Engineering a biological device to support a sick heart

  • The BRAVƎ project, which is funded by the European Commission, combines cell therapy and bioengineering to design a biological device that recovers cardiac functionality in people with cardiovascular disease.
  • Cardiovascular disease is the leading cause of death in the world

Spain, October 29th, 2019. BRAVƎ project is an international research initiative for cardiac regeneration. It combines cell therapy and bioengineering to design a biological device capable of recovering cardiac functionality in people with coronary heart disease. Clinica Universidad de Navarra (Spain) coordinates the project in which 13 more European institutions from 5 different countries participate. The European Commission finances this project with 8 million euros, within the Horizon 2020 Program.

Cardiovascular disease is the leading cause of death in the world. The World Health Organization (WHO) estimates that 18 million people die each year in the world, 4 million in Europe.  Although mortality is decreasing, 49 million people live in the European Union (E.U.) with this disease. Among the types of cardiovascular disease, the most frequent is coronary artery disease or ischemic heart disease. This condition consists of the blockage of the arteries of the heart, which prevents sufficient flow of blood and oxygen. It is a chronic limiting disease that causes a health expenditure of about 59 billion euros in the E.U.

Cardiac regeneration as a therapeutic alternative

“Each patient has a different type of heart attack. It depends on the affected part of the heart and the intensity of the injury. With the BRAVƎ project, we seek to provide patients with personalised and lasting ventricular assistance. To do so, we aim to design a device-generated with the patient stem cells that we can couple to his diseased heart,” says doctor Felipe Prósper. Dr Prosper is the researcher responsible for the project. He is also the director of the Cell Therapy Area at Clinica Universidad de Navarra and the director of the Regenerative Medicine Program at Cima Universidad de Navarra –the Spanish hospital’s applied medical research centre.

This biological device, called BioVAD, seeks to replace the current mechanical methods of cardiac ventricular assistance (ventricular assist device, VAD) used in patients in need of a heart transplant, in those with temporary heart failure or after some heart surgeries. These devices are not a lasting therapeutic solution; they rarely exceed five years of useful life. Also, their implantation generally requires open-heart surgery with significant associated risks.

At the head of human-scale innovation

In the BioVAD design, researchers will use the most advanced technology in 3D printing, in the development of new biomaterials and the knowledge of the potential of stem cells. For the first time, the scientist will develop this kind of device on a human scale, using swine as a model, as this is the animal with the most similar cardiac physiology to humans.

By computer or computational modelling, scientists will reproduce the functionality and biomechanics of the human heart. With this necessary data, they will replicate cardiac cells created from stem cells, with the characteristics of each patient’s heart. “We will design this device with the capacity to maximise the production of force by cells. This will ensure functional support for the diseased organ,” says Manuel Mazo, a researcher at Cima and collaborator on the project. “Given our clear translational intent, the project will begin on a clinically relevant animal model –pig– and will close upon transplantation of the BioVADs in that same model, on a personalised fashion: structure and function will be modelled in the same animals for which the BioVADs will be fabricated,’ explains Dr Prósper.

European consortium for BioVAD’s design

Alongside Clinica Universidad de Navarra, and in collaboration with Cima, 13 European institutions are part of this initiative: Eindhoven University of Technology (the Netherlands), Katholieke Universiteit Leuven (Belgium), Universitäts­klinikum Würzburg (Germany), Servicio Madrileño de Salud (Spain), University Medical Center Utrecht (the Netherlands), Institute for Bioengineering of Catalonia (Spain), Instituto de Biologia Experimental e Tecnológica (Portugal), Leartiker S. Coop. (Spain), University of Zaragoza (Spain), EBERS Medical Technology S.L. (Spain), Boston Scientific (Ireland), AE Medicalis (the Netherlands), and Ciaotech (Italy).


Caption: From left to right: Dr. Manuel Mazo, Dr. Juan José Gavira and Dr. Felipe Prósper.