33rd Annual Scientific Meeting proceedings

Portosystemic shunt (PSS) is a vascular anomaly of the liver which provides direct communication between the portal venous supply and the systemic circulation, bypassing the liver. This results in a variety of life-threatening biochemical and clinical abnormalities. Congenital PSS most commonly occurs as a single extrahepatic (EHPSS) or intrahepatic (IHPSS) abnormality. EHPSS can be usually visualized by diagnostic imaging and during laparotomy performed in order to attenuate the shunt. In contrast, surgical identification of an intrahepatic shunting vessel can be problematic.

This report of 3 cases describes the application of 3D technology in order to obtain a printed liver model before the surgical treatment of dogs with IHPSS.Three client-owned dogs with IHPSS diagnosed using CT angiography were included in this study. Through 3D volume and surface rendering, the vascular anomaly of each dog was identified in detail. Then, a patient-specific 3D liver model was printed and used for both preoperative planning, and intraoperative identification of the shunt. The model was manufactured using fused deposition modelling (FDM) technology in the form of lobes in partial cross-section to provide better visibility of the vascular pathology. In each case, the model enabled precise localization of the intrahepatic shunting vessel, which allowed shunt attenuation using an ameroid constrictor in one dog, and cellophane banding in 2 remaining patients. All three dogs recovered uneventfully.

In conclusion, 3D printing technology is a very helpful tool to facilitate learning and surgical planning for dogs with IHPSS.