Since the Advent of 3D-Printed Hearts, Surgeons Can Now Conduct Simulation Experiments

How Can You Distinguish Between a Good Surgeon and an Outstanding One?

Some medical experts believe that it is difficult for general practitioners to achieve a three-dimensional visual understanding of human organs solely through body scans.

“Only a handful of the world’s top surgeons possess the strong three-dimensional visual imagination of a sculptor,” said Dr. Deepak Srivastava, Director of the Gladstone Institute of Cardiovascular Disease in San Francisco.

“During the process of repairing cardiac issues, cardiovascular surgeons’ success often hinges largely on their ability to clearly visualize the heart’s three-dimensional structure in their minds, thereby facilitating further problem-solving,” said Srivastava. “This is even more challenging for younger physicians with less experience.”

Fortunately, recent advances in the field of computer modeling are poised to drive development in the medical sector over the coming years, offering greater benefits to surgeons.

Among these technologies, one is provided by Dassault Systèmes, a French company that uses specialized 3D design software to help engineers in the automotive and aerospace industries avoid fatal flaws. Similarly, surgeons and medical researchers can leverage such 3D software to address their own professional challenges.

Earlier this week, Dassault Systèmes released a high-fidelity digital model of the human heart, naming it the “Living Heart Project.” Through this model, physicians can auscultate each heartbeat rhythm. Additionally, by wearing 3D glasses and using a joystick, they can zoom in on the ventricles and valves for detailed observation.

This achievement can encourage medical device manufacturers and universities to propose more personalized diagnostic and treatment measures for common heart diseases through simulation experiments, while also potentially improving surgical outcomes.

“We scan the patient, reconstruct the images into a 3D model, and then simulate all possible scenarios preoperatively,” said Dr. Steve Levine, Chief Strategy Officer and Director of the “Living Heart Project.”

Figure: Digital model of the human heart developed by Dassault Systèmes

To date, the company has focused on simulating the heart rather than other human organs. This is because heart disease is the leading cause of death in the United States, accounting for one in every four deaths.

Some hospitals have also begun leveraging design software to simulate the outcomes of routine medical procedures, or conducting simulation experiments on common diseases (such as heart disease) to further develop solutions. In the future, physicians may test computational models before selecting a treatment regimen or medication for a specific patient.

Dassault Systèmes also expects medical device manufacturers to leverage the technologies of the “Living Heart Project” for research and development. This could help them rapidly and accurately generate actionable ideas and identify clinical trials worthy of investment.

The software is free for organizations that agree to share their research findings derived from its use. For commercial purposes, the license fee is at least $15,000 per year; for educational purposes, it is at least $500 per year.

Healthcare Recruitment Partner

“Actually, few people know that Dassault is a company with $3 billion in assets,” Lewin told KQED (San Francisco Public Radio) during a recent trip to Europe. “Because we all operate behind the scenes.”

In recent years, Dassault’s executive team has refocused its attention on industries beyond heavy industry. Lewin refers to this new path as “Modeling Life and Nature.”

For the “Living Heart Project,” the Lewin Group invited researchers from some of the world’s leading hospitals to share their respective findings.

To date, they have recruited 45 members (or partners) from the scientific community, each independently studying heart disease or specific cardiac functions. Additionally, researchers from institutions such as the Mayo Clinic, Stanford University, and the University of Oxford have also attempted this simulation.

Dassault Systèmes has also established a baseline simulation and analysis of the human heart by integrating research and leveraging engineering technologies. It can now successfully convert a patient’s 2D scans into a 3D model.

Lewin said that federal regulators initially adopted a wait-and-see attitude when they first learned of the project.

“But I told them (i.e., the U.S. Food and Drug Administration, FDA), ‘You cannot stand by as if nothing were happening. You must get involved.’”

In 2014, the agency agreed to collaborate with Dassault Systèmes on a five-year research project primarily aimed at assessing the reliability of pacing leads (thin wires that transmit electrical impulses from the device to the heart). However, they emphasized that this did not constitute full endorsement of the computational models used in the study.

The FDA hopes that physicians will utilize this simulation technology for planning purposes and clinical decision-making in the future. However, at this current early stage, it is important to remind physicians to devote greater effort to evaluating the credibility and potential limitations of these new technologies.

“To further adopt computer simulations, challenges such as the lack of data on certain physiological conditions must be addressed; otherwise, it is difficult to make robust predictions,” said Donna Lochner, Senior Science Advisor at the FDA’s Office of Science and Engineering Laboratories.

Figure: Magnified rendering simulated by the “Living Heart Project”

Does a hammer still have to find its own nails?

At the University of California, San Francisco, a team of cardiologists aims to achieve just one goal through the “Living Heart Project”: determining the optimal timing for patients to undergo valve replacement surgery.

Valves should be replaced as their service life nears its end, without being left in the body for so long that cardiac function deteriorates. Physicians must therefore strike a relative balance.

Dr. Jeffrey Olgin, Chief of the Division of Cardiology, has also been closely monitoring the team’s progress. However, he firmly believes that the “Living Heart Project” will not fundamentally change current clinical practice.

He questioned, “If this truly transforms current medical practice, wouldn’t it be like a hammer in search of nails? Would the solution itself become the problem to be solved?”

Orkin stated that perhaps the “Living Heart Project” is merely a technological solution in search of a problem, but it is too early to draw definitive conclusions. To date, he has not seen any compelling studies demonstrating that this simulation improves patient outcomes.

Unlike man-made objects such as cars and airplanes, it is difficult to predict how simulated human hearts will respond to real-world stresses. Orkin worries that doctors may become overly reliant on this technology in the future, or that medical device manufacturers might abruptly halt promising research upon encountering unfavorable simulation results.

He stated, “This technology does not provide equally compelling evidence of its trial outcomes as would be seen in animal studies or small-scale human trials.”

“Unfortunately, the human body does not always adhere to the laws of physics.”

Original Author: Christina Farr Compiled by: Tang Chaoyan Edited by: Mo Renying