Under the Microscope
The 3D printed part of the art installation at GOSH
Chances are a fair chunk of those reading this know somebody who was born with complications to their ticker - nearly 1% of births have congenital heart defects (CHD). For me it is my nephew Joseph, he spent much of his formative years in and out of hospitals having been born with complete Atrioventricular Septal Defect. The wonders of modern medicine means, at approaching 11-years-of-age, Joseph can often be found having this uncle in a headlock shouting “Can’t see me!” or other such WWE catchphrases.
Since Joseph’s major heart surgery a decade ago those wonders have become even more wonderful, according to many sources 3D printing regularly plays a part in making surgery safer and helps with communication between doctors and patients. Surgeons at one of the UK’s leading Children’s hospitals, Great Ormond Street Hospital (GOSH), regularly use 3D printed models in order to explain complications and surgery processes to parents.
In order to quantify the usefulness of 3D printed models in communications a team including Dr Giovanni Biglino, Lecturer in Cardiovascular Bioinformatics & Medical Statistics at the University of Bristol, conducted research that was published through the British Medical Journal, it concluded:
Parents of children with CHD and cardiologists both appreciated the use of 3D patient-specific models during routine/follow-up consultations. “I’m still looking at the heart [model] in absolute amazement and am guarding it like a Doberman! [...] It really does help knowing and understanding what is planned” (email communication from one of the parents of a patient). These models are useful for enhancing engagement with parents and, importantly, for improving communication between cardiologists and parents. In turn, this may also have a positive impact on parents’ and patients’ psychological adjustment to living with CHD.
Some of that research and the 3D printed medical models were an inspiration behind an exhibit in the Under the Microscope arts research project I was lucky enough to attend the opening ceremony of last month. The project, led by GOSH Artist in Residence, Sofie Layton, explores how children and families interpret and understand medical information and disease. One of the installations, Making the Invisible Visible, includes a series of 3D printed hearts displayed at the Institute of Child Health’s Winter Garden Gallery Space, some are facsimiles taken from MRI scans some are interpretations, all were created in conversation with the cardiovascular team, clinicians, parents and patients on GOSH’s Bear Cardiac Ward.
3D printed hearts in bell jars
All of the hearts involved an MRI scan and 3D printing at some stage in process
“Sofie had the idea of putting the 3D prints in bell jars and suddenly these 3D prints take on a museum quality,” Dr Giovanni Biglino tells me as we look upon a Victorian looking nurses trolley adorned with different heart models. Of the dozen or so models most are full heart models taken from MRI scans and printed in nylon using SLS technology. There are two that stand out from the crowd:
“One incorporates the image of a heart as a Rubik’s Cube,” says Biglino. “The idea that putting a heart back together once it is out of place is difficult. Another is a normal heart, scaled down, cast in bronze and suspended like a piece of jewellery to give a sense of the preciousness of the heart.”
The installation is touching, invoking memories of Jospeh’s ordeal years ago, but I was interested to find out if 3D printing really is aiding surgeons perform operations or if this is just hype and marketing talking.
“Scientifically we don’t have the evidence to say that it definitely helps with surgery,” Dr Biglingo tells me. “One small study looked into Atrioventricular Septal Defects and it showed that of about 30 medical students surveyed all reported that a 3D printed model gave them a better appreciation of the defects but I would say that evidence is lacking on a large scale. We are working with Materialise in order to conduct a multi-centre piece of research but until there is extensive research I don’t think we can say for sure.”