Scientists are turning to 3D printing, digital simulations for the treatment of heart disease

Mar 25, 2016 | | Say something

Scientists are turning to 3D printing, digital simulations for the treatment of heart disease ;

specific models aorta of patients with diseased coronary arteries. Credit: Alison Marsden, Author provided

My mother bought his first GPS in the 1990s few months later, he came home angry because he had directed him to the wrong side of the city, making her an hour late. “That’s too bad,” I said, and went on with our lives. We both understood that the commercial GPS was a new technology and was not infallible, one wasted hour was a small price to pay for 99 percent of travel in which worked properly driving. We knew that with more testing and user feedback, GPS technology continue to improve.

Things would have been different if that technology with a failure rate of 1 percent was a pacemaker or an artificial valve implanted in the heart of my mother and designed to keep her alive.

But how can we expect if the technology to improve a person’s health you are at stake? It is unethical to test new medical devices to patients without much evidence to go to work; extensive animal testing, clinical trials and approval process complicated FDA are needed before these devices are on the market. This means potentially lifesaving treatments can take years to reach patients.

Now, scientists are turning to new tools, including computer simulation and 3D printing to develop faster, safer ways to test medical devices without installing them on humans or live animals. My laboratory is working on the application of these techniques to heart and vascular disease. This work has the potential to improve outcomes of common invasive procedures in the treatment today.

Taking measurements within the body

Vascular, my area of ​​research, disease is a very common condition in the US There are hundreds of techniques for solving problems of the circulatory system, including stents (metal cylinders Pet blood vessels open) angioplasty balloon (clogged arteries reopened pushing obstructions out of the way) and even heart valve replacement .

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Scientists turn to 3D printing, digital simulations to treat heart disease
The flow simulation contours speed in the cross sections of three different geometries of vessels after Fontan procedure that compensates a ventricle weak heart in infants . This type of work allows surgeons to plan surgery. Credit: W. Yang, JA Feinstein, AL Marsden, et al, Author provided.

Before a cardiovascular device or procedure is considered safe and effective, it must be verified successfully to restore healthy blood flow in the body. It has been shown the details of blood flow, such as flow rate, direction and pressure, can affect the health of the cells lining the vessels blood and heart. Knowing what the blood flow is as before being fixed, and what can happen after an installation procedure or device, it can help predict the success of the technique.

Properties such as flow rate, direction and pressure are difficult to measure in a human or animal alive be because most measurement techniques require lancing of blood vessels. The few non-invasive methods or give unreliable results or are too slow and expensive for use in each patient. Moreover, most flow measurements in live animals and humans are is not sufficiently detailed to determine whether a procedure ultimately lead to disease of the walls of blood vessels affected.

Scientists turn to 3D printing, digital simulations to treat heart disease
simulated blood velocity and distribution of drugs in a model specific patient’s aorta. Credit: IA Carr, N Nemoto, SC Shadden, et al, Author provided.

The use of computers to model blood flow

To avoid this problem, scientists can test devices and procedures using simulations and cardiovascular synthetic models. These studies allow much more controlled and extensive gathering of data flow would be possible in a living patient. Several research groups, including mine, are currently doing this kind of work, which includes modeling fluid velocity and pressure in the blood vessels with computers. This process is called computational fluid dynamics (CFD).

Because each patient’s vascular network is a slightly different way, there has been a movement to perform specific simulations for each patient. That means scanning the blood vessels of each patient from medical and model images virtually. By varying the model to simulate a procedure or device implantation, doctors can predict how the patient’s blood flow will change and choose the best possible outcome in advance. For example, CFD has been is used to model the coronary aneurysms in children and suggest techniques for treating them.

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Scientists turn to 3D printing, digital simulations to treat heart disease
simulated blood velocity and distribution of drugs in a model specific patient’s aorta. Credit: IA Carr, N Nemoto, SC Shadden, et al, Author provided.

There are many advantages of using this method for predicting cardiovascular procedure and the success of the device. First, CFD produce detailed data on the flow of blood near the vessel walls, which are difficult to measure experimentally and yet are critical in determining the future health of the vessels. In addition, due to CFD can simulate variations in the shape of blood vessels, doctors can use to optimize plans without experiencing surgery on the patient. For example, CFD has been used to plan surgery to repair the hearts of babies born with only one functional ventricle.

CFD can also show how blood flow distributes medication to various organs and tissues motion tracking particles of medication is injected into a revealing container where they reach blood vessel walls .

However, CFD also has its challenges. cardiovascular devices are more difficult than surgery to model in a simulation. In addition, models fluid often must be coupled to the mechanical models of the arterial wall and biological factors such as cell responses to hormones for a complete simulation of a device or the impact of the procedure.

Scientists turn to 3D printing, digital simulations to treat heart disease
cross-sectional slices of experimental data speed in a model of curved blood vessel. The waveforms at the top indicate the points of the waveform of the cardiac cycle blood flow. Credit: Autumn L. Glenn, Kartik V. Bulusu, Fangjun Shu, W. Michael Pleśniak, Author provided

Using modeling experiments to blood flow

Some researchers, including my group, have been modeled beyond computers and have made physical models to study how cardiovascular devices affect blood flow. Now 3D printing technology is advanced enough to build realistic models of human blood vessels, and pumps may lead pulsatile flow through these vessels to mimic heart pumping. Since models of the vessels are synthetic, there is no ethical problems associated with puncture to take action flow.

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These real-world models also have the advantage that it is possible to install real cardiovascular devices and the use of royal blood, none of which can be achieved with a simulation. For example, a recent study found vortices previously unidentified in the blood flow through a curved artery downstream of a stent. However, experiments are slower than CFD, more expensive and typically generate lower resolution data.

There are still many challenges in the use of fluid mechanics simulations and experiments to predict the success of procedures and cardiovascular devices. The flow effect on the health of the blood vessels is closely linked to the elasticity of the walls of blood vessels and cell responses to blood chemistry; It is difficult to model all these factors together. It is also difficult to validate the model data against the flow of real human blood, because it is so difficult to take action in a living patient.

However, the models simulated blood flow are already being used in the clinic. For example, the FDA recently approved HeartFlow FFR-CT , a software package flow simulation to help health professionals evaluate the severity of the blockage of the coronary arteries. As modeling techniques continue to develop blood flow, it is our hope that we can acquire more data on the human circulatory system and the effectiveness of devices with minimal human or animal experimentation.

This article was originally published on medicalxpress, Read the original article

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