Cardiac Patient Education Goes Digital: From Paper-Based Methods and 3D-Printed Models to Virtual Reality

Background: Cardiac surgery represents one of the most intrusive surgical procedures in a patient's life. Due to the severity, many patients suffer from postoperative mental health issues. Therefore, the aim of this study was to employ digital models during the pre-surgical education, focusing on their impact on patient's anxiety.

Method: To create standardized digital models for CABG, SAVR and TAA procedures anonymized patient CT-datasets were collected retrospectively. These digital models were surface modified in a 3D-modeling software and subsequently inserted into a multi-user virtual reality (VR) platform or 3D printed. Presurgical patient education was conducted with patients admitted to our cardiac surgery department. Patients were randomly divided into three groups for different patient education methods based on conventional paper sheets, 3D-printed models, and VR models. Presurgical consultation with the paper sheet was treated as a control. Education quality and impact on patient anxiety was determined by a questionnaire combining customized questions with the standardized State-Trait Anxiety Inventory. A cardiac surgeon conducted pre-surgical consultation and questionnaires were filled out before and after.

Results: Three representative VR scenes were created for some of the most common procedures in cardiac surgery. Patient and physician, using two cordless VR headsets were able to freely move around the education model inside a medical-style VR room. The physician was able to cycle through different steps of the procedure, while highlighting and scaling important structures. Forty patients were included in classic paper sheet, 3D-printed model and VR-model education groups, respectively. Questionnaires revealed an increase in procedural understanding for all three groups, with the 3D-printed model and VR model groups additionally showing an increase in anatomical and spatial awareness. Anxiety levels decreased for patients educated with all education methods. Patients educated with 3D-printed and VR models expressed higher confidence in the procedure and surgical team. Ten patients in the VR-model group experienced nausea or struggled with the VR controls and were excluded from the study.

Conclusion: It was possible to create a VR- based patient education platform for the most common cardiac surgical procedures. The patients overall satisfaction with the 3D-models be it physical or digital, was very high making an integration into everyday clinical practice feasible.

Publication History

Article published online:
03 February 2022