Multidimensional Medicine

Pioneering experts use 3-D printing to move medicine into the next dimension

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In a cramped room on the ninth floor of CHOP’s Main Building sits a machine that’s reshaping the future of healthcare — one 3-D-printed heart at a time.

On a late summer morning last year, this machine — the Objet500 Connex3® 3-D printer —  was being prepped to build a three-dimensional model of a 3-year-old’s heart. A few days later, the child’s surgeon used the anatomically correct model of his heart to prepare for the complex surgery he needed to survive.

3-D printing any object you can imagine, let alone a child’s heart, may seem like the stuff of science fiction. But it has quickly become a reality here at CHOP.

next-level-printer-860x483Cardiologists Mark Fogel, M.D., and Yoav Dori, M.D., are using this massive 3-D printer to create replicas of their patients’ hearts. “Anyone can see that 3-D printing is cool,” says Fogel, “but we’re using it to push the medical field forward,” which is a lot more than just cool.

How Does 3-D Printing Work?

Think of an inkjet printer: Software on your computer sends data to the printer, which then injects tiny droplets of ink onto paper.

With 3-D printing, you first create a digital, 3-D model. The computer’s software sends the model’s data in cross sections to the printer. Instead of ink, the 3-D printer injects drops of liquid plastic onto the printing surface. Ultraviolet light then converts the liquid polymer to a solid layer before more plastic is injected on top, building the finished product layer by layer.

With 3-D printing, if you can dream it, you can probably design and build it. And the experts at CHOP are certainly not lacking for ideas on how to use the Hospital’s printer. Here are just two of the pioneering projects currently underway.

Planning for Complex Heart Surgeries

While tremendous strides have been made in treating children with complex congenital heart defects — many right here at CHOP — there’s always room for improvement. “All of the advanced imaging technology we have can facilitate the way surgeries are performed, but it still has its limitations,” says cardiologist Yoav Dori, M.D.

Instead of looking at a flat MRI to determine the best way to perform a surgical repair, Dori and cardiologist Mark Fogel, M.D., director of Cardiac Magnetic Resonance Imaging, can use the Connex printer to create an exact model of a heart, defects and all, in a material that can be cut into, patched and sewn by a surgeon.

The theory that 3-D-printed hearts can help improve surgical outcomes is the subject of a recently initiated multicenter trial. The trial is the first of its kind to put the medical benefits of 3-D printing to the test.

Customized Airway Devices for Kids

When a patient is under anesthesia, the muscles in the neck that keep the airway open become loose. Anesthesiologists like Jorge Galvez, M.D., use airway devices to keep the area open. Unfortunately, airway devices — like most medical devices — are designed for adults with normal anatomy, not children.

next-level-valve-doc-860x483Most airway devices, like this one used by anesthesiologist Jorge Galvez, M.D., are designed for adults. With the help of a 3-D printer, Galvez hopes to change the way pediatric medical devices are created.

“A lot of kids who are difficult to intubate and need an airway device are not going to have normal anatomy,” says Galvez. With the help of a 3-D printer, though, Galvez and mechanical engineering students at the University of Pennsylvania were able to manufacture a customizable airway device.

The Penn students designed a software program into which doctors can input measurements taken from a child. In just a few hours, a 3-D printer can produce an airway device that’s designed specifically for the patient’s size and anatomy.

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Only 16 percent of approved, high-risk medical devices were studied in children younger than 18 years old. Most devices are developed for adults, then later approved for children, despite a lack of evidence they are safe and effective in kids.

These 3-D printed airway devices have not yet been tested in people, and there are a few regulatory hurdles to manage before they can be used in the real world. Still, to say Galvez is excited about the potential uses for 3-D printing is an understatement. “Instead of continuing to work around the challenges of devices designed for adults,” he says, “we now have the power to create things made just for kids. Just think of all the possibilities!”

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