An In Vitro Circulatory Loop Model of the Pediatric Right Ventricular Outflow Tract as a Platform for Valve Evaluation

Kizilski, Shannen B.; Zhang, Xiaoya; Kneier, Nicholas E; Lizarraga, Martha D Chaillo; Schulz, Noah; Hammer, Peter E.; Hoganson, David M.

doi:10.1007/s13239-022-00648-w

Cited by 4 publications

(1 citation statement)

References 32 publications

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“…Immune-related failure can lead to immobile valve cusps because of chronic inflammation from foreign materials, causing issues like thromboembolic complications or infectious endocarditis ( 14 – 16 ). Posttreatment regurgitation rates vary substantially because of the numerous variables of design, morphology, surgery, and immune response ( 17 ). Factors contributing to monocusp dysfunction in the RVOT are not adequately quantified, partly because of limitations in current materials and characterization techniques in monocusp design literature.…”

Section: Introductionmentioning

confidence: 99%

Hemodynamic evaluation of biomaterial-based surgery for Tetralogy of Fallot using a biorobotic heart, in silico, and ovine models

Singh,

Roubertie,

Ozturk

et al. 2024

Sci. Transl. Med.

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Tetralogy of Fallot is a congenital heart disease affecting newborns and involves stenosis of the right ventricular outflow tract (RVOT). Surgical correction often widens the RVOT with a transannular enlargement patch, but this causes issues including pulmonary valve insufficiency and progressive right ventricle failure. A monocusp valve can prevent pulmonary regurgitation; however, valve failure resulting from factors including leaflet design, morphology, and immune response can occur, ultimately resulting in pulmonary insufficiency. A multimodal platform to quantitatively evaluate the effect of shape, size, and material on clinical outcomes could optimize monocusp design. This study introduces a benchtop soft biorobotic heart model, a computational fluid model of the RVOT, and a monocusp valve made from an entirely biological cell-assembled extracellular matrix (CAM) to tackle the multifaceted issue of monocusp failure. The hydrodynamic and mechanical performance of RVOT repair strategies was assessed in biorobotic and computational platforms. The monocusp valve design was validated in vivo in ovine models through echocardiography, cardiac magnetic resonance, and catheterization. These models supported assessment of surgical feasibility, handling, suturability, and hemodynamic and mechanical monocusp capabilities. The CAM-based monocusp offered a competent pulmonary valve with regurgitation of 4.6 ± 0.9% and a transvalvular pressure gradient of 4.3 ± 1.4 millimeters of mercury after 7 days of implantation in sheep. The biorobotic heart model, in silico analysis, and in vivo RVOT modeling allowed iteration in monocusp design not now feasible in a clinical environment and will support future surgical testing of biomaterials for complex congenital heart malformations.

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Section: Introductionmentioning

confidence: 99%

Hemodynamic evaluation of biomaterial-based surgery for Tetralogy of Fallot using a biorobotic heart, in silico, and ovine models

Singh,

Roubertie,

Ozturk

et al. 2024

Sci. Transl. Med.

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Applications of 3D Printing Technology in Diagnosis and Management of Heart Failure

Goswami,

Kazim,

Nguyen

2024

Curr Treat Options Cardio Med

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Purpose of Review 3D printing (3DP) technology has emerged as a valuable tool for surgeons and cardiovascular interventionalists in developing and tailoring patient-specific treatment strategies, especially in complex and rare cases. This short review covers advances, primarily in the last three years, in the use of 3DP in the diagnosis and management of heart failure and related cardiovascular conditions. Recent Findings Latest studies include utilization of 3DP in ventricular assist device placement, congenital heart disease identification and treatment, pre-operative planning and management in hypertrophic cardiomyopathy, clinician as well as patient education, and benchtop mock circulatory loops. Summary Studies reported benefits for patients including significantly reduced operation time, potential for lower radiation exposure, shorter mechanical ventilation times, lower intraoperative blood loss, and less total hospitalization time, as a result of the use of 3DP. As 3DP technology continues to evolve, clinicians, basic science researchers, engineers, and regulatory authorities must collaborate closely to optimize the utilization of 3D printing technology in the diagnosis and management of heart failure.

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Systematic Analysis of PTFE Monocusp Leaflet Design in a Patient-Based 3D in-Vitro Model of Tetralogy of Fallot

Zhang,

Kizilski,

Recco

et al. 2023

Cardiovasc Eng Tech

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An In Vitro Circulatory Loop Model of the Pediatric Right Ventricular Outflow Tract as a Platform for Valve Evaluation

Cited by 4 publications

References 32 publications

Hemodynamic evaluation of biomaterial-based surgery for Tetralogy of Fallot using a biorobotic heart, in silico, and ovine models

Hemodynamic evaluation of biomaterial-based surgery for Tetralogy of Fallot using a biorobotic heart, in silico, and ovine models

Applications of 3D Printing Technology in Diagnosis and Management of Heart Failure

Systematic Analysis of PTFE Monocusp Leaflet Design in a Patient-Based 3D in-Vitro Model of Tetralogy of Fallot

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