The development of a remotely expandable anastomosis device for use in paediatric cardiothoracic surgery

Student thesis: Doctoral Thesis

Abstract

Congenital Heart Disease (CHD) is one of the main causes of infant mortality in the UK and United States. In 2011, 47% of infants born with CHD in the UK did not survive to their first birthday. Often forms of CHD require the implantation of conduits (tubes) to redirect the blood flow around the reconstructed anatomy in the early days of life. In all cases, these children will require review surgery, often several times to replace the implanted conduit as the child grows. Critically every review procedure carries with it an increased mortality risk.This project represents the first stage in the development of a conduit/ anastomosis technology, which will grow in response to the growing child, matching haemodynamic demand and eliminating the need for revision surgery.Two prototypes were designed and developed. Each using an active drive mechanism to expand a stainless steel expansion strip with the slow and controlled movement required for such an application. Each of the designs were silicone coated using custom designed injection moulding techniques ensuring biocompatibility. Power and control systems were designed for each iteration taking into account their expansion methods to achieve the desired expansion rate of 12mm to 20mm in diameter of the implantation period.Three consecutive implantation studies were carried out throughout the device's development. In the first study, the device was implanted into the right ventricle of a cadaveric pig to determine any potential impediments that would need to be addressed for implantation into live animal models. The second implantation was carried out on 6 piglets, successfully establishing CPB proceduresThe third implantation was successfully carried out on 3 piglets, 2 of which survived the duration of the testing, confirming a successful encapsulation method to ensure biocompatibility, however it appeared the device failed to expand due to power line breakdown.
Date of Award1 Oct 2014
LanguageEnglish
Awarding Institution
  • University Of Strathclyde
SupervisorTerry Gourlay (Supervisor) & (Supervisor)

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