Development of a Self-Deploying Extra-Aortic Compression Device for Medium-Term Hemodynamic Stabilization: A Feasibility Study.

Journal: Advanced science (Weinheim, Baden-Wurttemberg, Germany)
PMID: 39731354

Abstract

Hemodynamic stabilization is crucial in managing acute cardiac events, where compromised blood flow can lead to severe complications and increased mortality. Conditions like decompensated heart failure (HF) and cardiogenic shock require rapid and effective hemodynamic support. Current mechanical assistive devices, such as intra-aortic balloon pumps (IABP) and extracorporeal membrane oxygenation (ECMO), offer temporary stabilization but are limited to short-term use due to risks associated with prolonged blood contact. This research presents a novel proof-of-concept soft robotic device designed with the aim of achieving low-risk, medium-term counterpulsation therapy. The device employs a nature-inspired growing mechanism for potentially minimally invasive deployment around the ascending aorta, coupled with hydraulic artificial muscles for aortic compression. It demonstrated a maximum stroke volume of 16.48 ± 0.21 mL (SD, n = 5), outperforming all other non-pneumatic extra-aortic devices. In addition, in vitro tests with a mock circulation loop (MCL) show a drop in aortic end-diastolic pressure by 6.32 mmHg and enhance coronary flow under mild aortic stenosis, which attenuate the device's assistive effect. These findings highlight the device's strong potential for optimization as a promising solution to improve outcomes for hemodynamically unstable HF patients.

Authors

  • Adrienne Ji
    Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
  • James Davies
    Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney 2052, Australia.
  • Phuoc Thien Phan
    Robotics Research Center, School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, Singapore.
  • Chi Cong Nguyen
    Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney 2052, Australia.
  • Bibhu Sharma
    Department of Biomedical Engineering, Center for Biomedical and Robotics Technology (BART LAB), Faculty of Engineering, Mahidol University, Nakhon Pathom 73170, Thailand.
  • Kefan Zhu
    Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
  • Emanuele Nicotra
    Graduate School of Biomedical Engineering, Faculty of Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
  • Jingjing Wan
    College of Design and Engineering, National University of Singapore, Singapore, Singapore.
  • Hoang-Phuong Phan
    School of Mechanical and Manufacturing Engineering, Faculty of Engineering, University of New South Wales (UNSW), Sydney, NSW, 2052, Australia.
  • Christopher Hayward
    Department of Cardiology, St Vincent's Hospital, Sydney, NSW 2010, Australia.
  • Nigel H Lovell
  • Thanh Nho Do
    Graduate School of Biomedical Engineering, Faculty of Engineering, University of New South Wales, Sydney, Australia.

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