According to Professor Pierre Dupont, there are currently two approaches to perform repairs inside the heart – open heart surgery and catheter interventions. Dupont, who recently was awarded a $5 million NIH grant to perform work in this area, believes there is a better way. Interestingly, he picked MEMS as the technology of choice for his project and is collaborating with Microfabrica, a microdevice manufacturer based in California. We recently spoke with Professor Dupont about his goals and why the size advantages of MEMS really matter in this case.
MEMS Investor Journal: What medical problem are you solving? Why is it important?
Pierre Dupont: We are developing technology to perform surgery inside the beating heart. Such surgeries are needed to correct congenital heart defects (the most common birth defect) in the fetal and pediatric heart as well as to repair the effects of heart disease in older patients.
Currently, simple problems inside the heart can be corrected using catheters, but many can only be repaired by stopping the heart, cutting it open and remodeling the tissue inside using handheld tools. Besides being very invasive, stopping the heart has side effects including neurodevelopmental defects in children and strokes in adults.
Our goal is to develop robotic instruments that can be used to perform complex repairs inside the beating heart through very small incisions in the heart wall.
MEMS Investor Journal: Why did you choose MEMS as the technology platform? Does size really matter in this case?
Pierre Dupont: Size does in fact matter. To enter the beating heart through a small incision and to navigate through its chambers to the site of the surgical repair, our instruments will have diameters of 1-4 mm. The tools deployed from these instruments will be comprised of sub-millimeter components. There is no strong competitor to MEMS for mass producing tools at this size scale.
MEMS Investor Journal: Why did you choose to work with Microfabrica? Did you have a previous relationship with them?
Pierre Dupont: Microfabrica’s technology is unique and ideally suited to making medical devices for the minimally-invasive procedures we’re targeting. Their devices are made from metal, which is far more robust than silicon, and they can produce extraordinarily complex 3-D mechanisms that offer much more functionality than simpler devices.
We were looking for the best technology to use for millimeter-scale tools when Microfabrica approached our clinical collaborators at Children’s Hospital Boston. Their technology was a perfect fit for our needs and they had a lot of terrific ideas so teaming with them was a natural choice.
MEMS Investor Journal: What are the main challenges your project faces in the near future? What about in the long term?
Pierre Dupont: To perform surgery inside a beating heart, we can’t just take surgeons’ handheld tools and mount them on a robot. The motion of the beating heart and the flow of the blood make this impossible. The challenge is to reinvent how these surgical procedures are accomplished by developing new tools and techniques.
A second challenge, independent of the instrument technology, is the real-time imaging of millimeter-scale tools interacting with tissue inside a beating heart. A number of private and federally funded groups are addressing this challenge. For example, I’m working on improving 3D real-time ultrasound imaging in a second NIH-funded collaboration with Philips Medical Systems, Children’s Hospital and Harvard University.
MEMS Investor Journal: What is the strongest competition to the technology you are developing?
Pierre Dupont: There are steerable catheters either on the market or coming to market that facilitate navigation of a device into the desired region of the heart, but they cannot provide a mechanically stable platform to perform a procedure involving tissue removal or suturing. This is where our robotic, joystick-controlled steerable instruments have a significant advantage.
What’s more, there are no catheter-mounted tools in existence that can remove extraneous tissue, capture it, and transport it away and few devices suitable to replace difficult and complex suturing procedures: we expect to do both of these with the tools we are developing.
MEMS Investor Journal: Are you working with practicing surgeons? What has their feedback been?
Pierre Dupont: Yes; I work very closely with the Chief of Cardiac Surgery as well as other surgeons and cardiologists at Children’s Hospital in Boston which is associated with Harvard Medical School. This is the fourth NIH-funded grant of our collaboration. The inspiration for our devices arises directly from the clinical challenges they face on a daily basis. They are excited by what we’ve done so far and by the potential to deliver a complex therapy in a minimally invasive manner.
MEMS Investor Journal: What is your commercialization plan for this technology?
Pierre Dupont: Both startup and licensing opportunities are being contemplated at this point. It’s also likely that some technology components will be directly commercialized by Microfabrica.
MEMS Investor Journal: What is the timeline for the project and what are the main milestones?
Pierre Dupont: This is a five-year project. We will develop the technology by tackling a sequence of increasingly difficult pediatric and adult surgical procedures. We will then move on to instruments for fetal surgery where the miniaturization challenge is greatest.
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Pierre E. Dupont is a Professor at Boston University and is also Associate Scientific Staff in the Department of Cardiovascular Surgery at Children’s Hospital, Boston. He received his PhD degree in Mechanical Engineering from Rensselaer Polytechnic Institute and held a postdoctoral fellowship at Harvard University. His research team develops new technologies for image-guided minimally invasive surgery. He has published over 70 journal and conference papers and has received research funding from NIH, NSF and ONR. Prof. Dupont holds a number of positions with the IEEE Robotics and Automation Society and is also affiliated with Boston University's Center for Information and Systems Engineering (CISE).
Surgeons realized the limitations of hypothermia - complex intracardiac repairs take more time and the patient needs blood flow to the body (and particularly the brain); the patient needs the function of the heart and lungs provided by an artificial method, hence the term cardiopulmonary bypass.
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