On 21 January 2020, the British Heart Foundation (BHF) announced that Hybrid Heart is one of four finalists out of 75 initial submissions that will compete in the Big Beat Challenge to win a 30 million GBP award to explore and develop a radical new approach to treat cardiovascular diseases. With the World Health Organization (WHO) forecasting an increase in cardiovascular deaths worldwide, the Big Beat Challenge is a global initiative to encourage researchers and inspire transformational solutions to tackle the world’s biggest killer. As the next step, the Hybrid Heart team has to submit a full application in June 2020. The winner of the prestigious award will be announced by the end of 2020.

Hybrid Heart – Introducing a soft robotic heart
The Hybrid Heart project proposes a radical new concept for treating heart failure by replacing the diseased heart with a bioinspired and completely soft robotic heart, with in situ tissue-engineered inner lining (making it a hybrid heart), which can be wirelessly charged. The team, led by the Dutch cardiothoracic surgeon professor Jolanda Kluin (AMC, Amsterdam), roboticist/physicist dr. ir. Bas Overvelde (AMOLF, Amsterdam) and tissue-engineer professor Carlijn Bouten (TU/E, Eindhoven), strongly believes that Hybrid Heart can fully restore natural blood flow, can prevent limitations and complications inherent to current heart failure treatment, and will allow patients to move freely without a percutaneous driveline.

In the video below professor Jolanda Kluin introduces the Hybrid Heart project proposal. The video was recorded during the Big Beat Challenge event on 21 January 2020 in London.

Background – Eureka!
“On a Saturday morning back in 2016 I was reading a Dutch newspaper, I came across an interview with Bas Overvelde talking about soft robotics, illustrated by a picture of a soft robotic octopus”, Kluin says. “The picture didn’t show the typical robot with hinges and metal legs, but instead, it was made from a rubbery material that, when inflated, started to move seemingly organically. Kluin immediately connected the dots: “We should use this technology to build an artificial heart!”. She picked up the phone and called dr. ir. Bas Overvelde. This is when the project started. “I was immediately excited!”, says Overvelde. “I didn’t see any reason why we would not be able to make this work and the potential impact is huge”.

The video below shows a similar soft robotic device (a starfish instead of an octopus) as mentioned above. The soft robot was made in Overvelde’s research group (Soft Robotic Matter group) at AMOLF, Amsterdam.

The need for a new solution
For patients with advanced heart failure, current treatment options include intravenous inotropic drug support requiring hospitalization, donor heart transplantation and implantation of a long-term mechanical circulatory support device. With only 5000 heart transplantations per year globally and the high morbidity and mortality that accompany current mechanical devices, there is an urgent need for a new alternative. Current solutions mostly rely on pumps that only assist the left ventricle of the heart and carry a high risk of complications such as thrombosis, bleeding and infections. “Replacement of the failing heart with a bioinspired soft robotic heart with a tissue-engineered biocompatible surface and a wireless energy transfer has the potential to replace and match a healthy human heart,” Kluin conveys. “This will transform the treatment of end-stage heart failure.”

Credits: British Heart Foundation and Hybrid Heart consortium

Transformational advance
Bas Overvelde: “Soft robotics have never before been used in artificial organ development nor has it ever been combined with in situ tissue-engineering, although during my PhD at Harvard University I collaborated on the development of a soft robotic sleeve to assist the heart.” Currently, none of the available mechanical circulatory support devices can function without a percutaneous driveline for the power source. As such, Hybrid Heart will transform the research and the clinical landscape. “This is an endeavour that relies on innovative collaborations across multiple disciplines, as illustrated by the diverse background of the members of the consortium. The efforts of this interdisciplinary and highly complementary consortium of global leaders in their respective fields of expertise, aim to cure the first patient using the Hybrid Heart by 2028.

Need for funding of this magnitude
“Our aim is to change the lives of heart failure patients within seven years. Whilst radical, our ambition is not completely science fiction”, says Kluin. In 2018, the Hybrid Heart project already started as a small consortium with a Horizon 2020 (FET OPEN) funded grant 3 million EUR) to explore the feasibility of the idea. “Based on our first results we are now convinced that we can achieve our ambitious goal by expanding our scientific and translational efforts to such a scale that is only possible with the proposed sponsorship of the British Heart Foundation”, Carlijn Bouten says. Additionally, to conquer the so-called ‘valley of death’ gap between scientific findings and clinical implementation and to enable viable translation to patients, the team will set up robust manufacturing and quality control. “Therefore, funding of this magnitude is absolutely essential to make this happen and give patients with heart failure a future”.

The international consortium
Besides the Dutch scientific trio, the research and development consortium consists of international partners spanning several countries, including dr. Matteo Cianchetti (SSSA, IT), assistant professor Ellen Roche (MIT, USA), professor Frans van de Vosse (TU/e, NL), professor Cathy Thornton (Swansea, UK), professor Bob Stevens (NTU, UK), Derek Williams-Wynn (PSTL, UK), Stefan Schätzl (Em-tec, DE), Praveen Sagar (OxDevice Ltd., UK), dr. Hadewych van Hauwermeiren (Medanex Clinical, BE), dr. Steven Tsui (Royal Papworth Hospital, UK), professor Victor Tsang (GOSH, UK), professor Hanneke Takkenberg (ErasmusMC, NL), professor Richard Huxtable (Bristol, UK), and dr. Rik Meijer (Factory-CRO, NL).