Virtual implantation of a novel LVAD: toward computer-assisted surgery for heart failure

BackgroundMechanical and hemodynamic factors are among the determinants of patient-device interaction and early-term and long-term outcomes in left ventricular assist device (LVAD) recipients.Material and methodsWe are currently developing computer simulation tools aimed at (1) analyze the intrathoracic and intracavitary positioning of LVADs after implantation and establish correlation with clinical outcomes; (2) assist surgeons in the choice of device and of left ventricular coring site for optimized intrathoracic placement and function; and (3) facilitate the planning of less-invasive LVAD implantation. A virtual representation of LVAD (mesh device component) was created through cone-beam computed tomography and semiautomatic segmentation. A modular framework software (CamiTK, Grenoble, France) was used to create a three-dimensional representation of patients' computed tomography (CT) scan and incorporate the mesh device component for virtual implantation.ResultsDevice reconstruction was included into a dedicated software with the purposes of virtual implantation, based on the preoperative CT scan of surgical candidates.ConclusionsWe present herein the first digital reconstruction of the novel HeartMate 3 LVAD. Virtual implantation on the basis of preoperative CT scan is feasible within a user-friendly interactive software. Future studies will be focused on correlation with clinical variables.