Heart failure has been a serious issue in medicine for ages, costing both precious lives and lots of money – about $32 billion per year in the US, as estimated. Affecting the quality of life of millions of people worldwide, scientists and researchers all over the world have since always been looking for practical and effective solutions for the problem, besides medical therapy, to bring down the death toll by a significant degree. What they came up with first: transplants. While replacing one’s diseased heart with a healthier one seemed a good option, there came a number of problems with it. Not everybody could be a donor, as being one required a whole set of certain criteria to be fulfilled. Not everybody could be a recipient, as not everyone came up to the other separate set of criteria to be one. And the number of donor hearts versus the number of expectants? Thousands have died while still in the waiting list.
This called for exploration of further options. With advancements in medical treatment, non-medical treatments also made significant progress, and researchers and biomedical engineers decided to introduce new technology mimicking a normal heart into the interventions. The result: ventricular assist devices (VADs), which like their name, aided failing ventricles in performing their function via a system of tubes that pumped blood into the body. Though seeming quite promising, it was soon found out that the risks of blood clots leading to lethal or crippling strokes peaked with their use, owing to the fact that the device directly contacted blood. While lifelong use of anticoagulants with VADs decreased the risk, further studies and researches had already begun regarding a better option.
What came next: cardiac sleeves. Keeping the principle of imitating a healthy heart intact, this device – as its name suggests – enveloped the heart and provided external pressure for ventricular compression. Though not directly contacting blood and eliminating the need for blood-thinners, these still failed to make their mark in cardiac medicine, as they did not function as effectively as near-normal ventricles. Hence another apparently operative idea was put down once again.
These failures failed to hold back biomedical engineers and scientists, so they all put their heads together and decided to incorporate ‘robots’ into the process. Learning from their mistakes and making use of technology the lack of which probably held them back in the past, they came up with an elastic silicone funnel-shaped device, with actuators for muscles and pressure-detecting sensors, all fueled with a compressed air store and power supply.
How was this better than the predecessors? It did not contact blood directly, thus surpassing VADs, and it not only compressed the heart but also twisted it exactly like ventricles, thus coming a step ahead of cardiac sleeves. Coated with hydrogel forming a protective layer between the soft robot and the heart, it reduced friction and also possibly the risk of infections. Lastly, it used sutures and suction devices to attach to the failing heart.
Once this soft robot ‘hugs’ the heart, it can easily re-create about 97% of the original cardiac output, as was experimented in cardiac arrest-induced pigs. Even though human trials are still pending, the prospect looks quite promising, as there are no blood-thinners required as with VADs, no inefficacies as with sleeves, no waiting lists as with transplants, and what you get is a better quality of life due to decreased load on the poor heart, and who knows, potentially even recovery! Once the bulkier system is made more portable and implantable, and better lightweight, conformable, able-to-achieve-complex-motions materials are used in robots, it goes without saying that they would be excellent breakthroughs in cardiac medicine. Who knew hugs could be so effective?