Individualized Biventricular Epicardial Augmentation Technology in a Drug-Induced Porcine Failing Heart Model

Jagschies, Lasse; Hirschvogel, Marc; Matallo, José; Maier, Andreas; Mild, Karin; Brünner, Horst; Hinkel, Rabea; Gee, Michael W.; Radermacher, Peter; Wildhirt, Stephen M.; Häfner, Sebastian

doi:10.1097/mat.0000000000000686

Cited by 8 publications

(15 citation statements)

References 17 publications

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“…The aim was to investigate the short‐term influence, impact, and function of the novel BiVAD prototypes on pharmacologically induced failing heart models in order to provide proof of concept and extract valuable indices of heart assistance to promote further developments in the field of this novel VAD technology. Particulars of the in vivo animal study are described in the previous study …”

Section: Methodsmentioning

confidence: 99%

“…A regression‐based statistical model was used in the existing study to evaluate whether BiVAD treatment has significant influence on cardiac function parameters for these two heart failure models. The analysis revealed that increasing left ventricular augmentation pressure significantly increased stroke volume and systolic pressures and lowered end‐diastolic pressure.…”

Section: Methodsmentioning

confidence: 99%

“…An alternative concept for mechanical cardiac assistance applies pulsatile pressure onto the epicardial surface, thereby avoiding blood contact as the major driver for many of the aforementioned complications and preserving the native cardiac function completely . These VADs consist of an implant with hydraulic or pneumatic units inside the pericardial space that are actuated by an external driving system.…”

Section: Introductionmentioning

confidence: 99%

“…Key aspects of an epicardial biventricular assist device (BiVAD) technology are patient‐specific design for optimal fit and unconstrained native cardiac function and synchronization to the cardiac cycle and individual support pressures for the left and right ventricle. One such device developed by the authors is studied in a large in vivo porcine experiment series (11 animals), demonstrating efficiency of the cardiac support and biological compatibility with the body environment.…”

Section: Introductionmentioning

confidence: 99%

“…Then, two drug‐induced heart failure models are studied for verification and validation: a low‐afterload version generated by β 1 ‐blockade (named low‐afterload heart failure LA‐HF ) and a high‐afterload variant generated by phenylephrine (named high‐afterload heart failure HA‐HF ) . The computational models are personalized to the individual's homeostatic state depending on the heart failure case by calibrating active ventricular dynamics and vascular resistances to match experimentally measured left ventricular pressure and volume data …”

Section: Introductionmentioning

confidence: 99%

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An in silico twin for epicardial augmentation of the failing heart

Hirschvogel

Jagschies

Maier³

et al. 2019

Numer Methods Biomed Eng

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Advances in ventricular assist device (VAD) technology for the treatment of end‐stage congestive heart failure (CHF) are needed to cope with the increasing numbers of patients that cannot be provided with donor hearts for transplantation. We develop and investigate a novel extravascular VAD technology that provides biventricular, epicardial pressure support for the failing heart. This novel VAD concept avoids blood contact that is accompanied with typical complications such as coagulation and infections. To date, in vivo porcine model results with a prototype of the implant exist, further studies to improve the implant's performance and promote its applicability in humans are needed. In this contribution, we present a personalised functional digital twin of the heart, the vascular system, and the novel VAD technology in terms of a calibrated, customized computational model. The calibration procedure is based on patient‐specific measurements and is performed by solving an inverse problem. This in silico model is able to (a) confirm in vivo experimental data, (b) predict healthy and pathologic ventricular function, and (c) assess the beneficial impact of the novel VAD concept to a high level of fidelity. The model shows very good agreement with in vivo data and reliably predicts increases in stroke volume and left ventricular pressure with increasing ventricular support. Furthermore, the digital twin allows insight into quantities that are poorly or not at all amenable in any experimental setup. Conclusively, the model's ability to link integral hemodynamic variables to local tissue mechanical deformation makes it a highly valuable tool for the dimensioning of novel VAD technologies and future treatment strategies in heart failure. The presented in silico twin enhances in vivo studies by facilitating the accessibility and increasing the range of quantities of interest. Because of its flexibility in the assessment of design variants and optimization loops, it may substantially contribute to a reduction of the amount of animal experiments in this and similar settings.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An in silico twin for epicardial augmentation of the failing heart

Hirschvogel

Jagschies

Maier³

et al. 2019

Numer Methods Biomed Eng

Self Cite

View full text Add to dashboard Cite

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Artificial Muscles and Soft Robotic Devices for Treatment of End‐Stage Heart Failure

et al. 2023

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Medical soft robotics constitutes a rapidly developing field in the treatment of cardiovascular diseases, with a promising future for millions of patients suffering from heart failure worldwide. Herein, the present state and future direction of artificial muscle‐based soft robotic biomedical devices in supporting the inotropic function of the heart are reviewed, focusing on the emerging electrothermally artificial heart muscles (AHMs). Artificial muscle powered soft robotic devices can mimic the action of complex biological systems such as heart compression and twisting. These artificial muscles possess the ability to undergo complex deformations, aiding cardiac function while maintaining a limited weight and use of space. Two very promising candidates for artificial muscles are electrothermally actuated AHMs and biohybrid actuators using living cells or tissue embedded with artificial structures. Electrothermally actuated AHMs have demonstrated superior force generation while creating the prospect for fully soft robotic actuated ventricular assist devices. This review will critically analyze the limitations of currently available devices and discuss opportunities and directions for future research. Last, the properties of the cardiac muscle are reviewed and compared with those of different materials suitable for mechanical cardiac compression.

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