3D-printed implants restore baby's breathing

Date: Mar-20-2014Because of a condition that put huge pressure on his airways, 18-month-old Garrett

Peterson of Utah had been tethered to ventilators and lived in hospitals since he was

born. He was in mortal danger because his airways had collapsed, and even on their highest

settings, the ventilators could not prevent his breathing from stopping several times a

day.

Now, thanks to splints that surgeons at the University of Michigan's C.S. Mott Children's

Hospital have implanted in his airway, thus saving his life, Garrett can go home and gradually be

weaned off the ventilators.

Garrett's condition is called tetralogy of Fallot with absent pulmonary valve, and in his

case, it had developed into severe tracheobronchomalacia, or softening of his trachea and

bronchi, to the point that the airways had collapsed to the size of small slits.

Severe tracheobronchomalacia is very rare and affects about 1 in 2,200 newborns. Most grow

out of it by age 2 or 3, but it can be misdiagnosed as asthma that does not respond to treatment.

Severe cases, like Garrett's, are about 10% of that number.

3D imaging and printing technology used to make biodegradable splints

From a medical standpoint, the remarkable thing about Garrett's story is that the life-saving

implants were made using CT scanning and 3D imaging and printing technology to produce

bioresorbable splints of the exact shape to ensure a snug fit in the little boy's airways.

And not only this, but the devices will gradually biodegrade harmlessly in the child's body,

as his trachea and bronchi strengthen so he can breathe on his own without ventilation.

In fact, this is only the second time this technology has been used to save a child's life -

both times at the same hospital. The first time was in early 2013, when a 3D-printed splint of a windpipe

saved the life of another toddler, Kaiba Gionfriddo of Ohio, whose life was also threatened by

tracheobronchomalacia, causing his airway to collapse.

The devices were developed at the University of Michigan by Glenn Green, associate professor

of pediatric otolaryngology and Scott Hollister, professor of biomedical engineering and

mechanical engineering and associate professor of surgery.

The video below details Garrett's story, his surgery and the team's successful efforts:

Team used emergency clearance provisions from FDA to make/implant splints

After reading about Kaiba's story, Garrett's parents, who were desperately running out

of options to save their son's life, contacted the team at Michigan, who used provisions for

emergency clearance from the Food and Drug Administration (FDA) to create a tracheal splint from a

biopolymer called polycaprolactone to implant into the little boy's airway.

Speaking to the press about Garrett's condition, Prof. Green says, "It was highly questionable whether or not he would survive."

Prof. Hollister made the custom-designed, custom-fabricated splints using high-resolution

imaging and computer-aided design. He started with a CT scan of Garrett's trachea and

bronchi, then used an image-based computer model with laser-based 3D printing to produce the

splint.

Prof. Green assisted Richard G. Ohye, head of pediatric cardiovascular surgery at C.S. Mott,

to perform the operation at the end of January 2014. The procedure involved sewing the devices

on two spots of the baby's airway.

They sewed the splints around Garrett's left and right bronchi to widen the airway and keep

it open so it would grow correctly. As Garrett grows, over the next 3 years or so, the

splint will biodegrade and be reabsorbed in his body. Over that time, his trachea should remodel

and grow into a healthy state.

Surgeons are 'very optimistic'

Prof. Green says he knew the splints were working when during the surgery they saw Garrett's

lungs begin to inflate and he was able to ventilate both lungs. "I'm very optimistic for him,"

he adds.

Garrett will still need to stay on the ventilator, but as he gains strength to breathe on his

own, he will gradually need it less and less. It is already on less than a quarter of the

pressure it was on before the operation, and he is able to go for short periods completely off

it.

Prof. Hollister says:

"It is a tremendous feeling to know that this device has saved another child. We believe

there are many other applications for these techniques, but to see the impact living and

breathing in front of you is overwhelming."

Written by Catharine Paddock PhD




View all articles written by Catharine, or follow Catharine on:




Copyright: Medical News Today

Not to be reproduced without the permission of Medical News Today.

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.