Researchers have developed a groundbreaking process for multi-material 3D printing of lifelike models of the heart’s aortic valve and the surrounding structures that mimic the exact look and feel of a real patient.
These patient-specific organ models, which include 3D-printed soft sensor arrays integrated into the structure, are fabricated using specialized inks and a customized 3D printing process. Such models can be used in preparation for minimally invasive procedures to improve outcomes in thousands of patients worldwide.
Led by the University of Minnesota (UMN), with support from Medtronic, the research is published in Science Advances, a peer-reviewed scientific journal published by the American Association for the Advancement of Science (AAAS). Washington State University assistant professor Kaiyan Qiu, formerly a postdoctoral researcher at UMN, was one of the first authors of the work.
The researchers 3D printed what is called the aortic root, the section of the aorta closest to and attached to the heart. The aortic root consists of the aortic valve and the openings for the coronary arteries. The aortic valve has three flaps, called leaflets, surrounded by a fibrous ring. The model also included part of the left ventricle muscle and the ascending aorta.
“Our goal with these 3D-printed models is to reduce medical risks and complications by providing patient-specific tools to help doctors understand the exact anatomical structure and mechanical properties of the specific patient’s heart,” said Michael McAlpine, a University of Minnesota mechanical engineering professor and senior researcher on the study. “Physicians can test and try the valve implants before the actual procedure. The models can also help patients better understand their own anatomy and the procedure itself.”
The work brings together research in additive manufacturing, materials, flexible electronics, and mechanical engineering in a comprehensive way, Qiu said. It’s the first time that researchers have so closely developed an aortic root model with the physical properties of tissue, accurately mimicking its geometry and mechanical properties.
“It feels like the real thing, and it has excellent sensing functions,” he said.
This organ model was specifically designed to help doctors prepare for a procedure called a Transcatheter Aortic Valve Replacement (TAVR) in which a new valve is placed inside the patient’s native aortic valve. The procedure is used to treat a condition called aortic stenosis that occurs when the heart’s aortic valve narrows and prevents the valve from opening fully, which reduces or blocks blood flow from the heart into the main artery. Aortic stenosis is one of the most common cardiovascular conditions in the elderly and affects about 2.7 million adults over the age of 75 in North America. The TAVR procedure is less invasive than open heart surgery to repair the damaged valve.
The aortic root models are made by using CT scans of the patient to match the exact shape. They are then 3D printed using specialized silicone-based inks that mechanically match the feel of real heart tissue the researchers obtained from the University of Minnesota’s Visible Heart Laboratories. Commercial printers currently on the market can 3D print the shape, but use inks that are often too rigid to match the softness of real heart tissue.
On the flip side, the specialized 3D printers at the University of Minnesota were able to mimic both the soft tissue components of the model, as well as the hard calcification on the valve flaps by printing an ink similar to spackling paste used in construction to repair drywall and plaster.
Physicians can use the models to determine the size and placement of the valve device during the procedure. Integrated sensors that are 3D printed within the model give physicians the electronic pressure feedback that can be used to guide and optimize the selection and positioning of the valve within the patient’s anatomy.
The work could possibly lead to better surgical training for doctors, help them better predict postoperative complications, and help manufacturers improve medical devices, Qiu said. He hopes to continue research in developing 3D-printed, pre-surgical organ models at WSU with industry and academic collaborators. He also would like to continue his research into 3D printing of biotic tissue and models that could someday be used to replace real tissue or organs in the body.
“This work provides limitless possibilities in the development of next-generation protheses and medical devices,” he said.
In addition to McAlpine and Qiu, the team included University of Minnesota researchers Ghazaleh Haghiashtiani, co-first author and a recent mechanical engineering Ph.D. graduate who now works at Seagate; Jorge D. Zhingre Sanchez, a former biomedical engineering Ph.D. student who worked in the University of Minnesota’s Visible Heart Laboratories who is now a senior R&D engineer at Medtronic; Zachary J. Fuenning, a mechanical engineering graduate student; Paul A. Iaizzo, a professor of surgery in the Medical School and founding director of the U of M Visible Heart Laboratories; Priya Nair, senior scientist at Medtronic; and Sarah E. Ahlberg, director of research & technology at Medtronic.
This research was funded by Medtronic, the National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health, and the Minnesota Discovery, Research, and InnoVation Economy (MnDRIVE) Initiative through the State of Minnesota. Additional support was provided by University of Minnesota Interdisciplinary Doctoral Fellowship and Doctoral Dissertation Fellowship awarded to Ghazaleh Haghiashtiani.
To read the full research paper, entitled “3D printed patient-specific aortic root models with internal sensors for minimally invasive applications,” visit the Science Advances website.