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Karen J. Dickinson, MBBS, BS, Jane Matsumoto, MD, Stephen D

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1 Individualizing Management of Complex Esophageal Pathology Using Three- Dimensional Printed Models 
Karen J. Dickinson, MBBS, BS, Jane Matsumoto, MD, Stephen D. Cassivi, MD, MS, J. Matthew Reinersman, MD, Joel G. Fletcher, MD, Jonathan Morris, MD, Louis M. Wong Kee Song, MD, Shanda H. Blackmon, MD, MPH  The Annals of Thoracic Surgery  Volume 100, Issue 2, Pages (August 2015) DOI: /j.athoracsur Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Constructing a three-dimensional (3D) printed model. (A) The segmented data from the computed tomographic scan is converted into a virtual 3D anatomic model. (B) After data conversion to a STereoLithography file format the model is printed with surrounding support material. (C) The support material is washed off. (D) This leaves the final 3D printed anatomic model. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) In a patient after a left pneumonectomy, aortic bypass, and esophageal diversion, three-dimensional modeling enabled delineation between vascular structures and the air- and contrast-filled distended distal esophagus. (B) From computed tomographic data, the spine and ribs, esophagus and fistulous tract, spit fistula, stomach, aorta, aortic graft, trachea, veins, and diaphragmatic crus were segmented and color-coded. (C) This was converted into a virtual model using a STereoLithography file and (D) a life-size model was printed. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 (A) In a patient with multiple esophageal diverticula a three-dimensional model was created using our novel positive oral contrast and air technique to delineate the esophagus. (B) The imaging data were segmented to highlight and color code the esophagus, stomach, diaphragmatic crus, aorta, and spine. (C) A virtual model was created and converted into a STereoLithography file, from which a multi-material, multi-colored model was printed (D). The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Using the anatomic model in the operating room.
The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions


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