CaRi-heart technology
Revolutionary new technology to assess the risk of a serious heart condition or heart attack – many years before anything happens.
Designing a new heart
Using his experience in 3D printing for his architecture clients, David built a life-size model of his own heart and ribcage to help visualise and plan his endoscopic heart surgery with Mr Toufan Bahrami.
Just two months after undergoing heart surgery at HCA Healthcare UK's The Harley Street Clinic, David, who is in his 70s, is looking forward to his forthcoming trip to Copenhagen, Stockholm and Gothenburg with his wife. A senior partner at an international architecture firm, David says walking around cities is one of his favourite things to do.
“We do urban planning as well as building design, so it’s going to be a bit of a busman’s holiday,” he laughs. Yet even a few months ago, a city walking tour would have been challenging for David, who was starting to get short of breath when walking upstairs.
“Looking back, I was getting tired more quickly, although I didn’t always notice it at the time. But now, after the surgery, I can do everything I could do before, and more. I'm less out of breath and feel stronger. I just hope I keep improving!”
David had been suffering from calcification of the aortic valve and mitral valve which can cause restricted blood flow and, if left unchecked, lead to heart disease and even heart failure. “I started doing regular health checks about eight years ago, when they identified a mild heart murmur, which progressed to ‘moderate’ within a few years. By 2023 I was told it was severe, and I would need to do something about it.”
David’s health insurance provider recommended a cardiologist and cardiac surgeon. But, when David discovered they would only offer open surgery, he requested a second opinion.
Conventional open-heart surgery, the traditional way of performing the valve repair that David needed, is highly complex and taxing on the body. During a typical four-hour ‘sternotomy’, the surgeon cuts through the breastbone and opens the ribcage to access the heart. For some patients, this is the only way to deal with their condition, however it can often mean up to six months of recovery and rehabilitation.
“Interestingly, a good friend and colleague had had a similar operation six months before,” says David. “He originally wanted to go to the US but, after extensive research, he opted for an endoscopic procedure with Mr Bahrami. It went really well so I knew minimally invasive was the way to go.” It was then that David met senior cardiothoracic surgeon, Mr Toufan Bahrami, who specialises in minimally invasive and endoscopic cardiac surgery, and consultant cardiologist, Dr Jonathan Clague.
In endoscopic surgery, the surgeon accesses the heart through a small, 3cm incision in the rib cage. The procedure itself is shorter than an open sternotomy, recovery time is a lot quicker and there are fewer risks and complications overall.
After meeting Mr Bahrami and Dr Clague, David’s mind was set. He went back to his insurers to request an endoscopic procedure with Mr Bahrami, rather than the open surgery that had been suggested, and the change of plan was approved.
“My friend and colleague realised that endoscopic surgery can be planned in detail using 3D imaging. Before his own operation he printed a 3D model of his heart and ribcage to allow Mr Bahrami to decide on the correct entry point.”
This procedure was particularly interesting for David. “3D printing is part of our life blood as architects,” he says. “Creating a three-dimensional view is a crucial part of any building design or city plan, that helps us identify and correct design issues at an early stage. What’s amazing is that, with the help of another colleague and a company in Ireland called Axial 3D, we were able to convert the CT scans of my chest and create something similar to our architectural models.”
Together, they created a precise 3D model of David’s heart and ribcage to share with Mr Bahrami. “It was strange holding my heart in my hands. I had to distance myself a bit,” says David. “I never realised how big a human heart is. It was quite an eye opener!”
The 3D view also allowed David to print ‘slices’ of his heart, offering a colour-coded outline of the precise placement and thickness of the calcium around the valves. This meant Mr Bahrami could see exactly where to place the clamp and make the incision, and how much calcification could be safely removed.
Being so involved in the printing process also meant David felt confident about the procedure and was able to go into the surgery in a more relaxed state. “Mr Bahrami is a great communicator,” he says. “He really takes the time to explain the process, which not everybody does. And having a 3D model demystified a lot for me. As my wife said, I didn’t have the usual pre-op nerves.”
David stayed in The Harley Street Clinic for a total of seven days, during which time he had the aortic valve replacement and a separate procedure to have a pacemaker fitted. “The hospital was very good,” he says. “It was everything one imagines it should be. The people are amazing – all the staff at all levels. They were very attentive, very helpful.”
Feeling well cared for, David recovered quickly and suffered no complications. Just two weeks after discharge, he was able to walk 10,000 steps. After just six weeks, he went back to work.
“The recovery period was amazing,” he says. “I never felt any pain. I was a bit slow at first, but I was soon walking about, doing my rehabilitation programme, and probably doing too much, too soon! It felt great to be back.”
David says he has huge respect for Mr Bahrami and his surgical ability. “He’s amazing at what he does. To go in through my right rib cage to operate on the left – and monitor the procedure on a big screen – to do all that is a great, great skill.”
This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.