It was an unusual case.
Forty years after undergoing rigorous chemotherapy to treat Hodgkin’s lymphoma, Karlie Gause's aortic valve—which controls blood flow out of the heart—was failing. Because of side effects caused by chemotherapy and radiation, her breathing was extremely difficult, which led to constant fatigue. Everyday activities were nearly impossible.
“The chemo and radiation saved my life, but also weakened other parts of my body,” Gause said. “Two years ago, my quality of life took a turn for the worst and I knew something needed to change.”
After trying all available medications with little success, her doctors suggested she explore a procedure called transcatheter aortic valve replacement, or TAVR for short. During the procedure, a new valve is inserted into your heart via a catheter. Then the new valve is mounted on a stent frame and placed within the diseased valve, eliminating the need for open-heart surgery.
At first, Karlie did not appear to be a viable candidate. Unlike most TAVR candidates, her aortic valve did not have calcification and plaque build-up, conditions that typically warrant this procedure. Without the usual leaflet calcification, the clinical team was worried that the artificial valve would not hold in place.
Still, her referring physician was hopeful that University of Minnesota Health Heart Care experts would be able to find a workable solution.
“I’m a realistic person and knew that my situation wasn’t like most people who need TAVR,” said Gause. “So when I went to visit University of Minnesota Health, I didn’t get my hopes up.”
M Health Interventional Cardiologist Greg Helmer, MD, needed a definitive answer before moving forward with the procedure. Knowing the 3-D printing capabilities of the University of Minnesota, Helmer turned to Paul Iaizzo, professor within the university’s medical school and director of the Visible Heart® Laboratory.
Iaizzo’s research team then printed several exact replicas of Karlie’s heart using soft, malleable material to mimic her heart anatomy.
“We have unique capabilities within the Visible Heart Lab and our research team uses 3-D printing for various applications with the goal of advancing medicine” said Iaizzo. “We hope that for clinical teams to have such a resource like this is something that will aid in improved care delivery.”
The lab’s graduate students along with the clinical team implanted various sized artificial valves in the 3-D model—exploring each devices' optimal placement in the replica organ—to learn which valve placement option would work best for Karlie’s heart. Contrary to the care group’s hypothesis, the larger valve appeared to be an ideal fit, giving Helmer and his TAVR team the confidence to proceed with Karlie’s procedure.
“There were differing opinions on this case, which was fairly unusual,” said Helmer. “But, we brought the best minds and technology together to make sure our approach was best for the patient.”
On March 4, 2016, Karlie received her new aortic valve. While she was in recovery, Helmer told Karlie’s husband Gary Pelcl that an exact 3-D printed model of her heart was used to test numerous valves to ensure a favorable outcome. After the brief description, Gary wanted to keep the heart model as a souvenir.
In less than a week, Karlie returned to work. She can now do things that most people take for granted, like walking up stairs and shopping for groceries.
“I could feel a big difference shortly after the procedure,” Karlie said. “I hope other patients will be able to experience the benefits of 3-D printing in healthcare too.”