A hybrid mock circulatory loop integrated with a LED-PIV system for the investigation of AAA compliant phantoms.

Background: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide and require extensive investigation through studies. Mock Circulatory Loops (MCLs) are advanced platforms that accurately replicate physiological and pathological hemodynamic conditions, while also allowing for precise and patient-specific data collection. Particle Image Velocimetry (PIV) is the standard flow visualization technique for studies, but it is costly and requires strict safety measures.

Three-dimensional printed models as an effective tool for the management of complex congenital heart disease.

Introduction: Three-dimensional printed models are widely used in the medical field for surgical and interventional planning. In the context of complex cardiovascular defects such as pediatric congenital heart diseases (CHDs), the adoption of 3D printed models could be an effective tool to improve decision-making. In this paper, an investigation was conducted into the characteristics of 3D printed models and their added value in understanding and managing complex pediatric congenital heart disease, also considering the associated cost.

Case Report: Role of numerical simulations in the management of acute aortic syndromes.

Penetrating aortic ulcer (PAU) represents a subset of acute aortic syndromes characterized by high rupture risk and management challenges, particularly in elderly patients with significant comorbidities. This case report showcases a 75-year-old patient with a history of coronary artery bypass graft (CABG) and with multiple PAUs involving the aortic arch, deemed unfit for conventional open surgery. A branched aortic endograft with a pre-cannulated side component for the left subclavian artery (LSA) was employed to preserve the patency of the previous CABG.

Left atrial appendage occlusion: On the need of a numerical model to simulate the implant procedure.

Left atrial appendage occlusion (LAAO) is a percutaneous procedure to prevent thromboembolism in patients affected by atrial fibrillation. Despite its demonstrated efficacy, the LAA morphological complexity hinders the procedure, resulting in postprocedural drawbacks (device-related thrombus and peri-device leakage). Local anatomical features may cause difficulties in the device's positioning and affect the effectiveness of the device's implant.

Three-Dimensional Multi-Modality Registration for Orthopaedics and Cardiovascular Settings: State-of-the-Art and Clinical Applications.

The multimodal and multidomain registration of medical images have gained increasing recognition in clinical practice as a powerful tool for fusing and leveraging useful information from different imaging techniques and in different medical fields such as cardiology and orthopedics. Image registration could be a challenging process, and it strongly depends on the correct tuning of registration parameters. In this paper, the robustness and accuracy of a landmarks-based approach have been presented for five cardiac multimodal image datasets.

Fabrication of deformable patient-specific AAA models by material casting techniques.

Background: Abdominal Aortic Aneurysm (AAA) is a balloon-like dilatation that can be life-threatening if not treated. Fabricating patient-specific AAA models can be beneficial for investigations of hemodynamics, as well as for pre-surgical planning and training, testing the effectiveness of different interventions, or developing new surgical procedures. The current direct additive manufacturing techniques cannot simultaneously ensure the flexibility and transparency of models required by some applications.

Numerical investigation on circular and elliptical bulge tests for inverse soft tissue characterization.

The acquisition of insights concerning the mechanobiology of aneurysmatic aortic tissues is an important field of investigation. The complete characterization of aneurysm mechanical behaviour can be carried out by biaxial experimental tests on ex vivo specimens. In literature, several works proposed bulge inflation tests as a valid method to analyse aneurysmatic tissue.

3D Printed Model-Guided Neonatal Transcatheter Closure of Left Main Coronary Artery-to-Right Ventricle Fistula.

We report on a 2-week-old infant with huge left main coronary artery-to-right ventricular outflow tract fistula causing myocardial ischemia due to global coronary steal who was successfully submitted to percutaneous closure guided by a 3-dimensional-printed model using a duct-occluder vascular plug. ().

Impact of wall displacements on the large-scale flow coherence in ascending aorta.

In the context of aortic hemodynamics, uncertainties affecting blood flow simulations hamper their translational potential as supportive technology in clinics. Computational fluid dynamics (CFD) simulations under rigid-walls assumption are largely adopted, even though the aorta contributes markedly to the systemic compliance and is characterized by a complex motion. To account for personalized wall displacements in aortic hemodynamics simulations, the moving-boundary method (MBM) has been recently proposed as a computationally convenient strategy, although its implementation requires dynamic imaging acquisitions not always available in clinics.

Transcatheter Treatment of Native Idiopathic Multiloculated Aortic Aneurysm Guided by 3D Printing Technology.

Pediatric idiopathic aortic aneurysm is rare. Single saccular malformation can complicate native or recurrent aortic coarctation; however, multiloculated dilatations of the descending thoracic aorta, associated with aortic coarctation, have so far never been described in literature. In our case, printed 3D model technology was crucial in planning transcatheter treatment.

An image-based approach for the estimation of arterial local stiffness .

The analysis of mechanobiology of arterial tissues remains an important topic of research for cardiovascular pathologies evaluation. In the current state of the art, the gold standard to characterize the tissue mechanical behavior is represented by experimental tests, requiring the harvesting of specimens. In recent years though, image-based techniques for the estimation of arterial tissue stiffness were presented.

A Hybrid Mock Circulatory Loop for Fluid Dynamic Characterization of 3D Anatomical Phantoms.

Goal: This work presents the development of a Hybrid Mock Circulatory Loop (HMCL) to simulate hemodynamics at patient-specific level in terms of both 3D geometry and inlet/outlet boundary conditions.

Methods: Clinical data have been processed to define the morphological and functional patient-specific settings. A piston pump is used to impose a parametric flow rate profile at the inlet of the hemodynamic circuit.

High-Versatility Left Ventricle Pump and Aortic Mock Circulatory Loop Development for Patient-Specific Hemodynamic In Vitro Analysis.

The importance of experimental setups able to reproduce cardiac functions was well established in the field of clinical innovations. The mock circulatory loops acquired rising relevance, and the possibility to have a complete reproduction of different and specific fluid dynamic conditions within the setup is pivotal. A system with enough versatility to reproduce the physiologic range of both flows and pressures is required.

Transcatheter Treatment of Ascending Aorta Pseudoaneurysm Guided by 3D-Model Technology.

Ascending aorta pseudoaneurysm is a rare but potentially life-threatening complication of atherosclerosis, infections, chest trauma, transcatheter or surgical interventions. Due to high surgical risk, percutaneous closure is considered a valuable cost-effective therapeutic alternative. In this setting, 3D printing technology is emerging as a powerful tool to plan transcatheter repair.

On the Role and Effects of Uncertainties in Cardiovascular Analyses.

The assessment of cardiovascular hemodynamics with computational techniques is establishing its fundamental contribution within the world of modern clinics. Great research interest was focused on the aortic vessel. The study of aortic flow, pressure, and stresses is at the basis of the understanding of complex pathologies such as aneurysms.

Fully-Coupled FSI Computational Analyses in the Ascending Thoracic Aorta Using Patient-Specific Conditions and Anisotropic Material Properties.

Computational hemodynamics has become increasingly important within the context of precision medicine, providing major insight in cardiovascular pathologies. However, finding appropriate compromise between speed and accuracy remains challenging in computational hemodynamics for an extensive use in decision making. For example, in the ascending thoracic aorta, interactions between the blood and the aortic wall must be taken into account for the sake of accuracy, but these fluid structure interactions (FSI) induce significant computational costs, especially when the tissue exhibits a hyperelastic and anisotropic response.

Fabrication and in-vitro characterization of a polymeric aortic valve for minimally invasive valve replacement.

The valve replacement therapy is the standard treatment for severe heart valve diseases. Nowadays, two types of commercial prosthesis are available: mechanical and biological, but both of them have severe limitations. Moreover, alternative therapeutic approach for valve replacement, based on minimally invasive techniques (MIAVR), motivates the search for new valve materials.

Correlation between micro and macrostructural biaxial behavior of ascending thoracic aneurysm: a novel experimental technique.

Mechanical properties and microstructural modifications of vessel tissues are strongly linked, as established in the state of the art of cardiovascular diseases. Techniques to obtain both mechanical and structural information are reported, but the possibility to obtain real-time microstructural and macrostructural data correlated is still lacking. An experimental approach to characterize the aortic tissue is presented.

A novel formulation for the study of the ascending aortic fluid dynamics with in vivo data.

Numerical simulations to evaluate thoracic aortic hemodynamics include a computational fluid dynamic (CFD) approach or fluid-structure interaction (FSI) approach. While CFD neglects the arterial deformation along the cardiac cycle by applying a rigid wall simplification, on the other side the FSI simulation requires a lot of assumptions for the material properties definition and high computational costs. The aim of this study is to investigate the feasibility of a new strategy, based on Radial Basis Functions (RBF) mesh morphing technique and transient simulations, able to introduce the patient-specific changes in aortic geometry during the cardiac cycle.

3D model-guided transcatheter closure of left ventricular pseudoaneurysm: a case series.

Left ventricular pseudoaneurysm (LVPsA) is a rare complication of myocardial infarction, cardiac surgery, chest trauma, infection or transcatheter interventions. It may cause arrhythmias, mass effect, thromboembolism and life-threatening rupture. The transcatheter approach is nowadays considered a cost-effective alternative to surgery.

Left atrial appendage occlusion device: Development and validation of a finite element model.

Atrial Fibrillation (AF) is a common disease that significantly increases the risk of strokes. Oral anticoagulants represent the standard preventive treatment, but they involve severe drawbacks, including intracerebral bleedings. Since in patients affected by nonvalvular AF, the Left Atrial Appendage (LAA) is the primary source of thromboembolism, percutaneous closure of the LAA is a viable option for people unsuitable for long-term anticoagulant therapy.

3D Printing in Modern Cardiology.

Background: 3D printing represents an emerging technology in the field of cardiovascular medicine. 3D printing can help to perform a better analysis of complex anatomies to optimize intervention planning.

Methods: A systematic review was performed to illustrate the 3D printing technology and to describe the workflow to obtain 3D printed models from patient-specific images.