Multidisciplinary Series: Providing Exemplary Heart Transplant Care Through System-Wide Collaboration
by Mary Sheridan Bilbao, PA-C, MPAS
March 31, 2025
By collaborating across hospital and university lines, we can often provide patients with extraordinary care that would otherwise be impossible. In 2024, Lucile Packard Children’s Hospital Stanford underwent a remarkable cross-disciplinary effort to support a young patient named Zoë. The collaboration showcased the extraordinary capabilities and dedication of our Stanford Medicine and Lucile Packard Children’s Hospital Stanford teams. The result was a potentially quicker donor match and a better heart transplant outcome for the 12-year-old.
Pediatric heart surgeons from the Department of Cardiothoracic Surgery at Stanford Medicine worked with a highly specialized imaging lab at the Department of Radiology to quickly perform donor size matching and create a 3D-printed model of Zoë’s heart — a tangible keepsake and a powerful tool for surgical planning.
Pediatric cardiac surgeons Elisabeth Martin, MD, MPH, Clinical Assistant Professor, and Michael Ma, MD, Division Chief of Pediatric Cardiac Surgery and Associate Professor, managed Zoë’s care, who was in advanced heart failure due to cardiomyopathy.
Early on, Dr. Martin used advanced imaging and worked quickly to implant a ventricular assist device (VAD) to improve Zoë’s heart function. Zoë received a cutting-edge VAD traditionally used for adults; Packard Children’s has led the way in implanting the device in older children. The advantage of the adult device is that it puts the pump inside the chest rather than outside, like many pediatric VADs. While the VAD supported the left side of Zoë’s heart, rhythm issues on her right side worsened. Zoë needed a donor heart and a heart transplant as soon as possible.
Packard Children’s is known for its innovative techniques in getting children to transplant more quickly. One of those ways is to rapidly answer the question of whether or not a donor's heart matches with a child. That is where the expertise and innovation of Stanford’s 3D and Quantitative Imaging Lab (3DQ Lab) came in. “We are one of a few places in the world to offer 24/7 total cardiac volume size-matching, largely because we have such a wonderful 3DQ Lab,” said John Dykes, MD, the VAD medical director at Packard Children’s. The 3DQ Lab’s pioneering work in standardizing size-matching methods provides transplant doctors with crucial information quickly and accurately, setting a national benchmark.
“Our 3DQ Lab technologists manage a delicate, complex workflow of rapid 3D heart analyses, then communicate our findings to the transplant evaluation team,” said Shannon Walters, 3DQ Lab Executive Director.
The lab also created a custom heart model for Zoë. This added touch provided her with a unique and personalized keepsake, easing the burden of her heart transplant.
Robert Wilkerson and Chris LeCastillo of the 3DQ Lab played a hands-on role in bringing Zoë’s model to life. Their dedication and technical skill translated imaging data into a precise, 3D representation of Zoë’s original heart.
“Facing the prospect of a challenging heart transplant was hard for Zoë, but receiving the 3D model afterwards gave her some closure,” said Zoë’s mom.
The creation of Zoë’s 3D heart model was a profoundly collaborative endeavor. Dr. Dykes performed the detailed pre-transplant measurements and collaborated with the lab to run the rapid heart volumetry tests. Christine Tao, Zoë’s dedicated child life specialist, spearheaded the effort to turn the vision into reality. Andrea Fasbinder, MSN, RN, PHN, the VAD nurse coordinator on the Pediatric Advanced Cardiac Therapies (PACT) team, played a key role in coordinating efforts across multiple departments, reaching out to experts, and guiding the project forward.
Dr. Ma used the 3D heart model to guide Zoë’s heart transplant. Still, it is more commonly used to help him perform highly challenging open heart surgeries, such as complex biventricular reconstructions. “We do not typically need it for heart transplant, more often, we use it when anatomy is especially complex,” Dr. Ma said.
Zoë’s heart transplant went smoothly, and as planned, and when she faced unexpected complications afterward, Dr. Ma addressed them quickly by expediting the placement of lifesaving extracorporeal membrane oxygenation (ECMO).
The cross-departmental collaboration included essential contributions from the Department of Cardiothoracic Surgery, Packard Children’s, and the remarkable innovation of the 3DQ Lab team, who work closely with physicians, including radiologists, cardiac surgeons, interventional cardiologists, and cardiologists. Their combined expertise refined and optimized the imaging support and model creations needed to give Zoë the best outcome possible.
“Our team went above and beyond to create the 3D heart model for Zoë. It is not a small endeavor. It takes a lot of work for several specialties to make it occur,” Dr. Ma said.
Time lapse video of Zoë’s 3D printed heart
Credit: Kyle Gifford, 3D Printers & Marketing
Special thank you to Zoë and her Family for allowing us to share their incredible story.
Lucile Packard Children’s Hospital Stanford Credit:
● John Dykes, MD, VAD Medical Director; Clinical Associate Professor of Pediatric Cardiology
● Christine Tao, MS, CCLS, Inpatient Child Life Specialist
● Andrea Fasbinder, MSN, RN, PHN, VAD Nurse Coordinator and PACT Member
Stanford Medicine, 3DQ Lab Credit:
● Photo credit of 3D printed heart: Kyle Gifford, 3D Printers & Marketing
● Shannon Walters, MS, Executive Technical Director
● Robert Wilkerson, Biomedical Engineer
● Chris LeCastillo, Innovations Manager
● Dominik Fleischmann, MD, Medical Director of the 3DQ Lab; Professor of Radiology
The cross-departmental collaboration with the Stanford Department of Radiology includes Henry Guo, MD, PhD, Clinical Professor in Radiology, who oversees workflows, and Dominik Fleischmann, MD, Professor and Medical Director of the 3DQ Lab, who leads the lab’s efforts with the cardiothoracic surgery and multidisciplinary teams. Together, they refine and optimize these workflows.
All 3DQ Lab work is performed under the supervision and guidance of radiologists, who play a critical role in ensuring the highest quality imaging support for interventional procedures. Their expertise helps translate imaging data into actionable insights, aligning with the needs of clinicians, interventionalists, and surgeons.
This collaboration across departments and specialties, including cardiothoracic surgery, radiology, and cardiovascular imaging, ensures a comprehensive approach to advancing patient care through innovation and expertise.
Thank you to the extensive time and attention from the following :