Rosemaylee Thelusma has always been an active child. The 13-year-old’s favorite activity is cheerleading, which came to an abrupt halt when her pediatrician noticed a heart murmur that had previously gone undetected.

She was referred to pediatric cardiologist Dr. Danyal Khan with Nicklaus Children’s Hospital’s Heart Institute for further evaluation. Imaging studies revealed she had a serious and complex heart condition, a sinus of valsava aneurysm that had ruptured into the left ventricle. This caused severe aortic regurgitation, which causes blood from the aorta to flow backwards into the left ventricle. This problem causes heart enlargement, heart failure and is ultimately fatal unless treated surgically.

Dr. Redmond Burke, Chief of Cardiovascular Surgery and Co-Director of the Heart Institute, says that the lesion was not only rare, it was in a location that made the surgery an extremely complicated and treacherous one.

“The defect in her heart was surrounded by three critical and delicate heart structures.  We had to find a pathway to her defect that would not harm these delicate areas.”

The team used a combination of mixed-reality tools to support the planning of her complex surgery. The Advanced Projects Laboratory at Nicklaus Children’s Hospital created multiple three dimensional models of Rosemaylee’s heart, using the Stratasys J750 BioPrinter, including operable and dissectible models for surgical planning. The original CT angiogram data and the model files were loaded into the Microsoft HoloLens2 with VSI Apoqlar software to allow the images to be examined holographically, in 3D and in real time. “The two methods are dramatically synergistic, each amplifying the utility of the other,” said Dr. Robert Hannan, director of the APL.

“We created a 3D-printed heart model that enabled the team to feel, cut and sew an exact replica of Rosemaylee’s heart to plan this complicated surgery, said Dr. Hannan.

“Surgeons were also able to view 3D holograms of her heart using Microsoft HoloLens2 mixed-reality technology and the techniques complemented and amplified each other perfectly.”

“The cutting edge technology helped us plan a challenging operation, and enabled us to reduce the operative trauma for our patient, which is our ultimate goal.” said Dr. Burke.

Rosemaylee’s four-hour surgery was a complete success. After seven days of hospitalization to monitor her progress, she was able to go home. Her family is grateful to the team at Nicklaus Children’s for a future of new adventures with her newly repaired heart.

Watch a video about the use of mixed-reality technology to repair Rosemaylee’s heart:

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