Microneedle (MN), a miniaturized needle with a length‐scale of hundreds of micrometers, has received a great deal of attention because of its minimally invasive, pain‐free, and easy‐to‐use nature. However, a major challenge for controlled long‐term drug delivery or biosensing using MN is its low tissue adhesion. Although microscopic structures with high tissue adhesion are found from living creatures in nature (e.g., microhooks of parasites, barbed stingers of honeybees, quills of porcupines), creating MNs with such complex microscopic features is still challenging with traditional fabrication methods. Here, a MN with bioinspired backward‐facing curved barbs for enhanced tissue adhesion, manufactured by a digital light processing 3D printing technique, is presented. Backward‐facing barbs on a MN are created by desolvation‐induced deformation utilizing cross‐linking density gradient in a photocurable polymer. Barb thickness and bending curvature are controlled by printing parameters and material composition. It is demonstrated that tissue adhesion of a backward‐facing barbed MN is 18 times stronger than that of barbless MN. Also demonstrated is sustained drug release with barbed MNs in tissue. Improved tissue adhesion of the bioinspired MN allows for more stable and robust performance for drug delivery, biofluid collection, and biosensing.

We present a novel framework for the fluid dynamics analysis of healthy subjects and patients affected by ascending thoracic aorta aneurysm (aTAA). Our aim is to obtain indications about the effect of a bulge on the hemodynamic environment at different enlargements. 3D surface models defined from healthy subjects and patients with aTAA, selected for surgical repair, were generated. A representative shape model for both healthy and pathological groups has been identified. A morphing technique based on radial basis functions (RBF) was applied to mould the shape relative to healthy patient into the representative shape of aTAA dataset to enable the parametric simulation of the aTAA formation. CFD simulations were performed by means of a finite volume solver using the mean boundary conditions obtained from three-dimensional (PC-MRI) acquisition. Blood flow helicity and flow descriptors were assessed for all the investigated models. The feasibility of the proposed integrated approach of RBF morphing technique and CFD simulation for aTAA was demonstrated. Significant hemodynamic changes appear at the 60% of the bulge progression. An impingement of the flow toward the bulge was observed by analyzing the normalized flow eccentricity index.

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Background: 3D printing represents an emerging technology in the field of cardiovascular medicine. 3D printing can help to perform a better analysis of complex anatomies to optimize intervention planning. Methods: A systematic review was performed to illustrate the 3D printing technology and to describe the workflow to obtain 3D printed models from patient-specific images. Examples from our laboratory of the benefit of 3D printing in planning interventions were also reported. Results: 3D printing technique is reliable when applied to high-quality 3D image data (CTA, CMR, 3D echography) but it still need the involvement of expert operators for image segmentation and mesh refinement. 3D printed models could be useful in interventional planning, although prospective studies with comprehensive and clinically meaningful endpoints are required to demonstrate the clinical utility. Conclusion: 3D printing can be used to improve anatomy understanding and surgical planning.

Computational models of cardiovascular structures rely on their accurate mechanical characterization. A validated method able to infer the material properties of patientspecific large vessels is currently lacking. The aim of the present study is to present a technique starting from the flow-area (QA) method to retrieve basic material properties from magnetic resonance (MR) imaging. MethodsThe proposed method was developed and tested, first, in silico and then in vitro. In silico, fluid-structure interaction (FSI) simulations of flow within a deformable pipe were run with varying elastic modules (E) between 0.5 and 32 MPa. The proposed QA-based formulation was assessed and modified based on the FSI results to retrieve E values. In vitro, a compliant phantom connected to a mock circulatory system was tested within MR scanning. Images of the phantom were acquired and post-processed according to the modified formulation to infer E of the phantom. Results of in vitro imaging assessment were verified against standard tensile test. ResultsIn silico results from FSI simulations were used to derive the correction factor to the original formulation based on the geometrical and material characteristics. In vitro, the modified QA-based equation estimated an average E = 0.51 MPa, 2% different from the E derived from tensile tests (i.e. E = 0.50 MPa). ConclusionThis study presented promising results of an indirect and non-invasive method to establish elastic properties from solely MR images data, suggesting a potential image-based mechanical characterization of large blood vessels.

Computational hemodynamics has become increasingly important within the context of precision medicine, providing major insight in cardiovascular pathologies. However, finding appropriate compromise between speed and accuracy remains challenging in computational hemodynamics for an extensive use in decision making. For example, in the ascending thoracic aorta, interactions between the blood and the aortic wall must be taken into account for the sake of accuracy, but these fluid structure interactions (FSI) induce significant computational costs, especially when the tissue exhibits a hyperelastic and anisotropic response. The objective of the current study is to use the Small On Large (SOL) theory to linearize the anisotropic hyperelastic behavior in order to propose a reduced-order model for FSI simulations of the aorta. The SOL method is tested for fully-coupled FSI simulations in a patient-specific aortic geometry presenting an Ascending Thoracic Aortic Aneurysm (aTAA). The same model is also simulated with a fully-coupled FSI with non-linear material behavior, without SOL linearization. Eventually, the results and computational times with and without the SOL are compared. The SOL approach is demonstrated to provide a significant reduction of computational costs for FSI analysis in the aTAA, and the results in terms of stress state distribution are comparable. The method is implemented in ANSYS and will be further evaluated for clinical applications.

Cardiovascular diseases are the leading cause of death in the western countries. Robotic surgery recently emerged as a confirmed strategy in the cardiovascular field, especially thanks to the improvement of soft robotics. These techniques have demonstrated their potential in terms of speed of execution and precision. In this context, a deeper knowledge of the material properties of the blood vessels is required, especially for computational soft robotics applications. A constitutive model including the contribution of the collagen fibers families is needed to take hyperelasticity and anisotropy into account. For this purpose, four different models are presented: two fiber families with dispersion (2FFD), two fiber families without dispersion (2FF), four fiber families with dispersion (4FFD), and four fiber families without dispersion (4FF). A set of experimental biaxial data obtained from ex-vivo specimens was used to assess the model performances. Two fitting procedures were imposed: a procedure with no weighting of scores and a procedure with a weight set to enhance the model performances in the contact range. A finite element simulation of a contact procedure was developed to evaluate the effect on the contact pressures and forces according to the different model implementations. In particular, a minimally invasive aortic valve positioning process through a previously designed soft robot was simulated. The results confirmed the overall fitting procedure. The adoption of the weighting process for the fitting was successful, as it permitted an accurate prediction in the region of interest through models with less parameters.

The development of accurate replicas of the circulatory and cardiac system is fundamental for a deeper understanding of cardiovascular diseases and the testing of new devices. Although numerous works concerning mock circulatory loops are present in the current state of the art, still some limitations are present. In particular, a pumping system able to reproduce the left ventricle motion and completely compatible with the magnetic resonance environment to permit the four-dimensional flow monitoring is still missing. The aim of this work was to evaluate the feasibility of an actuator suitable for cardiovascular mock circuits. Particular attention was given to the ability to mimic the left ventricle dynamics including both compression and twisting with the magnetic resonance compatibility. In our study, a left ventricle model to be actuated through vacuum was designed. The realization of the system was evaluated with finite element analysis of different design solutions. After the in silico evaluation phase, the most suitable design in terms of physiological values reproduction was fabricated through three-dimensional printing for in vitro validation. A pneumatic experimental setup was developed to evaluate the pump performances in terms of actuation, in particular ventricle radial and longitudinal displacement, twist rotation, and ejection fraction. The study demonstrated the feasibility of a custom pneumatic pump for mock circulatory loops able to reproduce the physiological ventricle movement and completely suitable for the magnetic resonance environment.