The Cleveland Clinic PediPump: virtual fitting studies in children using three-dimensional reconstructions of cardiac computed tomography scans.

The fitting of implantable ventricular assist devices (VADs) is a particular challenge for pediatric patients and patients with small body surface area. The purpose of this study was to determine optimal placement of the PediPump, a pediatric VAD currently under development at the Cleveland Clinic, using virtual three-dimensional (3D) on-screen models. Digital models were created from computed tomographic datasets of pediatric hearts using commercially available 3D image processing software. Pixels representing the myocardium, great vessels, sternum, and rib cage were selected and rendered as on-screen models (n = 13) from pediatric patients with or without congenital heart disease (median age 42 months; range 2 days to 13 years 11 months). Using 3D model manipulation software, virtual models of the PediPump (70 x 10 mm) were combined on-screen with the anatomic models. A variety of virtual fitting options were created, which allowed easy detection of device interference with surrounding tissues. Generation of 3D on-screen models of cardiac structures in relation to PediPump placement has provided useful preliminary fitting information, which is being used to guide further development of this device.