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t m c » p u l s e | d e c e m b e r 2 0 1 5 6 6 "Skeletal structures practically print themselves," Krishnamurthy said. "They're very easy to extract from the CT data set, to separate from the surrounding anat- omy, and to create a model out of it. It's like printing on paper with an inkjet printer." Orthopedic surgeons at Texas Children's initially wanted to experiment with different techniques to approach operating on patients with hip dysplasia, so Krishnamurthy and his team printed out a model of Left: A range of colors and materials are used to create 3-D printed models, making them as lifelike as possible. Right: 3-D Print Texas partners with Houston Methodist to create 3-D models with varying textures and materials. After printing, the models are bathed in a water-solution tank that dissolves support material and leaves the final product intact. by helping them visualize the area they're operating on and simulate the procedure before the patient arrives at the hospital. "You can argue that if you're a talented cardiac sur- geon or somebody who has been doing this for a while, [you] can look at the raw data and know exactly what is going on," Krishnamurthy said. "But when you're dealing with such a complex situation where there are different organ systems that are abnormal, and each one needing its own specialist team, with real- time decision-making at the time of surgery, then it becomes very difficult—the coordination, the planning, the decision-making." The time it takes to create the models can range anywhere from one day to a week, depending on the complexity of the model. Stephen Little, M.D., director of the Valve Clinic at Houston Methodist DeBakey Heart and Vascular Center, agreed that 3-D printing plays a valuable role in surgical planning. the pelvis and femur to physically test what angles to cut the bone to change its alignment for a better fit. They eventually became sophisticated enough to explore printing more complicated anatomy, such as a model of a baby's heart that did not have any arteries going to the lungs, and even a case of conjoined twins with complete fusion of the chest, abdomen and pelvis. According to Krishnamurthy, having the heart models that show the internal anatomy benefits the surgeons