News › Fraun­ho­fer IOF · Rese­arch with heart saves human lives

Rese­ar­chers and entre­pre­neurs from Jena are win­ning hearts – lite­rally. Tog­e­ther with the start-up Nova­Pump from Jena and the Jena Uni­ver­sity Hos­pi­tal, the Fraun­ho­fer Insti­tute for Applied Optics and Pre­cis­ion Engi­nee­ring IOF has deve­lo­ped inno­va­tive heart val­ves and pumps. On the occa­sion of World Heart Day on Sep­tem­ber 29, we look back on the history of a long-stan­ding and cor­dial cooperation.

The human heart per­forms extra­or­di­nary feats day after day. It sup­plies tis­sues and organs with the neces­sary amount of oxy­gen and remo­ves harmful sub­s­tances. Every minute, it pumps the entire blood through the body once. Under stress, it even does so up to five times and con­ti­nues to do so ide­ally for many deca­des. If the heart gets out of sync or can no lon­ger per­form as requi­red due to ill­ness, spe­cia­lists like Dipl.-Ing. Ronald Reich and Prof. Dr. Dr. Mar­kus Fer­rari from Nova­Pump GmbH and Dr. Tho­mas Peschel from Fraun­ho­fer IOF are nee­ded to res­tore synchronization.

All three have been invol­ved in the deve­lo­p­ment of highly effi­ci­ent implants for wea­k­ened hearts for many years, in close sci­en­ti­fic col­la­bo­ra­tion with the Depart­ment of Inter­nal Medi­cine I at Jena Uni­ver­sity Hos­pi­tal. Tog­e­ther with the team of cli­nic direc­tor Prof. Dr. Chris­tian Schulze, as well as his pre­de­ces­sor Prof. Dr. Hans-Rei­ner Figulla, they have repea­tedly worked clo­sely tog­e­ther in the past to deve­lop various the­ra­peu­tic solu­ti­ons – most recently in two public pro­jects fun­ded by the Ger­man Fede­ral Minis­try of Edu­ca­tion and Rese­arch (BMBF) to rea­lize inno­va­tive right and left heart pumps. These are inser­ted via the leg ves­sels to the heart in acute pati­ents in the cathe­ter labo­ra­tory while the heart is still bea­ting. Tem­po­r­a­rily, these self-expan­ding heart pumps can pro­vide effec­tive pum­ping sup­port for a few days until fur­ther dia­gno­stic and the­ra­peu­tic mea­su­res are taken and the wea­k­ened heart mus­cle has reco­vered. The deve­lo­p­ment of these inno­va­tive heart pumps is based on a long-stan­ding coope­ra­tion bet­ween rese­ar­chers and entre­pre­neurs from Jena, which goes back to the 1990s.

Long­stan­ding coope­ra­tion pro­du­ces diverse heart implants

Since 1998, Dr. Tho­mas Peschel has been rese­ar­ching various implants for the heart, in addi­tion to many other things at Fraun­ho­fer IOF. His work in this field began with the deve­lo­p­ment of an arti­fi­cial heart valve. The heart valve includes a vas­cu­lar sup­port, also cal­led a »stent«. Tog­e­ther with a team of rese­ar­chers from Fraun­ho­fer IOF and phy­si­ci­ans from the Uni­ver­sity Hos­pi­tal of Jena, Peschel deve­lo­ped a pro­sthe­sis that can be pla­ced at the site of the dama­ged heart valve wit­hout major surgery.

This tech­no­logy is an inno­va­tive solu­tion for elderly or weak pati­ents in par­ti­cu­lar, as their health often does not per­mit exten­sive sur­gery on the open chest. What is spe­cial about the heart valve deve­lo­ped by Peschel and his team is that the valve does not unfold tog­e­ther with the stent until it is in place. After years of suc­cessful rese­arch, the idea was trans­fer­red into medi­cal prac­tice with the help of a spin-off company.

Simul­ta­neously with Peschel’s rese­arch, the start-up Nova­Pump GmbH was foun­ded in Jena. Its co-foun­der, Prof. Dr. Dr. Mar­kus Fer­rari, was invol­ved in heart valve deve­lo­p­ment on the part of Jena Uni­ver­sity Hos­pi­tal. Tog­e­ther with his busi­ness part­ner Dipl.-Ing. Ronald Reich, now mana­ging direc­tor of Nova­Pump GmbH, the two approa­ched Tho­mas Peschel’s team at Fraun­ho­fer IOF again in 2013 and inspi­red him with the idea of buil­ding on the expe­ri­ence of heart valve deve­lo­p­ment to next deve­lop novel self-expan­ding, pul­sa­tile heart pumps.

A tech­no­logy grows: from heart val­ves to heart pumps

For Peschel, this was an inte­res­t­ing new chall­enge: Tog­e­ther with Nova­Pump, he and his team first began working on a pump for the so-cal­led right ven­tricle, or heart cham­ber. The right ven­tricle pumps deoxy­gen­a­ted blood toward the pul­mo­nary cir­cu­la­tion, where it is sub­se­quently oxy­gen­a­ted in the lungs and pum­ped back into the body. »The right ven­tricle was very well sui­ted to the idea of a novel self-expan­ding and cathe­ter-based pul­sa­tile heart pump. The pres­sure is lower than in the left side of the heart, and there is only one com­pe­ti­tor sys­tem on the mar­ket today that is based on a pum­ping prin­ci­ple that is dis­ad­van­ta­ge­ous for pati­ents,« the rese­ar­cher explains. Just like the pre­viously deve­lo­ped heart val­ves, the pump must be able to be folded to the smal­lest pos­si­ble size to be trans­por­ted to its place of use in the heart. Only once it arri­ves in the respec­tive heart cham­ber does it begin to unfold its­elf in a defi­ned man­ner due to the inno­va­tive material.
Ronald Reich illus­tra­tes the implan­ta­tion of the right heart pump.

The Nova­Pump right heart pump uses inno­va­tive val­ves inside and a small bal­loon as a drive. It can be fil­led with helium in a frac­tion of a second and then defla­ted again – a clas­sic posi­tive dis­pla­ce­ment pump. In order to work flaw­lessly, the bal­loon needs an extre­mely sta­ble sup­port struc­ture. This unfolds in the supe­rior vena cava in such a way that the bal­loon is directly ready for use and can be acti­va­ted via a con­trol con­sole that has pro­ven its­elf in car­diac medi­cine for many years. To rea­lize this extre­mely dif­fi­cult under­ta­king, a spe­cial shape memory metal is used for the sup­port­ing struc­ture of the heart pump. The pump cage is cut out of a thin metal tube with a laser and then fur­ther trea­ted in such a way that it deve­lops its requi­red sta­bi­lity at body tem­pe­ra­ture and can nevert­hel­ess be explan­ted again via the leg vein in a cathe­ter-based and folded man­ner after car­diac sup­port has been provided.
The implan­ta­tion pro­cess is illus­tra­ted on the model.

»We want to save lives«

After suc­cessfully demons­t­ra­ting the right heart pump in various test series, the team led by Peschel, Schulze, Reich and Fer­rari then went on to deve­lop ano­ther pump – this time for the left ven­tricle. After exten­sive rese­arch, they finally suc­cee­ded in fin­ding the ideal design and mate­rial match for it to meet the ana­to­mical requi­re­ments and pres­su­res in the left ventricle.

Nova­Pump GmbH is now vigo­rously working on making these the­rapy sys­tems available to acute pati­ents world­wide. »We want to use them to save lives,« says Ronald Reich. »Our per­cu­ta­neous heart pumps are to be used in par­ti­cu­lar in cases where acute car­diac events, e.g., a heart attack or car­dio­ge­nic shock, have occur­red and the cir­cu­la­tion needs to be sta­bi­li­zed and sup­ported within minu­tes. Safe and com­pli­ca­tion-free hand­ling of the pumps with maxi­mum pati­ent bene­fits is cru­cial in order to fur­ther reduce today’s still high mor­ta­lity rate of up to 50 % after these acute events,« con­ti­nues the CEO.