Noecker Angela M, Cingoz Faruk, Ootaki Yoshio, Liu Jenny, Kuzmiak Stacie, Kopcak Mike W, Fukamachi Kiyotaka, Duncan Brian W
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
ASAIO J. 2007 Nov-Dec;53(6):716-9. doi: 10.1097/MAT.0b013e31805fe98b.
Implantation of ventricular assist devices (VADs) is challenging in small patients with limited space in the chest. We created three-dimensional models of lambs to facilitate fitting of the PediPump, a pediatric VAD currently under development. Serial computed tomography (CT) scans were acquired at multiple time points (n = 8) for three lambs. Digital models were created using these CT datasets and three-dimensional image processing software (Mimics, Materialise). Pixels representing the heart and chest wall were rendered as three-dimensional models. Using three-dimensional model manipulation software (Magics RP, Materialise), on-screen models of extravascular and intravascular VADs were placed in right, left and biventricular support configurations to determine optimal placement. A cannulation strategy was established and in some cases three-dimensional models of the inflow and outflow grafts were created. After the final CT study, an open-chest fitting study was performed using rapid prototype models of the pediatric VAD and cannulas. The pump location and orientation predictions from the virtual fitting studies matched those determined at the time of the open-chest fitting studies. Using three-dimensional modeling, we have established a fitting protocol that facilitates animal implantations; the same modeling techniques may be useful for device fitting in humans.
对于胸腔空间有限的小患者而言，植入心室辅助装置（VAD）颇具挑战性。我们构建了羔羊的三维模型，以助力一款目前正在研发的儿科VAD——儿童泵（PediPump）的适配。对三只羔羊在多个时间点（n = 8）进行了系列计算机断层扫描（CT）。利用这些CT数据集和三维图像处理软件（Mimics，Materialise公司）创建了数字模型。将代表心脏和胸壁的像素渲染为三维模型。使用三维模型操作软件（Magics RP，Materialise公司），将血管外和血管内VAD的屏幕模型以右心室、左心室和双心室支持配置放置，以确定最佳放置位置。制定了插管策略，在某些情况下还创建了流入和流出移植物的三维模型。在最后一次CT研究后，使用儿科VAD和插管的快速原型模型进行了开胸适配研究。虚拟适配研究中对泵的位置和方向预测与开胸适配研究时确定的结果相符。通过三维建模，我们建立了一种有助于动物植入的适配方案；相同的建模技术可能对人体装置适配也有用。
