A 53-year-old woman had been turned down by several hospitals in Germany and beyond due to the complexity of her health issue—she had a large aortic malformation close to her heart and was suffering from a bulging blood vessel on her neck. She finally approached Prof. Dr. Dorweiler, Head of the Department of Vascular Surgery at University Hospital Mainz, Cardiothoracic and Vascular Surgery Department, for help. Due to his experience with 3D printing to model similar surgeries, Dr. Dorweiler thought he and his team could handle the complex procedure.
Surgeons at the University of Mainz Cardiothoracic and Vascular Surgery Department have been using a Stratasys Polyjet 3D printer to transform the hospital’s surgical planning process for life-critical vascular cases.
According to the University hospital, the use of 3D printed models for surgical planning has resulted in a significant reduction in costs when designing and fitting implants, and saving time during surgery, leading to an overall improvement in patient outcomes.
As an internationally recognized Center of Excellence for Cardiothoracic and Vascular Surgery, the University Hospital Mainz provides research and patient care in areas related to the heart, thorax and blood vessels in the human body. The hospital treats patients suffering from life-threatening aortic illnesses needing immediate attention and patient-specific surgical treatment.
“On average, each vascular-related patient case can have 1000-2000 CT scans, which the surgeons use to analyze and diagnose an illness. This can be ambiguous and time-consuming when the issue is complex,” says Prof. Dr. Dorweiler.
“Looking through the CT Scans, it was impossible to clearly visualize the anatomy,” says Prof. Dr. Dorweiler. “So we decided to 3D print a model, and it was then for the first time that it became clear what the origin and magnitude of the problem was. Not only did we use the model to explain our findings to the patient to increase her compliance for the planned 3-step operation, but we even took it into each of the three surgeries as a point of reference during operation, which was crucial to the successful outcome.”
To date, treatment of complex aortic illnesses with the endovascular method has been a difficult procedure. Surgeons rely on a monitor to implant a small wire-mesh tube (stent) through the arteries to be placed at the affected area of the aorta. In a separate recent case, Prof. Dr. Dorweiler and his team faced this challenge with a complex case of aortic arch aneurysm. Requiring an intricate implant, the team undertook a pre-operative simulation of the surgery using a stent prototype and 3D printed aortic arch model of the patient.
The practice on the 3D printed model enabled the surgeons to ensure the correct design and fit of the stent implant the first time – significantly reducing time and cost in the operating theatre.
“As pointed out in current published studies, there are savings in operating time of 5-45 minutes when using 3D printed models prior to surgery,” says Prof. Dr. Dorweiler. “Research is still ongoing, but if you take an average surgery time of 2-4 hours, you are looking at time savings of up to 40%. When you are dealing with complex vascular cases every day, these time-savings can be the difference between life and death.”
Training future vascular surgeons for success
At the forefront of German medical research and development, the Vascular Surgery Department at the University Hospital Mainz has an extensive training facility, in which 3D printing is integral.
“We use the Stratasys Eden260VS 3D Printer in our BiomaTicS research platform to produce models of aortic anatomies from real-life cases, so that we can use them to teach future vascular surgeons how to successfully perform complex endovascular surgeries,” says Prof. Dr. Dorweiler. “With 3D printed patient-specific aortic models in clear transparent material, the trainees can practice endovascular procedures and learn difficult Wire-Skills using the accurate replicas of blood vessels. For healthcare, it is crucial that we continue to leverage the capabilities of 3D printing for medical training, education and research for future breakthrough-implementation.”
Rene Martin, Business Manager Healthcare EMEA, Stratasys, concludes: “The pioneering use of 3D printing witnessed today underpins why the University Hospital Mainz is at the forefront of German medical research and development. Leveraging high resolution 3D printing, the ability to replicate patient-specific anatomy is enabling physicians and surgeons to quickly plan, practice and determine life-saving surgical approaches – not only to improve patient care and outcomes, but also mitigate risk and reduce costs.”