EX VIVO cardiac simulators are emerging as a promising tool for personalised cardiovascular care, according to a new narrative review.
These simulator platforms combine native cardiac tissue with mechanical circulatory systems to recreate physiologically relevant cardiac function and provide insights that may be difficult or impossible to obtain in living patients.
The review highlighted the growing burden of cardiovascular disease worldwide and the need for more precise approaches to treatment planning.
Ex vivo cardiac simulators were described as a potential solution because they preserve authentic anatomical and electrophysiological properties while allowing controlled experimentation.
The authors outlined a wide range of applications for ex vivo cardiac simulators.
These included surgical training platforms that allow clinicians to practise valve repair procedures in realistic haemodynamic environments and preoperative planning systems that can help evaluate the impact of interventions before treatment.
The review also highlighted the role of these systems in studying complex valvular disease, congenital heart disease, and cardiac arrhythmias.
By reproducing patient specific haemodynamic and anatomical conditions, researchers can investigate procedural outcomes and biomechanical responses in a controlled setting.
Whole heart simulators were noted to provide realistic operative environments, while isolated tissue models offer detailed analysis of valve mechanics and device performance.
Medical device development represented another key application.
Ex vivo cardiac simulators can be used to evaluate new cardiovascular devices under physiologically relevant conditions before clinical testing, potentially reducing risk during early development and supporting performance assessment across a range of haemodynamic scenarios.
Looking ahead, the review identified artificial intelligence and digital modelling as important future directions for ex vivo cardiac simulators.
Artificial intelligence could assist with analysing haemodynamic data, interpreting medical imaging, and automating simulator control to produce patient specific physiological conditions more efficiently.
The authors also suggested that integrating digital twin technologies with physical simulators may improve intervention planning by combining predictive modelling with experimental validation.
The review further highlighted the potential for multi-organ simulation platforms that reproduce interactions between the heart and organs such as the lungs, kidneys, liver, and brain.
Although these systems remain at an early stage of development, they may provide a more comprehensive understanding of cardiovascular disease and its wider physiological effects.
Overall, the authors concluded that continued advances in ex vivo cardiac simulators could accelerate the move towards truly personalised cardiovascular medicine by improving diagnostic accuracy, enhancing procedural planning, and supporting safer development of new therapies.
Reference
Putos V et al. Ex vivo cardiac simulator platforms for personalized cardiovascular diagnostics and intervention planning. npj Cardiovasc Health. 2026;DOI:10.1038/s44325-026-00151-4.
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