scholarly journals Use of 3D printing for parent and patient education in repair of vascular ring and circumflex aorta

2021 ◽  
Author(s):  
Robroy MacIver ◽  
David Overman ◽  
Brooke Moore ◽  
Amanda Tenhoff ◽  
Tinen Iles ◽  
...  
Keyword(s):  
3D Printing ◽  
Aortic Arch ◽  
Circulatory Arrest ◽  
Vascular Ring ◽  
Three Dimensional ◽  
Communication Strategy ◽  
Clear Understanding ◽  
Repeat Operation ◽  
Airway Pathology ◽  
Circumflex Aorta

A clear understanding by the patient and family of airway pathology caused by vascular rings can be difficult to achieve. The pathology is three-dimensional in nature, and is a compilation of differing anatomic structures. Patient confusion can lead to misunderstandings regarding the nature of the operation, attendant risks, and the expected post-operative course. In this review we describe our use of 3D printing in the setting of circumflex aorta and double aortic arch to help guide a child and their family through the decision for treatment of what can be a difficult problem in both diagnosis and management. Our patient underwent two operations. First, a thoracoscopic division of a left ligamentum and atretic distal left aortic arch. While symptoms improved somewhat post-operatively, moderate dysphagia and dyspnea persisted. Based on further evaluation we concluded that the circumflex aorta was the etiology of the ongoing symptoms, so an aortic uncrossing procedure under circulatory arrest was recommended and performed. We used a 3D model in the education of the patient and family prior to the second surgery and greatly enhanced their understanding of why a repeat operation was required to address an additional component of this complex vascular ring. The use of 3D printing in preoperative discussions facilitated better understanding of complex three dimensional anatomy for the patient and patient’s family. In addition, this communication strategy helped frame expectations regarding the post-operative course and convalescence.

Digital Design and 3D Printing of Aortic Arch Reconstruction in HLHS for Surgical Simulation and Training

2018 ◽  
Vol 9 (4) ◽  
pp. 454-458 ◽  
Author(s):  
Sarah A. Chen ◽  
Chin Siang Ong ◽  
Nagina Malguria ◽  
Luca A. Vricella ◽  
Juan R. Garcia ◽  
...  
Keyword(s):  
3D Printing ◽  
Aortic Arch ◽  
Surgical Simulation ◽  
Three Dimensional ◽  
3D Models ◽  
Digital Design ◽  
Patient Specific ◽  
Aortic Arch Reconstruction ◽  
Arch Reconstruction ◽  
And Training

Purpose: Patients with hypoplastic left heart syndrome (HLHS) present a diverse spectrum of aortic arch morphology. Suboptimal geometry of the reconstructed aortic arch may result from inappropriate size and shape of an implanted patch and may be associated with poor outcomes. Meanwhile, advances in diagnostic imaging, computer-aided design, and three-dimensional (3D) printing technology have enabled the creation of 3D models. The purpose of this study is to create a surgical simulation and training model for aortic arch reconstruction. Description: Specialized segmentation software was used to isolate aortic arch anatomy from HLHS computed tomography scan images to create digital 3D models. Three-dimensional modeling software was used to modify the exported segmented models and digitally design printable customized patches that were optimally sized for arch reconstruction. Evaluation: Life-sized models of HLHS aortic arch anatomy and a digitally derived customized patch were 3D printed to allow simulation of surgical suturing and reconstruction. The patient-specific customized patch was successfully used for surgical simulation. Conclusions: Feasibility of digital design and 3D printing of patient-specific patches for aortic arch reconstruction has been demonstrated. The technology facilitates surgical simulation. Surgical training that leads to an understanding of optimal aortic patch geometry is one element that may potentially influence outcomes for patients with HLHS.

Circumflex aorta: An uncharted territory

2021 ◽  
pp. 021849232110150
Author(s):  
Maruti Haranal ◽  
Balaji Srimurugan ◽  
Sivakumar Sivalingam
Keyword(s):  
Aortic Arch ◽  
Vascular Ring ◽  
Management Strategies ◽  
Vascular Anatomy ◽  
Resonance Imaging ◽  
Comprehensive Search ◽  
Magnetic Resonance Imaging Mri ◽  
Circumflex Aorta ◽  
Reference Section

Background Vascular rings are aortic arch anomalies with a spectrum of manifestations ranging from asymptomatic lesions detected incidentally to an acute presentation secondary to tracheo-esophageal compression. Circumflex retro-esophageal aortic arch is an extreme form of true vascular ring. It remains an uncharted territory to many surgeons. Methods A comprehensive search of peer reviewed journals was completed based on the key words, “Circumflex aorta,” “Circumflex retro-esophageal aorta” and “circumflex arch” using Google scholar, Scholars Portal Journals and PubMed. The reference section for each article found was searched to obtain additional articles. Literature on the circumflex aorta was reviewed starting from the embryogenesis to the latest management strategies. Results Right circumflex aorta is more prevalent compared to left circumflex aorta. It can occur in isolation or in association with other intracardiac lesions. Mainly presents in children, however reported in adults too. The presentation may vary from asymptomatic lesion to acute respiratory distress secondary to airway compression. Computerized tomography (CT) and magnetic resonance imaging (MRI) are important tools in delineating the vascular anatomy. Aortic uncrossing is the definitive procedure. However, the role of concomitant tracheobronchopexy is emerging. Native tissue-to-tissue anastomosis is commonly preferred, but cases of extra-anatomic grafts are reported. Conclusion Circumflex aorta is amenable to complete repair. Preoperative delineation of anatomy is important for successful surgical outcome. Division of the retro-esophageal segment is crucial in relieving the compressive symptoms. In addition, tracheobronchopexy is helpful in addressing residual tracheomalacia but this accounts for a high-risk surgery.

Bronchoscopy versus multi-detector computed tomography in the diagnosis of congenital vascular ring

2010 ◽  
Vol 125 (3) ◽  
pp. 301-308 ◽  
Author(s):  
A H Gaafar ◽  
K I El-Noueam
Keyword(s):  
Computed Tomography ◽  
Aortic Arch ◽  
Vascular Ring ◽  
Three Dimensional ◽  
Rigid Bronchoscopy ◽  
Spontaneous Respiration ◽  
Reconstruction Algorithms ◽  
Tomography System ◽  
Operative Evaluation ◽  
First Year Of Life

AbstractBackground:Vascular rings are congenital vascular anomalies of the aortic arch complex which cause compression of the trachea and/or oesophagus. A variety of investigations may lead to diagnosis of these anomalies, including bronchoscopy and computed tomography. During the latter, image acquisition and processing use the multi-detector row technique and new reconstruction algorithms, producing high-resolution images which can be visualised as complex, three-dimensional renditions.Objective:This study aimed to assess and compare the roles of bronchoscopy and multi-detector row computed tomography in the diagnosis of congenital vascular ring.Patients and methods:We included infants and children below the age of 16 years who presented with congenital vascular ring. All patients underwent rigid bronchoscopy under general anaesthesia, with spontaneous respiration. All computed tomography scans were obtained using a 16 multi-detector row computed tomography system, followed by data reconstruction on a three-dimensional workstation.Results:Ten patients with congenital vascular ring were identified (six boys and four girls). Fifty per cent of cases presented within the first year of life. Double aortic arch was the most common anomaly (40 per cent). Bronchoscopy detected external tracheal compression in nine cases (90 per cent). Associated airway lesions were detected endoscopically in three cases. In contrast, multi-detector row computed tomography detected the vascular ring in all cases, with accurate detection of the compressing vessel; however, it did not detect any associated airway lesions.Conclusion:Bronchoscopy and radiological evaluation are essential for the diagnosis and pre-operative evaluation of congenital vascular ring. Multi-detector row computed tomography can provide more information about the nature of the disease, and can facilitate better communication between clinicians, compared with conventional computed tomography.

scholarly journals Double Aortic Arch Mimics the Clinical Characteristics of Severe Reactive Airway Disease in a Pediatric Patient

2020 ◽  
Vol 09 (02) ◽  
pp. 141-144
Author(s):  
Osman Yesilbas ◽  
Hazar Dogus Kus ◽  
Güntülü Şik ◽  
Agop Citak ◽  
Bahar Temur ◽  
...  
Keyword(s):  
Aortic Arch ◽  
Clinical Characteristics ◽  
Vascular Ring ◽  
Three Dimensional ◽  
Clinical Manifestations ◽  
Airway Disease ◽  
Double Aortic Arch ◽  
Reactive Airway Disease ◽  
Reactive Airway ◽  
Life Threatening

AbstractReactive airway disease is a prevalent condition that can be detected in the early infancy period. The condition might also deteriorate into asthma in some cases. If infants do not respond to the treatment of persistent wheeze and coughing, other rare causes should be investigated. The complete form of vascular ring is an extremely uncommon congenital cardiovascular abnormality. Double aortic arch constitutes the most significant portion of the complete vascular ring anomalies. Clinical manifestations of the anomaly are mainly respiratory due to the tracheal compression and mimicking the conditions of asthma. There have not been many reports about the clinical presentations of double aortic arch being remarkably similar to the same clinical manifestations of asthma in the literature. As far as we can be sure, there have not been any reported cases about severe reactive airway disease that caused a patient to have a life-threatening condition in the pediatric intensive care unit. Herein, we present a 5-month-old girl who had double aortic arch. Her anatomical aberration was diagnosed by three-dimensional computed tomography angiography of thorax, and the anomaly mimicked the clinical characteristics of life-threatening severe reactive airway disease.

3D-printing models to create custom-made devices for coil embolisation of anastomotic leak after aortic arch replacement

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
D Schmauss ◽  
R Sodian ◽  
C Schmitz ◽  
A Bigdeli ◽  
M Schmoeckel ◽  
...  
Keyword(s):  
3D Printing ◽  
Aortic Arch ◽  
Anastomotic Leak ◽  
Coil Embolisation ◽  
Aortic Arch Replacement ◽  
Custom Made

scholarly journals Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yuan-Wei Zhang ◽  
Xin Xiao ◽  
Wen-Cheng Gao ◽  
Yan Xiao ◽  
Su-Li Zhang ◽  
...  
Keyword(s):  
3D Printing ◽  
Blood Loss ◽  
Three Dimensional ◽  
Operation Time ◽  
Varus Deformity ◽  
Conventional Group ◽  
Intraoperative Blood Loss ◽  
Cubitus Varus ◽  
Guide Plate ◽  
Significant Difference

Abstract Background This present study is aimed to retrospectively assess the efficacy of three-dimensional (3D) printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. Material and methods Twenty-five patients (15 males and 10 females) with the cubitus varus deformity from June 2014 to December 2017 were included in this study and were enrolled into the conventional group (n = 11) and 3D printing group (n = 14) according to the different surgical approaches. The operation time, intraoperative blood loss, osteotomy degrees, osteotomy end union time, and postoperative complications between the two groups were observed and recorded. Results Compared with the conventional group, the 3D printing group has the advantages of shorter operation time, less intraoperative blood loss, higher rate of excellent correction, and higher rate of the parents’ excellent satisfaction with appearance after deformity correction (P < 0.001, P < 0.001, P = 0.019, P = 0.023). Nevertheless, no significant difference was presented in postoperative carrying angle of the deformed side and total complication rate between the two groups (P = 0.626, P = 0.371). Conclusions The operation assisted by 3D printing osteotomy guide plate to correct the adolescent cubitus varus deformity is feasible and effective, which might be an optional approach to promote the accurate osteotomy and optimize the efficacy.

scholarly journals Three-dimensional(3D) printing in forensic science–An emerging technology in India

2021 ◽  
Vol 1 ◽  
pp. 100006
Author(s):  
Gargi Jani ◽  
Abraham Johnson ◽  
Jeidson Marques ◽  
Ademir Franco
Keyword(s):  
3D Printing ◽  
Forensic Science ◽  
Three Dimensional ◽  
Emerging Technology
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