3D printed surgical guides for cardiovascular surgeries

Cappello's research focuses on creating patient-specific 3D printed surgical guides for use in hybrid electrophysiology surgeries. These procedures, performed by electrophysiologists and cardiac surgeons, involve open chest surgeries where precision is paramount. The custom surgical guides, built using a patient’s CT scan and LGE-MRI data, provide a clear visual aid that helps surgeons quickly and accurately locate key treatment areas on the heart, such as the optimal location to build the bypass vein after narrowed coronary artery or necrotic zones after ​ prolonged ischemia due to atherosclerotic plaques.

“Despite advances in medical technology, cardiac surgeons often rely on 2D images to locate the optimal place for bypass grafts implantation. It’s surprising that, in 2024, we are still using such outdated methods," says Cappello. "My research aims to change that, offering a practical, precise tool to improve outcomes for patients.”

Cappello developed two types of surgical guides: ​

1. Bypass surgery guide: this model assists surgeons in identifying the optimal site for bypass graft placement, taking into account factors such as the vessel diameter and the distance from blockages. ​

2. Ventricular tachycardia ablation guide: this guide helps pinpoint areas of scar tissue, which can cause life-threatening heart arrhythmias, so that surgeons can precisely burn or "ablate" the tissue to prevent abnormal electrical signals from causing dangerous heart rhythms.

“A major highlight of the work is the potential to combine both guides into one surgical tool, allowing for simultaneous treatment of coronary artery disease and arrhythmias during a single procedure. This dual-treatment capability could significantly reduce surgery time and improve recovery outcomes for patients.” Cappello continues

Cappello finished her PhD in a shortened period of 2.5 years, and conducted extensive experiments, including trials on pig hearts in saline solutions, to ensure the safety and efficacy of the materials used for these surgical guides. Her findings have been published in several academic journals, and she has co-authored five papers in under two years.

References: 

Cappello, I.A.; Candelari, M.; Pannone, L.; Monaco, C.; Bori, E.; Talevi, G.; Ramak, R.; La Meir, M.; Gharaviri, A.; Chierchia, G.B.; et al. 3D Printed Surgical Guide for Coronary Artery Bypass Graft: Workflow from Computed Tomography to Prototype. Bioengineering 2022, 9, 179. https://doi.org/10.3390/ bioengineering9050179

Candelari M, Cappello IA, Pannone L, Monaco C, Talevi G, Bori E, Ramak R, La Meir M, Gharaviri A, Chierchia GB, Innocenti B and de Asmundis C (2022) A 3D-printed surgical guide for ischemic scar targeting and ablation. Front. Cardiovasc. Med. 9:1029816. doi: 10.3389/fcvm.2022.1029816

Cappello IA, Candelari M, Pannone L, Monaco C, Bori E, Talevi G, Ramak R, La Meir M, Gharaviri A, Chierchia GB, Innocenti B and de Asmundis C (2022) Temperature analysis of 3D-printed biomaterials during unipolar and bipolar radiofrequency ablation procedure. Front. Cardiovasc. Med. 9:978333. doi: 10.3389/fcvm.2022.978333

Candelari, M., Cappello, I. A., Pannone, L., Monaco, C., Bori, E., Talevi, G., Ramak, R., La Meir, M., Gharaviri, A., Chierchia, G. B., de Asmundis, C., & Innocenti, B. (2023). 3D-Printed Biomaterial Testing in Response to Cryoablation: Implications for Surgical Ventricular Tachycardia Ablation. Journal of Clinical Medicine, 12(3), 1036. https://doi.org/10.3390/jcm12031036