Dynamic Augmentation of Left Ventricle and Mitral Valve Function With an Implantable Soft Robotic Device

Saeed, Mossab; Story, BE David Van; Wamala, Isaac; Shin, Beomju; Bautista‐Salinas, Daniel; Zurakowski, David; Nido, Pedro J. del; Walsh, Conor J.; Vasilyev, Nikolay V.

doi:10.1016/j.jacbts.2019.12.001

Cited by 14 publications

(20 citation statements)

References 49 publications

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“…In our prior work, we have demonstrated that a SRVAD not only augments left ventricular function but also concurrently acts on the mitral valve to reduce mitral valve insufficiency during actuation. 11 In the current experiments, the device itself did not increase or reduce the tricuspid valve function. We observed augmentation of RV output to the levels of the second baseline prior to RHF or better, only in some animals, despite evidence that the device was able to augment RV contraction, as evidenced by the increase in RV and maximal PA pressures.…”

Section: Discussionmentioning

confidence: 46%

“…We have previously demonstrated the feasibility of optimizing the actuation and placement of soft robotic assist devices, such that secondary mitral valve insufficiency is minimized during systole. 11 The RV however offers a different and potentially more substantial challenge. With a relatively thin wall and bellow-like contraction, its ejection mechanics are more complicated.…”

Section: Introductionmentioning

confidence: 99%

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Importance of Preserved Tricuspid Valve Function for Effective Soft Robotic Augmentation of the Right Ventricle in Cases of Elevated Pulmonary Artery Pressure

Wamala

Saeed

Bautista‐Salinas

et al. 2021

Cardiovasc Eng Tech

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Purpose In clinical practice, many patients with right heart failure (RHF) have elevated pulmonary artery pressures and increased afterload on the right ventricle (RV). In this study, we evaluated the feasibility of RV augmentation using a soft robotic right ventricular assist device (SRVAD), in cases of increased RV afterload. Methods In nine Yorkshire swine of 65–80 kg, a pulmonary artery band was placed to cause RHF and maintained in place to simulate an ongoing elevated afterload on the RV. The SRVAD was actuated in synchrony with the ventricle to augment native RV output for up to one hour. Hemodynamic parameters during SRVAD actuation were compared to baseline and RHF levels. Results Median RV cardiac index (CI) was 1.43 (IQR, 1.37–1.80) L/min/m2 and 1.26 (IQR 1.05–1.57) L/min/m2 at first and second baseline. Upon PA banding RV CI fell to a median of 0.79 (IQR 0.63–1.04) L/min/m2. Device actuation improved RV CI to a median of 0.87 (IQR 0.78–1.01), 0.85 (IQR 0.64–1.59) and 1.11 (IQR 0.67–1.48) L/min/m2 at 5 min (p = 0.114), 30 min (p = 0.013) and 60 (p = 0.033) minutes respectively. Statistical GEE analysis showed that lower grade of tricuspid regurgitation at time of RHF (p = 0.046), a lower diastolic pressure at RHF (p = 0.019) and lower mean arterial pressure at RHF (p = 0.024) were significantly associated with higher SRVAD effectiveness. Conclusions Short-term augmentation of RV function using SRVAD is feasible even in cases of elevated RV afterload. Moderate or severe tricuspid regurgitation were associated with reduced device effectiveness.

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Section: Discussionmentioning

confidence: 46%

Section: Introductionmentioning

confidence: 99%

Importance of Preserved Tricuspid Valve Function for Effective Soft Robotic Augmentation of the Right Ventricle in Cases of Elevated Pulmonary Artery Pressure

Wamala

Saeed

Bautista‐Salinas

et al. 2021

Cardiovasc Eng Tech

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“…This energy can then power a device that can monitor cardiac output, effectively self-powering its own monitoring system. This device relays information wirelessly, allowing data monitoring on portable devices including smartphones [78]. This device can monitor and actuate muscle cell precursors, or myoblasts, electrically to control their differentiation and proliferation.…”

Section: Implantable Soft Robotsmentioning

confidence: 99%

The Role of Soft Robotic Micromachines in the Future of Medical Devices and Personalized Medicine

et al. 2021

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Developments in medical device design result in advances in wearable technologies, minimally invasive surgical techniques, and patient-specific approaches to medicine. In this review, we analyze the trajectory of biomedical and engineering approaches to soft robotics for healthcare applications. We review current literature across spatial scales and biocompatibility, focusing on engineering done at the biotic-abiotic interface. From traditional techniques for robot design to advances in tunable material chemistry, we look broadly at the field for opportunities to advance healthcare solutions in the future. We present an extracellular matrix-based robotic actuator and propose how biomaterials and proteins may influence the future of medical device design.

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“…[ 19 ] A new type of VAD is currently under development, which directly compresses the heart using soft actuators or pressurized cups that either cover the entire epicardial surface or target just one of the diseased ventricles. [ 10,20–25 ]…”

Section: Figurementioning

confidence: 99%

Magnetically Active Cardiac Patches as an Untethered, Non‐Blood Contacting Ventricular Assist Device

Bertrand

Boehler

et al. 2020

Advanced Science

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Patients suffering from heart failure often require circulatory support using ventricular assist devices (VADs). However, most existing VADs provide nonpulsatile flow, involve direct contact between the blood flow and the device's lumen and moving components, and require a driveline to connect to an external power source. These design features often lead to complications such as gastrointestinal bleeding, device thrombosis, and driveline infections. Here, a concept of magnetically active cardiac patches (MACPs) that can potentially function as non‐blood contacting, untethered pulsatile VADs inside a magnetic actuationsystem is reported. The MACPs, which are composed of permanent magnets and 3D‐printed patches, are attached to the epicardial surfaces, thus avoiding direct contact with the blood flow. They provide powerful actuation assisting native heart pumping inside a magnetic actuation system. In ex vivo experiments on a healthy pig's heart, it is shown that the ventricular ejection fractions are as high as 37% in the left ventricle and 63% in the right ventricle. Non‐blood contacting, untethered VADs can eliminate the risk of serious complications associated with existing devices, and provide an alternative solution for myocardial training and therapy for patients with heart failure.

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Dynamic Augmentation of Left Ventricle and Mitral Valve Function With an Implantable Soft Robotic Device

Cited by 14 publications

References 49 publications

Importance of Preserved Tricuspid Valve Function for Effective Soft Robotic Augmentation of the Right Ventricle in Cases of Elevated Pulmonary Artery Pressure

Importance of Preserved Tricuspid Valve Function for Effective Soft Robotic Augmentation of the Right Ventricle in Cases of Elevated Pulmonary Artery Pressure

The Role of Soft Robotic Micromachines in the Future of Medical Devices and Personalized Medicine

Magnetically Active Cardiac Patches as an Untethered, Non‐Blood Contacting Ventricular Assist Device

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