Comprehensive In Vitro Study of the Flow Past Two Transcatheter Aortic Valves: Comparison with a Severe Stenotic Case.

We investigate the flow past two transcatheter aortic valves (TAVs) and one severely calcified valve in an anatomically realistic aorta geometry to evaluate the ability of the TAVs to establish a healthier aortic flow compared to a diseased case. Velocity measurements of pulsatile flow are carried out using the 3D-particle tracking velocimetry technique. We present a novel approach based on the Smagorinsky model to assess the important subvoxel-scale (here smaller than 750 [Formula: see text]m) shear stress contribution that is usually unavailable in experiments. Both TAV models feature a small retrograde flow of about 5% of the stroke volume and a lower number of coherent vortical structures. Turbulence past the TAVs is strongly suppressed as evidenced by the lower levels of turbulent kinetic energy even though the newer generation TAV performs better than the old one. Also lysis indices are substantially reduced in both models. The new generation TAV displays a slightly higher risk for thrombogenicity due to longer exposure times. We anticipate that our new approach to include turbulence and shear stress related quantities may help to validate the design of cardiovascular devices.

Ultrasonic sensor concept to fit a ventricular assist device cannula evaluated using geometrically accurate heart phantoms.

Future left ventricular assist devices (LVADs) are expected to respond to the physiologic need of patients; however, they still lack reliable pressure or volume sensors for feedback control. In the clinic, echocardiography systems are routinely used to measure left ventricular (LV) volume. Until now, echocardiography in this form was never integrated in LVADs due to its computational complexity. The aim of this study was to demonstrate the applicability of a simplified ultrasonic sensor to fit an LVAD cannula and to show the achievable accuracy in vitro. Our approach requires only two ultrasonic transducers because we estimated the LV volume with the LV end-diastolic diameter commonly used in clinical assessments. In order to optimize the accuracy, we assessed the optimal design parameters considering over 50 orientations of the two ultrasonic transducers. A test bench was equipped with five talcum-infused silicone heart phantoms, in which the intra-ventricular surface replicated papillary muscles and trabeculae carnae. The end-diastolic LV filling volumes of the five heart phantoms ranged from 180 to 480 mL. This reference volume was altered by ±40 mL with a syringe pump. Based on the calibrated measurements acquired by the two ultrasonic transducers, the LV volume was estimated well. However, the accuracies obtained are strongly dependent on the choice of the design parameters. Orientations toward the septum perform better, as they interfere less with the papillary muscles. The optimized design is valid for all hearts. Considering this, the Bland-Altman analysis reports the LV volume accuracy as a bias of ±10% and limits of agreement of 0%-40% in all but the smallest heart. The simplicity of traditional echocardiography systems was reduced by two orders of magnitude in technical complexity, while achieving a comparable accuracy to 2D echocardiography requiring a calibration of absolute volume only. Hence, our approach exploits the established benefits of echocardiography and makes them applicable as an LV volume sensor for LVADs.

Modification of silicone elastomers with Bioglass 45S5® increases in ovo tissue biointegration.

Silicone is an important material family used for various medical implants. It is biocompatible, but its bioinertness prevents cell attachment, and thus tissue biointegration of silicone implants. This often results in constrictive fibrosis and implant failure. Bioglass 45S5® (BG) could be a suitable material to alter the properties of silicone, render it bioactive and improve tissue integration. Therefore, BG micro- or nanoparticles were blended into medical-grade silicone and 2D as well as 3D structures of the resulting composites were analyzed in ovo by a chick chorioallantoic membrane (CAM) assay. The biomechanical properties of the composites were measured and the bioactivity of the composites was verified in simulated body fluid. The bioactivity of BG-containing composites was confirmed visually by the formation of hydroxyapatite through scanning electron microscopy as well as by infrared spectroscopy. BG stiffens as prepared non-porous composites by 13% and 36% for micro- and nanocomposites respectively. In particular, after implantation for 7 days, the Young's modulus had increased significantly from 1.20 ± 0.01 to 1.57 ± 0.03 MPa for microcomposites and 1.44 ± 0.03 to 1.69 ± 0.29 MPa to for nanocpmosites. Still, the materials remain highly elastic and are comparably soft. The incorporation of BG into silicone overcame the bioinertness of the pure polymer. Although the overall tissue integration was weak, it was significantly improved for BG-containing porous silicones (+72% for microcomposites) and even further enhanced for composites containing nanoparticles (+94%). These findings make BG a suitable material to improve silicone implant properties. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1180-1188, 2019.

Long-Term Performance of a Pneumatically Actuated Soft Pump Manufactured by Rubber Compression Molding.

We present a long-term performance study on a pneumatically actuated soft pump (SP). The pump was manufactured by adapting rubber compression technology. Important parameters influencing pump performance (e.g., inflation and deflation times and fluid outlet pressures) were studied. Based on design improvement and material selection, SP durability could be enhanced for over 1 million actuation cycles. This resulted in conveyance of more than 140,000 L of water in less than 12 days. In a next step, we analyzed our SP on a hybrid mock circulation and achieved 1.8 L/min against 10 kPa (75 mmHg). In situ analysis by color Doppler imaging further allowed real-time assessment of the SP's diaphragm motion. We then summarized our findings for future SP development with particular use as a heart replacement therapy. This work demonstrates a new manufacturing approach for future development of long-term stable SPs.

A Soft Total Artificial Heart-First Concept Evaluation on a Hybrid Mock Circulation.

The technology of 3D-printing has allowed the production of entirely soft pumps with complex chamber geometries. We used this technique to develop a completely soft pneumatically driven total artificial heart from silicone elastomers and evaluated its performance on a hybrid mock circulation. The goal of this study is to present an innovative concept of a soft total artificial heart (sTAH). Using the form of a human heart, we designed a sTAH, which consists of only two ventricles and produced it using a 3D-printing, lost-wax casting technique. The diastolic properties of the sTAH were defined and the performance of the sTAH was evaluated on a hybrid mock circulation under various physiological conditions. The sTAH achieved a blood flow of 2.2 L/min against a systemic vascular resistance of 1.11 mm Hg s/mL (afterload), when operated at 80 bpm. At the same time, the mean pulmonary venous pressure (preload) was fixed at 10 mm Hg. Furthermore, an aortic pulse pressure of 35 mm Hg was measured, with a mean aortic pressure of 48 mm Hg. The sTAH generated physiologically shaped signals of blood flow and pressures by mimicking the movement of a real heart. The preliminary results of this study show a promising potential of the soft pumps in heart replacements. Further work, focused on increasing blood flow and in turn aortic pressure is required.

Effect of polyol sugars on the stabilization of monoclonal antibodies.

We investigate the impact of sugars and polyols on the heat-induced aggregation of a model monoclonal antibody whose monomer depletion is rate-limited by protein unfolding. We follow the kinetics of monomer consumption by size exclusion chromatography, and we interpret the results in the frame of two mechanistic schemes describing the enhanced protein stability in the presence of polyols. It is found that the stabilization effect increases with increasing polyol concentration with a comparable trend for all of the tested polyols. However, the stabilization effect at a given polyol concentration is polyol specific. In particular, the stabilization effect increases as a function of polyol size until a plateau is reached above a critical polyol size corresponding to six carbon atoms. Our results show that the stabilization by polyols does not depend solely on the volume fraction filled by the polyol molecules, but is also affected by the polyol chemistry.