The baby boy was born with multiple congenital heart differences that, without surgery, would be catastrophic. Simply put, Brayden Otten's heart could not properly pump his blood.
Cincinnati Children's Hospital Medical Center surgeons managed to create workarounds that helped Brayden's blood circulate back then, and Brayden, now 12, has lived a normal life other than having to take breaks during some physical activities.
But his doctors and parents, Michelle and John Otten of Wyoming, have always known that the surgical fix provided to Brayden as an infant wasn't perfect or permanent. "Unfortunately," said Dr. David Morales, his current cardiothoracic surgeon, "it would eventually result in heart failure."
Enter virtual reality.
A Cincinnati Children's team has advanced virtual reality technology to the point where a surgeon can use it to "walk into" a patient's twin organ, see all of its features and complications and plan exactly how to repair them in an individualized surgery.
It's much more advanced than using a 3D print of an organ, said Morales. Before, every time Morales wanted to make a change, he had to reprint the model. Now he says, "I just hit reset."
Dr. Ryan Moore, a pediatric cardiologist and a 3D medical imaging expert – who knew and helped care for Brayden when he was a baby – led the VR team with Morales’ input.
“I have a background in digital arts and gaming," Moore explained. It's not unusual at Cincinnati Children's. "We have VR developers on staff. We have digital animators on staff."
He said the team knew they could use the technology to enhance surgeons' abilities in the operating room.
Operations that in the past would've taken multiple surgeries and might have complications became more fluid with VR planning. In particular, surgeries on children with multiple heart differences (a term Morales coined because, he says, "I don’t like kids to think of themselves as defective or diseased") could be improved.
The advances that the Cincinnati Children's VR team has made are unparalleled, Moore said.
The technology has been used for about 15 complex heart surgeries so far, Morales said. He and Moore – along with Brayden's cardiologist, Dr. Haleh Heydarian – knew Morales could plan a surgery for Brayden that would've otherwise taken several surgeries and possibly posed surprises.
Moore made a virtual twin of Brayden's heart, and Morales spent hours in the VR world, day after day, planning the surgery.
They were confident, even excited about what Morales learned and how he'd planned the surgery.
Brayden was less enthused. After all, what seventh-grade boy wants a complex surgery? Especially near Christmas.
"He didn’t feel terrible," Morales explained. "It’s like, ‘I know that, in five or 10 years, I’m not going to be well and I have an opportunity to change something now."
To ease his anxiety, the doctors asked Brayden to come to the hospital and check out the surgical plan.
So on Nov. 24, the day before Thanksgiving, Brayden pulled on the VR headset and moved into the virtual operating room. Effortlessly, he captured his own heart, resized it, stepped into it and began exploring the heart, using tools such as a virtual headlamp to see things better.
"I could see what they're gonna do in the surgery, like, 'I'm going to make an incision here,'" Brayden said. "I thought it was pretty fun, and it was VR, and it was cool."
The doctors were stunned at his ability to integrate with a virtual world. The boy even tried out a tool that Morales hadn't used.
Michelle Otten took a turn with the headset, too. The experience offered her a look of her son's heart that she could never have seen before, and his surgeon's explanations made sense. "That gave me comfort," she said.
The surgery was set for Nov. 30.
“I’d already done the operation in my head several times," Morales said.
Brayden said he knew Morales was ready but, "I still didn't want to have the surgery."
It lasted about 12 hours and it went off flawlessly, the doctors said. Brayden's early recovery was smooth and, on Dec. 15, he was allowed to go home.
On Tuesday, just a few days before Christmas, Brayden, dressed in his favorite Joe Burrow Bengals jersey, sat with his family to talk about the experience. He was still a little tired, his mom said, but his oxygen level had already improved to an ideal level for anyone.
Brayden was getting better every day, she said.
"He's going to be able to have a little bit more stamina, to keep up with his buddies," Michelle Otten said, smiling.
"He's hoping to be able to do baseball in the spring," said John Otten.
His little sister, Aubrey, wasn't thinking that far ahead.
Glancing at her brother, she said, "I'm just really happy that Brayden is well."
As for Brayden? He was looking forward to going to his grandparents' homes on Christmas Eve and Christmas Day.
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