Heart Imaging and 3D Printing

The Structural Heart & Valve Disease Program at the Swedish Heart & Vascular Institute (SHVI) has the most advanced, specialized heart imaging. This technology allows your doctor to evaluate your heart’s structure and how your heart and valves function before, during and after therapy. It also helps your doctor determine the best possible therapy for your particular needs. Heart imaging technology at SHVI includes:

Cardiac computerized tomography (cardiac CT)

Cardiac CT uses X-rays to take images of your heart. The scanner works very quickly, so it takes very precise pictures even though your heart is beating. Your doctor can view the pictures from different angles. Sometimes your doctor will ask the technician to use a contrast dye during the cardiac CT.

A cardiac CT can show:
  • Calcium deposits that might be limiting how well a valve is working
  • How well your heart is pumping
  • Scarring on a valve from an infection or on the heart muscle from a heart attack
  • Plaque (a fatty deposit that sticks to the walls of arteries and narrows the opening so blood cannot flow freely) build-up in your arteries
  • Size of the blood vessels in your abdomen and legs
  • If you have any heart defects that were present at birth (congenital)

Cardiac CT is extremely helpful in evaluating for transcatheter aortic valve replacement (TAVR). The CT scan for TAVR provides images from your neck to your leg vessels to help your doctor determine the best approach to use for the catheter.

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This is a picture of multi-slice CT evaluating the coronary arteries.


CT measurements prior to PDA closure.

CT showing 3D view of vessels to plan access for TAVR procedure.

Cardiac CT can be used alone or in combination with other diagnostic imaging and tests.

What to Expect
: Your doctor will give you directions to follow before you have a cardiac CT — especially if a contrast dye will be used. A cardiac CT is a painless procedure that usually takes about 5-10 minutes. During the cardiac CT:
  • You will lie on a table that is attached to the CT machine
  • The technician will place electrodes on your chest to help monitor your heart and also to help the CT scanner’s computers take the pictures
  • When you are ready, the table will slowly move into the arched scanner
  • The scanner will be around you, but it won’t be touching you
  • The technician will watch you through a window and ask you to hold your breath periodically
  • There is a microphone and speaker inside the scanner, so you can talk with the technician
  • When the scan is complete, the technician will remove the electrodes
  • Most people go back to their normal activities right after a cardiac CT scan

Cardiac Magnetic Resonance Imaging (Cardiac MRI)

An MRI uses a magnetic field, radiofrequency waves and a computer to take precise pictures inside your body. A cardiac MRI uses this technology to show your heart in action, which is very useful in evaluating blood flow. Sometimes your doctor will ask the technician to use a contrast dye during the cardiac MRI to produce better images.

An MRI can show damage or other conditions that are affecting how well your heart is pumping. For example, a cardiac MRI can detect:
  • Damage from a heart attack
  • Defects that were present at birth (congenital)
  • Diseases of the lining of the heart
  • A problem in the aorta
  • An enlarged heart
  • Tumors or other growths
  • Heart valve disorders, such as regurgitation

Cardiac MRI is particularly helpful in determining the exact location and size of a valve defect. It can identify how much a valve is leaking, which helps your doctor determine the best time for a procedure to correct the problem.

What to Expect: A cardiac MRI is a painless procedure that typically lasts 30-90 minutes. Your doctor will give you instructions for you to follow before your MRI — especially if you will have a contrast dye.

Important: Because MRI uses magnets, be sure to tell your doctor and the technician if you have any metal in your body, such as an implanted defibrillator, pacemaker, metal dental implants, intrauterine devices (IUDs), metal fragments from an accident, neuro-muscular implants, etc. Although some of these devices may be MRI safe, it is important to be certain before you have an MRI.

Cardiac MRI can be used alone or in combination with other imaging and tests.

During a cardiac MRI:

  • You will lie very still on a table that moves into the MRI machine
  • The technician will place a small coil by your heart to send the radio waves and receive the MRI signal
  • The technician may give you ear plugs or headphones, so you can listen to music during the MRI procedure
  • If your doctor has requested a contrast dye, you will have an IV in your arm
  • When you are ready, the table will move into the MRI machine
  • The technician will watch you through a window
  • There is a microphone and speaker inside the MRI machine, so you can talk with the technician
  • You won’t feel the radio waves or the magnetic field, but the machine will make a loud tapping or thumping noise
  • Most people go back to their regular activities right away after a cardiac MRI

Intracardiac Echocardiography (ICE)

Intracardiac echocardiography (ICE) is an imaging technology your doctor will use during a catheter-based procedure (medical procedure that uses a catheter to deliver instruments and devices that are used to correct a medical condition). Using ICE can help avoid the need for general anesthesia (the use of special medicines to put a patient to sleep to control pain) for some procedures.

ICE can be used for atrial septal defect (ASD) (an abnormal opening in the wall/septum between the two upper chambers of the heart called the atria), ventricular septal defect (VSD) (a hole in the wall/septum that separates the two lower chambers of the heart, the ventricles), tricuspid valve (the valve that is located between the right atrium and the right ventricle to control blood flow between the two chambers of the heart) and mitral valve (the valve located between the left atrium and the left ventricle of the heart) procedures, as well as for device placement.

The ultrasound image allows your doctor to:
  • Evaluate the size and location of the septal defect or valve problem
  • Measure the leak through the septal defect or through/around the valve
  • Determine the best placement of the device

What to Expect: The use of ICE is part of the catheter-based procedure. After your anesthesiologist has administered conscious (twilight) sedation (a combination of a sedative to relax the patient and an anesthetic to control pain that is administered by an anesthesiologist. Conscious sedation may be used during some medical or dental procedures instead of general anesthesia) and a local anesthetic (special medicine given to numb one part of the patient’s body), your doctor will place a tiny ultrasound probe in the appropriate heart chamber. It will remain there until our doctor has completed the procedure.

Rotational Angiography

Rotational angiography uses X-ray technology to provide a three-dimensional image (an image that shows multiple angles of an object: length, width and depth). Your doctor may use rotational angiography during your procedure evaluate the device placement from different angles.

Rotational angiography is frequently used during all structural heart and valve procedures to show the best placement of devices.

Using rotational angiography may avoid or minimize the use of a contrast dye during the procedure.

What to Expect: Rotational angiography is used while you are under conscious (twilight) sedation and after your doctor has placed the new device. The equipment moves around your body, creating a rotating image of the new device.

Rotational angiography showing placement of PDA occluder device.

Three-Dimensional Transesophageal Echocardiogram (3D TEE)

An echocardiogram (echo) uses sound waves made by a transducer to create images of tissue, organs and structures inside your body. When the sound waves bounce off the target, they create an echo that goes back to the transducer and then to a computer to create the image.

A 3D transesophageal echocardiogram (3D TEE) is a type of echo specifically for the heart. It gives your doctor a view without skin, muscle or bones in the way. It is an effective diagnostic imaging technology for evaluating and managing valve disease, and for determining the best time for a procedure.

What to Expect: 

Your doctor will use a 3D TEE while you are under conscious (twilight) sedation. A tiny transducer is sent down your esophagus (the muscular tube that connects the throat to the stomach)  to a position next to your heart. It remains in position until your doctor completes the evaluation.

Three-dimensional TEE showing guidance for Mitraclip procedure.

Three-Dimensional Printing

Although Swedish has the most up-to-date heart imaging available, sometimes there is nothing better than holding an object in your hand. The Structural Heart and Valve Program has the technology to print a 3D model of your heart or damaged valve. Before you arrive for your procedure, your doctor is able to use the 3-D model to test the device, and to plan how the procedure will go. This reduces the time required for the procedure and improves the outcome. This advanced technology is especially helpful with complex cases.

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Your doctor may use images from your CT and MRI scans to make a 3D model. This model may be used to help plan your procedure.