SUBPULMONARY SUPPORT OF FONTAN PATIENTS - FROM COMPUTER SIMULATION TO CLINICAL APPLICATION

Objectives: A novel venous cannula (VC) was designed as an additional component of the EXCOR-VAD™ (Berlin Heart) to improve sub-pulmonary hemodynamics as a bridge to transplant of patients suffering a failure of their subpulmonary Fontan-circulation. After clinical implementation, the need for an ad...

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Bibliographic Details
Published in:International journal of artificial organs 2023-07, Vol.46 (7), p.407
Main Authors: Minol, J, Scheithauer, J, Brockmann, H, Sander, I, Meißner, M, Robbenmenke, C, Schöndorf, T, Medart, D, Hansen, S, Menon, A K
Format: Article
Language:English
Subjects:
Blood circulation
Body weight
Cannulae
Cannulation
Computer simulation
Heart surgery
Heart transplantation
Hemodynamics
Optimization
Simulation
Three dimensional models
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Summary:Objectives: A novel venous cannula (VC) was designed as an additional component of the EXCOR-VAD™ (Berlin Heart) to improve sub-pulmonary hemodynamics as a bridge to transplant of patients suffering a failure of their subpulmonary Fontan-circulation. After clinical implementation, the need for an adjustment of the VC to address a larger number of smaller patients became obvious. We like here to describe the crucial part of different techniques of computer simulation in this process. Methods: After having interviewed several experts, their suggestions regarding an adjustment of the VC-shape for smaller patients were summarized by a computed model. In a three-dimensional simulation, its morphological compatibility with the anatomy of small patients (Body Surface Area: < 0.6 m2; Body Weight: < 15kg) was examined by a virtual fitting. The resultant model was subjected to a hemodynamic flow-simulation to assure proper function. Results: The virtual fitting revealed an optimal adjustment of the VC to smaller patients not only by a true-to-scale minimization of the former model, but also by the reduction of shape as crucial step. The hemodynamic flow-simulation demanded only a minimal modification. Conclusions: We achieved by this computer-simulated workflow a suitable approach for a new design of a VAD-cannula that allows optimal results in size, shape and function in the very specific issue of small patients suffering a failure of their subpulmonary Fontan-circulation.
ISSN:0391-3988
1724-6040