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Rosalia L, Ozturk C, Coll-Font J, Fan Y, Nagata Y, Singh M, Goswami D, Mauskapf A, Chen S, Eder RA, Goffer EM, Kim JH, Yurista S, Bonner BP, Foster AN, Levine RA, Edelman ER, Panagia M, Guerrero JL, Roche ET, Nguyen CT. A soft robotic sleeve mimicking the haemodynamics and biomechanics of left ventricular pressure overload and aortic stenosis. Nat Biomed Eng 2022; 6:1134-1147. [PMID: 36163494 PMCID: PMC9588718 DOI: 10.1038/s41551-022-00937-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 08/12/2022] [Indexed: 12/14/2022]
Abstract
Preclinical models of aortic stenosis can induce left ventricular pressure overload and coarsely control the severity of aortic constriction. However, they do not recapitulate the haemodynamics and flow patterns associated with the disease. Here we report the development of a customizable soft robotic aortic sleeve that can mimic the haemodynamics and biomechanics of aortic stenosis. By allowing for the adjustment of actuation patterns and blood-flow dynamics, the robotic sleeve recapitulates clinically relevant haemodynamics in a porcine model of aortic stenosis, as we show via in vivo echocardiography and catheterization studies, and a combination of in vitro and computational analyses. Using in vivo and in vitro magnetic resonance imaging, we also quantified the four-dimensional blood-flow velocity profiles associated with the disease and with bicommissural and unicommissural defects re-created by the robotic sleeve. The design of the sleeve, which can be adjusted on the basis of computed tomography data, allows for the design of patient-specific devices that may guide clinical decisions and improve the management and treatment of patients with aortic stenosis.
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Affiliation(s)
- Luca Rosalia
- Health Sciences and Technology Program, Harvard - Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA,Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Caglar Ozturk
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA
| | - Jaume Coll-Font
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Yiling Fan
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA,Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA,Department of Mechanical Engineering, Massachusetts Institute of Technology, 33 Massachusetts Avenue, Cambridge, MA 02139, USA
| | - Yasufumi Nagata
- Cardiac Ultrasound Laboratory, Massachusetts General Hospital, 55 Fruit Boston, MA 02114, USA,Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Manisha Singh
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA
| | - Debkalpa Goswami
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA
| | - Adam Mauskapf
- Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, 55 Fruit Boston, MA 02114, USA
| | - Shi Chen
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Robert A. Eder
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Efrat M. Goffer
- Health Sciences and Technology Program, Harvard - Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA
| | - Jo H. Kim
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Salva Yurista
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Benjamin P. Bonner
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Anna N. Foster
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA
| | - Robert A. Levine
- Cardiac Ultrasound Laboratory, Massachusetts General Hospital, 55 Fruit Boston, MA 02114, USA,Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA
| | - Elazer R. Edelman
- Health Sciences and Technology Program, Harvard - Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA,Brigham and Women’s Hospital, Cardiovascular Division, 75 Francis Street, Boston, MA 02115, USA
| | - Marcello Panagia
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,Cardiovascular Medicine Section, Department of Medicine, Boston University Medical Center, 715 Albany Street, Boston, MA 02118, USA
| | - Jose L. Guerrero
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA
| | - Ellen T. Roche
- Health Sciences and Technology Program, Harvard - Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Institute for Medical Engineering and Science, Massachusetts Institute of Technology, 45 Carleton Street, Cambridge, MA 02139, USA,Department of Mechanical Engineering, Massachusetts Institute of Technology, 33 Massachusetts Avenue, Cambridge, MA 02139, USA,Correspondence and requests for materials should be addressed to ;
| | - Christopher T. Nguyen
- Health Sciences and Technology Program, Harvard - Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA,Cardiovascular Research Center, Massachusetts General Hospital, 149 13th Street, Charlestown, MA 02129, USA,A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, 149 13th Street Charlestown, MA 02129, USA,Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA,Cardiovascular Innovation Research Center, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA,Correspondence and requests for materials should be addressed to ;
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