A Study Implementing Models for Mechanical Circulatory Support Presurgical Assessment in Congenital Heart Disease Treatment (IMMPACT)

Abstract Kanwal M. Farooqi, MD is an Assistant Professor of Pediatrics in the Division of Pediatric Cardiology at Columbia University Irving Medical Center. Her long term goal is to create a shift in what is considered standard of care in advanced imaging for patients with complex congenital heart disease (CHD). Specifically, she aims to demonstrate the utility and need for inclusion of personalized 3D printed models for pre-procedural planning in patients with complex cardiac abnormalities. To that end, she will be focusing on patients with CHD and heart failure (HF). Ventricular assist devices (VAD) in patients with CHD and HF remain underutilized, in part due to the highly variable cardiac anatomy and complex physiology. This disparity exists despite outcomes following VAD placement having been shown to be similar in patients with and without CHD. Imaging technologies such as computed tomography (CT) or magnetic resonance imaging (MRI) are limiting in that they demonstrate cardiac anatomy in 2D planes. 3D printed models allow the surgeon to visualize the cardiac anatomy in 3D as they will see it in the operating room. This is a prospective multicenter randomized control trial assessing the utility of preoperative use of 3D printed personalized models use for VAD and cannula placement planning. The aims of this study are: 1) To assess if 3D printed cardiac models improve visualization of VAD and cannula placement sites in CHD-HF patients as compared to 2D imaging. 2) To determine if perioperative factors and patient outcomes improve in CHD-HF patients with use of 3D printed model in VAD placement planning. These aims will be accomplished through implementation of surgical survey tools and collection of clinical data to assess improvement in outcomes. Surgeons will report on survey tools, the ease with which important surgical landmarks such as cannula sites are visualized on routine modes of imaging as compared to a 3D printed model. Clinical data will be compared between the model and control group to assess improvement in clinical variables such as cardiopulmonary bypass time and VAD flows. CUIMC is the primary site for this study with Dr. Farooqi as the primary investigator. Dr. Farooqi’s career development plan consists of the following learning modules and training goals: 1) Training in patient oriented research methods and multicenter study conduction 2) Surgical survey design and implementation 3) Image acquisition and model creation methods 4) Research dissemination and career Development. The co-mentoring and advisory team which she has organized will help her to acquire these skills and successfully complete her learning goals through this award. Through completion of this study, Dr. Farooqi aims to demonstrate the significance of 3D printed in pre-procedural planning for patients with complex CHD. This will lead to an independent NIH proposal aiming to demonstrate the importance of incorporation of these models across a wider range of congenital heart lesions and procedures, changing the way we think of standard of care for advanced image modality inclusion in the care of patients with complex CHD.