• MitraClip
• Left heart flow simulator

The mitral valve is a dynamic structure that allows blood flowing from the left atrium to the left ventricle during diastole and ensures the closure of the atrium from the ventricle during systole. Abnormal functioning of any components, or their interaction can results in mitral regurgitation. Understanding the anatomy and physiology of all the components of the mitral valve is important for diagnosis and optimal planning of repair procedures. Less invasive percutaneous techniques, which have the potential to treat mitral regurgitation in high-risk surgical patients, are needed. The aim of this thesis was the design and development of a 3D-printed left heart flow simulator to perform MitraClip procedure in a dynamic environment. At first, patient’s images were segmented. This phase involved patient data obtained from two different imaging modalities, CT and TEE, and proceeded with the CAD design phase. In this regard, a detailed description of the physical realization of the models using 3D printing techniques is provided in the dissertation. Two different manufacturing techniques were adopted: 1) stereolithography (SLA) 3D printing technique for both left heart model production and the 3D printing of molds, in combination with fused deposition modeling (FDM), and 2) silicone casting for the mitral valve fabrication. The realization of flow simulator set-up is then described. The performance of the silicone mitral valve was assessed in two different test conditions by inserting the left heart and mitral valve models in a mock-circulatory loop system. Fluid-dynamic data, in terms of flow and pressure waveforms, were processed. Although the overall results were satisfactory, there was the evidence of mitral regurgitation due to the pressure conditions during the tests. A validation phase of the model is required, and it may be useful to conduct visibility tests using diagnostic imaging techniques for a more comprehensive study.