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Cardiovascular Engineering

Cardiovascular Engineering - Poster Session C

Poster H9 - Enhancing Surgical Training and Patient Outcomes Using Customizable 3D Printed Surgical Models for the WATCHMAN Device Insertion Procedure

Friday, October 25, 2024
10:00 AM - 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  In atrial fibrillation, the vast majority of stroke-causing clots originate in the left atrial appendage. The WATCHMAN Procedure takes a minimally invasive approach by threading a catheter through the left femoral vein and deploying the WATCHMAN device into the left atrial appendage to decrease risk of atrial fibrillation-related strokes. Currently, no tailored surgical models exist for this procedure. This means surgeons who are learning the procedure must perform on patients instead of practice models. This project aims to fill that gap and create an interactive, customizable model for surgical practice.

Materials and

Methods:  First, MIMICS analyzes the greyscale of DICOM files from CT or MRI scans to transform 2D pixels into a mask. To enhance quality of the 3D print, live editing is allowed on the mask to create a model that is accurate to the source imaging. Once the mask is edited to desire, the program converts it into a part.

Then, 3-Matic imports the part produced by MIMICS and converts it into a Standard Tessellation Language (STL) file, which is the file format accepted by the 3D printers. STL files define surfaces in 3D spaces in terms of triangles and are used in biomedical engineering for their ability to accurately approximate organic structures, such as human anatomy. The program is also used to complete edits on the part, such as hollowing.

SOLIDWORKS also allows for the creation of parts through the sketch feature.  After being sketched, the part can be extruded to create a 3D object. Modifications can be made to the part such as hollowing or wrapping. Parts can then be combined to create an assembly which is converted into an STL file for 3D printing.

Finally, either the Formlabs printer or Stratasys F170 deposit material layer by layer to create the print. The Formlabs printer uses a soft resin material for a more anatomically accurate model while the Stratasys F170 uses a hard plastic to create durable models. Following the completed print, the object is post-processed using an isopropyl bath or a sodium hydroxide bath depending on the material.

Results, Conclusions, and Discussions: Using 3D printing technology, a full body model was created to allow for the training of surgeons. A clear and flexible material was used to print the heart and a removable atrial appendage while a hard plastic material was used to create the chest. The leg was then created by using silicon mold. The catheter can be inserted through tubing that runs through the leg and then be manipulated within the heart to mimic the watchman procedure.
This customizable 3D model of a WATCHMAN device insertion will revolutionize the training of surgeons for complex procedures such as this surgical procedure. Instead of performing the WATCHMAN device insertion during surgery, surgeons and the healthcare team can utilize a 3D printed practice model that has the potential to be tailored to specific patient anatomy. This project aims to bridge the training deficit by creating a low-stakes, practice environment with a practice model. By providing surgeons with the practice tools for successful WATCHMAN device insertion, the hospital system and healthcare team will reap the benefits of improved quality of care for their patients. Another key application of this surgical model is patient education. This model may be used in improving patient understanding and health literacy. Looking to the future, our 3D printing research framework used in this project can be applied to numerous other surgical procedures—aiding in reducing the education gap for surgeons and improving patient care and comprehension.

Acknowledgements (Optional):  Andrew Calvin, M.D.
Vaibhav Vaidya, M.B.B.S.
Joseph Wildenberg, M.D., Ph.D.
UW-Eau Claire Biomedical Innovator Program
Mayo Clinic Health System – Eau Claire