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Robotic Sleeve Helps Heart Going Strong.
By: Patrick Mansfield | U.S. Health Alerts


Robotic Sleeve Helps Heart Going Strong.
Every year, over 300,000 Americans are expected to die from heart failure. Almost six million Americans have varying degrees of heart failure. Worldwide, the number of people with failing hearts is 42 million. Their hearts are having, or are beginning to have, trouble pumping enough blood through their bodies, leading to disability and, eventually, death.

Currently, Ventricular Assist Devices, or VADs, are used to provide assistance to the weakened heart. They help pump the blood through the heart. These devices, small pumps, are implanted in the patient's chest and are used to give the patient time until a new heart can be found. They are, occasionally, used on a permanent basis for those not eligible for a transplant. However, the fact that the device handles blood leaves the patient susceptible to infections and requires the use of anticoagulants to avoid the dangers of blood clots.

The VAD doesn't interact directly with a patient's heart. Basically, the device gives the patient more time. It doesn't improve heart function. It merely delays death from heart failure.

A possible improvement in the heart assist process is being developed at Harvard Medical School. The device, called a robotic sleeve, is a silicon sleeve that fits around the heart and, when activated by compressed air, the device is able to actually mimic the movements of the normal heart. The robotic sleeve for the heart, a set of artificial muscles, can be selectively activated to twist and compress either or both sides of the heart. It can also twist and compress simultaneously.

Currently, it is being tested on pigs that are given drug-induced cardiac arrest - heart failure. It seems the device increases the volume of blood moved by the pigs' heart. The tests demonstrated the restoration of normal blood flow to six pigs.

Human and pig hearts are similar in several critical ways. Both have four chambers and blood flows through the hearts, in the same way, making the pig heart perfect for testing the sleeve. However, to state an obvious fact, pigs are not humans.

The primary reason the robotic sleeve for heart works when other similar devices have failed in the past is the fact that the doctors are able to program the sleeve with instructions on where to squeeze and where to relax. It is, quite literally, a robot, applying it abilities where they are needed.

Additionally, the device goes outside the heart. It doesn't have to come in contact with blood. This completely avoids the risks associated with the VAD. There is no risk of clotting, no need to give the patient anticoagulants, and what would seem to be a greater time to find a heart replacement. The VAD simply augments the amount of blood pumped by the heart. As the failure increases, the VAD has to pump a larger amount of blood. Nothing is done for the heart itself. Eventually, the heart fails completely. It's possible the robotic sleeve for heart addresses this.

The researchers also discovered the sleeve might have an additional benefit. Professor Connor Walsh, the author of the Science and Transaction Medicine (18 January 2017), suggests the sleeve might improve heart function. That by physically moving the heart, essentially forcing it to exercise, the heart might be spurred to some measure of healing.

The Harvard Medical team cautions that the device is a long way from being used in humans. They emphasize that they are in the early stages of development and are only now completing what amounts to a proof of concept. And while the proof of concept has proven successful at this stage in the sleeve development, there are many obstacles that have to be overcome before humans can be brought into testing. And even then, there would be several years of human testing to determine both the safety and efficacy of the device.

There is a great deal of motivation to move the development along. The fact is there are not enough hearts through transplant to meet the needs of those who have failing hearts. VADs simply put off the inevitable. By contrast, the development of the robotic sleeve holds the promise of not simply extending the patient's life by a couple of years, still ending in heart failure, but perhaps improving the patient's heart function and improving their quality of life.
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