3D printing in cardiac surgery

The technology of three-dimensional printing was invented in 1983 by Chuck Hull, an American physicist and engineer . He was the first to conceive the idea that the induction of light over multiple thin plastic layers positioned over each other would be able to lead to the construction of three-dimensional objects. Hull came up with the idea while working with ultraviolet light to harden tabletop coatings. In his original concept, a computer-guided beam of ultraviolet light is directed over liquid photopolymer transforming it into plastic. The idea is not just restricted to liquids but can be applied to all substances that have the capacity to alter their condition or become solidified. His invention is usually described by the terms 3D printing, stereolithography, or additive manufacturing. In a few words, 3D printing is a new technology aimed at transforming digital images to physical objects. In 1986, Hull founded in California the enterprise 3D Systems, which has since then become the pioneer for the developments in 3D printing worldwide.

As far as the procedure of 3D printing is concerned, this includes various stages . At first, a computer model design for the specific production is created, based on the application of specialized software. Afterward, the 3D printer is loaded with the production material. This is usually plastic, but can include a variety of other materials, such as metal, glass, sand, clay, and biomaterials. Finally, the process of ejection takes place, ending to the extraction of the requested product from the printer. Quite often, some extra final steps of processing are necessary in order to freeze the produced object and clean it as well as detach it from the printer or from supporting structures.

The 3D printers can vary substantially in size and shape depending on their application. Generally, the progress in related technology constantly produces faster, cheaper, and more sizable models. Lately, stereolithography which is a laser-based 3D printing technology that uses UV-sensitive liquid resins is one of the most widely used rapid prototyping technologies. The current application of 3D printing technology in science and human activity encompasses various fields: aerospace engineering, mechanical engineering, cosmetology, medicine, dentistry, etc. The main advantage of this form of production is the ability to construct objects based on individualized needs, at low cost and beyond the standard industrialized lines of production. Since this technique opens the possibility of manufacturing highly specialized products to a broad spectrum of customers, it is already considered as a revolution in science and technology as well as in industry and commerce.

Cardiac surgery

Evolution of cardiac surgery

Cardiac Surgery is the medical discipline dealing with the surgical treatment of congenital and acquired diseases of the heart and great vessels. Among the most common procedures within the specialty are coronary artery bypass grafting; aortic, mitral, and tricuspid valve surgery (replacement and repair); and surgery on the thoracic aorta as well as various procedures for heart anomalies. Furthermore, the full spectrum of the specialty comprises minimally invasive, endoscopic, endovascular, and robotic procedures.

Francisco Romero , a Catalonian physician, became the first heart surgeon when he performed an open pericardiostomy to treat a pericardial effusion in 1801. He presented his work at the Society of the School of Medicine in Paris in 1815, but the procedure was considered too aggressive and his work was silenced for many years. Almost a 100 years later, in 1896, Ludwig Rehn , a German surgeon, repaired a stab wound to the heart by direct suture, thus starting the era of heart surgery. The first half cycle was the period of closed heart surgery when mainly congenital diseases of the heart were treated surgically. It was John Gibbon in 1953 , an American heart surgeon, who managed to perform the first successful open heart operation with the use of a heart-lung machine. Introduction and wide use of this machine, called thereafter extracorporeal circulation, enabled cardiac surgery to expand its potential into the heart (open heart surgery) and hence deal thoroughly with the congenital as well as all acquired heart diseases, i.e., coronary artery disease, valve diseases, transplantation, aortic surgery, etc. Thus, cardiac surgery became a routine surgery. Nowadays, it is estimated that over 1 million heart operations are performed worldwide annually. This number clearly shows both the progress of the specialty, as well as its impact on the current health status of the general population internationally.

There are not many specialties so tightly linked to technology as cardiac surgery. The extracorporeal circulation machine, one of the highest technologies used, substitutes the pumping action of the heart and the respiratory function of the lungs during the surgical procedure. Hi-tech monitoring devices are employed in order to control perfusion intraoperatively. Furthermore, high-resolution cardiac computed tomography and cardiac magnetic resonance are often used for the preoperative planning of cardiac procedures. Pacemakers, prosthetic valves, mechanical assist devices, and artificial hearts are all products of advanced technology related to heart surgery. This reality, along with the fact that the cardiovascular system has a lot of variations, comprises the rationale for the necessity of preoperative study of three-dimensional models and subsequent design of the surgical procedure in such a wide range pathology. Thus, cardiac surgery represents one of the fields where 3D printing is expected to contribute to the progress of the specialty.

You're Reading a Preview

Become a Clinical Tree membership for Full access and enjoy Unlimited articles

Become membership

If you are a member. Log in here