Book cover art, Structural Heart Disease Interventions, 2011; Lippincott Williams & Wilkins, J. Carroll, MD; J. Webb, MD Editors
Above, front cover image: high detail segmentation of a cardiac CT. Surface mesh models were repaired and optimized, then sculpted and painted in Mudbox. The Edwards Sapian valve was modeled in Rhino 3D.
Structural Heart Disease Interventions, back cover image 1 - catheter crossing an atrial septal defect as visualized from the right atrium.
Structural Heart Disease Interventions, back cover image 2 - guide wire being inserted into a left atrial appendage, visualized from the posterior aspect of the left atrium.
A stylized rendering not used in the book highlighting the valve delivery system and TEE probe.
Edwards Sapian transcatheter aortic valve and balloon.
Edwards Sapian valve and delivery system after being deformed for placement inside aorta. A centerline was generated to guide the deformation, with deflection (deviation from the centerline) added manually.
Renderings (paired with matching physical models) created to show ICE catheter positions within the heart. A representation of the imaging plane, and the resulting ultrasound image quickly communicate how a single static plane could misrepresent the true shape and dimensions of a defect.
Illustrations were routinely created as part of physical model project design to ensure all components were accurate before physical models were produced.
A series of simple images created to give a quick visual overview of a multi-step procedure.
A rendering depicting the classic “Valentine” orientation of the heart with and without vasculature to depict its unusual nature when considering the rest of the anatomy.
Step by step overview for catheter tie-off.
A shaded-line rendering of an idealized left heart showing two different catheter approaches to the the mitral valve, with different crossing locations in the fossa ovalis (faintly outlined).
A promotional graphic created for a recurring educational workshop at an international conference.
Stylized image showing the treatment progression for glioblastoma - resection, radiation, chemotherapy.
A multi layer rendering of Nimotuzumab, a therapeutic monoclonal antibody against epidermal growth factor receptor, created for a presentation (geometry from the Protien Data Bank). Pubmed: 19584289
Pre-procedural planning using an interactive 3D viewer created with Unity 3D, instead of physical models. The viewer allowed physicians to discuss the anatomy, and the spatial relationships to other structures in a novel manner prior to performing the intervention. Above: test case where spatial relationships of the apex of the heart, lungs and ribs were required to determine optimal approach for valve replacement.
A 360° rotation of the fully optimized geometry.
Early experimental version of the viewer, investigating the complexities of a mitral valve-in-valve intervention, exploring both trans-femoral and trans-apical approaches.
Detail of the failing prosthetic mitral valve; apical approach.
The final format of the viewer with an intuitive and minimal interface.
An example of X-Ray (projection image) simulation.
The viewer was used extensively for TAVR, with multiple cases each week.
Aortic calcifications were also extracted.
Post intervention overlay images showing the 3D model from the viewer rotated to the same gantry position and superimposed on an X-Ray image from the intervention.
Above and below: complex aortic dissection with several abnormal communications that were potential sites for plug devices (all sites were isolated for independent visualization).
Early test case determining which structures needed to be visualized for LAA closure. The ostial plane of the LAA was averaged through surface curvature, delivery system catheter was modeled in place, visually estimating the curvature.
Above and below: experimenting with Houdini to simulate the introduction of a guide wire into an idealized aortic arch, testing the utility of simulation tools to generate wires and catheters with more predictive shapes when loaded into the pre-procedural viewer.
A simple cardiac anatomy App made with Unity 3D. The heart retained extensive detail with a performance optimized model, while the App featured basic rotation and pinch zoom, dynamic text labels and X-Ray gantry angle display.
Internal left heart structures - medial leaflet of the mitral valve, chordae and papillary muscles, left ventricular trabeculations.
Screen capture of the App in use.
Anatomical breakdown for a more comprehensive model, regionally isolated down to the cardiac skeleton.
Heart Voyager Free App icon.
Heart Voyager Free splash image.
A low resolution optimized model displaying a highly unusual left atrial appendage.
In 2006 the 3D Lab started utilizing rapid prototyping to aid in pre-planning of complex cases. This developed into a cardiac modeling project, which I directed, with extensive customization and project design, primarily for the device industry (used both in device training and bench top testing).
Related Publications:
A medium resolution model (models were typically subdivided sufficiently to eliminate any faceting during printing).
The base component of what became our most used model. The entire right lateral aspect of the heart was detachable (all removable parts had magnets glued in recessed regions), with a detachable viewing window in the right ventricle, a completely detachable atrial septum, and a detachable left atrial appendage. Lastly, this model had an extended inferior vena cava to facilitate the introduction of catheters, and a removable mounting stand that allowed the heart to rest in a correct supine position.
An example of a small atrial septal defect insert (the yellow regions would be flexible in the physical model).
A rendering of the superior region of the model, showing the truncated pulmonary artery and ascending aorta sitting above the insert region for the removable left atrial appendage.
An example of one of the many, shapes of the LAA.
A photograph of the physical model.
A photograph of the model showing the right side, with a catheter crossing a very large atrial septal defect and being introduced into the LAA. The removable viewing window in the right ventricular outflow tract allows direct visualization of the LAA ostium.
Interior view of the left atrium from the medial-posterior aspect, with the atrial septum on the bottom right of the image (with an artificial septal puncture site). In the center of the image is a clear, rigid mitral valve. This model was created in a manner to allow a voltage gradient across the atrial walls.
Right and left atria, and a portion of both the IVC and aorta were created as a porous membrane model, with a region around the valve plane designed to be bonded to a rigid part.
A rendering of the final heart.
Optimized geometry from one cardiac time phase is warped and re-projected onto the surface mesh of another cardiac time phase (typically end diastole to end systole). These two objects are then used to create a blendshape in order to create a linear deformation from one phase to another.
Two phase reconstruction of left heart including the left atrium, pulmonary vein ostia, LAA ostia, mitral valve annulus, left ventricle and aortic root.
A anatomical subset focusing on the left heart valve regions - the mitral valve annulus (marked with the green color band), the sub-valvular region in the left ventricle and the aortic root.
A more focused region specifically showing the mitral valve annulus.
A screen capture showing an atrial septal defect and partial aortic root, reconstructed as a three phase dynamic model (ED, ES and one intermediate phase), as part of a collaboration between the UC Denver 3D Lab and the FDA.
Rendering of a generic, closed-cell coronary stent that has been deformed, or “mapped” into a region of coronary artery geometry. Detailed stent geometry and arterial geometry were exported for use with CFD.
Colors representing the inner and outer surfaces, along with a pink region representing the option for an edge chamfer.
Visual overview of the modeling process in Rhino 3D.
Stent geometry was mapped into specific regions of coronary arteries, where stents had been deployed.
Anaglyph renderings of an unusual left atrial appendage, used to give a sense of the three dimensional shape while being presented at a traditional poster session.
Renderings of a pediatric skull and dermal tissue created from MRI, final output was a solid model.
Helix curve speaker design, sized around a Norwegian 10 cm full range driver.
Anthropomorphic farm robot, based on concept art by Eric Will.
Hard surface modeling with a focus on a streamlined forms with multi-articulated limbs.
Traditional polygon / subdivision surface modeling with sculpted detail, emphasis on eye detail.
