Simulation of Optimal Surgical Insertion of Pediatric Ventricular Assist Device

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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.