Patient specific 3D printed tissue engineered vascular graft for aortic reconstruction designed by artificial intelligence algorithm.

1本研究的目标是创建患者特异性的，血流动力学优化的，组织工程化的 2个血管移植物（TEVG）用于主动脉弓修复手术。这些TEVG针对高压进行了优化 3循环使用3D打印技术和人工智能，并将与患者一起成长，希望 4避免了未来手术更换移植物的需要，这可能发生在当代足弓重建中 5材料。先天性心脏病（CHD）是由于先天性异常导致死亡的主要原因。尽管 冠心病外科治疗的6项重大进展，是发病率和死亡率的一个重要来源 7来自主动脉弓不同解剖结构手术的复杂性。 狭窄或发育不全动脉瘤手术重建后的弓形几何结构对于 9尽量减少能量损失和减少弓内不良流动，这会导致高血压、异常 10血管反应和心室功能障碍。确保患者特定的移植物设计， 术前11个路径的能量损失和壁切应力最小，可为患者带来长期受益 12健康与生活质量 我们已经证明了小型和大型动物中TEVG的天然血管样新组织形成 14项研究。基于这些经验，我们开发了一种新颖的3D打印技术， 15个金属芯轴，采用静电纺丝技术。通过这种3D打印技术，我们证明， 16 TEVG在绵羊模型中的静脉循环中形成天然样新血管形成。为了下一步，我们 17旨在开发可应用于主动脉重建的动脉循环中的移植物。我们还将开发 18种自动设计算法，用于设计最佳移植物形状，以减少患者特定的时间和成本 19设计。我们假设可以设计使用我们的3D打印技术的患者特异性TEVG， 20借助术前成像和血流数据，计算机辅助设计（CAD），自动设计 基于计算流体动力学（CFD）结果的21种算法，并将证明适当的新组织 22形成和生长，同时保持最佳设计的血液动力学。 该项目将是患者特异性血管移植物临床应用的重要一步， 24概括了天然解剖结构和机械性能。这项工作的成果将产生更广泛的影响 25关于其他更复杂的心血管植入结构的设计和制造。这种范式 血管移植技术的转变将提高儿科患者护理的质量和安全性。

1 The goal of this study is to create patient-specific, hemodynamically optimized, tissue engineered 2 vascular grafts (TEVG) for use in aortic arch repair surgery. These TEVGs are optimized for high pressure 3 circulation using 3D printing technology and artificial intelligence, and will grow with the patient, in hopes of 4 obviating need for future surgeries to replace grafts, which can occur with contemporary arch reconstruction 5 materials. Congenital heart disease (CHD) is the leading cause of death due to congenital anomalies. Despite 6 significant advances in surgical management for CHD, one significant source of morbidity and mortality arises 7 from the complexity of surgery for diverse anatomies in the aortic arch. Previous studies have demonstrated 8 that the resultant arch geometry after surgical reconstruction of stenotic or hypoplastic aortas is important to 9 minimize reduce energy loss and undesirable flow inside the arch, which can lead to hypertension, abnormal 10 vascular response and ventricular dysfunction. Ensuring a patient-specific graft design for ideal reconstructed 11 route before surgery with minimum energy loss and wall shear stress may yield long-term benefits for patient 12 health and quality of life. 13 We have demonstrated native vessel like neotissue formation of TEVG in small and large animal 14 studies. Based on these experiences, we have developed a novel 3D printing technology combining 3D printed 15 metal mandrels with nanofiber electro-spun technology. With this 3D printing technology, we showed that 16 TEVG developed native like neovessel formation in venous circulation in a sheep model. For this next step, we 17 aim to develop grafts in arterial circulation that can be applied to aortic reconstruction. We will also develop 18 automatic design algorithms to design optimal graft shape in order to reduce time and cost of patient specific 19 design. We hypothesize that patient-specific TEVG using our 3D printing technology can be designed, 20 aided by pre-operative imaging and flow data, computer assisted design (CAD), automatic design 21 algorithms based on computation fluid dynamics (CFD) results, and will demonstrate proper neotissue 22 formation and growth while maintaining optimally designed hemodynamics. 23 This project will be an important step towards clinical application of patient-specific vascular grafts that 24 recapitulate the native anatomy and mechanical properties. The results of this work will have a broader impact 25 on the design and fabrication of other more complex cardiovascular structures for implantation. This paradigm 26 shift in vascular graft technology will improve the quality and safety of pediatric patient care.