MSGID: 1:317/3 63f6ebe2   
   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Custom, 3D-printed heart replicas look and pump just like the real thing   
    The soft robotic models are patient-specific and could help clinicians   
   zero in on the best implant for an individual.    
      
     Date:   
         February 22, 2023   
     Source:   
         Massachusetts Institute of Technology   
     Summary:   
         Engineers developed a procedure to 3D print a soft and flexible   
         replica of a patient's heart. These models could help doctors   
         tailor treatments, such as aortic valves, to an individual patient.   
      
      
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   FULL STORY   
   ==========================================================================   
   No two hearts beat alike. The size and shape of the the heart can vary   
   from one person to the next. These differences can be particularly   
   pronounced for people living with heart disease, as their hearts and   
   major vessels work harder to overcome any compromised function.   
      
      
   ==========================================================================   
   MIT engineers are hoping to help doctors tailor treatments to patients'   
   specific heart form and function, with a custom robotic heart. The team   
   has developed a procedure to 3D print a soft and flexible replica of   
   a patient's heart. They can then control the replica's action to mimic   
   that patient's blood-pumping ability.   
      
   The procedure involves first converting medical images of a patient's   
   heart into a three-dimensional computer model, which the researchers can   
   then 3D print using a polymer-based ink. The result is a soft, flexible   
   shell in the exact shape of the patient's own heart. The team can also   
   use this approach to print a patient's aorta -- the major artery that   
   carries blood out of the heart to the rest of the body.   
      
   To mimic the heart's pumping action, the team has fabricated sleeves   
   similar to blood pressure cuffs that wrap around a printed heart and   
   aorta. The underside of each sleeve resembles precisely patterned bubble   
   wrap. When the sleeve is connected to a pneumatic system, researchers   
   can tune the outflowing air to rhythmically inflate the sleeve's bubbles   
   and contract the heart, mimicking its pumping action.   
      
   The researchers can also inflate a separate sleeve surrounding a printed   
   aorta to constrict the vessel. This constriction, they say, can be tuned   
   to mimic aortic stenosis -- a condition in which the aortic valve narrows,   
   causing the heart to work harder to force blood through the body.   
      
   Doctors commonly treat aortic stenosis by surgically implanting a   
   synthetic valve designed to widen the aorta's natural valve. In the   
   future, the team says that doctors could potentially use their new   
   procedure to first print a patient's heart and aorta, then implant a   
   variety of valves into the printed model to see which design results   
   in the best function and fit for that particular patient. The heart   
   replicas could also be used by research labs and the medical device   
   industry as realistic platforms for testing therapies for various types   
   of heart disease.   
      
   "All hearts are different," says Luca Rosalia, a graduate student in   
   the MIT- Harvard Program in Health Sciences and Technology. "There are   
   massive variations, especially when patients are sick. The advantage of   
   our system is that we can recreate not just the form of a patient's heart,   
   but also its function in both physiology and disease."  Rosalia and his   
   colleagues report their results in a study appearing today in Science   
   Robotics.MIT co-authors include Caglar Ozturk, Debkalpa Goswami, Jean   
   Bonnemain, Sophie Wang, and Ellen Roche, along with Benjamin Bonner   
   of Massachusetts General Hospital, James Weaver of Harvard University,   
   and Christopher Nguyen, Rishi Puri, and Samir Kapadia at the Cleveland   
   Clinic in Ohio.   
      
   Print and pump In January 2020, team members, led by mechanical   
   engineering professor Ellen Roche, developed a "biorobotic hybrid heart"   
   -- a general replica of a heart, made from synthetic muscle containing   
   small, inflatable cylinders, which they could control to mimic the   
   contractions of a real beating heart.   
      
   Shortly after those efforts, the Covid-19 pandemic forced Roche's lab,   
   along with most others on campus, to temporarily close. Undeterred,   
   Rosalia continued tweaking the heart-pumping design at home.   
      
   "I recreated the whole system in my dorm room that March," Rosalia   
   recalls.   
      
   Months later, the lab reopened, and the team continued where it left off,   
   working to improve the control of the heart-pumping sleeve, which they   
   tested in animal and computational models. They then expanded their   
   approach to develop sleeves and heart replicas that are specific to   
   individual patients.   
      
   For this, they turned to 3D printing.   
      
   "There is a lot of interest in the medical field in using 3D printing   
   technology to accurately recreate patient anatomy for use in preprocedural   
   planning and training," notes Wang, who is a vascular surgery resident   
   at Beth Israel Deaconess Medical Center in Boston.   
      
   An inclusive design In the new study, the team took advantage of 3D   
   printing to produce custom replicas of actual patients' hearts. They   
   used a polymer-based ink that, once printed and cured, can squeeze and   
   stretch, similarly to a real beating heart.   
      
   As their source material, the researchers used medical scans of 15   
   patients diagnosed with aortic stenosis. The team converted each patient's   
   images into a three-dimensional computer model of the patient's left   
   ventricle (the main pumping chamber of the heart) and aorta. They fed   
   this model into a 3D printer to generate a soft, anatomically accurate   
   shell of both the ventricle and vessel.   
      
   The team also fabricated sleeves to wrap around the printed forms. They   
   tailored each sleeve's pockets such that, when wrapped around their   
   respective forms and connected to a small air pumping system, the sleeves   
   could be tuned separately to realistically contract and constrict the   
   printed models.   
      
   The researchers showed that for each model heart, they could accurately   
   recreate the same heart-pumping pressures and flows that were previously   
   measured in each respective patient.   
      
   "Being able to match the patients' flows and pressures was very   
   encouraging," Roche says. "We're not only printing the heart's anatomy,   
   but also replicating its mechanics and physiology. That's the part that   
   we get excited about."  Going a step further, the team aimed to replicate   
   some of the interventions that a handful of the patients underwent, to   
   see whether the printed heart and vessel responded in the same way. Some   
   patients had received valve implants designed to widen the aorta. Roche   
   and her colleagues implanted similar valves in the printed aortas modeled   
   after each patient. When they activated the printed heart to pump, they   
   observed that the implanted valve produced similarly improved flows as   
   in actual patients following their surgical implants.   
      
   Finally, the team used an actuated printed heart to compare implants of   
   different sizes, to see which would result in the best fit and flow -   
   - something they envision clinicians could potentially do for their   
   patients in the future.   
      
   "Patients would get their imaging done, which they do anyway, and we would   
   use that to make this system, ideally within the day," says co-author   
   Nyugen. "Once it's up and running, clinicians could test different valve   
   types and sizes and see which works best, then use that to implant."   
   Ultimately, Roche says the patient-specific replicas could help develop   
   and identify ideal treatments for individuals with unique and challenging   
   cardiac geometries.   
      
   "Designing inclusively for a large range of anatomies, and testing   
   interventions across this range, may increase the addressable target   
   population for minimally invasive procedures," Roche says.   
      
   This research was supported, in part, by the National Science Foundation,   
   the National Institutes of Health, and the National Heart Lung Blood   
   Institute.   
      
       * RELATED_TOPICS   
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                   # Heart_Disease # Diseases_and_Conditions #   
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             o Matter_&_Energy   
                   # Medical_Technology # Electronics # 3-D_Printing #   
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             o Heart_valve o Personalized_medicine o Face_transplant o   
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   ==========================================================================   
   Story Source: Materials provided by   
   Massachusetts_Institute_of_Technology. Original written by Jennifer   
   Chu. Note: Content may be edited for style and length.   
      
      
   ==========================================================================   
   Journal Reference:   
      1. Luca Rosalia, Caglar Ozturk, Debkalpa Goswami, Jean Bonnemain,   
      Sophie X.   
      
         Wang, Benjamin Bonner, James C. Weaver, Rishi Puri, Samir   
         Kapadia, Christopher T. Nguyen, Ellen T. Roche. Soft robotic   
         patient-specific hydrodynamic model of aortic stenosis and   
         ventricular remodeling. Science Robotics, 2023; 8 (75) DOI:   
         10.1126/scirobotics.ade2184   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/02/230222141222.htm   
      
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