Laser-Printed Air Tube Saves Baby’s Life

A baby boy can now breathe easy thanks to a 3-D-printed tracheal splint implant developed at the University of Michigan.

Kaiba Gionfriddo was born with a defect that caused his airway to collapse, blocking crucial air supply to his lungs. About 1 in 2200 babies is born with tracheobronchomalacia each year; in most cases, the defect corrects itself by the time a child is 2 or 3 years old. But in severe cases, like Kaiba’s, the defect can stop children from breathing.

Kaiba’s parents, April and Bryan, discovered the problem when the family was at a restaurant and the 6-week-old turned blue. After the incident, Kaiba would stop breathing on a regular basis and required resuscitation daily.

“Quite a few doctors said he had a good chance of not leaving the hospital alive,” said April Gionfriddo about her now 20-month-old son. “At that point, we were desperate. Anything that would work, we would take it and run with it.”

They found hope at the University of Michigan, where a bioresorbable device that could help Kaiba was under development. Kaiba’s doctors in Ohio contacted Dr. Glenn Green, associate professor of pediatric otolaryngology.

Doctors at the University of Michigan bioprinted this splint, custom-designed for Kaiba Giofriddo's trachea. It fits around the outside and supports the windpipe. Images courtesy of The University of Michigan.

“Even with the best treatments available, he continued to have these episodes. He was imminently going to die,” Green said. “The physician treating him in Ohio knew there was no other option, other than our device in development here.”

Green and his colleague, Dr. Scott Hollister, professor of biomedical and mechanical engineering and associate professor of surgery, went into action, obtaining emergency clearance from the FDA to create and implant a tracheal splint made of a biopolymer called polycaprolactone.

On Feb. 9, 2012, at C.S. Mott Children’s Hospital, the custom-designed splint was sewn around Kaiba’s airway to expand the bronchus and give it a skeleton to aid proper growth. Over about three years, the splint will be reabsorbed by the body.

“It was amazing,” Green said. “As soon as the splint was put in, the lungs started going up and down for the first time, and we knew he was going to be OK.”

“The material we used is a nice choice for this,” Hollister said. “It takes about two to three years for the trachea to remodel and grow into a healthy state, and that’s about how long this material will take to dissolve into the body.”

Using high-resolution imaging and CAD, Green and Hollister made the custom-fabricated device directly from a CT scan of Kaiba’s trachea/bronchus, integrating the image-based computer model with laser-based 3-D printing to produce the splint.

The splint, shown here, was created using a 3-D printer. The bioresorbable device was sewn around Kaiba’s airway to expand the bronchus and give it a skeleton to aid proper growth.

Kaiba was taken off ventilator support three weeks after the procedure and has not had breathing trouble since.

“He has not had another episode of turning blue,” April said. “We are so thankful that something could be done for him. It means the world to us.”

The image-based design and 3-D biomaterial printing process can also be adapted to build and reconstruct other tissue structures, the investigators said. They have utilized the process to build and test patient-specific ear, nose and bone (spine, craniofacial and long bone) structures in preclinical models.

The research appeared in the New England Journal of Medicine (doi: 10.1056/NEJMc1206319).

For more information, visit: www.umich.edu