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Agrafiotis E, Zimpfer D, Mächler H, Holzapfel GA. Review of Systemic Mock Circulation Loops for Evaluation of Implantable Cardiovascular Devices and Biological Tissues. J Endovasc Ther 2024:15266028241235876. [PMID: 38528650 DOI: 10.1177/15266028241235876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
CLINICAL IMPACT On needs-based ex vivo monitoring of implantable devices or tissues/organs in cardiovascular simulators provides new insights and paves new paths for device prototypes. The insights gained could not only support the needs of patients, but also inform engineers, scientists and clinicians about undiscovered aspects of diseases (during routine monitoring). We analyze seminal and current work and highlight a variety of opportunities for developing preclinical tools that would improve strategies for future implantable devices. Holistically, mock circulation loop studies can bridge the gap between in vivo and in vitro approaches, as well as clinical and laboratory settings, in a mutually beneficial manner.
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Affiliation(s)
| | - Daniel Zimpfer
- Division of Cardiac Surgery, Medical University of Graz, Graz, Austria
| | - Heinrich Mächler
- Division of Cardiac Surgery, Medical University of Graz, Graz, Austria
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Graz, Austria
- Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, Norway
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He F, Li M, Wang X, Hua L, Guo T. Numerical investigation of quantitative pulmonary pressure ratio in different degrees of stenosis. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2024; 21:1806-1818. [PMID: 38454661 DOI: 10.3934/mbe.2024078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Pulmonary artery stenosis endangers people's health. Quantitative pulmonary pressure ratio (QPPR) is very important for clinicians to quickly diagnose diseases and develop treatment plans. OBJECTIVE Our purpose of this paper is to investigate the effects of different degrees (50% and 80%) of pulmonary artery stenosis on QPPR. METHODS An idealized model is established based on the normal size of human pulmonary artery. The hemodynamic governing equations are solved using fluid-structure interaction. RESULTS The results show that the QPPR decreases with the increase of stenosis degree, and it is closely related to the pressure drop at both ends of stenosis. Blood flow velocity and wall shear stress are sensitive to the stenosis degree. When the degree of stenosis is 80%, the amplitude of changes of blood flow velocity and wall shear stress at both ends of stenosis is lower. CONCLUSIONS The results suggest that the degree of pulmonary artery stenosis has a significant impact on QPPR and hemodynamic changes. This study lays a theoretical foundation for further study of QPPR.
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Affiliation(s)
- Fan He
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Minru Li
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Xinyu Wang
- School of Science, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Lu Hua
- Thrombosis Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
| | - Tingting Guo
- Thrombosis Center, National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China
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Amabili M, Franchini G, Asgari M, Giovanniello F, Ghayesh MH, Breslavsky ID. Active and passive mechanical characterization of a human descending thoracic aorta with Klippel-Trenaunay syndrome. J Mech Behav Biomed Mater 2023; 148:106216. [PMID: 37924665 DOI: 10.1016/j.jmbbm.2023.106216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/28/2023] [Indexed: 11/06/2023]
Abstract
A human aorta from a female donor affected by Klippel-Trenaunay syndrome was retrieved during a surgery for organ donation for transplant. The aorta was preserved in refrigerated Belzer UW organ preservation solution and tested within a few hours for mechanical characterization with and without vascular smooth muscle activation. KCl and Noradrenaline were used as vasoactive agents in bubbled Krebs-Henseleit buffer solution at 37 °C. A quasi-static and a dynamic mechanical characterization of the full wall and the three individual layers were carried out for strips taken in longitudinal and circumferential directions. The full wall in the descending portion of the aorta underwent mechanical tests with and without smooth muscle activation. Results were compared to data obtained from healthy aortas and show a reduced stiffness of the full wall in circumferential direction. Also, a significant reduction of the response to vasoactive agents in circumferential direction was observed, while the longitudinal response was similar to healthy cases.
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Affiliation(s)
- Marco Amabili
- Department of Mechanical Engineering, McGill University, Montreal, H3A 0C3, Canada.
| | - Giulio Franchini
- Advanced Material Research Center, Technology Innovation Institute, Abu Dhabi, United Arab Emirates
| | - Meisam Asgari
- Department of Medical Engineering, University of South Florida, Tampa, FL, USA
| | | | - Mergen H Ghayesh
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, Australia
| | - Ivan D Breslavsky
- Department of Mechanical Engineering, McGill University, Montreal, H3A 0C3, Canada
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Giudici A, van der Laan KWF, van der Bruggen MM, Parikh S, Berends E, Foulquier S, Delhaas T, Reesink KD, Spronck B. Constituent-based quasi-linear viscoelasticity: a revised quasi-linear modelling framework to capture nonlinear viscoelasticity in arteries. Biomech Model Mechanobiol 2023; 22:1607-1623. [PMID: 37129690 PMCID: PMC10511394 DOI: 10.1007/s10237-023-01711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/08/2023] [Indexed: 05/03/2023]
Abstract
Arteries exhibit fully nonlinear viscoelastic behaviours (i.e. both elastically and viscously nonlinear). While elastically nonlinear arterial models are well established, effective mathematical descriptions of nonlinear viscoelasticity are lacking. Quasi-linear viscoelasticity (QLV) offers a convenient way to mathematically describe viscoelasticity, but its viscous linearity assumption is unsuitable for whole-wall vascular applications. Conversely, application of fully nonlinear viscoelastic models, involving deformation-dependent viscous parameters, to experimental data is impractical and often reduces to identifying specific solutions for each tested loading condition. The present study aims to address this limitation: By applying QLV theory at the wall constituent rather than at the whole-wall level, the deformation-dependent relative contribution of the constituents allows to capture nonlinear viscoelasticity with a unique set of deformation-independent model parameters. Five murine common carotid arteries were subjected to a protocol of quasi-static and harmonic, pseudo-physiological biaxial loading conditions to characterise their viscoelastic behaviour. The arterial wall was modelled as a constrained mixture of an isotropic elastin matrix and four families of collagen fibres. Constituent-based QLV was implemented by assigning different relaxation functions to collagen- and elastin-borne parts of the wall stress. Nonlinearity in viscoelasticity was assessed via the pressure dependency of the dynamic-to-quasi-static stiffness ratio. The experimentally measured ratio increased with pressure, from 1.03 [Formula: see text] 0.03 (mean [Formula: see text] standard deviation) at 80-40 mmHg to 1.58 [Formula: see text] 0.22 at 160-120 mmHg. Constituent-based QLV captured well this trend by attributing the wall viscosity predominantly to collagen fibres, whose recruitment starts at physiological pressures. In conclusion, constituent-based QLV offers a practical and effective solution to model arterial viscoelasticity.
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Affiliation(s)
- Alessandro Giudici
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands.
- GROW School for Oncology and Reproduction, Maastricht University, Maastricht, The Netherlands.
| | - Koen W F van der Laan
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
| | - Myrthe M van der Bruggen
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
| | - Shaiv Parikh
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
| | - Eline Berends
- Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Sébastien Foulquier
- Department of Pharmacology and Toxicology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | - Tammo Delhaas
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
| | - Koen D Reesink
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
| | - Bart Spronck
- Department of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Universiteitssingel 40, Room C5.568, 6229 ER, Maastricht, The Netherlands
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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Jen N, Hadfield J, Bessa GM, Amabili M, Nobes DS, Chung HJ. Jacketed elastomeric tubes for passive self-regulation of pulsatile flow. J Mech Behav Biomed Mater 2023; 145:105994. [PMID: 37418970 DOI: 10.1016/j.jmbbm.2023.105994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/22/2023] [Accepted: 06/24/2023] [Indexed: 07/09/2023]
Abstract
Regulating pulsatile flow is important to achieve optimal separation and mixing and enhanced heat transfer in microfluidic devices, as well as maintaining homeostasis in biological systems. The human aorta, a composite and layered tube made (among others) of elastin and collagen, is an inspiration for researchers who seek an engineering solution for a self-regulation of pulsatile flow. Here, we present a bio-inspired approach showing that fabric-jacketed elastomeric tubes, manufactured using commercially available silicone rubber and knitted textiles, can be used to regulate pulsatile flow. Our tubes are evaluated via incorporation into a mock-circulatory 'flow loop' that replicates the pulsatile fluid flow conditions of an ex-vivo heart perfusion (EVHP) device, a machine used in heart transplants. Pressure waveforms measured near the elastomeric tubing clearly indicated an effective flow regulation. The 'dynamic stiffening' behavior of the tubes during deformation is analyzed quantitatively. Broadly, the fabric jackets allow for the tubes to experience greater magnitudes of pressure and distension without risk of asymmetric aneurysm within the expected operating time of an EVHP. Owing to its highly tunable nature, our design may serve as a basis for tubing systems that require passive self-regulation of pulsatile flow.
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Affiliation(s)
- Nathan Jen
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada
| | - Jake Hadfield
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Guilherme M Bessa
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Marco Amabili
- Department of Mechanical Engineering, McGill University, Montreal, QC, Canada
| | - David S Nobes
- Department of Mechanical Engineering, University of Alberta, Edmonton, AB, Canada.
| | - Hyun-Joong Chung
- Department of Chemical and Materials Engineering, University of Alberta, Edmonton, AB, Canada.
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Wang X, Carpenter HJ, Ghayesh MH, Kotousov A, Zander AC, Amabili M, Psaltis PJ. A review on the biomechanical behaviour of the aorta. J Mech Behav Biomed Mater 2023; 144:105922. [PMID: 37320894 DOI: 10.1016/j.jmbbm.2023.105922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 05/14/2023] [Accepted: 05/20/2023] [Indexed: 06/17/2023]
Abstract
Large aortic aneurysm and acute and chronic aortic dissection are pathologies of the aorta requiring surgery. Recent advances in medical intervention have improved patient outcomes; however, a clear understanding of the mechanisms leading to aortic failure and, hence, a better understanding of failure risk, is still missing. Biomechanical analysis of the aorta could provide insights into the development and progression of aortic abnormalities, giving clinicians a powerful tool in risk stratification. The complexity of the aortic system presents significant challenges for a biomechanical study and requires various approaches to analyse the aorta. To address this, here we present a holistic review of the biomechanical studies of the aorta by categorising articles into four broad approaches, namely theoretical, in vivo, experimental and combined investigations. Experimental studies that focus on identifying mechanical properties of the aortic tissue are also included. By reviewing the literature and discussing drawbacks, limitations and future challenges in each area, we hope to present a more complete picture of the state-of-the-art of aortic biomechanics to stimulate research on critical topics. Combining experimental modalities and computational approaches could lead to more comprehensive results in risk prediction for the aortic system.
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Affiliation(s)
- Xiaochen Wang
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Harry J Carpenter
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Mergen H Ghayesh
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia.
| | - Andrei Kotousov
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Anthony C Zander
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, South Australia 5005, Australia
| | - Marco Amabili
- Department of Mechanical Engineering, McGill University, Montreal H3A 0C3, Canada
| | - Peter J Psaltis
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia 5005, Australia; Department of Cardiology, Central Adelaide Local Health Network, Adelaide, South Australia 5000, Australia; Vascular Research Centre, Heart Health Theme, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, South Australia 5000, Australia
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Giovanniello F, Asgari M, Breslavsky ID, Franchini G, Holzapfel GA, Tabrizian M, Amabili M. Development and mechanical characterization of decellularized scaffolds for an active aortic graft. Acta Biomater 2023; 160:59-72. [PMID: 36792047 DOI: 10.1016/j.actbio.2023.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023]
Abstract
Decellularized porcine aortas are proposed as scaffolds for revolutionary active aortic grafts. A change in the static and dynamic mechanical properties, associated with the microstructure of elastin and collagen fibers, corresponds to alteration in the cyclic expansion and perfusion, in addition to possible graft damage. Therefore, the present study thoroughly investigates the mechanical response of the decellularized scaffolds of human and porcine origin to static and dynamic mechanical loads. The responses of the native human and porcine aortas are also compared; this is unavailable in the literature. Because the aorta is subjected to pulsatile blood pressure, dynamical responses to cyclic loads and their associated viscoelastic properties are particularly relevant for advanced graft design. In parallel, this study examines the microstructure of the decellularized aorta. The resulting data are compared to the analogous data obtained for the native human and porcine tissues. The results indicate that by using an optimized decellularization protocol - based on sodium dodecyl sulfate (SDS) and DNase - that minimizes mechanical and structural changes of the tissue, layered scaffolds with static and dynamic properties very similar to natural human aortas are obtained. In particular, a decellularized porcine aorta is non-inferior to a decellularized human aorta. STATEMENT OF SIGNIFICANCE: About 55,000 patients undergo abdominal aortic aneurysm repair annually in the USA. The currently implanted grafts present a large mechanical mismatch with the native tissue. This increases the pulsatile nature of the blood flow with negative consequences to the organ perfusion. For this reason, biomimetic and mechanically compatible grafts for aortic repair are urgently needed and they can be obtained through tissue engineering. In this study, scaffolds from porcine and human aortas are obtained from an optimized decellularization protocol. They are accurately compared to the native tissue and present the ideal static and dynamic mechanical properties for developing innovative aortic grafts.
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Affiliation(s)
| | - Meisam Asgari
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Ivan D Breslavsky
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Giulio Franchini
- Department of Mechanical Engineering, McGill University, Montreal, Canada
| | - Gerhard A Holzapfel
- Institute of Biomechanics, Graz University of Technology, Austria; Department of Structural Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Maryam Tabrizian
- Department of Biomedical Engineering, McGill University, Montreal, Canada; Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - Marco Amabili
- Department of Mechanical Engineering, McGill University, Montreal, Canada; Advanced Materials Research Center, Technology Innovation Institute (TII), Abu Dhabi, UAE.
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Zhao X, Zhao L, Xu J, Li D, Li H, Li Y, Chen H, Zhang Y. Aortic valve opening in mock-loop with continuous-flow left ventricular assist device. Int J Artif Organs 2022; 45:809-816. [PMID: 35818176 DOI: 10.1177/03913988221111811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The appropriate opening of aortic valves is crucial for heart failure (HF) patients with left ventricular assist devices (LVADs). Nevertheless, up to the present time, aortic valve monitoring has not been performed in discharged patients. In this study, a mock-loop platform was developed to investigate the aortic valve performance in LVAD patients. An additional sluice valve was placed next to the aortic valve that when the sluice valve is manually closed, the aortic valve will remain closed; when the sluice valve is open, the aortic valve is opened or closed upon the pressures. The results showed that when the LVAD speed was below 2600 rpm, the aortic valve can be intermittently opened, while when the LVAD speed was over 2600 rpm, the aortic valve was persistently closed. The left ventricular end-systolic pressure (LVESP) was found to be an indicator of aortic valve closure that, upon the aortic valve closure LVESP suddenly decreased. The LVESP is suggested for future monitoring the status of the aortic valve for patients with implanted LVADs. The effects of heart failure (HF) degrees, circulation resistance, and aortic compliance on aortic valve closure were further studied. The results revealed that LVAD implantation in patients with early HF degrees will help to avoid persistent aortic valve closure.
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Affiliation(s)
- Xiang Zhao
- School of Medicine, Tsinghua University (School of Medicine) - RocketHeart Co. Ltd Joint Research Center for Artificial Heart, Tsinghua University, Beijing, China.,School of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Luxiang Zhao
- School of Medicine, Tsinghua University (School of Medicine) - RocketHeart Co. Ltd Joint Research Center for Artificial Heart, Tsinghua University, Beijing, China.,School of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Jian Xu
- School of Medicine, Tsinghua University (School of Medicine) - RocketHeart Co. Ltd Joint Research Center for Artificial Heart, Tsinghua University, Beijing, China
| | - Donghai Li
- Advanced Medical Research Institute, Shandong University, Shandong, China
| | - Heping Li
- Department of Engineering Physics, Tsinghua University, Beijing, China
| | - Yongjian Li
- School of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Haosheng Chen
- School of Mechanical Engineering, State Key Laboratory of Tribology, Tsinghua University, Beijing, China
| | - Yu Zhang
- School of Medicine, Tsinghua University (School of Medicine) - RocketHeart Co. Ltd Joint Research Center for Artificial Heart, Tsinghua University, Beijing, China
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