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In cases where surgical repair is insufficient to return the heart to normal function, a patient may proceed to advanced heart failure, and a heart transplant may be required. Unfortunately, a finite number of available donor hearts are available. A mechanical circulatory support (MCS) device can be used to bridge the time between heart failure and reception of a donor heart. These MCS devices are typically constructed for the adult population. Accordingly, the size associated to the device is a limiting factor for small adults or pediatric patients who often have smaller thoracic measurements. While current eligibility criteria are based on correlative measurements, the aforementioned 3D visualization capabilities can be leveraged to accomplish patient-specific fit analysis.
The main objectives of the work presented in this dissertation were 1) to develop and evaluate an optimized process for 3D printing cardiovascular anatomy for surgical planning and medical education and 2) to develop and evaluate computational tools to assess MCS device fit in specific patients. The evaluations for objectives 1 and 2 were completed with a collection of qualitative and quantitative validations. These validations include case studies to illustrate meaningful, qualitative results as well as quantitative results from surgical outcomes. The latter results present the first quantitative supporting evidence, beyond anecdotal case studies, regarding the efficacy of 3D printing for pre-procedural planning; this data is suitable as pilot data for clinical trials. The products of this work were used to plan 200 cardiovascular procedures (including 79 cardiothoracic surgeries at Phoenix Children's Hospital), via 3D printed heart models and assess MCS device fit in 29 patients across 6 countries.
The purpose of this study is to collect baseline internal and external pressure data for the three most commonly used pelvic circumferential compression devices (PCCD). Unstable pelvic fractures as a result of automobile accidents, falls, and other traumatic injuries mortality rate [3]. Early use of pelvic circumferential compression devices can mitigate fatal outcomes [4]-[5]. Prolonged eternal pressure above 9.3kPa can result in long-term soft tissue damage and pressure ulcers [7]. This study hypothesizes that the application of the three most commonly used PCCDs would result in the same mean maximum point pressure exertion. To study this, internal and external, both analog and digital, pressure apparati were used to collect data. The results of this data collection demonstrate a discrepancy in the pressure distribution between right and left greater trochanters within each PCCD. Additionally, the results suggest there is an effect of internal packing on the pressure exertion externally at the two greater trochanters within each PCCD. Lastly, the differences in pressure exertion between each PCCD, internally and externally, were inconclusive as some compared metrics resulted in statistically significant results while others did not. The methodologies employed in this study can be improved through fixation of pressure collection instruments, utilization of digital pressure mats, and removal of confounding factors. The results of this study indicate that digitized, discrete data over a fixed time interval may be clinically useful, suggesting that a digital data collection would yield more reliable data. Additionally, internally mounted pressure sensor data will provide more precise results than the analog method employed herein, as well as provide insight towards bone reduction and displacement following the application of PCCDs. Finally, the information gathered from this study can be utilized to improve upon existing technologies to create a more innovative solution.
The purpose of this study is to collect baseline internal and external pressure data for the three most commonly used pelvic circumferential compression devices (PCCD). Unstable pelvic fractures as a result of automobile accidents, falls, and other traumatic injuries mortality rate [3]. Early use of pelvic circumferential compression devices can mitigate fatal outcomes [4]-[5]. Prolonged eternal pressure above 9.3kPa can result in long-term soft tissue damage and pressure ulcers [7]. This study hypothesizes that the application of the three most commonly used PCCDs would result in the same mean maximum point pressure exertion. To study this, internal and external, both analog and digital, pressure apparati were used to collect data. The results of this data collection demonstrate a discrepancy in the pressure distribution between right and left greater trochanters within each PCCD. Additionally, the results suggest there is an effect of internal packing on the pressure exertion externally at the two greater trochanters within each PCCD. Lastly, the differences in pressure exertion between each PCCD, internally and externally, were inconclusive as some compared metrics resulted in statistically significant results while others did not. The methodologies employed in this study can be improved through fixation of pressure collection instruments, utilization of digital pressure mats, and removal of confounding factors. The results of this study indicate that digitized, discrete data over a fixed time interval may be clinically useful, suggesting that a digital data collection would yield more reliable data. Additionally, internally mounted pressure sensor data will provide more precise results than the analog method employed herein, as well as provide insight towards bone reduction and displacement following the application of PCCDs. Finally, the information gathered from this study can be utilized to improve upon existing technologies to create a more innovative solution.