Background
Tetralogy of Fallot with major aortopulmonary collateral arteries is a heterogeneous form of pulmonary artery (PA) stenosis that requires multiple forms of intervention. We present a patient‐specific in vitro platform capable of sustained flow that can be used to train proceduralists and surgical teams in current interventions, as well as in developing novel therapeutic approaches to treat various vascular anomalies. Our objective is to develop an in vitro model of PA stenosis based on patient data that can be used as an in vitro phantom to model cardiovascular disease and explore potential interventions.
Methods and Results
From patient‐specific scans obtained via computer tomography or 3‐dimensional (3D) rotational angiography, we generated digital 3D models of the arteries. Subsequently, in vitro models of tetralogy of Fallot with major aortopulmonary collateral arteries were first 3D printed using biocompatible resins and next bioprinted using gelatin methacrylate hydrogel to simulate neonatal vasculature or second‐order branches of an older patient with tetralogy of Fallot with major aortopulmonary collateral arteries. Printed models were used to study creation of extraluminal connection between an atretic PA and a major aortopulmonary collateral artery using a catheter‐based interventional method. Following the recanalization, engineered
PA
constructs were perfused and flow was visualized using contrast agents and x‐ray angiography. Further, computational fluid dynamics modeling was used to analyze flow in the recanalized model.
Conclusions
New 3D‐printed and computational fluid dynamics models for vascular atresia were successfully created. We demonstrated the unique capability of a printed model to develop a novel technique for establishing blood flow in atretic vessels using clinical imaging, together with 3D bioprinting–based tissue engineering techniques. Additive biomanufacturing technologies can enable fabrication of functional vascular phantoms to model PA stenosis conditions that can help develop novel clinical applications.
Single ventricle physiology is a complex disease state requiring multiple open-heart surgeries to achieve stable hemodynamics. For patients with abnormalities in the pulmonary arteries (PAs), these must be remedied before the patient can be a candidate for such palliations. Transcatheter techniques could rescue this subset of single ventricle patients through intervascular PA connections, allowing a high-risk population to ultimately achieve stable pulmonary blood flow. However, there is currently no
in vitro
platform to model transcatheter processes for anastomosis, particularly to palliate single ventricle defects. This project utilizes 3D bioprinting and perfusion bioreactor technologies to develop a
functional
in vitro
biological device
to model severely stenotic PAs of single ventricle patients. Human endothelial (ECs) & smooth muscle (SMCs) cells embedded in extracellular matrix
bioink
are used in a multi-material bioprinting approach to create
3D bilayer vascular structures
with controlled geometry and flow.
In collaboration with CHOA Cardiac Catheterization Laboratory
, stent devices are deployed in the printed model to re-establish intervascular connection. Healthy, stenotic, and stented tissues are cultured via a bioreactor and analyzed for flow hemodynamics by echo PIV and 4D MR imaging. Cell viability, proliferation, and endothelialization of printed vessels, plus EC-SMC interplay were closely monitored pre- and post- anastomosis, to identify the effect of geometry and flow on cellular overgrowth. This advanced planning enables a subset of single ventricle patients, otherwise not eligible, to ultimately accept further palliative strategies.
Misfolded Aβ is involved in the progression of Alzheimer's disease (AD). However, the role of its polymorphic variants or conformational strains in AD pathogenesis is not fully understood. Here, we study the seeding properties of two structurally defined synthetic misfolded Aβ strains (termed 2F and 3F) using in vitro and in vivo assays. We show that 2F and 3F strains differ in their biochemical properties, including resistance to proteolysis, binding to strain‐specific dyes, and in vitro seeding. Injection of these strains into a transgenic mouse model produces different pathological features, namely different rates of aggregation, formation of different plaque types, tropism to specific brain regions, differential recruitment of Aβ40/Aβ42 peptides, and induction of microglial and astroglial responses. Importantly, the aggregates induced by 2F and 3F are structurally different as determined by ssNMR. Our study analyzes the biological properties of purified Aβ polymorphs that have been characterized at the atomic resolution level and provides relevant information on the pathological significance of misfolded Aβ strains.
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