our heart patients. We see patients with complex heart defects that most heart centers won't even consider repairing,” Dr. Tam said. “These heart defects tend to be very unique and have multiple abnormalities that you have to deal with. In these cases, it helps me to have something tangible in my hands so that I can see the different approaches that are available to me and formulate a plan of how to actually do the repair."

There are two components to the 3D aPPROaCH lab: 3D virtual models and 3D printed models.

Virtual models can be created as soon as images of the heart are available. These models can be easily manipulated in order to show the surgeon exactly what they want to see, or do not want to see. For example, it can include the patient's heart and lungs, or the heart alone; whatever information is most beneficial when planning for surgery.

Dr. Muyskens uses a virtual viewer called EchoPixel's True 3D, an interactive, mixed-reality software platform, to present the virtual models to clinicians. Currently, we have two machines linked to this software, one of which is mobile and can be taken into operating rooms or the catheterization suite.

As an alternative, there is now an online, cloud-based program that Dr. Muyskens, as well as other physicians, can use to access these virtual images; no special machine required. Using this new Mimics Viewer platform, he can view a 3D model from a desktop, laptop or even mobile device. The virtual models can then be oriented or cut in any manner necessary.

The 3D models, though they take more time to create, offer tactile learning, unlike the virtual models.

Cook Children's is one of only a few pediatric hospitals in the country to have access to digital anatomy printing (DAP). Using DAP, the models are more realistic; they are flexible and no longer hard. This gives the surgeons more functionality, as the models look and feel like the real thing. We can now print seamless models that include different tissue types, like bones, muscles, valves and vessels.

In July 2020, Cook Children's hired Luke Vierkant as a lead 3D lab tech. Since adding Luke to the team, we have considerably increased the number of models produced. Previous to Luke coming on board, approximately eight models were made per year. With Luke's help, the team was able to produce the same amount in a matter of four months.

Thanks to the support of donors, we find ourselves at the leading-edge of this technology, and we plan to stay there.