Abstract
Congenital heart defects affect over 40,000 newborns in the United States each year (CDC, 2024). Many of these defects require multiple open-heart surgeries during the first few years of life. These procedures carry significant risk and sometimes result in long-term complications such as chronic pain, adhesion growth, and increased susceptibility to cardiac arrhythmias (Open Heart Surgery, 2024). These invasive surgeries also impose substantial emotional and logistical burdens on families, as they involve prolonged recovery periods and frequent follow-up visits. To reduce the need for repeated open-heart surgeries, clinicians have increasingly adopted minimally invasive cardiac procedures performed in a catheterization laboratory. These procedures use catheters inserted through the groin to deploy stents and perform other interventions without opening the chest.
While minimally invasive techniques are well developed in adult cardiology, there remains a critical lack of pediatric-specific devices and procedures. A common current approach involves adapting adult vein grafts for pediatric use by mounting them on smaller balloon catheters for placement in the aorta or other obstructed vessels. However, there is no device available to uniformly crimp these grafts onto smaller balloons commonly used in pediatric cases. Currently, surgeons rely on valve crimpers that do not close to sufficiently small diameters or resort to manual crimping with their fingers, which often leads to non-uniform crimping and stent slippage during insertion. These issues can prolong procedure time, increase patient risk, and even result in lost or damaged stents, creating significant additional expenses for the hospital. These limitations highlight the need for a pediatric-specific crimping device. Therefore, the goal of this project is to design a pediatric stent crimper capable of uniformly crimping grafts onto 8 mm, 10 mm, and 14 mm balloon catheters that can be introduced through a 10 French catheter.
One of the primary ways that plastic waste generation can be reduced is by reducing the amount of plastic in the myriad of plastic-based items that are manufactured. Although more businesses are prioritizing plastic reduction in their design criteria for certain products, plastic waste generation remains an enormous issue, with the bulk of the production coming from high income areas, and the bulk of waste management coming from low-income areas (Kibria et al., 2023). Mismanaged plastic waste is any plastic that is not properly recycled, incinerated, or stored in sealed landfills- a phenomena that feeds a global waste crisis that extends beyond environmental damage into human rights and social justice (Mismanaged Plastic Waste, n.d.). In my STS research paper, I aim to explore how plastic waste mismanagement deepens gender inequality. Plastic waste mismanagement is not a gender-neutral issue; it disproportionately harms women by increasing their exposure to toxic health risks, forcing them into jobs in the informal waste sector, and reinforcing existing social and domestic burdens.
As a result of plastic waste mismanagement, women experience disproportionate health risks when compared to men. The unique physiological and social exposure pathways of women result in long-term health consequences from plastic pollution. Some of the chemical additives that contribute to plastic softness and durability, such as BPA and phthalates, act as endocrine disruptors, which can cause many health issues (Zurub et al., 2024). Systemic gender inequality structures the plastic value chain, pushing women into the most precarious, low-wage, and un-protected positions in waste management (Johansen et al., 2022). Women form a majority of the world's informal waste pickers in many developing regions (Gunsilius, n.d.). They are often paid less than male counterparts, lack contracts, and have no access to social security or healthcare. In addition to the exploitative nature of these jobs, women face extremely unhygienic conditions and exposure to physical hazards (Thelwell, 2022). In contrast, the formal waste and recycling sector, which is typically male dominated, offers stable wages, and provides safety equipment and benefits.
Existing stent crimper models, such as the Edwards Life Sciences Crimper, are comprised of a large amount of plastic. According to clinician feedback, the size of these devices is wholly unnecessary and often occupies an excessive amount of space on catheterization lab tables. Much of the current plastic waste mismanagement could be greatly improved by reducing the amount of global plastic waste. Plastic waste reduction can be achieved by both general quantity reduction and an individual product mass reduction, thereby reducing disproportionate implications on gender inequality in regions with higher levels of informal waste management. Ultimately, both my Capstone and STS project underscore the necessity of plastic waste reduction.
