Abstract

Optimizing cardiopulmonary resuscitation (CPR) requires accurate characterization of internal hemodynamics; however, high-fidelity human data remains limited due to ethical constraints and the limitations of existing experimental models. To address this gap, an anatomically representative 3D-printed in-vitro heart simulator was developed to measure aortic pressure and carotid flow under both physiological and CPR conditions.
The platform incorporates a flexible thermoplastic polyurethane heart model and seven valve configurations, including bioprosthetic, mesh-reinforced, and unreinforced designs. Under physiological conditions, the system successfully reproduced characteristic pulsatile waveforms, with Scenario 5 (dual mesh-reinforced valves) demonstrating hemodynamic behavior comparable to the bioprosthetic reference (Scenario 1).
Under CPR conditions, peak aortic pressures ranged from 52 to 58 mmHg, while mean aortic pressures varied between 31 and 42 mmHg. Corresponding carotid flow rates ranged from 114 to 133 mL/min, showing strong agreement with values reported in experimental and clinical studies. Valve performance analysis further revealed that mesh-reinforced configurations achieved a physiologically representative geometric orifice area of approximately 3.2 cm², whereas unreinforced valves exhibited leaflet prolapse and reduced stability.
These findings demonstrate that bioinspired leaflet reinforcement is essential for maintaining valve competence under CPR loading. Overall, the developed platform provides a reliable and repeatable surrogate for human circulation, enabling systematic evaluation of valve performance and offering a controlled framework for optimizing resuscitation strategies