Eleven-year-old Torin Geiger has the same competitive drive that pushes his four brothers and sisters in sports, but he knows that he has to hold back.
During a tonsillectomy at age 4, Torin’s anesthesiologist noticed a discrepancy between the blood pressure in his upper and lower extremities. That led to an appointment with a Seattle Children’s Hospital cardiologist and a diagnosis: Torin has heart defects including a coarctation of his aorta. Because of that, he can’t overexert himself in sports or participate in games where there’s a risk of impact to his chest.
For years, Torin has known about his condition, but in a sort of abstract way.
“I really didn’t understand what I had,” Torin said. “If my friends asked me, I was like, I have a heart condition.”
A pilot project at Seattle Children’s is helping make heart defects more tangible for patients and their families with the use of 3D models.
A team led by Dr. Sujatha Buddhe, a Seattle Children’s cardiologist, took radiology images of different heart abnormalities from 18 patients and turned them into the models. The plastic, 3D hearts are up to five-times larger than a fetal or baby heart, which is about the size of a strawberry. The hearts come apart to allow views of the inside, and go back together like a puzzle held in place by magnets. The models are simplified to make them easier to comprehend, but still spatially accurate.
“Seeing it helped me understand what was really going on, and the doctor pointing out what my condition was,” said Torin, who lives in Bothell, north of Seattle.
“When you see it, it’s easier to understand why you have to take precautions” to protect and monitor his heart, said Torin’s mom, Jessica Geiger.
Every year in the United States, approximately 40,000 babies are born with congenital heart defects. Many require surgery shortly after they’re born to help repair the condition. The models are important tools for families making difficult decisions about which surgeries to pursue to help their children.
“Until they know the problem well, it’s not easy to cope with what it is,” Buddhe said. “To look at the heart, that is when it actually makes sense.”
The doctors at Seattle Children’s perform close to 600 surgeries in their Heart Center each year. They’re often in a position of providing a lesson in cardiology 101 to a family gripped with worry for their child. It’s hard for parents to wrap their heads around the situation. But the different surgeries will have tradeoffs in terms of risks and benefits and families need to make informed decisions.
“It’s kind of shocking that people are going through the process of having a child with heart disease without a detailed understanding,” said Dr. Titus Chan, a pediatric cardiologist at Seattle Children’s.
The doctors say they’re using the models on a daily basis when consulting with families. Sometimes it’s patients like Torin who have been living with heart conditions for years, but still benefit from seeing the models. The defects can also change over time making them relevant at any age.
It took about a year to perfect the models used with patients. Buddhe worked with Dr. Seth Friedman in Seattle Children’s Radiology Department and Chris Howard in the hospital’s Imagination Lab, which creates equipment, devices and models for healthcare providers.
The pilot project received about $20,000 in funding. The models were created using a 3D printer and cost roughly $300 apiece.
The doctors are sharing the models with other healthcare providers at the hospital. Chan recently used to models to teach medical-school fellows working in intensive care. These doctors oversee for a variety of sick children, including cardiac patients. The models help them more precisely understand the cardiac defects and what they should be watching for.
“They uniformly said that the 3D models were almost a paradigm shift for how they understood the heart and how to take care of those patients,” Chan said.
For about five years, surgeons have used more accurate 3D-printed models built from images of their patients’ hearts in preparation for surgeries in complex cases. Seattle Children’s is part of a study to test whether patients have better outcomes when surgeons practiced on the models beforehand. Twelve U.S. and European hospitals are part of the large-scale study, which will include roughly 400 newborn patients.
The hope is that the models lead to better repairs, less time in surgery and a shorter recovery. These improvements could save lives and money.
“All of us feel that models are useful, but there is no data yet, so there is no insurance supporting it,” Buddhe said. The flexible hearts cost about $2,000 a piece to create.
In a couple more years, Torin will need an additional procedure to make new repairs on his heart. The Geigers would love to see a printout made from images of Torin’s own heart, as opposed to a representative model. It would be great to take home and share with friends and family, maybe even school nurses as well, said his mom.
“I understand über basic stuff, but seeing the 3D model, you can open it up and you can see,” said Jessica Geiger. “It’s a benefit to the family.”