A5076051189- Congenital Heart Disease Studies
- Cardiac Arrhythmias and Treatments
- Cardiac pacing and defibrillation studies
- Aortic Disease and Treatment Approaches
- Mechanical Circulatory Support Devices
- Cardiac Structural Anomalies and Repair
- Cardiac and Coronary Surgery Techniques
- Electrospun Nanofibers in Biomedical Applications
- Pulmonary Hypertension Research and Treatments
- Tissue Engineering and Regenerative Medicine
- Surgical Simulation and Training
- Cardiac Valve Diseases and Treatments
- Cardiovascular Function and Risk Factors
- Aortic aneurysm repair treatments
- Atrial Fibrillation Management and Outcomes
- Cardiovascular Issues in Pregnancy
- Anatomy and Medical Technology
- Renal and Vascular Pathologies
- Infectious Aortic and Vascular Conditions
- Advanced Multi-Objective Optimization Algorithms
- Cardiac Arrest and Resuscitation
- Simulation-Based Education in Healthcare
- Optimal Experimental Design Methods
- Cardiovascular Syncope and Autonomic Disorders
- Micro and Nano Robotics
Children's National
2019-2024
George Washington University Hospital
2022
George Washington University
2022
Institute for Learning Innovation
2019-2020
Background The complex 3-dimensional (3D) nature of anatomical abnormalities in congenital heart disease (CHD) necessitates multidisciplinary group discussions centered around the review medical images such as magnetic resonance imaging. Currently, viewings are constrained to 2-dimensional (2D) cross-sectional displays 3D scans. However, 2D display methods could introduce additional challenges since they require physicians accurately reconstruct mentally into anatomies for diagnosis,...
Abstract Background Pacemaker implantation in infants and small children is limited to epicardial lead placement via open chest surgery. We propose a minimally invasive solution using novel percutaneous access kit. Objective To evaluate the acute safety feasibility of pericardial tool kit implant pacemaker leads on epicardium under direct visualization. Methods A custom sheath with optical fiber lining inside wall was built provide intrathoracic illumination. Veress needle illumination...
Pericardial access is necessary for the application of epicardial cardiac therapies including ablation catheters, pacing and defibrillation leads, left atrial appendage closure systems. under fluoroscopic guidance difficult in patients without pericardial effusions may result coronary artery damage, ventricular injury, or perforation with potentially life-threatening bleeding up to 10% cases. There a clinical need technique safely deliver therapies.In this paper, we describe design...
This paper proposes a computational framework for automatically optimizing the shapes of patient-specific tissue engineered vascular grafts. We demonstrate proof-of-concept design optimization aortic coarctation repair. The consists three main components including 1) free-form deformation technique exploring graft geometries, 2) high-fidelity fluid dynamics simulations collecting data on effects parameters objective function values like energy loss, and 3) employing machine learning methods...
Patients with single ventricle heart defects receive 3 stages of operations culminating in the Fontan procedure. During procedure, a vascular graft is sutured between inferior vena cava and pulmonary artery to divert deoxygenated blood flow lungs via passive flow. Customizing configuration can maximize long-term benefits. However, planning patient-specific procedures has several challenges, including ability for physicians customize grafts evaluate their hemodynamic performance.The aim this...
Postoperative outcomes of the Fontan operation have been linked to geometry cavopulmonary pathway, including graft shape after implantation. Computational fluid dynamics (CFD) simulations are used explore different surgical options. The objective this study is perform a systematic
Fontan surgical planning involves designing grafts to perform optimized hemodynamic performance for the patient's long-term health benefit. The uncertainty of post-operative boundary conditions (BC) and graft anastomosis displacements can significantly affect designs lead undesirable outcomes, especially hepatic flow distribution (HFD). We aim develop a computation framework automatically optimize patient-specific with maximized possibility keeping results within clinical acceptable...
This paper proposes a semi-automatic Fontan surgery planning method for designing and manufacturing hemodynamically optimized patient-specific grafts. is palliative procedure patients with single ventricle heart defect by creating new path using vascular graft the deoxygenated blood to be directed lungs, bypassing heart. However, grafts hemodynamic performance complex task due variety of anatomies, confined surgical space, requirement simultaneously considering multiple design criteria...
Coarctation of the aorta (CoA) is associated with decreased exercise capacity despite successful repair. Altered flow patterns have been identified due to abnormal aortic arch geometry. Our previous work demonstrated size mismatch be intolerance in this population. In study, we studied during simulations repaired CoA using 4D cardiovascular magnetic resonance (CMR) replicas connected an vitro pump and correlated findings stress test results identify biomarkers intolerance. Patients repair...
The current total cavopulmonary connection Fontan has competing inflows and outflows, creating hemodynamic inefficiencies that contribute to failure complicate placement efficiency of mechanical circulatory support. We propose a novel convergent (CCPC) design create single, converged venous outflow the pulmonary arteries, thus increasing support access. then evaluate feasibility performance CCPC in various patient sizes using computational fluid dynamic assessments computer-aided...
The complexity of aortic arch reconstruction due to diverse 3-dimensional geometrical abnormalities is a major challenge. This study introduces printed tissue-engineered vascular grafts, which can fit patient-specific dimensions, optimize hemodynamics, exhibit antithrombotic and anti-infective properties, accommodate growth.
Purpose: In transposition of great arteries, increased right ventricular (RV) afterload is observed following arterial switch operation (ASO), which not always related to pulmonary artery (PA) stenosis. We hypothesize that abnormal PA bending from the Lecompte maneuver may affect RV in absence Thus, we sought identify novel measurements three-dimensional cardiac magnetic resonance (CMR) images arteries and compare with conventional their ability predict afterload. Methods: Conventional were...
Abstract Introduction Pacemaker implantation in infants typically consists of surgical epicardial lead placement with an abdominal generator. Here, we describe the chronic performance our minimally invasive prototype miniature pacemaker implanted under direct visualization immature porcine model. Methods Twelve piglets underwent implantation. A self‐anchoring two‐channel access port was inserted into a 1 cm incision subxiphoid space, and thoracoscope main channel to visualize thoracic cavity...
Cardiac procedures in infants and children require a high level of skill dexterity owing to small stature anatomy. Lower incidence procedure volume this population results fewer clinical opportunities for learning. Simulators have grown popularity education training, though most existing simulators are often cost-prohibitive or model adult anatomy.Develop low-cost simulator practicing the skills perform percutaneous pericardial access cardiac ablation pediatric patients.We describe 2...
Soft robots have emerged as powerful alternatives to their rigid counterparts due inherent advantages including safety for humanrobot interactions and adaptability manipulating delicate objects.Despite recent developments macroscale multi-actuator soft robots, manufacturing challenges impeded the miniaturization of such systems difficulties in facilitating macro-to-micro fluidic connections required controlling with actuation schemes.To bypass these barriers, here we introduce a novel "ex...
<b><i>Introduction:</i></b> Early detection and monitoring for malignant arrhythmias is fundamental to prenatal care in long QT syndrome (LQTS). Recently, we studied the feasibility of isolating fetal electrocardiogram (fECG) measuring electrocardiographic intervals with a noninvasive fECG device using blind source separation reference signal. Our aim was evaluate ability diagnose LQTS. <b><i>Case Presentations:</i></b> We identified 3 cases...
This paper proposes a novel method to noninvasively measure the peak systolic pressure difference (PSPD) across coarctation of aorta for diagnosing severity coarctation. Traditional non-invasive estimates drop from ultrasound can underestimate and invasive measurements by cardiac catheterization carry risks patients. To address issues, we employ computational fluid dynamics (CFD) computation accurately predict PSPD based on magnetic resonance (CMR) imaging data cuff one arm. The boundary...
Pericardial adhesions in infants and small children following cardiac surgery can impede access to the epicardium. We previously described minimally invasive epicardial lead placement under direct visualization an infant porcine model using a single subxiphoid incision. The objective of this study was assess acute feasibility approach presence postoperative pericardial adhesions.Adhesion group piglets underwent left thoracotomy with pericardiotomy followed by recovery period develop...