Dr Ellen Roche is working on a soft robotic sleeve that could help ailing hearts to keep pumping. She spoke to Claire O’Connell.
Wearing your heart on your sleeve is one thing, but what about wearing a sleeve on your heart? In the future, patients with heart failure could benefit from a soft robotic ‘sleeve’ that gives the ailing organ helpful squeezes to keep it pumping.
The silicone sleeve has just been described in a paper in Science Translational Medicine, and it will ultimately seek to help the millions of patients each year who present with heart failure where the organ cannot pump blood effectively.
A helpful squeeze
The paper’s first author, Dr Ellen Roche, is a postdoctoral researcher at NUI Galway and the work evolved from her PhD research at Harvard University.
But why the enveloping, robotic sleeve?
Current technology to support the hearts of patients awaiting transplant reroutes blood through a device to pump it around the body, but this is not without risk. Roche and colleagues at Harvard and Boston Children’s Hospital took a different approach: a thin silicone sleeve that wraps around the heart and uses externally controlled soft pneumatic actuators to mimic the outer muscle layers.
These give the heart a squeeze to augment the organ’s function. No contact with the blood supply is needed and the pumping can be customised to suit the patient’s needs.
In a bid to minimise inflammation, the researchers also used a layer of gel to help reduce the friction between the sleeve and the heart tissue, and their pre-clinical studies have shown that the robotic sleeve’s squeezing action was able to improve cardiac output in models of heart failure.
“In the last five years, soft robotics has become really big, and people are looking at different types of actuators and how to design and build soft robotics to augment body function,” Roche said.
“A lot of it is external – [devices] like robotic gloves and exosuits – and that is likely to be quicker to get to patients. Our work is looking at the implants.”
The next step for the implantable cardiac sleeve will be to see how it performs in the long term, particularly on models of chronic heart failure, where the heart tissue remodels. The research and regulatory approval needed mean that the device would not be widely in use in patients for a long while yet, noted Roche, but the proof of concept is a positive step.
Roche was initially drawn to biomedical engineering because it combined her interests in biology and maths. “When I was doing my Leaving Certificate, I was torn between doing engineering and medicine,” she said. “So the biomedical engineering course at NUI Galway was a perfect fit.”
After her bachelor’s degree, she worked in the medical device industry in Galway and the US, and then completed an MSc in bioengineering at Trinity College Dublin.
A Fulbright scholarship saw her return to the US to work at the Wyss Institute and Harvard Biodesign Lab.
“It was really serendipitous,” recalled Roche. “I went over to work with David Mooney, who is an expert in tissue engineering, and I got in contact with Trinity graduate Conor Walsh through an ‘Irish in Boston’ email list, and he said he was setting up a robotics lab. By working with them both, I was able to mix my interests in cardiac devices, robotics and tissue engineering.”
As well as the sleeve, Roche has worked on soft robotic heart stimulators, materials to deliver cells to the heart, and a catheter for closing holes in the heart. Next September, she will return to the US as an assistant professor in MIT to start her own lab at the Institute for Medical Engineering and Science.
Follow your heart
Roche’s advice to school students who are currently thinking about their third-level choices is to follow their interests. “It can be hard to know when you are 17 or 18, filling out the CAO form, and you will find there are trends too – some courses are popular,” she said. “But you can do a broad degree and specialise; it is becoming more common to do graduate courses.
“The main thing is to look at what you enjoy.”