When a one-and-a-half-year-old from Bahrain came to Frontier Lifeline Hospital with complex heart problems, doctors decided on a novel approach: they would take a 3-D print of his heart based on diagnostic images, plan the surgery with the model, and then carry it out.
And so, CT scan images of the malfunctioning heart were sent to a Mumbai-based software company and a plaster of paris model came back a week later: complete with every defect, in the heart’s original size, shape and contours.
This, said K.M. Cherian, chairman of the hospital, was then used to figure out how the heart’s defects could be resolved and there were many: dextrocardia – the heart being in the opposite side of the chest with atrio-ventricular discordance, a ventricular septal defect and a pulmonary valve obstruction, among others. This meant that there were holes in the heart and the blood vessels were not functioning well, leading to the heart not being able to pump properly.
For such a complex surgery, explained R. Subramaniyan, head of paediatric cardiology, planning is crucial.
“At the actual surgery, we can only make a tiny cut through which to see the heart, time is limited and we cannot see the back of the heart, which is lying against the spine. CT scans and MRIs help, but even then it is difficult to gauge distances or how to repair the heart so as not to hamper a valve opening. With a model, we can look at the heart from all angles, we can take it apart and we can decide how to go about the procedure. We basically have the patient’s heart in our hands before the surgery, which helps immensely,” he said.
Two previous surgeries
The child had already undergone two surgeries. Now, for the third, doctors decided to form a connection that would seal the hole, not obstruct the valve and yet allow blood pumped in the heart to fall into both the pulmonary artery and the aorta, which would then carry it to lungs and the rest of the body.
To form this tube too, took innovation.
“The tube was made partly with a homograft, which is human tissue, partly with a xenograft, which is a jugular vein taken from a buffalo and partly using Dacron, a polyester material,” said Dr. Cherian.
The six-hour surgery went well, and the child is now recovering, the doctors said.
‘It’s like having the patient’s heart in our hands before the surgery’
