Fig. 1

Benchtop Model Development. a CCTA scans of the heart tissue and the three main coronary arteries were imported into Vital Images. The cardiac application automatically segmented the aorta and the three main coronary arteries from the rest of the heart tissue. Manual segmentation was additionally implemented using Hounsfield thresholding and contouring methods. b The calcification within the coronary arteries was segmented separately from the rest of the heart tissue using Hounsfield thresholding. Both the vasculature and the calcification were imported into Autodesk Meshmixer for sculpting and artifact reduction. c A 2 mm wall was generated and a hollow lumen was created to allow for fluidic flow through the solid geometry. d A support structure was created in SolidWorks and imported into Autodesk Meshmixer where it was aligned with the vasculature. Each of the three main coronary arteries and their branches were aligned so that they perpendicularly connected to the corresponding chamber. e The vasculature was 3D printed, cleaned, and attached to a flow loop. Pressure sensors (red circles) were connected to the aorta and three main coronary arteries for pressure measurement recording. The calcification was printed within the models to properly simulate the disease state (yellow arrow). Catheters of varying lengths and diameters were attached to the chamber outlets (blue arrows) to simulate the distal resistance of the coronary arteries