The technology of 3D-printing has allowed the production of entirely soft pumps with complex chamber geometries. We used this technique to develop a completely soft pneumatically driven total artificial heart from silicone elastomers and evaluated its performance on a hybrid mock circulation. The goal of this study is to present an innovative concept of a soft total artificial heart (sTAH). Using the form of a human heart, we designed a sTAH, which consists of only two ventricles and produced it using a 3D-printing, lost-wax casting technique. The diastolic properties of the sTAH were defined and the performance of the sTAH was evaluated on a hybrid mock circulation under various physiological conditions. The sTAH achieved a blood flow of 2.2 L/min against a systemic vascular resistance of 1.11 mm Hg s/mL (afterload), when operated at 80 bpm. At the same time, the mean pulmonary venous pressure (preload) was fixed at 10 mm Hg. Furthermore, an aortic pulse pressure of 35 mm Hg was measured, with a mean aortic pressure of 48 mm Hg. The sTAH generated physiologically shaped signals of blood flow and pressures by mimicking the movement of a real heart. The preliminary results of this study show a promising potential of the soft pumps in heart replacements. Further work, focused on increasing blood flow and in turn aortic pressure is required.

Finding the appropriate cues to trigger the desired differentiation is a challenge in tissue engineering when stem cells are involved. In this regard, three-dimensional environments are often compared to cells' twodimensional culture behaviour (plastic culture dish). Here, we compared the gene expression pattern of human adipose-derived stem cells (ASC) seeded in a three-dimensional (3D) electrospun mesh and on a two-dimensional (2D) film -both of exactly the same material. Additionally, we conducted experiments with a scaffold floating above a film to investigate two-way paracrine effects (co-system). Electrospun meshes (3D scaffolds) and films (2D), consisting either of pristine poly-lactic-co-glycolic acid (PLGA) or of PLGA-containing dispersed amorphous calcium phosphate nanoparticles (PLGA/aCaP), were seeded with ASCs and cultured either in Dulbecco Minimum Essential Medium (DMEM) or in osteogenic medium. After two weeks, minimum stem cell criteria markers as well as typical markers for osteogenesis, endothelial cell differentiation, adipogenesis and chondrogenesis were analysed by quantitative real-time PCR. Interestingly, mostly osteogenic genes of cells seeded on 3D meshes were upregulated compared to those on 2D films, while stem cell markers seemed to be only slightly affected. Runx2 and osteocalcin showed an especially strong upregulation under all conditions, while most other factors analysed for 2D/3D changes were highly dependent on the material composition, the culture medium and on paracrine signalling effects. The beneficial 3D environment for stem cells found in many studies has therefore not to be attributed to the third dimension alone and should carefully be compared to 2D films fabricated of the same material. Furthermore, paracrine interactions triggering differentiation are not negligible.

Aside its historical use in contact with bone and teeth, an increasing number of studies use bioactive glasses (BG) in contact with soft tissue. BG could provide solutions for various medical problems. This study presents a first evaluation, whether BG containing silicone elastomers are a suitable material for left ventricular assist device drivelines and could enhance skin biointegration thereof. Three different nano-or microparticles of BG45S5® were incorporated into medical grade silicone elastomer and thin films of the composites were manufactured. Physicochemical, mechanical and in vitro experiments using primary human dermal fibroblasts were used to evaluate the nano-and microcomposites. The incorporation of BG particles reduced the tensile strength at break and percent elongation at break of the composites and increased the stiffness of the material. Especially the incorporation of nanosized BG decreased the percent elongation at break after immersion in SBF due to agglomerate formation and increased hydroxyapatite formation compared to commercially available microparticles. The cytocompatibility of BG containing composites increased significantly with increasing particle concentration. A clear trend regarding particle size was not observed. In general, the simple incorporation of particles into medical grade silicone elastomer allowed an easy modification of the mechanical properties and improvement in bioactivity (assessed by hydroxyapatite formation) of the material. The choice of either nano-or microparticles depends on the specific application and requirements for the material, as different particle types show different advantages and disadvantages.