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Patient-Specific Patch for an Intra-Atrial Rerouting Procedure Developed Through Surgical Simulation.
Yuki Nakamura1, Charles Romans2, Ravi Ashwath3
1Division of Pediatric Cardiothoracic Surgery, 21782The University of Iowa, Iowa, IA, USA.
World Journal for Pediatric & Congenital Heart Surgery
|March 8, 2021
Summary
This study explored 3D modeling for custom cardiac patches in pediatric surgery. While geometric morphometrics showed similar patch shapes, computational fluid dynamics revealed significant differences in blood flow efficiency, highlighting design variability.
Area of Science:
- Biomedical Engineering
- Pediatric Cardiology
- Computational Fluid Dynamics
Background:
- 3D modeling for custom prostheses in pediatric cardiac surgery is limited.
- Surgeons currently rely on intraoperative estimation for complex 3D structures from 2D materials.
- Surface modeling techniques from other industries offer potential but may introduce intradesigner variability.
Purpose of the Study:
- To develop and evaluate patient-specific 3D patches for intra-atrial rerouting (IAR) procedures in pediatric cardiac surgery using surface modeling.
- To compare the geometric and hemodynamic properties of two 3D patches created using different surface modeling approaches.
- To assess the feasibility and challenges of using 3D modeling for custom patch creation in pediatric cardiac surgery.
Main Methods:
- A patient-specific 3D heart model was created from CT data of a pediatric patient with partial anomalous pulmonary venous connection.
- Two patient-specific 3D patches for IAR were designed using different surface modeling techniques through collaboration between designers and clinicians.
- Geometric morphometrics (GM) and computational fluid dynamics (CFD) were used to analyze patch shape, size, pressure drop, and energy loss.
Main Results:
- GM analysis indicated that the size and shape of the two designed patches were nearly equivalent around the systemic vein orifice.
- CFD analysis revealed that one patch resulted in approximately twice the pressure drop and flow energy loss compared to the other.
- Intradesigner variability in patch design was observed despite similar geometric outcomes.
Conclusions:
- The developed platform for creating patient-specific 3D patches for IAR using surface modeling shows promise for pediatric cardiac surgery.
- Significant hemodynamic differences can arise between patches designed with similar geometric parameters, emphasizing the importance of functional evaluation.
- Addressing intradesigner variability is crucial for optimizing custom 3D patch design in pediatric cardiac procedures.
