Alterations in Coronary Blood Flow and the Risk of Left Ventricular Distension in Venoarterial Extracorporeal Membrane Oxygenation.

Previous theoretical studies have suggested that veno-arterial extracorporeal membrane oxygenation (VA-ECMO) ought to consistently result in markedly increased left ventricular (LV) intracavitary pressures and volumes because of increased LV afterload. However, this phenomenon of LV distension does not universally occur and occurs only in a minority of cases. We sought to explain this discrepancy by considering the potential implications of VA-ECMO support on coronary blood flow and consequently improved LV contractility (the "Gregg" effect), in addition to the effects of VA-ECMO support upon LV loading conditions, in a lumped parameter-based theoretical circulatory model. We found that LV systolic dysfunction resulted in reduced coronary blood flow; VA-ECMO support augmented coronary blood flow proportionally to the circuit flow rate. On VA-ECMO support, a weak or absent Gregg effect resulted in increased LV end-diastolic pressures and volumes and increased end-systolic volume with decreased LV ejection fraction (LVEF), consistent with LV distension. In contrast, a more robust Gregg effect resulted in unaffected and/or even reduced LV end-diastolic pressure and volume, end-systolic volume, and unaffected or even increased LVEF. Left ventricular contractility augmentation proportional to coronary blood flow increased by VA-ECMO support may be an important contributory mechanism underlying why LV distension is observed only in a minority of cases.

Experimental Investigation of the Anisotropic Mechanical Response of the Porcine Thoracic Aorta.

Knowledge of the mechanical properties of blood vessels and determining appropriate constitutive relations are essential in developing methodologies for accurate prognosis of vascular diseases. We examine the directional variation of the mechanical properties of the porcine thoracic aorta by performing uniaxial extension tests on dumbbell-shaped specimens cut at five different orientations with respect to the circumferential direction of the aorta. Specimens in all the orientations considered exhibit a nonlinear constitutive response that is typical of collagenous soft tissues. Shear strain under uniaxial extension demonstrates clearly discernible anisotropy of the mechanical response of the porcine aorta, and samples oriented at 45[Formula: see text] and 60[Formula: see text] with respect to the circumferential direction show a peculiar crescent-shaped shear strain-nominal stretch response not displayed by axial and circumferential specimens. Failure stress indicates decreasing tensile strength of the porcine aortic wall from the circumferential direction to the longitudinal direction. Furthermore, we determine the material parameters for the four-fiber-family and Gasser-Holzapfel-Ogden models from the mechanical response data of the circumferential and longitudinal specimens. It is shown how the material parameters derived from the uniaxial tests on circumferential and longitudinal specimens are insufficient to characterize the response of off-axis specimens.

Structure-Processing-Property Relationships of 3D Printed Porous Polymeric Materials.

Imparting porosity to 3D printed polymeric materials is an attractive option for producing lightweight, flexible, customizable objects such as sensors and garments. Although methods currently exist to introduce pores into 3D printed objects, little work has explored the structure-processing-property relationships of these materials. In this study, photopolymer/sacrificial paraffin filler composite inks were produced and printed by a direct ink writing (DIW) technique that leveraged paraffin particles as sacrificial viscosity modifiers in a matrix of commercial elastomer photocurable resin. After printing, paraffin was dissolved by immersion of the cured part in an organic solvent at elevated temperature, leaving behind a porous matrix. Rheometry experiments demonstrated that composites with between 40 and 70 wt % paraffin particles were able to be successfully 3D printed; thus, the porosity of printed objects can be varied from 43 to 73 vol %. Scanning electron microscopy images demonstrated that closed-cell porous structures formed at low porosity values, whereas open-cell structures formed at and above approximately 53 vol % porosity. Tensile tests revealed a decrease in elastic modulus as the porosity of the material was increased. These tests were simulated using finite element analysis (FEA), and it was found that the Neo-Hookean model was appropriate to represent the 3D printed porous material at lower and higher void fractions within a 75% strain, and the Ogden model also gave good predictions of porous material performance. The transition between closed- and open-cell behaviors occurred at 52.4 vol % porosity in the cubic representative volume elements used for FEA, which agreed with experimental findings that this transition occurred at approximately 53 vol % porosity. This work demonstrates that the tandem use of rheometry, FEA, and DIW enables the design of complex, tailorable 3D printed porous structures with desired mechanical performance.

Segmental Variations in the Peel Characteristics of the Porcine Thoracic Aorta.

Aortic dissection occurs predominantly in the thoracic aorta and the mechanisms for the initiation and propagation of the tear in aortic dissection are not well understood. We study the tearing characteristics of the porcine thoracic aorta using a peeling test and we estimate the peeling energy per unit area in the ascending and the descending segments. The stretch and the peel force per unit width undergone by the peeled halves of a rectangular specimen are measured. We find that there can be significant variation in the stretch within the specimen and the stretch between the markers in the specimen varies with the dynamics of peeling. We found that in our experiment the stretch achieved in the peeled halves was such that it was in the range of the stretch at which the stress-stretch curve for the uniaxial experiment starts deviating from linearity. Higher peeling energy per unit area is required in the ascending aorta compared to the descending aorta. Longitudinal specimens required higher peeling energy per unit area when compared to the circumferential specimens.