How virtual reality helped in a complex heart procedure in a child

The young boy was suffering from restrictive cardiomyopathy and severe pulmonary hypertension with recurrent heart failure admissions for the past year.
How virtual reality helped in a complex heart procedure in a child
How virtual reality helped in a complex heart procedure in a child
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Who would have imagined that virtual reality could save a child’s life? An 11-year-old boy from Egypt, suffering from a life-threatening condition was turned down by several doctors in the US and Western Europe.

The young boy has been suffering from restrictive cardiomyopathy and severe pulmonary hypertension (very high pressure in the lungs) with recurrent heart failure admissions for the past year and with a history of cardiac arrest.

Severe pulmonary hypertension meant that a heart transplant was out of question and left ventricular assist devices (LVADs) for a child this age and size weren’t commercially available anywhere in the world.

He was then referred to Dr K R Balakrishnan, Chairman - Cardiac Sciences and Director – Institute of Heart and Lung Transplant & Mechanical Circulatory Support in Chennai by the child’s paediatric cardiologist in Cairo.

Once he arrived in Chennai, the child’s heart condition worsened, leaving doctors with only one option: Whether a battery-operated, mechanical pump (LVAD) could be implanted to help the left chamber of the heart to pump blood to the rest of the body.

But there were two major impediments. Existing pumps are built for adults. So, could they be fitted into the small chest cavity of a child? What if the chest could not be closed after the operation? Also, the size of the heart chamber, the left ventricle was a major concern, as it was heavily muscle bound, full of excess, useless muscle with very small cavity size. There was no way of knowing if the pump can be fitted inside the heart or it will be sticking out, if it was too big.

That is when Dr Balakrishnan approached Professor Krishna Kumar, in the Department of Engineering design, IIT Madras, with whom he has been collaborating for the past twenty years, and requested him if a virtual reality model could be built from the CT scan of the child and the pump, so that a virtual implant could be carried out to ensure that the implant was possible.

A virtual model was then built using head-mounted 3D glasses, and they saw that the pump could be implanted virtually, in various positions, to make sure that the procedure was possible. Armed with the confidence of this knowledge, the implant was carried out and it was a great success.

The boy has recovered rapidly, gained weight and has taken to dancing to Bollywood songs.  They are waiting to return to Cairo, once air travel restrictions are lifted.

This technique is being presented at the Annual conference of The American society of artificial internal organs in Chicago, on June 1. The meeting is also virtual, on account of the COVID pandemic.

Speaking of the successful surgical procedure, Dr K R Balakrishnan said, “We thoroughly evaluated the child before planning for the LVAD. We had limited options. We decided to go ahead with the heart pump implant only after the virtual model built at IIT showed that it was feasible.”

Commenting on the virtual reality model, Professor R. Krishna Kumar said that there were many technical challenges as the image clarity of the commercial software built into the imaging machine did not meet the requirements.

“After intense discussions on the algorithms to be used, Sathish Kumar, my student built the Virtual Reality model in one night, as time was crucial. I was thrilled when Dr. Balakrishnan and his team visited our lab at 8:00 in the morning and tested it out to their satisfaction. When Dr. Balakrishnan tells me that it was a crucial input in saving the life of a child, what more can a researcher ask for,” he added.

The child’s mother, a pediatrician, while thanking the MGM Healthcare, said, “After being turned down by other hospitals in the US, and western countries, we had almost given up hope. Our child had been ailing for a few years and we could not bear to see him suffer like this. We are grateful that we were referred to this facility where the doctors were confident and ensured a fresh lease of life to our son.”

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