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侵入性手术，包括大量失血，多次输血和暴露于大面积生物材料表面。该项目旨在通过开发一种可快速部署的吻合系统，结合可植入式心室辅助装置（VAD）来解决这些风险因素。它适用于2.5公斤至15公斤儿童（从出生到两岁的患者）的独特和高风险人群的慢性支持（6个月）。该系统将由术前计划、快速吻合接头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心室顶点到升主动脉插管。术前CT图像将重建，以提供一个三维实体模型的胸部和血管系统。这些模型将用于模拟VAD和套管在患者体内的放置。正在设计一种吻合装置和插入工具，以实现快速剥离、插管和止血，理想情况下可通过侧开胸术展开。这种插管系统的优点是可以避免体外循环以及随之而来的出血、血栓形成、感染和输血并发症。

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.