Sept. 30, 2026
When Mayo Clinic pediatric cardiac surgeons need to visualize the intricacies of a patient's cardiovascular structures, imaging is helpful. Ordering a 3D life-size model of a patient's anatomy offers a deeper view.
Using CT scans, Mayo Clinic Radiology experts can create a virtual 3D model color coded for each anatomic part. Assisted by Mayo-developed artificial intelligence (AI) algorithms, subspecialist cardiac radiologists work through thousands of cross-sectional images to build a patient-specific digital twin. Then a 3D printer creates a physical life-size 3D model of that digital twin layer by layer with one of several technologies that harden resins with lasers, UV photocure polymers or by laser sintering nylon powders.
"Pediatric cardiac surgery is one of the most challenging fields in medicine. These patients often have unique and complex cardiac anatomy, changes from prior surgeries, and procedures that must be performed on very small structures. Because these patients are children, the decisions made during surgery can affect their lives for many years," says Thomas A. Foley, M.D., a cardiovascular radiologist at Mayo Clinic in Rochester, Minnesota. Dr. Foley helps create life-size 3D models of pediatric hearts in Radiology's Anatomic Modeling Unit. "3D modeling allows for the creation of life-size models with a patient's specific anatomy. I'm often struck by how small these structures are that surgeons operate on."
Congenital complexities
In congenital cardiac surgery, 3D modeling is used for procedure planning and patient and family education. "The models can give surgeons and interventionalists a sneak peek into the heart before the procedure. They provide a more intuitive view compared with reviewing two-dimensional images on a computer monitor," Dr. Foley says.
This allows the surgeon to:
- Know where to look for relevant anatomy.
- Plan surgery steps and approach.
- Clarify plans with the team presurgery.
Models are usually printed in plastic. However, they can be made with flexible, lifelike materials that surgeons can cut through and simulate surgical exposure and techniques. Simulating potential procedures using 3D models can lead to better and less invasive treatments.
The anatomic replicas can help show families why surgery is recommended and what will be done during the operation. Patients are often given their model as a keepsake after the surgery.
Custom building
"Congenital heart disease is the most common birth defect in the world, and every defect is structurally unique to that child. While there are generalities there are no standard templates. A surgeon operating on a child with complex or simple congenital heart disease is navigating anatomy that may not have existed in exactly that configuration before. This is the problem that patient-specific life-size 3D-printed models were built to solve," says Jonathan M. Morris, M.D., a radiologist and medical director of the Anatomic Modeling Unit at Mayo Clinic in Rochester, Minnesota.
"Every CT scan looks the same size on a monitor. A neonate's heart and an adult's heart occupy the same screen real estate. A 3D-printed model at true anatomic scale collapses that abstraction instantly," Dr. Morris says. "When a surgeon holds a patient-specific, life-size 3D model of a child's heart before the first incision, something fundamentally different happens. Haptic perception and visual perception combine in a way that no screen ever achieves. The anatomy becomes known rather than inferred before entering the OR. Surgeons can hold the geometry they will encounter in the operating room, at size with the spatial relationships intact."
Mayo manufacturing
Mayo Clinic established 3D printing in-house roughly two decades ago when surgeons requested a 3D model to help plan a surgery to separate conjoined twins. Since then, the Anatomic Modeling Unit has grown significantly with 26 3D printers and almost 10,000 square feet of purpose-built manufacturing space. Mayo's point-of-care manufacturing capabilities have expanded to impact roughly every medical and surgical specialty. The clinical service produces thousands of patient-specific models a year, including 50 preoperative pediatric cardiovascular surgery cases.
"The full chain from imaging to real model is integrated, reproducible and clinically validated," Dr. Morris says. "Mayo Clinic has invested in point-of-care manufacturing technology, and it's demonstrated something that few institutions have achieved. Mayo Clinic replicated and scaled the program to other parts of the enterprise with manufacturing capability across three geographically dispersed campuses in Minnesota, Arizona and Florida."
Some surgeries are urgent and on-site printing allows Mayo Clinic specialists to solve complex problems with quick turnaround times. "The Anatomic Modeling Unit is running AI-driven segmentation pipelines, manufacturing sterilizable cutting guides and custom implants as standard clinical services ordered through the electronic medical record," Dr. Morris says.
3D model leader
"Systematic reviews have documented that more than 80% of studies examining 3D anatomic models in surgical planning reported improved clinical outcomes. The data on reduced operative time, less blood loss, and better organ and tissue preservation is accumulating. There is a consequential gap between what 3D modeling makes possible and what most institutions are currently doing," Dr. Morris says.
3D modeling is particularly beneficial for pediatric cardiac surgery. Dr. Morris and his team have created 3D models for various pediatric cardiac surgeries including:
- Complex congenital heart surgery.
- Transposition of the great vessels.
- Double-outlet right ventricle.
- Total and partial pulmonary venous return.
- Reoperation of congenital heart surgery.
- Cardiac tumors.
- Aortic abnormalities.
"Mayo Clinic has been a leader for years in this technology and the key advantage is how the team works with the surgeon to tailor the model to the surgical needs. This includes the exposure and cuts of the model, the structures included, and how they are differentiated from one another, even soft models that allow us to simulate cutting in the surgery," says Elizabeth H. Stephens, M.D., Ph.D., a pediatric and congenital cardiovascular surgeon at Mayo Clinic in Rochester, Minnesota.
Models are used for surgical planning and optimization, including baffles, patches and determining how to reach certain structures. "The team creates models that give the surgical information and view that we need. They will provide exposure that is appropriate for our approach and focus on only including the relevant structures. This has allowed us to preplan our surgical procedure to minimize bypass and cross-clamp time and optimize success," Dr. Stephens says.
Looking ahead
While techniques and procedures progress in pediatric cardiac surgery, 3D models can play a key role supporting innovation. "One of the ultimate goals is the ability to create patient-specific grafts, shunts or replacement valves. As imaging, modeling software, printing materials and regulatory pathways continue to evolve, 3D modeling may become increasingly integrated into surgical planning, simulation, education and the design of patient-specific therapies," Dr. Foley says. "Models produced by the lab have become a vital part of advancing surgical and procedural practice at Mayo Clinic, as well as educating medical staff here and around the world."
For more information
Refer a patient to Mayo Clinic.