Q: Magazine Issue 2 July 2020 | Page 8

CARDIOLOGY A Model Lab What if 3D rotational angiography could do the work of a CT scan? In the catheterization lab Children’s Hospital Colorado congenital interventional cardiologists Jenny Zablah Alabi, MD, and Gareth Morgan, MD, are leveraging 3D rotational angiography in ways never described, using software and segmentation techniques Dr. Zablah largely developed herself. With them, their multidisciplinary team is creating detailed images of vessels and airways, life-size 3D printed models and virtual reality-based animations that place interventionists inside a beating heart. The patient was 4 months old, weighing just 10 pounds. She was born with transposition of the great arteries. The repair was successful, but it left her with progressive severe stenosis, a common complication. Pediatric cardiac interventionist Jenny Zablah Alabi, MD, explains the procedure using a life-size 3D model she printed in her office. She points out the pulmonary arteries. They’re hardly thicker than a hairpin. A second model depicts the patient’s heart postcatheterization, detailed enough to show latticework of stents Dr. Working with InWorks, Dr. Zablah uses 3DRA data to generate different types of models for different purposes. For families, she prints basic models in her office that help them understand the before-and-after of their child’s procedure. Zablah threaded up through the femoral artery and opened like tiny umbrellas at the areas of stenosis. Congenital interventional cardiologist Gareth Morgan, MD, considers the models. “The company that manufactured our imaging system didn’t know it had this sort of capability. They didn’t even realize it was possible.” Updated just more than a year ago with what Dr. Morgan calls “all the bells and whistles,” the system is one of the most powerful and capable on the market. Drs. Zablah and Morgan are figuring out how to leverage that capability in ways that go far beyond the commercial specs. “We’re squeezing out every drop,” he says. WORKING NEW ANGLES Three-dimensional rotational angiography, or 3DRA, has been a staple of catheterization labs for years. It’s typically used for procedural planning and sometimes guidance, layered on standard biplane angiograms to ensure accuracy. 8 | CHILDREN’S HOSPITAL COLORADO