Figure A: Rotational Video | Heart tissue – white | Mechanical mitral valve – blue

The 3DQ Lab was presented with a cardiac case in need of 3D printing for surgical planning purposes. The patient had a mechanical mitral valve in place already, but a leak had formed between the left atria and left ventricle, on top of the mitral ring. We were asked to print the heart muscle and mechanical valve, and make precise cuts along the atrium and ventricle to expose the leak.

During segmentation the model was divided into two pieces, an anterior and posterior portion of the heart. This was done to reduce the bulk, improve visibility, and provide clearance for cleaning the final model.

Most of the left atrial appendage was removed for a better view of the leak, and epicardial fat near the left atrial appendage was removed to expose the left circumflex artery and dominant OM; running from the aortic root and around the atrial groove.

The segmentation was reviewed by a radiologist to ensure all important anatomical structures were intact and accurate. Once approved, the files were prepped for 3D printing.

Figure B: Early segmentation of the heart in four views was sent to the requesting radiologist for review.

Figure D: Posterior heart view, demonstrating areas of interest.

The heart was printed in two pieces using polyjet technology, the central piece with the mitral valve and an anterior piece with the heart apex and a portion of the left atrial appendage. The mechanical mitral valve was printed in rigid blue, and the muscle in a semi-transparent flexible material. The printed model was used by radiologists and surgeons per-surgically to review the mitral hole and create treatment options.

Figure E: Both sections of the 3D print. The left piece shows the anterior heart including the apex, the right piece shows the main areas of interest including the mitral valve in blue.