Paola Bagnoli

The torsional behaviour of the heart (i.e. the mutual rotation of the cardiac base and apex) was proved to be sensitive to alterations of some cardiovascular parameters, i.e. preload, afterload and contractility. Moreover, pathologies which affect the fibers architecture and cardiac geometry were proved to alter the cardiac torsion pattern. For these reasons, the cardiac torsion represents a sensitive index of ventricular performance. The aim of this work is to provide further insight into physiological and pathological alterations of the cardiac torsion by means of computational analyses, combining a structural model of the two ventricles with simple lumped parameter models of both the systemic and the pulmonary circulations. Starting from diagnostic images, a 3D anatomy based geometry of the two ventricles was reconstructed. The myocytes orientation in the ventricles was assigned according to literature data and the myocardium mechanical behavior was modelled by an anisotropic hyperelastic law. Both the active and the passive phases of the cardiac cycle were modelled, and different clinical conditions were simulated. The results in terms of alterations of the cardiac torsion in the presence of pathologies are in agreement

Purpose: Only mechanical and biological heart valve prostheses are currently commercially available. The former show longer durability but require anticoagulant therapy; the latter display better fluid dynamic behavior but do not have adequate durability. New Polymeric Heart Valves (PHVs) could potentially combine the hemodynamic properties of biological valves with the durability of mechanical valves. This work presents a hydrodynamic evaluation of 2 groups of newly developed supra-annular, trileaflet prosthetic heart valves made from styrenic block copolymers (SBC): Poli-Valves. Methods: 2 types of Poli-Valves made of SBC and differing in polystyrene fraction content were tested under continuous and pulsatile flow conditions as prescribed by ISO 5840 Standard. A pulse duplicator designed ad hoc allowed the valve prototypes to be tested at different flow rates and frequencies. Pressure and flow were recorded; pressure drops, effective orifice area (EOA), and regurgitant volume were computed to assess the behavior of the valve. Results: Both types of Poli-Valves met the minimum requirements in terms of regurgitation and EOA as specified by the ISO 5840 Standard. Results were compared with 5 mechanical heart valves (MHVs) and 5 tissue heart valves (THVs), currently available on the market. Conclusions: Based on these results, PHVs based on styrenic block copolymers, as are Poli-Valves, can be considered a promising alternative for heart valve replacement in the near future.

The study was aimed to optimize the gas transfer in an innovative ventilator for neonatal Total Liquid Ventilation (TLV) that integrates the pumping and oxygenation functions in a non-volumetric pulsatile device made of parallel flat silicone membranes. A computational approach was adopted to evaluate oxygen (O2) and carbon dioxide (CO2) exchanges between the liquid perfluorocarbon (PFC) and the oxygenating gas, as a function of the geometrical parameter of the device. A 2D semi-empirical model was implemented to this purpose using Comsol Multiphysics to study both the fluid dynamics and the gas exchange in the ventilator. Experimental gas exchanges measured with a preliminary prototype were compared to the simulation outcomes to prove the model reliability. Different device configurations were modeled to identify the optimal design able to guarantee the desired gas transfer. Good agreement between experimental and simulation outcomes was obtained, validating the model. The optimal configuration, able to achieve the desired gas exchange (ΔpCO2 = 16.5 mmHg and ΔpO2 = 69 mmHg), is a device comprising 40 modules, 300 mm in length (total exchange area = 2.28 m(2)). With this configuration gas transfer performance is satisfactory for all the simulated settings, proving good adaptability of the device.

The potential of polymeric heart valves (PHV) prostheses is to combine the hemodynamic performances of biological valves with the durability of mechanical valves. The aim of this work is to design and develop a new tri-leaflet prosthetic heart valve (HV) made from styrenic block copolymers. A computational finite element model was implemented to optimize the thickness of the leaflets, to improve PHV mechanical and hydrodynamic performances. Based on the model outcomes, 8 prototypes of the designed valve were produced and tested in vitro under continuous and pulsatile flow conditions, as prescribed by ISO 5840 Standard. A specially designed pulse duplicator allowed testing the PHVs at different flow rates and frequency conditions. All the PHVs met the requirements specified in ISO 5840 Standard in terms of both regurgitation and effective orifice area (EOA), demonstrating their potential as HV prostheses.

Over the last twenty years major advancements have taken place in the design of medical devices and personalized therapies. They have paralleled the impressive evolution of three-dimensional, non invasive, medical imaging techniques and have been continuously fuelled by increasing computing power and the emergence of novel and sophisticated software tools. This paper aims to showcase a number of major contributions to the advancements of modeling of surgical and interventional procedures and to the design of life support systems. The selected examples will span from pediatric cardiac surgery procedures to valve and ventricle repair techniques, from stent design and endovascular procedures to life support systems and innovative ventilation techniques.

The functional anatomy of the respiratory system of dolphins has been scarcely studied. Specifically, the capacity of the system to resist pressure changes during diving has not been fully understood. Here we shortly describe the upper respiratory tract of dolphins based on three common species, the bottlenose dolphin Tursiops truncatus, the Risso's dolphin Grampus griseus, and the striped dolphin Stenella coeruleoalba. We emphasize the keymorphological features that represent evolutionary adaptations to life in the water, and, furthermore, also present a model of the tracheo-bronchial tree based on mechanical characterization and subsequent computational simulation of its biomechanical behaviour. Comparisons with the goat allowed us to determine how different structures may respond to diving-related pressure.