Simulation of Optimal Surgical Insertion of Pediatric Ventricular Assist Device

描述（由申请人提供）：需要循环支持的幼儿通常接受高度侵入性手术，涉及大量失血、多次输血和暴露于大的生物材料表面积。本项目旨在通过开发一种可快速展开的吻合系统与植入式心室辅助装置（VAD）结合来解决这些风险因素。其预期用于2.5 kg至15 kg之间的特殊高危儿童人群（从出生到两岁的患者）的长期支持（6个月）。该系统将由术前计划工具、快速吻合连接器和微创手术插入工具组成。该系统将适应各种解剖学异常，并且典型配置将需要从心室尖到升主动脉的插管。将重建术前CT图像，以提供胸部和血管系统的三维实体模型。这些模型将用于开发VAD和插管在患者体内放置的模拟。设计了一种吻合器械和插入工具，可实现快速分离、插管和止血，理想情况下可通过侧胸切开术展开。这种插管系统的优点是避免了心肺转流和伴随的出血、血栓形成、感染和输血相关并发症。

DESCRIPTION (provided by applicant): Young children who require circulatory support typically undergo a highly invasive procedure involving great loss of blood, multiple transfusions, and exposure to large biomaterial surface area. This project aims to address these risk factors by developing a rapidly-deployable anastomosis system in conjunction with an implantable ventricular assist device (VAD). It is intended for chronic support (6 months) of a unique and high-risk population of children between 2.5kg and 15kg (patients from birth to two years of age). The system will be comprised of a means for pre-surgical planning, a rapid anastomosis connector, and a minimally-invasive surgical insertion tool. The system will accommodate various anatomic anomalies, and the typical configuration will entail cannulation from the ventricular apex to the ascending aorta. Preoperative CT images will be reconstructed to provide a three-dimensional solid model of the thorax and vasculature. These models will be used in the development of simulations for the placement of the VAD and cannulae in patients. An anastomosis device and insertion tool is being designed to enable rapid dissection, cannulation, and hemostasis, ideally deployable though a lateral thoracotomy. The advantages of this cannulation system will be to obviate cardiopulmonary bypass and attendant complications of bleeding, thrombosis, infection and complications associated with transfusion.