title: A Mock Circulatory System Incorporating a Compliant 3D-Printed Anatomical Model to Investigate Pulmonary Hemodynamics.
abstract: A realistic mock circulatory system (MCS) could be a valuable in vitro testbed to study human circulatory hemodynamics. The objective of this study was to design a MCS replicating the pulmonary arterial circulation, incorporating an anatomically representative arterial model suitable for testing clinically relevant scenarios. A second objective of the study was to ensure the system's compatibility with magnetic resonance imaging (MRI) for additional measurements. A latex pulmonary arterial model with two generations of bifurcations was manufactured starting from a 3D-printed mold reconstructed from patient data. The model was incorporated into a MCS for in vitro hydrodynamic measurements. The setup was tested under physiological pulsatile flow conditions and results were evaluated using wave intensity analysis (WIA) to investigate waves traveling in the arterial system. Increased pulmonary vascular resistance (IPVR) was simulated as an example of one pathological scenario. Flow split between right and left pulmonary artery was found to be realistic (54 and 46%, respectively). No substantial difference in pressure waveform was observed throughout the various generations of bifurcations. Based on WIA, three main waves were identified in the main pulmonary artery (MPA), that is, forward compression wave, backward compression wave, and forward expansion wave. For IPVR, a rise in mean pressure was recorded in the MPA, within the clinical range of pulmonary arterial hypertension. The feasibility of using the MCS in the MRI scanner was demonstrated with the MCS running 2 h consecutively while acquiring preliminary MRI data. This study shows the development and verification of a pulmonary MCS, including an anatomically correct, compliant latex phantom. The setup can be useful to explore a wide range of hemodynamic questions, including the development of patient- and pathology-specific models, considering the ease and low cost of producing rapid prototyping molds, and the versatility of the setup for invasive and noninvasive (i.e., MRI) measurements.
authors.affiliation: UCL Institute of Child Health, London, United Kingdom.|Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom.|Department of Mechanical Engineering, University College London, London, United Kingdom.
authors.forename: Paul G M
authors.initials: PGM
authors.lastname: Knoops
authors.affiliation: Great Ormond Street Hospital for Children, NHS Trust, London, United Kingdom.|Bristol Heart Institute, School of Clinical Sciences, University of Bristol, Bristol, United Kingdom.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Biglino
authors.affiliation: UCL Institute of Cardiovascular Science, London, United Kingdom.
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
authors.affiliation: Department of Bioengineering, Imperial College London, London, United Kingdom.
authors.forename: Kim H
authors.initials: KH
authors.lastname: Parker
authors.affiliation: Department of Mechanical Engineering, University College London, London, United Kingdom.
authors.forename: Linzhang
authors.initials: L
authors.lastname: Xu
authors.affiliation: UCL Institute of Child Health, London, United Kingdom.|UCL Institute of Cardiovascular Science, London, United Kingdom.
authors.forename: Silvia
authors.initials: S
authors.lastname: Schievano
authors.affiliation: Department of Mechanical Engineering, University College London, London, United Kingdom.
authors.forename: Ryo
authors.initials: R
authors.lastname: Torii
mesh_terms: D000368:Aged; D005112:Extracorporeal Circulation / Q000295:instrumentation; D006439:Hemodynamics; D006801:Humans; D008168:Lung / Q000033:anatomy & histology / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D008297:Male; D008953:Models, Anatomic; D008955:Models, Cardiovascular; D066330:Printing, Three-Dimensional; D011651:Pulmonary Artery / Q000033:anatomy & histology* / Q000502:physiology*; D011652:Pulmonary Circulation
keywords: -3D printing; -Pulmonary artery; -Wave intensity analysis; Mock circulatory system