Heart failure is a very common clinical condition, afflicting millions of patients worldwide, and its prevalence is expected to further increase in the near future. Unfortunately, there are limited treatment options for advanced heart failure and the overall prognosis remains poor. Heart transplantation is considered to be the only definitive cure, but with a shortage of donors, it is unfeasible in many cases. Ventricular-assisted devices may be used as a bridge while waiting for transplantation, but are limited by the need for anti-coagulants and an increased rate of hemolysis.
Recently, an international team of scientists developed a new technique to overcome these problems and presented their results in the journal Science Translational Medicine. They created a soft robotic sleeve that supports heart function without the need for direct contact with blood. The device, which was tested in a swine model during a drug-induced cardiac arrest, utilizes external compression and twisting forces to the cardiac tissue, thereby improving cardiac performance. This biologically inspired design of a cardiac ventricular-assist device may obviate the need for blood thinners and may generate other advantages over currently applied devices.
Medgadget interviewed Prof. Ellen Roche, a co-author of this study, from the School of Engineering and Applied Sciences of Harvard University.
Udi Nussinovitch, Medgadget: How far are we from using the “robotic sleeve” in cardiac patients?
Prof. Ellen Roche: At least five years, as we require more design work and chronic animal studies to prove the long term efficacy of the device.
Medgadget: What challenges should be overcome before its use will become a reality?
Roche: An optimal attachment method and a miniaturized power/control system.
Medgadget: How big and heavy will a mobile version of the device be? Could it be carried around easily?
Roche: Yes, we envisage that it should be able to be worn on a belt or in a backpack as demonstrated by predicate devices for total artificial hearts (e.g. Syncardia).
Medgadget: Do you expect any special complications that may be associated with the current design in some circumstances? Like air embolism (due to compressed air leakage)? Cardiac ischemia (due to external compression applied to the coronary arteries)?
Roche: As the device doesn’t contact the blood the risk of air embolism is low. The risk of air in the thorax (pneumothorax) can be mitigated by building in safety mechanisms so that individual actuators can be deactivated if they lose pressure.
Medgadget: Will the device be energetically efficient? How often do you expect it should be charged?
Roche: This will be figured out in future work as we build portable control and power studies.
Medgadget: What are your future plans in regards to commercialization of the technology?
Roche: We would love to partner with industry to get the device through regulatory approval and in to first in human.
Study in Science Translational Medicine: Soft robotic sleeve supports heart function