Revolutionising access to the heart


Sometimes what makes a technology a “breakthrough” is the fact that it does not break through at all. Take, for example, the novel epicardial ablation techniques developed by Dr Srijoy Mahapatra, University of Virginia, USA. While current treatments for heart problems such as congestive heart failure centre on surgical techniques, he seeks to treat the heart from the outside, without breaking through the heart’s tissue.

“The heart is surrounded by a 1-millimeter wide, fluid-filled sac – that, by the way, you cannot even see on X-ray,” says Mahapatra, an assistant professor of internal medicine and biomedical engineering. “Our new tools allow us to go through that sac to the epicardium without actually entering the heart, reducing patients’ risk and recovery time.”

Among these new tools is an “epi-needle access system,” which includes a retractable needle and a sensor capable of measuring the pressure and pressure frequency of surrounding tissues. Developed with Dr George T Gillies, this revolutionary access system acts as a scope and thus requires only one 3-millimeter incision, making it much less invasive than surgical methods.
“Any time you reduce the risks of a procedure, as we have done with the epi-needle, you make treatment available to more people,” Mahapatra said. “Because this technology is less invasive, we can use it to treat people who are currently not being treated.”

That is good news for patients suffering from heart failure, atrial fibrillation, ventricular tachycardia and esophageal failure, all of whom could be helped by the scientists’ new epicardial technology. With its advanced precision, the epi-needle can also be used for safer pacemaker insertion, ablation techniques, stem cell delivery and drug delivery throughout the body, and it will reduce the risk of stroke associated with atrial fibrillation.

The epi-needle is the first of a suite of epicardial technologies developed by Mahapatra and Gillies and disclosed to the University of Virginia Patent Foundation.
“We are fortunate here at University of Virginia to have inventive medical doctors like Srijoy, who can foresee novel solutions to clinical needs,” says Gillies, research professor of mechanical and biomedical engineering. “It is indeed a pleasure to work with him on these exciting technologies.”

Mahapatra sees invention as an important and natural part of his work, and he encourages fellow clinicians to embark on paths to discovery through open, weekly discussions held in his office.

“I love taking a problem,” he says, “and solving it by creating a tool that you can use with your hands to help patients.”