- KKH takes the lead in paediatric clinical education for specialists in Asia

6 September 2016, Singapore – The Cardiac Centre (consisting of the Cardiology Service and Cardiothoracic Surgery Service) at KK Women’s and Children’s Hospital (KKH) has adopted the use of three-dimensional (3D) printed heart models to enhance the planning of clinical management leading to improved outcomes for complex congenital heart conditions. Eight of these models, each depicting a different congenital heart disease in actual patients, provide intricate views into tiny hearts to aid cardiothoracic surgeons in their pre-planning of complex surgeries. The Cardiac Centre is the main paediatric cardiology referral centre in Singapore and performs an average of approximately 200 surgeries a year.

Compared to adults, children have much smaller chest cavities, which render their hearts to be significantly smaller than an adult’s heart. In addition, the complexity of certain congenital heart defects makes congenital heart surgery more challenging in comparison to adult heart surgery.

“There are many challenges operating on tiny hearts and good pre-surgical planning work is critical to enhance success and to achieve optimal patient outcomes. While our pre-surgical preparatory work was previously guided by our hands-on experience, these 3D print heart models have enabled us to be more efficient and precise, especially in cases with complex anatomies,” said Dr Nakao Masakazu, Consultant, Cardiothoracic Surgery Service, KKH.

“The diagnosis and management of structural and congenital heart disease have historically been driven largely by two-dimensional (2D) echocardiography. However, congenital heart disease is a 3D problem, so 2D imaging methods often lack critical spatial information. The advancement of 3D printing technology has enabled us to examine the heart, a 3D structure, in an actual 3D format, which can be held in our hands; this is more useful in relaying anatomy than simply trying to imagine the structure from 2D images,” said Dr Chen Ching Kit, Consultant, Cardiology Service, KKH.

“Other leading children hospitals in the West such as Boston Children’s Hospital in the United States and The Hospital for Sick Children (SickKids) in Canada, have shared with us their success stories using the 3D print heart models in their surgical work. We are happy to adopt and adapt this amazing technology in paediatric heart surgeries. Moving forward, we are also looking at imparting our knowledge to more paediatric surgeons and cardiologists out there,” added Dr Nakao, the Co-Chairperson of an upcoming pre-congress workshop on Surgical Morphology and Imaging of Congenital Heart Disease. “In collaboration with industrial partners, namely Materialise® and Creatz3D®, for instance, we printed the heart of a child with a rare form of complex congenital heart disease, double outlet left ventricle, in order to better visualise the structure of the heart for surgical planning,” said Dr Chen.

As an Academic Medical Centre and a major teaching hospital for all three medical schools in Singapore, KKH is well-positioned to take this technological advancement in the field of medicine further. To set in motion this simulation in medical training using the 3D printed heart models, KKH will be organising a workshop on Surgical Morphology and Imaging of Congenital Heart Disease on 21 and 22 September 2016 to train 50 specialists from Singapore as well as around the region. The workshop is a part of the SingHealth Duke-NUS Scientific Congress taking place on 23 and 24 September 2016, and is already fully booked.

Dr Chen, who is also the Chairperson of the pre-congress workshop said, “The use of 3D print of actual paediatric hearts facilitates the process of learning and understanding of congenital heart disease among doctors as well as resident physicians in the hospital. While it is ideal for doctors to learn by examining pathology specimens, such specimens may not always be readily available. A 3D print heart model of a real patient’s heart thus provides a very good alternative for simulation-based training. Simulation in medical education is an effective educational tool, thus doctors who are better trained and equipped to optimise surgical procedures will bring about enhanced cardiovascular and patient care. Through the pre-congress workshop, which is targeted at local and regional doctors, not only do we hope to draw attention to the relevance and viability of 3D printing technology in the medical field, we also hope to further promote KKH and Singapore as the centre of excellence for paediatric cardiovascular care in the region.”