The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective
Objectives: Paraplegia is a distressing complication after open thoracoabdominal aortic aneurysm (TAAA) repair, and revascularization of T8-L2–level segmental arteries is considered pivotal to prevent paraplegia. We employed 3-dimensional (3D) printing to efficiently revascularize segmental/visceral...
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Elsevier
2023-08-01
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| Series: | JTCVS Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666250723001372 |
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| author | Sung Jun Park, MD, PhD Jin Kyung Kim, MD Hong Rae Kim, MD, PhD Taehun Kim, MS Sangwook Lee, MS Guk Bae Kim, PhD Dong Hyun Yang, MD, PhD Joon Bum Kim, MD, PhD |
| author_facet | Sung Jun Park, MD, PhD Jin Kyung Kim, MD Hong Rae Kim, MD, PhD Taehun Kim, MS Sangwook Lee, MS Guk Bae Kim, PhD Dong Hyun Yang, MD, PhD Joon Bum Kim, MD, PhD |
| author_sort | Sung Jun Park, MD, PhD |
| collection | DOAJ |
| description | Objectives: Paraplegia is a distressing complication after open thoracoabdominal aortic aneurysm (TAAA) repair, and revascularization of T8-L2–level segmental arteries is considered pivotal to prevent paraplegia. We employed 3-dimensional (3D) printing to efficiently revascularize segmental/visceral arteries and prospectively evaluated its safety and efficacy. Methods: From January 1, 2020, to June 30, 2022, we prospectively enrolled patients of extent I, II, or III TAAA repair. Guidance models were 3D-printed based on preoperative computed tomography, and multibranched aortic grafts were manually constructed upon this model before surgery. The composite outcome of operative mortality, permanent stroke, and permanent spinal cord deficit (SCD) was compared with the historical control group (n = 77, in 2015-2020), subjected to similar TAAA repair without 3D printing. Results: A total of 38 patients (58.6 ± 13.2 years) underwent open TAAA repair with the aid of 3D printing. Extent I, II, and III repairs were performed in 14 (36.8%), 17 (44.7%), and 7 (18.4%), respectively. Concomitant arch repair and bi-iliac reconstruction were performed in 7 (18.4%) and 6 patients (15.8%), respectively. Mean pump time was 107.7 ± 55.5 minutes. Operative mortality, permanent stroke, and permanent SCD each occurred in 1 patient (2.6%), and the incidence of the composite outcome was 7.9% (3/38). In the control group, mean pump time was 166.0 ± 83.9 minutes, significantly longer than the 3D-printing group (P < .001), and operative mortality, permanent stroke, permanent SCD, and the composite outcome occurred in 7 (9.1%), 9 (11.7%), 8 (10.4%), and 19 (24.7%), respectively. Conclusions: Open repairs of extensive TAAA with 3D printing showed favorable safety and efficacy, which need further validation by larger studies. |
| format | Article |
| id | doaj-art-77bde9080d8844c19e1d5c8e601ed0cc |
| institution | Kabale University |
| issn | 2666-2507 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JTCVS Techniques |
| spelling | doaj-art-77bde9080d8844c19e1d5c8e601ed0cc2025-08-20T04:01:57ZengElsevierJTCVS Techniques2666-25072023-08-01201910.1016/j.xjtc.2023.04.011The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspectiveSung Jun Park, MD, PhD0Jin Kyung Kim, MD1Hong Rae Kim, MD, PhD2Taehun Kim, MS3Sangwook Lee, MS4Guk Bae Kim, PhD5Dong Hyun Yang, MD, PhD6Joon Bum Kim, MD, PhD7Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, KoreaDepartment of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, KoreaDepartment of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, KoreaDepartment of Convergence Medicine, Asan Medical Institute of Convergence Science and Technology, University of Ulsan, Asan Medical Center, Seoul, KoreaAnymedi Inc (Product R&D Center), Seoul, KoreaAnymedi Inc (Product R&D Center), Seoul, KoreaDepartment of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, KoreaDepartment of Thoracic and Cardiovascular Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea; Address for reprints: Joon Bum Kim, MD, PhD, Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Korea.Objectives: Paraplegia is a distressing complication after open thoracoabdominal aortic aneurysm (TAAA) repair, and revascularization of T8-L2–level segmental arteries is considered pivotal to prevent paraplegia. We employed 3-dimensional (3D) printing to efficiently revascularize segmental/visceral arteries and prospectively evaluated its safety and efficacy. Methods: From January 1, 2020, to June 30, 2022, we prospectively enrolled patients of extent I, II, or III TAAA repair. Guidance models were 3D-printed based on preoperative computed tomography, and multibranched aortic grafts were manually constructed upon this model before surgery. The composite outcome of operative mortality, permanent stroke, and permanent spinal cord deficit (SCD) was compared with the historical control group (n = 77, in 2015-2020), subjected to similar TAAA repair without 3D printing. Results: A total of 38 patients (58.6 ± 13.2 years) underwent open TAAA repair with the aid of 3D printing. Extent I, II, and III repairs were performed in 14 (36.8%), 17 (44.7%), and 7 (18.4%), respectively. Concomitant arch repair and bi-iliac reconstruction were performed in 7 (18.4%) and 6 patients (15.8%), respectively. Mean pump time was 107.7 ± 55.5 minutes. Operative mortality, permanent stroke, and permanent SCD each occurred in 1 patient (2.6%), and the incidence of the composite outcome was 7.9% (3/38). In the control group, mean pump time was 166.0 ± 83.9 minutes, significantly longer than the 3D-printing group (P < .001), and operative mortality, permanent stroke, permanent SCD, and the composite outcome occurred in 7 (9.1%), 9 (11.7%), 8 (10.4%), and 19 (24.7%), respectively. Conclusions: Open repairs of extensive TAAA with 3D printing showed favorable safety and efficacy, which need further validation by larger studies.http://www.sciencedirect.com/science/article/pii/S2666250723001372thoracoabdominal aortic aneurysm3D printingparaplegiaintercostal arterysegmental artery |
| spellingShingle | Sung Jun Park, MD, PhD Jin Kyung Kim, MD Hong Rae Kim, MD, PhD Taehun Kim, MS Sangwook Lee, MS Guk Bae Kim, PhD Dong Hyun Yang, MD, PhD Joon Bum Kim, MD, PhD The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective JTCVS Techniques thoracoabdominal aortic aneurysm 3D printing paraplegia intercostal artery segmental artery |
| title | The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective |
| title_full | The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective |
| title_fullStr | The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective |
| title_full_unstemmed | The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective |
| title_short | The result of prospective evaluation of 3-dimensional printing–aided extensive thoracoabdominal aorta repairCentral MessagePerspective |
| title_sort | result of prospective evaluation of 3 dimensional printing aided extensive thoracoabdominal aorta repaircentral messageperspective |
| topic | thoracoabdominal aortic aneurysm 3D printing paraplegia intercostal artery segmental artery |
| url | http://www.sciencedirect.com/science/article/pii/S2666250723001372 |
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