This national collaborative will scale and standardize personalized 3D heart modeling and virtual surgical planning tools so that they can be used in patient care across a broader network of children’s hospitals
The heart of every person with a congenital heart defect is incredibly unique – with no two hearts exactly alike. Today, when a heart team prepares for a complex procedure on a child with CHD, they typically rely on two-dimensional imaging and their individual experience to understand the patient’s highly individualized anatomy and determine the optimal procedural approach. Often, they can’t really understand the nuances of the procedure to be performed until the patient is actually on the operating table.
However, at some CHD centers today, CHD clinicians have the ability to turn those flat scans into a lifelike, three-dimensional model of a patient’s actual heart, either 3D printed or explored virtually. These models can help clinicians visualize complex anatomy, evaluate potential procedural approaches, and plan a patient-specific strategy before entering the operating room. These same 3D models can also be brought into the operating room, guiding clinicians in real time as the procedure is being performed.
“These 3D models coupled with the the extensive preoperative planning that we are now able to do with virtual surgery and flow simulation have been transformative in how we care for many of our complex patients.”said Dr. David Hoganson, Cardiac Surgeon, Department of Cardiac Surgery; Director, Computational 3D Visualization Program, Boston Children’s Hospital.
The Mussallem CHD Alliance has formed a new national collaborative, P3-CHD, led by Boston Children’s Hospital, Stanford Medicine, and Children’s Hospital of Philadelphia (“CHOP”). P3-CHD aims to take each instution’s existing capabilities for personalized, three-dimensional surgical and procedural planning for children born with congenital heart defects (CHD), standardize the software and approach, and scale these resources so they can be used at many more centers nationwide.
“The system we are developing and scaling in this collaborative will be an incredibly powerful tool for heart teams: customized 3D maps of individual CHD patient hearts. If we are successful in scaling this tool across the field, it could transform the nature of how congenital heart surgery gets performed for children with CHD,” said Orin Herskowitz, President of the Mussallem CHD Alliance.
Today, the process for using 3D heart mapping tools varies widely from surgeon to surgeon and center to center. 3D-printed heart models, virtual surgery simulations, and other patient-specific planning tools have shown they can improve decision-making and outcomes for these children, but so far they remain labor intensive and available at only a small number of highly specialized centers.
“We are incredibly excited to channel top bioengineering talent and cutting-edge technologies towards a group of patients who so often get overlooked,” said Dr. Alison Marsden, PhD, the Douglass M. and Nola Leishman Professor of Cardiovascular Diseases and Professor of Bioengineering and Pediatrics at Stanford Medicine.
Boston Children’s Hospital, Stanford Medicine, and CHOP are leading P3-CHD, with the Mussallem CHD Alliance’s support. The collaborative will offer will hospitals without in-house capabilities the opportunity to draw on expertise from the three institutions, while beginning to develop a standardized software platform built specifically for CHD care, with a long-term goal of FDA clearance. The goal is to scale access to 3D modeling and virtual planning technology across hospitals nationwide, so every CHD care team, not just those at a handful of top centers, can use these tools to prepare for a procedure in advance and have that same 3D map on hand to guide them in the room while it’s underway, leading to better patient outcomes.
“Collaboratively building software and simulation tools dedicated to informing successful repairs for kids with congenital heart disease everywhere is a dream come true for our team,” said Dr. Matthew Jolley, Attending Anesthesiologist, Division of Cardiac Anesthesiology, and the Topolewski Endowed Chair in Pediatric Cardiology at Children’s Hospital of Philadelphia.
If the initial pilot group demonstrates that this model can work across multiple institutions, the collaborative plans to expand and work with more children’s hospitals over time, helping increase access to these services for more children born with complex heart defects, wherever they’re treated.