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会经历高度侵入性的手术，包括大量失血、多次输血和暴露在大的生物材料表面积中。该项目旨在通过开发一种可快速部署的吻合系统与植入性脑室辅助装置(VAD)相结合来解决这些风险因素。它旨在为2.5公斤至15公斤的独特和高危儿童(从出生到两岁的患者)提供长期支持(6个月)。该系统将由手术前计划的手段、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异常，典型的配置将需要从脑室尖端到升主动脉的插管。手术前的CT图像将被重建，以提供胸部和血管的三维实体模型。这些模型将用于开发VAD和导管在患者体内放置的模拟。正在设计一种吻合器和插入工具，以实现快速解剖、插管和止血，理想的情况是可以通过侧开胸展开。这种插管系统的优点将是避免体外循环和随之而来的出血、血栓形成、感染和与输血相关的并发症。

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.