Coronary Artery Flow Modeling in an Ex-vivo Biorobotic Heart*

Coronary artery disease remains a significant global health concern, leading to high morbidity and mortality, with conditions like spontaneous coronary artery dissection (SCAD) presenting unique challenges in diagnosis and treatment. SCAD, a critical cause of acute coronary syndrome and myocardial infarction, complicates percutaneous coronary intervention (PCI) due to the fragility of the affected vessels. To improve PCI techniques specifically tailored to treat SCAD, we developed an ex-vivo biorobotic coronary artery flow simulator to model SCAD in a benchtop setup. The simulator integrates intraventricular balloons, McKibben soft robotic actuators, and a synchronized flow loop to replicate physiological coronary flow and myocardial wall motion in an explanted porcine heart. After recreating healthy conditions of ventricular wall motion and coronary flow, we induced a coronary dissection model, performed stent implantation, and assessed the intervention deployment using intravascular optical coherence tomography (IV-OCT). This platform can potentially enable precise testing of interventional strategies, improve PCI techniques, examine catheter or PCI-induced dissection, train clinicians, and facilitate testing of novel coronary imaging and intervention devices.