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- Genre: Doctoral Dissertation
- Genre: Interactive multimedia--Philosophy.
Description
The advent of medical imaging has enabled significant advances in pre-procedural planning, allowing cardiovascular anatomy to be visualized noninvasively before a procedure. However, absolute scale and tactile information are not conveyed in traditional pre-procedural planning based on images alone. This information deficit fails to completely prepare clinicians for complex heart repair, where surgeons must consider the varied presentations of cardiac morphology and malformations. Three-dimensional (3D) visualization and 3D printing provide a mechanism to construct patient-specific, scale models of cardiovascular anatomy that surgeons and interventionalists can examine prior to a procedure. In addition, the same patient-specific models provide a valuable resource for educating future medical professionals. Instead of looking at idealized images on a computer screen or pages from medical textbooks, medical students can review a life-like model of patient anatomy.
In cases where surgical repair is insufficient to return the heart to normal function, a patient may proceed to advanced heart failure, and a heart transplant may be required. Unfortunately, a finite number of available donor hearts are available. A mechanical circulatory support (MCS) device can be used to bridge the time between heart failure and reception of a donor heart. These MCS devices are typically constructed for the adult population. Accordingly, the size associated to the device is a limiting factor for small adults or pediatric patients who often have smaller thoracic measurements. While current eligibility criteria are based on correlative measurements, the aforementioned 3D visualization capabilities can be leveraged to accomplish patient-specific fit analysis.
The main objectives of the work presented in this dissertation were 1) to develop and evaluate an optimized process for 3D printing cardiovascular anatomy for surgical planning and medical education and 2) to develop and evaluate computational tools to assess MCS device fit in specific patients. The evaluations for objectives 1 and 2 were completed with a collection of qualitative and quantitative validations. These validations include case studies to illustrate meaningful, qualitative results as well as quantitative results from surgical outcomes. The latter results present the first quantitative supporting evidence, beyond anecdotal case studies, regarding the efficacy of 3D printing for pre-procedural planning; this data is suitable as pilot data for clinical trials. The products of this work were used to plan 200 cardiovascular procedures (including 79 cardiothoracic surgeries at Phoenix Children's Hospital), via 3D printed heart models and assess MCS device fit in 29 patients across 6 countries.
In cases where surgical repair is insufficient to return the heart to normal function, a patient may proceed to advanced heart failure, and a heart transplant may be required. Unfortunately, a finite number of available donor hearts are available. A mechanical circulatory support (MCS) device can be used to bridge the time between heart failure and reception of a donor heart. These MCS devices are typically constructed for the adult population. Accordingly, the size associated to the device is a limiting factor for small adults or pediatric patients who often have smaller thoracic measurements. While current eligibility criteria are based on correlative measurements, the aforementioned 3D visualization capabilities can be leveraged to accomplish patient-specific fit analysis.
The main objectives of the work presented in this dissertation were 1) to develop and evaluate an optimized process for 3D printing cardiovascular anatomy for surgical planning and medical education and 2) to develop and evaluate computational tools to assess MCS device fit in specific patients. The evaluations for objectives 1 and 2 were completed with a collection of qualitative and quantitative validations. These validations include case studies to illustrate meaningful, qualitative results as well as quantitative results from surgical outcomes. The latter results present the first quantitative supporting evidence, beyond anecdotal case studies, regarding the efficacy of 3D printing for pre-procedural planning; this data is suitable as pilot data for clinical trials. The products of this work were used to plan 200 cardiovascular procedures (including 79 cardiothoracic surgeries at Phoenix Children's Hospital), via 3D printed heart models and assess MCS device fit in 29 patients across 6 countries.
ContributorsRyan, Justin Robert (Author) / Frakes, David (Thesis advisor) / Collins, Daniel (Committee member) / LaBelle, Jeffrey (Committee member) / Pizziconi, Vincent (Committee member) / Pophal, Stephen (Committee member) / Arizona State University (Publisher)
Created2015
Description
Wittgenstein’s claim: anytime something is seen, it is necessarily seen as something, forms the philosophical foundation of this research. I synthesize theories and philosophies from Simondon, Maturana, Varela, Wittgenstein, Pye, Sennett, and Reddy in a research process I identify as a paradigm construction project. My personal studio practice of inventing experiential media systems is a key part of this research and illustrates, with practical examples, my philosophical arguments from a range of points of observation. I see media systems as technical objects, and see technical objects as structurally determined systems, in which the structure of the system determines its organization. I identify making, the process of determining structure, as a form of structural coupling and see structural coupling as a means of knowing material. I introduce my theory of conceptual plurifunctionality as an extension to Simondon’s theory. Aspects of materiality are presented as a means of seeing material and immaterial systems, including cultural systems. I seek to answer the questions: How is structure seen as determining the organization of systems, and making seen as a process in which the resulting structures of technical objects and the maker are co-determined? How might an understanding of structure and organization be applied to the invention of contemporary experiential media systems?
ContributorsLahey, Byron (Author) / Burleson, Winslow (Thesis advisor) / Xin Wei, Sha (Committee member) / Collins, Daniel (Committee member) / Paine, Garth (Committee member) / Arizona State University (Publisher)
Created2015
Description
Human experience exists within space; it is the studio for the stories of our lives. Bounded by time, location and personal experience we assign our own meanings and feelings to them, and they become personal, symbolic places: some are unique to us, imagined places where we act out stories or dreams; most are part of the natural world.
Most spaces, though, are built or controlled by others; these constructed environments can become places where we may, or may not, like to be.
This research examined spaces and places of children's lives through the material worlds of their neighborhoods and schools, focusing on the visible environment outside of the school building. The intersection of school and community, it is a material embodiment of, and evidence toward, how a community's resources are apportioned to
important aspects of children's developmental years. These visible representations speak of that society's values and goals for the children for whom they (we) are responsible.
This examination used multiple research tools, primarily using visual approaches such as current photographs, archival images and data, descriptive census materials and maps. Historical documents, (many of which are now digitized), as well as other academic literature, local journalistic efforts and school district publications added important materials for analysis.
Findings lead to deeper understanding of ways that visible, material worlds of schools and neighborhoods -- past and present - can reflect, and direct the experiences of childhood today, and often mirror those of children past. These visual and narrative approaches contributed to understanding the importance of material evidence in revealing
inequity and class differences in ways that children, then, must &ldquodo school &rdquo
Most spaces, though, are built or controlled by others; these constructed environments can become places where we may, or may not, like to be.
This research examined spaces and places of children's lives through the material worlds of their neighborhoods and schools, focusing on the visible environment outside of the school building. The intersection of school and community, it is a material embodiment of, and evidence toward, how a community's resources are apportioned to
important aspects of children's developmental years. These visible representations speak of that society's values and goals for the children for whom they (we) are responsible.
This examination used multiple research tools, primarily using visual approaches such as current photographs, archival images and data, descriptive census materials and maps. Historical documents, (many of which are now digitized), as well as other academic literature, local journalistic efforts and school district publications added important materials for analysis.
Findings lead to deeper understanding of ways that visible, material worlds of schools and neighborhoods -- past and present - can reflect, and direct the experiences of childhood today, and often mirror those of children past. These visual and narrative approaches contributed to understanding the importance of material evidence in revealing
inequity and class differences in ways that children, then, must &ldquodo school &rdquo
Contributorsvan Walsum, Joyce I. (Author) / Margolis, Eric M. (Thesis advisor) / Moore, Elsie (Thesis advisor) / Collins, Daniel (Committee member) / Arizona State University (Publisher)
Created2014