Nearly a decade ago, K R Balakrishnan, a heart-lung transplant surgeon in Chennai, and Pete Ayre, a bioengineering professor at University of New South Wales, met for dinner in a Chennai hotel. When the discussion turned to
artificial heart pumps
, they borrowed pencils from the waiter and scribbled some designs on paper napkins.
Soon, the drawings from the dining table made it to labs and, in five years, out came some prototypes.
A couple of them — one for the left side of the heart and a smaller one for the right — are now being tested in sheep in Australia. If things go as planned, the team — it has patented the technology — will start clinical trials on humans in India and Australia by Dec 2024.
A pocket-friendly device
“We never thought we’d get this far,” said Balakrishnan, who heads the heart and lung transplant department at MGM Healthcare. “Our discussion started casually. When I left the hotel, I never thought anything would come of it. I was surprised when Pete called me a week later, and things started happening.” The two have founded a company called
Cardiobionic
.
Their plan was simple: To build a
heart pump
that would be a long-term and affordable solution to
heart failure
. Heart pumps available in the market now cost US$100,000 (more than 80 lakh). The team wanted to make one that cost one-fourth of that. “The ones available now are bulky, almost the size of a cricket ball,” said Ayre. “While surgeons may place pumps outside the chest cavity, it is not suitable for petite people and children.”
Moreover, pumps today support only one chamber of the heart, the left ventricle. Several people who are given these pumps end up in intensive care for life support when the right side of the heart fails.
But just when laboratory studies and designs began to show promise, the team hit its first roadblock. “We needed funds,” said Balakrishnan. “I spoke to more than 50 businessmen from across the world. Two Indian investors, whose details I cannot reveal now, agreed to invest. That’s when the project took off.”
Seeking a lasting solution
In five years, they developed a
bi-ventricular assist pump
that supports both sides of the heart with one console and a smaller device, which would cost about a fourth of the existing device.
The pump is made of titanium and inside there’s a non-contact impella — a device that pulls blood from the ventricle and pushes it out into the aorta, delivering oxygen-rich blood to the rest of your body. “It floats on blood and spins continuously. That means it may be a permanent solution and not just a bridge to a transplant,” said Ayre.
Several heart failure patients across the country die waiting for an organ. “There are many hurdles in organ transplant. With better awareness, we are getting organs from brain-dead patients. But not all hearts are utilised because we don’t have the network to transport them within its shelf life of four hours. In most parts of the world there are no programmes for heart transplant,” he said. “This pump could prevent many deaths.”
A smaller pump that supports the right side of the heart in adults can be used as an LVAD, or left ventricular assist device, for a child. “There are no pumps specifically for children now,” said Balakrishnan. However, more research is needed to understand why some hearts fail despite having an artificial pump.
Connected care
The team, meanwhile, is working to convert the pump into a remote monitoring device so that patients can be tracked from anywhere using the internet. They are also looking to make the entire system wireless. “Now, we have a driveline that connects the implanted pump to an external console via a cable across the skin. This can increase chances of infection,” he said.
Doctors are pushing the team to make the pump work as efficiently as the human heart. “The heart can increase output by up to 50% during pregnancy, exercise, or emergency. We want to build pressure sensors that help the pump do this,” Ayre said.
While the trials in Australian sheep are showing promise, the team is trying for product approval in India, US and Europe.
