Friday, May 24th, 2013
The happy little guy above is Kaiba Gionfriddo, 19 months old, having fun with every breath he takes, but if a brilliant medical team had not placed a 3D-printed plastic splint onto his bronchial airway to hold it open, it’s unlikely he would be alive today.
Kaiba was born with a rare condition called tracheobronchomalacia, which causes the airways to be weak and prone to collapse. Additionally, some of the arteries around his heart were malformed; encircling the trachea tightly enough to compress the airway.
Sadly, most parents only become aware of this when their child suddenly stops breathing and dies. Baby Kaiba stopped breathing and turned blue in a restaurant when he was six weeks old. His father, Bryan Gionfriddo, used CPR to revive him, but the episodes continued and Kaiba was put on a breathing machine when he was two months old. Despite the best treatments available, it was virtually certain that he would die soon.
Kaiba’s doctor in Youngstown, Ohio had learned that doctors at the University of Michigan were developing a solution for this problem and contacted them. The UM doctors’ solution was to put a tubular device around the trachea that would hold it open. The tube/scaffold/splint has small holes the surgeon can use to suture it in place.
Since this would be the first time the device was used on a human, the doctors requested and received special permission to proceed from their school’s advisory board and the U.S. Food & Drug Administration (FDA).
The medical team made a model of Kaiba’s trachea and, using a program they developed, designed the tubular scaffold. The bioplastic material they used to build the scaffold on their 3D bioprinter is called polycaprolactone (PCL), a polymer approved by the FDA to fill small holes in the skull. The bioprinter melts the powder material and then builds the designed shape layer by micro-thin layer. The doctors made many of them in different sizes.
In February of 2012 the U. of Michigan surgical team carefully rearranged Kaiba’s twisted heart arteries and trachea, and then carefully placed the splint. And as soon as the splint was put in, the little lungs began moving up and down for the first time. The doctors say that in three years the material will be completely reabsorbed and excreted by the body, and the airways will be able to function on their own.
Kaiba went home three weeks after the surgery and has not had a breathing crisis since. His parents say he is learning how to get around and is being spoiled by his 6-year-old brother and 11-year-old sister.
The new procedure using the splint made by 3D printing plastic material was made public this week by the medical team at the C.S. Mott Children’s Hospital of the University of Michigan in Ann Arbor, MI via an article in the New England Journal of Medicine. There is now hope for children born with this rare condition, where previously there was virtually none.
Polycaprolactone is a biodegradable polyester material, and the PCL used in 3D printing — also known as additive manufacturing (AM) — is a special grade of the material. Probably the most common use of PCL is in the manufacturing of polyurethane materials, where it helps achieve good water, oil, solvent, and chlorine resistance. It is also added to other resins to improve their processing and certain end-product properties, for example impact resistance.