A clear understanding by the patient and family of airway pathology
caused by vascular rings can be difficult to achieve. The pathology is
three-dimensional in nature, and is a compilation of differing anatomic
structures. Patient confusion can lead to misunderstandings regarding
the nature of the operation, attendant risks, and the expected
post-operative course. In this review we describe our use of 3D printing
in the setting of circumflex aorta and double aortic arch to help guide
a child and their family through the decision for treatment of what can
be a difficult problem in both diagnosis and management. Our patient
underwent two operations. First, a thoracoscopic division of a left
ligamentum and atretic distal left aortic arch. While symptoms improved
somewhat post-operatively, moderate dysphagia and dyspnea persisted.
Based on further evaluation we concluded that the circumflex aorta was
the etiology of the ongoing symptoms, so an aortic uncrossing procedure
under circulatory arrest was recommended and performed. We used a 3D
model in the education of the patient and family prior to the second
surgery and greatly enhanced their understanding of why a repeat
operation was required to address an additional component of this
complex vascular ring. The use of 3D printing in preoperative
discussions facilitated better understanding of complex three
dimensional anatomy for the patient and patient's family. In addition,
this communication strategy helped frame expectations regarding the
post-operative course and convalescence.