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Healing Hearts
July 29, 2011   
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The Foundation for Cardiac Surgery Development in Zabrze was set up in 1991 as an initiative by the late Prof. Zbigniew Religa, a pioneering Polish heart transplant surgeon. It aims to support the development of Polish cardiac surgery and bring modern techniques and technologies to clinical practice in heart disease treatment.

Over the years, the foundation has grown into an innovative hi-tech center that conducts various research programs, including research into a new type of biological heart valve, heart prostheses, an artificial heart, surgical robots, biotechnology and biocybernetics. The research and design work is conducted in four laboratories: the Artificial Heart Laboratory, Biological Heart Laboratory, Biocybernetics Laboratory and Bioengineering Laboratory. The foundation has a staff of 80, including 50 research workers. It pursues its mission thanks to subsidies, research grants and donations from private individuals, firms and institutions interested in the development of Polish cardiac surgery.

A tissue bank spun off from the Biological Heart Laboratory has been operated by the foundation since 1998. Apart from heart valves, it prepares corneas for implantation, human skin dressings used in the treatment of burns, and tendon and ligament grafts for reconstructive orthopedic surgery.

Key projects:
Polish Artificial Heart 2007-2012

A long-term government program aimed at developing a range of Polish heart prostheses and bringing them into clinical practice. A wide variety of prostheses is being developed under the program: from extracorporeal devices for short-term use and partially implantable devices to a fully implantable permanent heart prosthesis (total artificial heart). A few dozen scientific research centers and several clinical centers are taking part in the program. The foundation coordinates the program and carries out some of the research tasks.

The program has resulted in developing—and bringing into clinical practice—the extracorporeal Pneumatic Cardiac Assist System POLCAS composed of the Ventricular Assist Device POLVAD and its controller POLPDU provided with an independent power supply. The POLCAS system has been used in hospitals since 1996 as an advanced treatment method for critical chronic heart failure in adults. The system is used as “a bridge-to-transplantation,” in which case it assists the failing hearts of patients while they are waiting for heart transplant surgery, or as “a bridge-to-recovery” designed to help the failing heart regenerate. In many cases, the system may enable the heart of a patient qualified for transplantation to heal itself completely, preventing the need for surgery. The system has been used in more than 200 cases, with the patients’ age ranging from 14 to 76.

Other designs include the pneumatic total artificial heart POLTAH, put into production and used experimentally in clinical practice, a prototype of the implantable electro-hydraulic left ventricular assist device POLHIVAD and a model of the implantable heart prostheses POLVAD built with the use of a flexible nanolayer coating of titanium nitride on a bio-compatible polymer. This innovation won the Grand Prix award at the 53rd World Exhibition of Innovation, Research and New Technology in Brussels in 2004.

The foundation’s most recent priority project, launched in 2008, involves the construction of the extracorporeal heart prosthesis for children POLVAD-PED. Clinical trials for the device are scheduled to begin soon.

Robin Heart Surgical Robot

Since 2000 the Biocybernetics Laboratory has been carrying out an unprecedented project aimed at designing—and putting into clinical practice—a range of prototype surgical robots called Robin Heart. The result of the design work so far is a range of robots with a modular structure, which means they can be used for various types of surgery.

Three models—Robin Heart 0, Robin Heart 1 and Robin Heart 2—have been developed to date. The Robin Heart 1 has an independent base and is controlled via an industrial computer. The Robin Heart 2 is mounted on the operating table and is provided with two arms, to which various surgical instruments or an endoscopic camera can be attached. The researchers are now conducting tests and working to improve the technology and optimize the prototypes so as to develop a range of products for clinical applications.

The Robin Heart Vision robot for controlling the position of the endoscopic video channel was developed in 2007-2008. It is expected to be the first to enter clinical practice and pave the way for the whole robotic family. Work is under way to develop and apply fully original mechatronic surgical instruments called Robin Heart Uni System, including a needle holder, scalpel scissors, riveter, stitching device, instruments for inserting cannulae into the body, and instruments for stitching tissue together. The instruments will be mounted on a robotic arm and controlled via the robot’s console, or attached to a special holder to be controlled manually. Procedures performed using such instruments, inserted through small incisions in the patient’s body, will be less invasive and will shorten the time of surgery and recovery for patients.

Heart Valve Prostheses

Under the New Methods for Preparing Biological Valves project, the researchers are working on a prototype autologous valve—a tissue-engineered biological heart valve in which a decellularized or biodegradable scaffold will be seeded with the patient’s own, or autologous, cells derived from the bone marrow. A valve of this kind would be free of complications associated with the use of contemporary heart valves.

At the same time, the Biological Heart and Biocybernetics Laboratories is conducting research to develop animal-based biological heart valve prostheses, taking advantage of a new chemical preservation method, which could help solve the problem of the shortage of human material used for treatment purposes. All the designs developed as part of the project have been submitted for patent protection.
Ewa Dereń

Jan Sarna, general manager of the Foundation for Cardiac Surgery Development
The Foundation for Cardiac Surgery Development is a small non-state-owned and nonprofit institute. It fills a niche in the market for technologies associated with the artificial heart and cardiac surgical robots. These technologies are such a narrow and specialized field of research that no one wants to deal with them. The foundation is a unique institution in terms of its multidisciplinary character. We have experts from various disciplines in our team: engineers, designers, biologists, chemists and physicists. Their work has resulted in not only publications and patents but also practical applications. We follow a policy of moving from research to practice. Owing to our interdisciplinary team, we are able to communicate with various scientific communities—from universities of technology and technological institutes to hospitals and clinics—and integrate them in order to carry out interdisciplinary research projects.

In 2004, the Foundation for Cardiac Surgery Development, became the only nongovernmental organization among 80 institutions—research centers, institutes of the Polish Academy of Sciences, and universities—to gain the status of coordinator of a Center of Excellence under a resolution by the State Committee for Scientific Research. At present, there are around 100 institutions with this status in Poland, 90 of which are universities or large institutes. Among them is our small foundation with no funding from the national budget. I regard this as a big success because this shows we are able to prove our usefulness and credibility. We are not a wealthy center—we have only as much money as we can earn through innovation and reliable work with our partners. And we have many partners—several dozen of them are working with us on the Polish Artificial Heart program alone.

Additionally, we collaborate on a day-to-day basis with more than 10 foreign centers, both universities and commercial research centers. We have a great variety of partners. Many of them specialize in narrow fields of expertise.

This year the foundation is celebrating its 20th anniversary. It will be marked by several projects. We are going to give special prominence to the extracorporeal heart prosthesis for children, POLVAD-PED. By the fall clinical experiments with the device will have been completed and the prosthesis will be ready for use in clinical practice. This means that the first child could have it implanted next year. The development will crown our 20 years of work. One reason why this prosthesis is so important to us is that its development was wholly financed through fundraising among the public without any grants or subsidies. We want to show that we are able to carry out such projects relying on the foundation’s own resources.

Research on the Robin Heart cardiac surgical robot is also nearing completion. It has recently undergone a series of experiments on animals and will probably be brought to operating theaters this fall.

Among the foundation’s latest achievements I would like to mention our biggest success of last year—a portable controller for the extracorporeal heart prosthesis system. As regards, the Polish Artificial Heart, the project is being carried out according to schedule and a prototype will be ready in 2012. But before the artificial heart is launched on the market it will have to go through clinical trials, a certification process and so on. This may take a few years.
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