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Bianchi D, Conti M, Bissacco D, Domanin M, Trimarchi S, Auricchio F. Impact of thoracic endovascular aortic repair on aortic biomechanics: Integration of in silico and ex vivo analysis using porcine model. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3594. [PMID: 35340129 DOI: 10.1002/cnm.3594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/09/2022] [Accepted: 03/16/2022] [Indexed: 05/12/2023]
Abstract
Thoracic endovascular aortic repair (TEVAR) is widespread in clinical practice for treating aortic diseases but it has relevant systemic complications, such as increase of the cardiac workload due to post-TEVAR aortic stiffening, and local issues such as re-entry tears due to the tissue damage caused by endograft interaction. The present study aims to elucidate these aortic biomechanical mechanisms by coupling ex vivo and in silico analysis. By ex vivo tests, the pulse wave velocity before and after TEVAR is measured. Uni-axial tensile tests are performed to measure regional mechanical response of tissue samples, supplied as input data for the in silico analysis. Numerical analysis is finally performed to compute the wall stress induced by the stent-graft deployment and the arterial pressurization. The ex vivo results highlight an increase of baseline PWV by a mean .78 m/s or 12% after TEVAR with a 100 mm stent-graft (p <.013). In the in silico analysis, the average von Mises stress in the landing zone increases of about 15% and 20% using, respectively stent-graft with radial oversizing of 10% and 20%. This work shows the effectiveness of integrated framework to analyze the biomechanical post TEVAR mechanisms. Moreover, the obtained results quantify the effect of prosthesis selection on the stiffening of the aorta after TEVAR and on the local increase of the aortic wall stress that is proportional to the stent-graft oversizing.
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Affiliation(s)
- Daniele Bianchi
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
| | - Michele Conti
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
| | - Daniele Bissacco
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Maurizio Domanin
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Santi Trimarchi
- Department of Health and Community Sciences, University of Milan, Milan, Italy
- Operative Unit of Vascular Surgery, Fondazione IRCCS Ca' Grande Ospedale Maggiore Policlinico Milano, Milan, Italy
| | - Ferdinando Auricchio
- Department of Civil Engineering and Architecture (DICAr), University of Pavia, Pavia, Italy
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Verma N, Sharma P, Jayabal H, Dingari NN, Gupta R, Rai B. Multiscale modeling of skin mechanical Behavior: Effect of dehydrating agent on Collagen's mechanical properties. J Biomech 2022; 145:111361. [PMID: 36347117 DOI: 10.1016/j.jbiomech.2022.111361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 09/13/2022] [Accepted: 10/26/2022] [Indexed: 11/05/2022]
Abstract
The dermis, second layer of human skin, is mainly responsible for mechanical response of the skin. The unique viscoelastic nature of this layer arises from the characteristic hierarchical structure of collagen at various length scales. The effect of topical formulation on skin's mechanical properties of great importance for several personal-care applications. Understanding the transport of an active ingredient across skin layer and its effects on the structure of collagen assembly is crucial for successful design of these applications. In this study, we report a multiscale modelling framework mimicking the skin's mechanical behavior. The framework captures the details from the nanoscale (tropocollagen) to microscale (fibers). At first, atomistic molecular dynamics simulations (MDS) of tropocollagen (TC) molecules of various lengths (∼100 nm) were performed to obtain the molecular modulus of TC. The stress-strain response data obtained from these simulations, were utilized in macroscopic models of fibrils and fibers. The modulus obtained from the mentioned framework was in good agreement with earlier reported experimental data. Further, we have utilized this framework to show the effect of dehydrating agent on skin's mechanical response. The hydration effect is utilized in many anti-ageing strategies to improve the overall mechanical property of skin. We showed that on incorporation of hydrating agent, the collagen structure changes significantly at molecular scale which effects the overall response of the skin at macroscopic scale. The reported multiscale framework can further be explored to gain insights into interlinked properties of collagen at much larger scales without extensive molecular simulations and detailed experiments.
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Affiliation(s)
- Nitu Verma
- Physical Sciences Research Area, TCS Research, Pune 411013, India
| | - Paramveer Sharma
- Physical Sciences Research Area, TCS Research, Pune 411013, India
| | | | | | - Rakesh Gupta
- Physical Sciences Research Area, TCS Research, Pune 411013, India.
| | - Beena Rai
- Physical Sciences Research Area, TCS Research, Pune 411013, India
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3
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Bianchi D, Morin C, Badel P. Implementing a micromechanical model into a finite element code to simulate the mechanical and microstructural response of arteries. Biomech Model Mechanobiol 2020; 19:2553-2566. [PMID: 32607921 PMCID: PMC7603465 DOI: 10.1007/s10237-020-01355-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 05/30/2020] [Indexed: 12/26/2022]
Abstract
A computational strategy based on the finite element method for simulating the mechanical response of arterial tissues is herein proposed. The adopted constitutive formulation accounts for rotations of the adventitial collagen fibers and introduces parameters which are directly measurable or well established. Moreover, the refined constitutive model is readily utilized in finite element analyses, enabling the simulation of mechanical tests to reveal the influence of microstructural and histological features on macroscopic material behavior. Employing constitutive parameters supported by histological examinations, the results herein validate the model's ability to predict the micro- and macroscopic mechanical behavior, closely matching previously observed experimental findings. Finally, the capabilities of the adopted constitutive description are shown investigating the influence of some collagen disorders on the macroscopic mechanical response of the arterial tissues.
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Affiliation(s)
- Daniele Bianchi
- Mines Saint-Etienne, Univ. Lyon, Univ. Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, 42023 Saint-Etienne, France
| | - Claire Morin
- Mines Saint-Etienne, Univ. Lyon, Univ. Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, 42023 Saint-Etienne, France
| | - Pierre Badel
- Mines Saint-Etienne, Univ. Lyon, Univ. Jean Monnet, INSERM, U 1059 Sainbiose, Centre CIS, 42023 Saint-Etienne, France
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Xiong Z, Yang P, Li D, Qiu Y, Zheng T, Hu J. A computational fluid dynamics analysis of a patient with acute non-A-non-B aortic dissection after type I hybrid arch repair. Med Eng Phys 2020; 77:43-52. [PMID: 31948772 DOI: 10.1016/j.medengphy.2019.10.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/10/2019] [Accepted: 10/14/2019] [Indexed: 02/08/2023]
Abstract
The clinical presentation and natural courses in acute non-A-non-B aortic dissection (AD) are quite different from classical acute type A or type B AD, and the benefit of hybrid technique for this clinical scenario has not been validated. By using computational fluid dynamics (CFD) analysis, we aim to investigate a series of hemodynamic-related changes in aortic morphology in a patient who underwent type I hybrid arch repair (HAR). Computed tomographic angiographies (preoperative, one week, one month and one year after HAR) of a 52-year old male patient with arch-entry type acute non-A-non-B dissection were collected. Three-dimensional models were reconstructed by using an image processing package Mimics (materialize). Morphological and hemodynamic parameters of aorta and its branch vessels were analysed. Post-operatively, the false lumen index (FLI) gradually decreased from 2.02 to 0.38 and the curvature of the aortic arch was also reduced. However, the aortic arch lengthened and the diameter of the distal abdominal aorta expanded. In addition, the blood flow gradually became organised and the pressure in the true lumen (TL) increased over time and eventually approximated the pressure in the false lumen (FL). Moreover, the region of the abnormal wall shear stress (WSS) in the TL progressively decreased while the WSS in most areas of the FL remained below 4 dyne/cm2. The blood supply to most of the aortic branches returned to normal at the one-year follow-up. Type I HAR is an effective procedure for patients with acute non-A-non-B aortic dissection in terms of restoring normal blood flow in TL and facilitating positive remodeling of distal aorta. Long-term surveillance and follow-up is mandatory.
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Affiliation(s)
- Zhuxiang Xiong
- Department of Applied Mechanics, Sichuan University, Chengdu 610065, China
| | - Peng Yang
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Da Li
- Department of Applied Mechanics, Sichuan University, Chengdu 610065, China
| | - Yue Qiu
- Department of Applied Mechanics, Sichuan University, Chengdu 610065, China
| | - Tinghui Zheng
- Department of Applied Mechanics, Sichuan University, Chengdu 610065, China.
| | - Jia Hu
- Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
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Ayyalasomayajula V, Pierrat B, Badel P. A computational model for understanding the micro-mechanics of collagen fiber network in the tunica adventitia. Biomech Model Mechanobiol 2019; 18:1507-1528. [PMID: 31065952 PMCID: PMC6748894 DOI: 10.1007/s10237-019-01161-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 04/26/2019] [Indexed: 12/11/2022]
Abstract
Abdominal aortic aneurysm is a prevalent cardiovascular disease with high mortality rates. The mechanical response of the arterial wall relies on the organizational and structural behavior of its microstructural components, and thus, a detailed understanding of the microscopic mechanical response of the arterial wall layers at loads ranging up to rupture is necessary to improve diagnostic techniques and possibly treatments. Following the common notion that adventitia is the ultimate barrier at loads close to rupture, in the present study, a finite element model of adventitial collagen network was developed to study the mechanical state at the fiber level under uniaxial loading. Image stacks of the rabbit carotid adventitial tissue at rest and under uniaxial tension obtained using multi-photon microscopy were used in this study, as well as the force-displacement curves obtained from previously published experiments. Morphological parameters like fiber orientation distribution, waviness, and volume fraction were extracted for one sample from the confocal image stacks. An inverse random sampling approach combined with a random walk algorithm was employed to reconstruct the collagen network for numerical simulation. The model was then verified using experimental stress-stretch curves. The model shows the remarkable capacity of collagen fibers to uncrimp and reorient in the loading direction. These results further show that at high stretches, collagen network behaves in a highly non-affine manner, which was quantified for each sample. A comprehensive parameter study to understand the relationship between structural parameters and their influence on mechanical behavior is presented. Through this study, the model was used to conclude important structure-function relationships that control the mechanical response. Our results also show that at loads close to rupture, the probability of failure occurring at the fiber level is up to 2%. Uncertainties in usually employed rupture risk indicators and the stochastic nature of the event of rupture combined with limited knowledge on the microscopic determinants motivate the development of such an analysis. Moreover, this study will advance the study of coupling microscopic mechanisms to rupture of the artery as a whole.
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Affiliation(s)
- Venkat Ayyalasomayajula
- Mines Saint-Étienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 SAINBIOSE, Centre CIS, 42023, Saint-Étienne, France.
| | - Baptiste Pierrat
- Mines Saint-Étienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 SAINBIOSE, Centre CIS, 42023, Saint-Étienne, France
| | - Pierre Badel
- Mines Saint-Étienne, Univ Lyon, Univ Jean Monnet, INSERM, U1059 SAINBIOSE, Centre CIS, 42023, Saint-Étienne, France
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Marino M, Pontrelli G, Vairo G, Wriggers P. A chemo-mechano-biological formulation for the effects of biochemical alterations on arterial mechanics: the role of molecular transport and multiscale tissue remodelling. J R Soc Interface 2018; 14:rsif.2017.0615. [PMID: 29118114 DOI: 10.1098/rsif.2017.0615] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 10/11/2017] [Indexed: 12/21/2022] Open
Abstract
This paper presents a chemo-mechano-biological framework for arterial physiopathology. The model accounts for the fine remodelling in the multiscale hierarchical arrangement of tissue constituents and for the diffusion of molecular species involved in cell-cell signalling pathways. Effects in terms of alterations in arterial compliance are obtained. A simple instructive example is introduced. Although oversimplified with respect to realistic case studies, the proposed application mimics the biochemical activity of matrix metalloproteinases, transforming growth factors beta and interleukins on tissue remodelling. Effects of macrophage infiltration, of intimal thickening and of a healing phase are investigated, highlighting the corresponding influence on arterial compliance. The obtained results show that the present approach is able to capture changes in arterial mechanics as a consequence of the alterations in tissue biochemical environment and cellular activity, as well as to incorporate the protective role of both autoimmune responses and pharmacological treatments.
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Affiliation(s)
- Michele Marino
- Institut für Kontinuumsmechanik, Leibniz Universität Hannover, Hannover, Germany
| | - Giuseppe Pontrelli
- Istituto per le Applicazioni del Calcolo, National Research Council (CNR), Rome, Italy
| | - Giuseppe Vairo
- Dipartimento di Ingegneria Civile e Ingegneria Informatica, Università degli Studi di Roma 'Tor Vergata', Rome, Italy
| | - Peter Wriggers
- Institut für Kontinuumsmechanik, Leibniz Universität Hannover, Hannover, Germany
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Direct and inverse identification of constitutive parameters from the structure of soft tissues. Part 1: micro- and nanostructure of collagen fibers. Biomech Model Mechanobiol 2018; 17:1011-1036. [DOI: 10.1007/s10237-018-1009-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 02/13/2018] [Indexed: 12/17/2022]
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Guerciotti B, Vergara C, Ippolito S, Quarteroni A, Antona C, Scrofani R. A computational fluid–structure interaction analysis of coronary Y-grafts. Med Eng Phys 2017; 47:117-127. [DOI: 10.1016/j.medengphy.2017.05.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 04/12/2017] [Accepted: 05/16/2017] [Indexed: 10/19/2022]
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Bianchi D, Monaldo E, Gizzi A, Marino M, Filippi S, Vairo G. A FSI computational framework for vascular physiopathology: A novel flow-tissue multiscale strategy. Med Eng Phys 2017; 47:25-37. [PMID: 28690045 DOI: 10.1016/j.medengphy.2017.06.028] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 05/05/2017] [Accepted: 06/01/2017] [Indexed: 11/27/2022]
Abstract
A novel fluid-structure computational framework for vascular applications is herein presented. It is developed by combining the double multi-scale nature of vascular physiopathology in terms of both tissue properties and blood flow. Addressing arterial tissues, they are modelled via a nonlinear multiscale constitutive rationale, based only on parameters having a clear histological and biochemical meaning. Moreover, blood flow is described by coupling a three-dimensional fluid domain (undergoing physiological inflow conditions) with a zero-dimensional model, which allows to reproduce the influence of the downstream vasculature, furnishing a realistic description of the outflow proximal pressure. The fluid-structure interaction is managed through an explicit time-marching approach, able to accurately describe tissue nonlinearities within each computational step for the fluid problem. A case study associated to a patient-specific aortic abdominal aneurysmatic geometry is numerically investigated, highlighting advantages gained from the proposed multiscale strategy, as well as showing soundness and effectiveness of the established framework for assessing useful clinical quantities and risk indexes.
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Affiliation(s)
- Daniele Bianchi
- Department of Civil Engineering and Computer Science (DICII), Universitá degli Studi di Roma "Tor Vergata", Via del Politecnico 1, Rome 00133, Italy.
| | - Elisabetta Monaldo
- Department of Engineering, Universitá degli Studi "Niccoló Cusano" - Telematica, Roma, Via Don C. Gnocchi 3, Rome 00166, Italy
| | - Alessio Gizzi
- Department of Engineering, Unit of Nonlinear Physics and Mathematical Modeling, University Campus Bio-Medico of Rome, Via A. del Portillo 21, Rome 00128, Italy
| | - Michele Marino
- Institute of Continuum Mechanics, Leibniz Universität Hannover, Appelstr. 11, Hannover 30167, Germany
| | - Simonetta Filippi
- Department of Engineering, Unit of Nonlinear Physics and Mathematical Modeling, University Campus Bio-Medico of Rome, Via A. del Portillo 21, Rome 00128, Italy
| | - Giuseppe Vairo
- Department of Civil Engineering and Computer Science (DICII), Universitá degli Studi di Roma "Tor Vergata", Via del Politecnico 1, Rome 00133, Italy
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10
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Sturla F, Vismara R, Jaworek M, Votta E, Romitelli P, Pappalardo OA, Lucherini F, Antona C, Fiore GB, Redaelli A. In vitro and in silico approaches to quantify the effects of the Mitraclip ® system on mitral valve function. J Biomech 2016; 50:83-92. [PMID: 27863743 DOI: 10.1016/j.jbiomech.2016.11.013] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/02/2016] [Indexed: 12/01/2022]
Abstract
Mitraclip® implantation is widely used as a valid alternative to conventional open-chest surgery in high-risk patients with severe mitral valve (MV) regurgitation. Although effective in reducing mitral regurgitation (MR) in the majority of cases, the clip implantation produces a double-orifice area that can result in altered MV biomechanics, particularly in term of hemodynamics and mechanical stress distribution on the leaflets. In this scenario, we combined the consistency of in vitro experimental platforms with the versatility of numerical simulations to investigate clip impact on MV functioning. The fluid dynamic determinants of the procedure were experimentally investigated under different working conditions (from 40bpm to 100bpm of simulated heart rate) on six swine hearts; subsequently, fluid dynamic data served as realistic boundary conditions in a computational framework able to quantitatively assess the post-procedural MV biomechanics. The finite element model of a human mitral valve featuring an isolated posterior leaflet prolapse was reconstructed from cardiac magnetic resonance. A complete as well as a marginal, sub-optimal grasping of the leaflets were finally simulated. The clipping procedure resulted in a properly coapting valve from the geometrical perspective in all the simulated configurations. Symmetrical complete grasping resulted in symmetrical distribution of the mechanical stress, while uncomplete asymmetrical grasping resulted in higher stress distribution, particularly on the prolapsing leaflet. This work pinpointed that the mechanical stress distribution following the clipping procedure is dependent on the cardiac hemodynamics and has a correlation with the proper execution of the grasping procedure, requiring accurate evaluation prior to clip delivery.
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Affiliation(s)
- Francesco Sturla
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy.
| | - Riccardo Vismara
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Michal Jaworek
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Emiliano Votta
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | | | - Omar A Pappalardo
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy; Division of cardiovascular Surgery, Università degli Studi di Verona, Verona, Italy
| | - Federico Lucherini
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Carlo Antona
- Forcardiolab, Fondazione per la ricerca in Cardiochirurgia ONLUS, Milan, Italy; Cardiovascular Surgery Department, "Luigi Sacco" University general Hospital, Milan, Italy; Università degli Studi di Milano, Milan, Italy
| | - Gianfranco B Fiore
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
| | - Alberto Redaelli
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milano, Italy
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Marino M, Korossis S. Cardiovascular biomechanics in health and disease. J Biomech 2016; 49:2319-20. [PMID: 27240751 DOI: 10.1016/j.jbiomech.2016.04.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Michele Marino
- Institute of Continuum Mechanics, Leibniz Universität Hannover, Appelstraße 11, 30167 Hannover, Germany.
| | - Sotirios Korossis
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Lower Saxony Centre for Biomedical Engineering, Implant Research and Development, Hannover Medical School, Stadtfelddamm 34, 30625 Hannover, Germany.
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