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Pirozzi I, Kight A, Han AK, Cutkosky MR, Dual SA. Circulatory Support: Artificial Muscles for the Future of Cardiovascular Assist Devices. Adv Mater 2023:e2210713. [PMID: 36827651 DOI: 10.1002/adma.202210713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/11/2023] [Indexed: 06/18/2023]
Abstract
Artificial muscles enable the design of soft implantable devices which are poised to transform the way we mechanically support the heart today. Heart failure is a prevalent and deadly disease, which is treated with the implantation of rotary blood pumps as the only alternative to heart transplantation. The clinically used mechanical devices are associated with severe adverse events, which are reflected here in a comprehensive list of critical requirements for soft active devices of the future: low power, no blood contact, pulsatile support, physiological responsiveness, high cycle life, and less-invasive implantation. In this review, we investigate and critically evaluate prior art in artificial muscles for their applicability in the short and long term. We highlight the main challenges regarding the effectiveness, controllability, and implantability of recently proposed actuators and explore future perspectives for attachment, physiological responsiveness, durability, and biodegradability as well as equitable design considerations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Ileana Pirozzi
- Department of Bioengineering, Stanford University, Palo Alto, 94301, USA
| | - Ali Kight
- Department of Bioengineering, Stanford University, Palo Alto, 94301, USA
| | - Amy Kyungwon Han
- Department of Mechanical Engineering, Seoul National University, Seoul, 08826, South Korea
| | - Mark R Cutkosky
- Department of Mechanical Engineering, Stanford University, Palo Alto, 94301, USA
| | - Seraina A Dual
- Department of Biomedical Engineering, KTH Royal Institute of Technology, 14157, Huddinge, Sweden
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Kight A, Pirozzi I, Liang X, McElhinney DB, Han AK, Dual SA, Cutkosky M. Decoupling Transmission and Transduction for Improved Durability of Highly Stretchable, Soft Strain Sensing: Applications in Human Health Monitoring. Sensors (Basel) 2023; 23:1955. [PMID: 36850551 PMCID: PMC9967534 DOI: 10.3390/s23041955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/24/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
This work presents a modular approach to the development of strain sensors for large deformations. The proposed method separates the extension and signal transduction mechanisms using a soft, elastomeric transmission and a high-sensitivity microelectromechanical system (MEMS) transducer. By separating the transmission and transduction, they can be optimized independently for application-specific mechanical and electrical performance. This work investigates the potential of this approach for human health monitoring as an implantable cardiac strain sensor for measuring global longitudinal strain (GLS). The durability of the sensor was evaluated by conducting cyclic loading tests over one million cycles, and the results showed negligible drift. To account for hysteresis and frequency-dependent effects, a lumped-parameter model was developed to represent the viscoelastic behavior of the sensor. Multiple model orders were considered and compared using validation and test data sets that mimic physiologically relevant dynamics. Results support the choice of a second-order model, which reduces error by 73% compared to a linear calibration. In addition, we evaluated the suitability of this sensor for the proposed application by demonstrating its ability to operate on compliant, curved surfaces. The effects of friction and boundary conditions are also empirically assessed and discussed.
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Affiliation(s)
- Ali Kight
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Ileana Pirozzi
- Department of Bioengineering, Stanford University, Stanford, CA 94305, USA
| | - Xinyi Liang
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
| | - Doff B. McElhinney
- Department of Cardiology, Lucile Packard Children’s Hospital, Stanford University, Stanford, CA 94305, USA
| | - Amy Kyungwon Han
- Department of Mechanical Engineering, Seoul National University, Seoul 08826, Republic of Korea
| | - Seraina A. Dual
- Department of Biomedical Engineering, KTH Royal Institute of Technology, 11428 Stockholm, Sweden
| | - Mark Cutkosky
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305, USA
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Frishman S, Kight A, Pirozzi I, Maddineni S, Imbrie-Moore AM, Karachiwalla Z, Paulsen MJ, Kaiser AD, Woo YJ, Cutkosky MR. DynaRing: A Patient-Specific Mitral Annuloplasty Ring With Selective Stiffness Segments. J Med Device 2022; 16:031009. [PMID: 35646225 PMCID: PMC9125864 DOI: 10.1115/1.4054445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/23/2022] [Indexed: 09/03/2023] Open
Abstract
Annuloplasty ring choice and design are critical to the long-term efficacy of mitral valve (MV) repair. DynaRing is a selectively compliant annuloplasty ring composed of varying stiffness elastomer segments, a shape-set nitinol core, and a cross diameter filament. The ring provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Moreover, adjusting elastomer properties provides a mechanism for effectively tuning key MV metrics to specific patients. We evaluate the ring embedded in porcine valves with an ex-vivo left heart simulator and perform a 150 million cycle fatigue test via a custom oscillatory system. We present a patient-specific design approach for determining ring parameters using a finite element model optimization and patient MRI data. Ex-vivo experiment results demonstrate that motion of DynaRing closely matches literature values for healthy annuli. Findings from the patient-specific optimization establish DynaRing's ability to adjust the anterior-posterior and intercommissural diameters and saddle height by up to 8.8%, 5.6%, 19.8%, respectively, and match a wide range of patient data.
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Affiliation(s)
- Samuel Frishman
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305
| | - Ali Kight
- Department of Bioengineering, Stanford University, Stanford, CA 94305
| | - Ileana Pirozzi
- Department of Bioengineering, Stanford University, Stanford, CA 94305
| | | | | | | | - Michael J. Paulsen
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA 94305
| | | | - Y. Joseph Woo
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA 94305
| | - Mark R. Cutkosky
- Department of Mechanical Engineering, Stanford University, Stanford, CA 94305
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Liu A, Mazumder D, Pirozzi I, Sammut J, Booth M. The effect of dietary choline and water temperature on the contribution of raw materials to the muscle tissue of juvenile yellowtail kingfish (Seriola lalandi): An investigation using a stable isotope mixing model. Anim Feed Sci Technol 2021. [DOI: 10.1016/j.anifeedsci.2021.115087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Frishman S, Kight A, Pirozzi I, Coffey MC, Daniel BL, Cutkosky MR. Enabling In-Bore MRI-Guided Biopsies With Force Feedback. IEEE Trans Haptics 2020; 13:159-166. [PMID: 31976906 DOI: 10.1109/toh.2020.2967375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Limited physical access to target organs of patients inside an MRI scanner is a major obstruction to real-time MRI-guided interventions. Traditional teleoperation technologies are incompatible with the MRI environment and although several solutions have been explored, a versatile system that provides high-fidelity haptic feedback and access deep inside the bore remains a challenge. We present a passive and nearly frictionless MRI-compatible hydraulic teleoperator designed for in-bore liver biopsies. We describe the design components, characterize the system transparency, and evaluate the performance with a user study in a laboratory and a clinical setting. The results demonstrate % difference between input and output forces during realistic manipulation. A user study with participants conducting mock needle biopsy tasks indicates that a remote operator performs equally well when using the device as when holding a biopsy needle directly in hand. Additionally, MRI compatibility tests show no reduction in signal-to-noise ratio in the presence of the device.
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Pirozzi I, Snider A, Kraus M, Schönbrunner ER, Tripathi A. Microfluidic Immiscible Phase Filtration System for the Isolation of Small Numbers of Cells from Whole Blood. Cytometry A 2019; 95:885-897. [PMID: 30852843 DOI: 10.1002/cyto.a.23736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 12/24/2018] [Accepted: 02/05/2019] [Indexed: 11/09/2022]
Abstract
Isolation of circulating tumor cells (CTCs) has generated clinical and academic interest due to the important role that CTCs play in cancer metastasis and diagnosis. Here, we present a PDMS and glass prototype of a microfluidic device for the immunomagnetic, immiscible phase filtration based capture, and isolation of MCF-7 breast cancer cells, from various sample matrices including PBS-based buffer, blood plasma, and unprocessed whole blood. Following optimization of surface energy of an oil-water interface, microfluidic geometry, and bead-binding kinematics, our microfluidic device achieved 95 ± 4% recovery of target cells from PBS-based buffer with 95% purity, 90 ± 3% recovery of target cells from blood plasma and recovery of ~70 ± 5% from unprocessed whole blood with purity >99% with 1 ml blood samples with 1,000 spiked target cells. From quantitative studies to assess the nonspecific carryover of contaminants from whole blood, we found that our system accomplishes a >175 fold depletion in platelets, >900 fold depletion in erythrocytes, and >1,700 fold depletion in leukocytes with respect to unprocessed whole blood, enabling us to avoid sample pre-processing. In addition, we found that ~95% of the isolated target cells were viable, making them suitable for subsequent molecular and cellular studies. We quantify and propose mechanisms for the carryover of platelet, erythrocyte, and leukocyte contamination in purified samples, rather than relying on sample pre-processing. These results validate the continued study of our platform for extraction of CTCs from patient samples and other rare cell isolation applications. © 2019 International Society for Advancement of Cytometry.
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Affiliation(s)
- Ileana Pirozzi
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island
| | - Adam Snider
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island
| | - Morey Kraus
- PerkinElmer, 940 Winter St, Waltham, Massachusetts
| | | | - Anubhav Tripathi
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, Rhode Island
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Clerici-Bagozzi D, Pirozzi I, Garlaschi L, Colombo R, Varotto F, Marini A. [Isolation of Staphylococcus at a neonatal intensive care unit]. G Ital Chemioter 1991; 38:137-40. [PMID: 1365568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Affiliation(s)
- D Clerici-Bagozzi
- Divisione di Patologia Neonatale, Clinica OG L. Mangiagalli, Università degli Studi, Milano
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