EH 5_2015

EUROPEAN HOSPITAL  Vol 24 Issue 5/15 10 CARDIOLOGY Cardiac surgery gains an excellent planning tool Suitable for coun Cardiac monitor achieves good pi 3-D printed hearts A highly surgical L The thinner, l insertable car The CSI Congress (Congenital, Structural and Valvular Interventions) is one of the major fixtures for catheter therapy of congenital and structural heart defects. Key moments in this high profile event are live broadcasts and the audience can not only to listen to but also interact with the teams in the cath labs involved Report: Ralf Mateblowski At this year’s CSI gathering, three live interventions – one case of mitral valve insufficiency, a degenerated bioprosthetic tricuspidal valve and a transcatheter aortic valve implan- tation, performed in Frankfurt/ Germany in late June – demonstrat- ed how patient-specific 3-D printed heart models can be used for surgi- cal planning. Belgium-based manufacturer Materialise offers software solutions and services for 3-D imaging and 3-D printing. Just before he began to enable the first live case, Dr Sameer Gafoor of the Cardio-Vascular Centre Frankfurt summarised his experi- ences with the firm’s HeartPrint models. ‘To see the model means to change strategies,’ he said. Based on CT, MRI and/or 3-D ultrasound image data, the transpar- ent silicone models show the indi- vidual anatomy in amazingly realis- tic detail. This allows a physician in the pre-operative planning phase to literally get his hands on the struc- tures he is going to see – down to the different tissue thicknesses of muscles and vessels, including calci- fications! This kind of haptic explo- ration of the intervention site helps to decide whether catheter access will in the leg or the neck. In turn, that decision informs the choice of instruments to be used. In complex cases, interventional cardiologists and cardiac-surgeons can test their actual operating theatre strategy on the model, adapt their procedure, if needed, and even discuss it prior to the intervention, during the multi- disciplinary cardio board. Thus, the entire team knows what’s in store. ‘Basically open heart interven- tions cannot be repeated,’ Dr Gafoor explained, pointing at two further advantages of 3-D print models for planning purposes – high sur- gical success rates and markedly improved patient outcomes. Even more: the ‘test runs’ with the 3-D models reduce intervention time, which in turn has several posi- tive side effects: shorter anaesthesia times reduce health risks for the patient resulting in faster recovery. For the hospital this translates into quicker t h e a t r e t u r n - around-times and short- er length of stay. In short: sig- nificant cost savings. 3-D models are not only used for intervention planning, they also support patient information very effectively: now the patient may bet- ter understand why the intervention is necessary and how it is going to be done. This should deepen trust in the physician and intervention acceptance – an important psycho- logical factor, positively impacting on a patient’s attitude before, during and after the intervention. Obviously ‘learning by 3-D model’ is not limited to physicians, patients and families – it is also a per- fect tool for training medical stu- dents and junior cardio-surgeons. Last, but not the least, the medical technology manufacturers benefit from 3-D models from the develop- ment, throughout pre-clinical trials to product marketing. While the use of 3-D models in cardiology, as described above, is more or less still in the beginning cranio-max- illofacial surgery and orthopaedic patients already receive 3-D printed implants. In these disciplines the innovation potential of 3-D print models to optimise patient-specific care is already being realised and the results indicate immense poten- tial awaits exploration in cardiology – above all in paediatric patients, since a baby’s heart can be merely the size of a walnut. 3-D printed cardiovascular model from Materialise, a registered Class 1 Medical Device StarLED3 NX, a lamp produced by ACEM Me generation LED technology ‘… assuring cold consumption,’ the manufacturer reports. ‘It’s both for surgery and the operating theatre – dermatology, general medicine and surgery ‘StarLED3 NX grants a homogene- ous and shadow-less light thanks to its special LED optics created by ACEM that directs light beams at best according to the needs,’ the firm continues. ‘The visual area is perfectly illuminated assuring both excellent visual comfort and work- ing conditions. Its next generation LEDs produce an unparalleled qual- ity of light with a colour tempera- ture (CCT) of 4.500 °K and a colour rendering index (CRI) of 95.’ With light intensity of 130.000 lux the lamp also has a with a low energy consumption of 69W. ‘The life cycle of its LEDs is about 50.000 hours.’ ACEM points out. Composed of three reflectors, these produce a well-blended and intense cone of light focusable through the automatic adjustment of the light spot diameter. The firm also points to assets in the lamp’s slim, practical and compact and ergonomic design and suitability for the laminar flows of the operating theatre. The ENDO function (light for endoscopy) also adds the value of using this lamp for minimally inva- sive surgery. ‘Functions are adjusted by its innovative easy-to-read, ergonomic The subcutaneous insertable cardiac BioMonitor 2 has received CE mark approval after pilot study results confirmed its reliability. Involving patients in Australia, the study showed that the device can be inserted in less than two minutes, and provides high R-Wave ampli- tudes and a greater than 90 per- cent success rate for daily Biotronik Home Monitoring transmissions. In addition, the device has a capacity of over 60 minutes of ECG record- ing time and can transmit up to six sECGs (subcutaneous ECG) daily via Home Monitoring. ‘The results of the pilot study con- firm the deliverability of the device and excellent sensing amplitudes afforded by the increased sensing Biotronik’s BioMonitor 2

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