How OSU Wexner physicians are using 3-D heart models to improve valve replacement surgeries

Physicians at The Ohio State University Wexner Medical Center in Columbus are teaming up with the university's biomedical engineers to improve care for patients receiving aortic valve replacements.

Aortic valves typically need to be replaced due to aortic stenosis, or the narrowing of the valve opening. Over decades, the valve leaflets may become stiff from calcification, which makes it more difficult to pump blood from the left ventricle into the aorta.

To replace diseased valves, physicians can either complete open heart surgery through a traditional opening of the chest, or use a less invasive transcatheter method, which deploys a tissue (bioprosthetic) valve through a blood vessel in the leg.

To determine the best approach for each patient, physicians and biomedical engineers at Ohio State created personalized 3-D models of the aortic valve and neighboring structures, which help them simulate how a new valve will function.

"For most patients, available valves work comparably. However, in some cases the anatomy of the patient may create additional considerations" said Scott Lilly, MD, PhD, interventional cardiologist and co-director of the structural heart program at Columbus-based Ohio State Ross Heart Hospital. "For example, the patient may have calcified nodules on the valve leaflets, or coronary arteries that arise in close proximity to the valve. The ability to reconstruct the areas where the valve is going to rest is important."

Dr. Lilly and his heart structural team work with Lakshmi Prasad Dasi, PhD, associate professor of biomedical engineering and surgery in Ohio State's Davis Heart and Lung Research Institute, to reconstruct a patient's aorta.

They 3-D print the aorta from the patient's CT scan using various flexible materials imitating the real aorta and load the model into a heart simulator, which pumps simulated blood through the system.

"We can model various therapies, positions and types of valves to better understand problems such as leakage, clotting or coronary obstruction," Dr. Dasi said. "We can observe how different valves not only relieve the stenosis but also minimize the likelihood of blood clots forming on the leaflets, which is the goal of the treatment."

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