Eastern Cardiothoracic Surgical Society

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The Utility of Three Dimensional Printing in Cardiothoracic Surgery
John Kucera1, Kenneth P. Seastedt, MD1, Junewai Reoma2.
1Uniformed Services University of The Health Sciences, Bethesda, MD, USA, 2Walter Reed National Military Medical Center, Bethesda, MD, USA.

OBJECTIVE:
Anatomical 3D printing in Cardiothoracic surgery can allow surgeons to plan an efficient operation, of particular utility when reconstruction is impacted by surgical technique and approach. We present the utility 3D printing provides in operative planning the successful repair of a Sinus of Valsalva Aneurysm and two-vessel CABG.
METHODS:

The patient is a 67 year-old male with coronary artery disease and 5.6 centimeter Sinus of Valsalva Aneurysm. A model of the aorta and coronary arteries based on CT angiogram was constructed using 3D printing. With the model, it was noted that the aneurysm had spared the right coronary ostia. This information was critical, as the patient was also undergoing two-vessel CABG due to coronary artery disease with ejection fraction of 20%. The model provided visualization of aortic sinus and annulus that would support patch placement. Prior to surgery we measured on the model that a 3x3cm patch would be needed. The patch was fashioned based on these measurements prior to cardiopulmonary bypass, thereby saving ischemic time. In the OR, the defect was noted below the right coronary ostia, and the pre-formed patch sewn to aortic sinus and annulus just as the model predicted.
RESULTS:
3D printing provided physical visualization of relevant anatomy and allowed for planning the aortic root repairi prior to taking the patient to the operating room
CONCLUSIONS:
3D printing allows surgeons to effectively prepare for aortic cases in the operating room. It has utility in Cardiothoracic surgery and has potential to save surgical time


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