Stories about: Devices

A “half-hearted” solution to one-sided heart failure

Illustration showing how the system supports a failing right ventricle
Illustration showing sectional view of a heart with the soft robotic system helping to draw blood into (left) and pump blood out (right) of the heart’s right ventricle.

Soft robotic actuators, which are pneumatic artificial muscles designed and programmed to perform lifelike motions, have recently emerged as an attractive alternative to more rigid components that have conventionally been used in biomedical devices. In fact, earlier this year, a Boston Children’s Hospital team revealed a proof-of-concept soft robotic sleeve that could support the function of a failing heart.

Despite this promising innovation, the team recognized that many pediatric heart patients have more one-sided congenital heart conditions. These patients are not experiencing failure of the entire heart — instead, congenital conditions have caused disease in either the heart’s right or left ventricle, but not both.

Read our Vector story on the soft robotic heart sleeve that mimics cardiac muscles.

“We set out to develop new technology that would help one diseased ventricle, when the patient is in isolated left or right heart failure, pull blood into the chamber and then effectively pump it into the circulatory system,” says Nikolay Vasilyev, MD, a researcher in cardiac surgery at Boston Children’s.

Now, Vasilyev and his collaborators — researchers from Boston Children’s, the Harvard John A. Paulson School of Engineering and Applied Sciences and the Wyss Institute for Biologically Inspired Engineering at Harvard University — have revealed their soft robotic solution. They describe their system in a paper published online in Science Robotics today.

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Shunt-flushing device for hydrocephalus gets FDA clearance; could help patients avoid extra surgery

A new shunt-flushing device flushes out shunt blockages noninvasively.
Brain shunts frequently clog up, requiring surgical repair or replacement. A new device flushes out the blockages with the press of a button. (Wikimedia/Adobe Images)

Children with hydrocephalus often have shunts implanted to drain the excess cerebrospinal fluid that builds up inside their brain. Unfortunately, shunts have a tendency to plug up. This potentially life-threatening event necessitates emergency surgery to correct or replace the shunt.

“If you have a shunt, you are always worried about what might happen in the future,” says Joseph Madsen, MD, a neurosurgeon at Boston Children’s Hospital. “Close to half of shunts will have a revision within the first year of implantation. About 80 percent will require a revision within 10 years.”

Last week, the FDA cleared a device originally conceived by Madsen that can potentially flush out a clogged shunt noninvasively, avoiding the need for surgery in both children and adults. The neurosurgeon or other trained healthcare professional could simply press a button at the back of the patient’s head, just under the skin, in an office setting, Madsen says.

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Making breastfeeding a breeze: Cleft lip/palate and beyond

Breast Breeze
Breast Breeze developers Olivia Oppel (left) and Janet Conneely (Photos: Katherine C. Cohen)

Janet Conneely, BSN, RN, CPN, was visiting a new mother in the hospital who had just delivered a baby with a cleft palate to let her know about Boston Children’s Hospital’s Cleft Lip and Palate Program. The mother was trying, without success, to breastfeed, but because of cleft palate, her baby didn’t have an intact hard surface on the roof of her mouth, so couldn’t create enough suction to draw milk.

“I was new to seeing these moms,” Conneely recalls. “This mother was in tears, pleading for ‘some way to be able to breastfeed my baby!’” She adamantly did not want to be shown the specialty bottle typically used for babies with cleft palate.

Conneely tapped her colleague, Olivia Oppel, BSN, RN, CPN, CLC, and together, they reviewed existing breastfeeding products. The few that were available — nipple shields, bottle attachments and a sling that holds the bottle against the breast — were either awkward to use or didn’t really allow for skin-to-skin contact.

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Organs-on-chips reveal breathing’s critical role in lung cancer development

Image of lung cancer cells grown alongside human lung small airway cells inside an organ-on-a-chip
Inside view of a lung cancer chip: Lung adenocarcinoma cells are grown as a tumor cell colony (blue) next to normal human lung small airway cells (purple). Credit: Wyss Institute at Harvard University

One of the biggest challenges facing cancer researchers — and lots of other medical researchers, in fact — is that experimental models cannot perfectly replicate human diseases in the laboratory.

That’s why human Organs-on-Chips, small devices that mimic human organ environments in an affordable and lifelike manner, have quickly been taken up into use by scientists in academic and industry labs and are being tested by the U.S. Food and Drug Administration.

Now, the chips have helped discover an important link between breathing mechanics and lung cancer behavior.

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Meeting an unmet need: A surgical implant that grows with a child

Depiction of a growth-accommodating implant expanding in sync with a child's growing heart.
Artist’s rendering showing how a braided, tubular implant could grow in sync with a child’s heart valve. Credit: Randal McKenzie

Medical implants can save lives by correcting structural defects in the heart and other organs. But until now, the use of medical implants in children has been complicated by the fact that fixed-size implants cannot expand in tune with a child’s natural growth.

To address this unmet surgical need, a team of researchers from Boston Children’s Hospital and Brigham and Women’s Hospital have developed a growth-accommodating implant designed for use in a cardiac surgical procedure called a valve annuloplasty, which repairs leaking mitral and tricuspid valves in the heart. The innovation was reported today in Nature Biomedical Engineering.

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What do hospitals want from prospective digital health partners?

how digital health startups can better approach hospitals
How digital health startups can better approach hospitals.

How can the growing number of digital health startups sell their products to large-scale healthcare enterprises? Earlier this year, Rock Health, a San Francisco-based venture fund dedicated to digital health, conducted 30-minute interviews with executives at multiple startups and a few large healthcare organizations. They identified several key sticking points: navigating the internal complexities of hospitals, finding the right buyer, identifying the product’s value proposition and relevance to the hospital and avoiding “death by pilot.”

Now, in a Rock Health podcast, John Brownstein, PhD, Chief Innovation Officer at Boston Children’s Hospital’s Innovation and Digital Health Accelerator and Adam Landman, MD, MS, MIS, MHS, Chief Information Officer at Brigham and Women’s Hospital and part of its Innovation Hub, offer further tips from the inside. They were hosted by Rock Health’s director of research, Megan Zweig.

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From clinician to clinician-innovator: Designing a surgical innovation fellowship

Ramos at Boston Children’s Hospital’s 3D printing facility (Photos: Katherine C. Cohen/Boston Children’s)

Gabriel Ramos, MD, is a second-year general surgery resident from Puerto Rico, is Boston Children’s Hospital’s first Surgical Innovation Fellow.

I have devoted considerable time and training to become a surgeon. But I recently took a detour from my surgical education to pursue a research fellowship at Boston Children’s Hospital. I originally applied for a basic science research fellowship, but Dr. Heung Bae Kim – director of the Pediatric Transplant Center at Boston Children’s — described a new Surgical Innovation Fellowship. I decided to apply.

The early-stage nature of the fellowship meant I would not only learn about healthcare innovation, but also shape its future at Boston Children’s Hospital. The idea of learning more about the intersection of innovation, business and surgery was fascinating to me.

I was about to stop thinking as a surgeon – and start thinking as an innovator.

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From idea to product: 6 tips for surgical innovators

surgical innovation tips

Gabriel Ramos, MD, is a second-year general surgery resident from Puerto Rico and Boston Children’s Hospital’s first Surgical Innovation Fellow.

Learning how to think like a clinician-innovator is a journey that all clinicians should take. But be forewarned that the journey does not end with developing this new mindset. It starts with it.

What does it take to sustain innovation both inside and outside of the operating room? As a surgical innovation fellow at Boston Children’s Hospital, I learned to go back in time and immerse myself in the mindset of my toddler years, constantly asking “Why?” and “What if…?” This mindset is critical to sustaining innovation and solving clinical, research or administrative pain points.

Often, the hardest part of innovation is coming up with the right idea. Numerous factors must align, especially in surgical innovation, since the typical operating room is a difficult, distracting and stressful environment.

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Monitoring mitochondria: Laser device tells whether oxygen is sufficient

Shining a laser-based device on a tissue or organ may someday allow doctors to assess whether it’s getting enough oxygen, a team reports today in the journal Science Translational Medicine.

Placed near the heart, the device can potentially predict life-threatening cardiac arrest in critically ill heart patients, according to tests in animal models. The technology was developed through a collaboration between Boston Children’s Hospital and device maker Pendar Technologies (Cambridge, Mass.).

“With current technologies, we cannot predict when a patient’s heart will stop,” says John Kheir, MD, of Boston Children’s Heart Center, who co-led the study. “We can examine heart function on the echocardiogram and measure blood pressure, but until the last second, the heart can compensate quite well for low oxygen conditions. Once cardiac arrest occurs, its consequences can be life-long, even when patients recover.”

In critically ill patients with compromised circulation or breathing, oxygen delivery is often impaired. The new device measures, in real time, whether enough oxygen is reaching the mitochondria, the organelles that provide cells with energy.

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Pediatric devices wanted: Boston Children’s Hospital and the Boston Pediatric Device Consortium launch $250,000 challenge

Boston Pediatric Device Strategic Partner Challenge opens

There’s generally little incentive for industry to develop medical devices for children: The pediatric market is small (most children are healthy) and clinical trials are harder to do in children.

“Innovation in medical devices with the potential to improve the health of children and adolescents continues to lag in comparison to those for adults,” says Pedro del Nido, MD, leader of the Boston Pediatric Device Consortium and Chief of Cardiac Surgery at Boston Children’s Hospital. 

This week, the Innovation and Digital Health Accelerator (IDHA) at Boston Children’s Hospital and the Boston Pediatric Device Consortium (BPDC) announced a national challenge to try to remedy this problem. The Boston Pediatric Device Strategic Partner Challenge will award up to $50,000 to entrepreneurs and innovators seeking to create novel pediatric medical devices, from a total pool of up to $250,000.

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