Cardiovascular disease in Australia claims one life every 12 minutes. The irreversible damage to the heart is known as heart failure, a condition that progressively prevents the heart from providing the proper amount of blood to our body. This means that patients will not receive enough oxygen and nutrients in several organs, leaving them breathless and fatigued and increasingly dependent on hospital care. If not resolved with a heart transplant, a heart failure patient will die, and yet a heart transplantation often remains out of reach for most who need it.
Every year, around 120 Australians receive a heart transplant. This leaves heart failure patients in hope for a suitable heart transplant. The reality is that many will die while on a waiting list and thousands more will never be eligible in the first place. Even when a match is found, the procedure is very invasive and risky, followed by a long, demanding recovery and a life left taking immunosuppression drugs. This means that any patient older than 70 may not be eligible for a heart transplant and will slowly die.
For the past two decades, I have dedicated my career to understanding what differentiates a healthy from a diseased heart, as well as to developing a safer, less risky alternative approach to a heart transplant. Together at the Heart Research Institute and the University of Technology Sydney, my team and I have been working towards a different paradigm, one where we do not replace the failing heart, but rather protect it.
After 21 years of research and development, and seven years of focused material experimentation, we are now closer than ever to translating that idea into a clinical reality.
The breakthrough has come in the form of an advanced 3D-printed “mini-heart” patch, which is a bioengineered bandaid for the heart. A personalised, flexible, living scaffold designed to be applied directly to damaged cardiac tissue. Unlike conventional patches, this one is built from a patient’s own stem cells combined with natural biomaterials, including silk fibroin.
Derived from silkworms, the material is exceptionally strong, making the bandaid uniquely durable to function under constant cardiac motion, it is highly elastic, and biocompatible. Crucially, it does not trigger a significant immune response, which is why it is already used in other medical applications, such as screws or sutures.
In pre-clinical testing, our results have been compelling. We have been able to show the patch is not only safe, but it also helps a failing heart pump blood better, almost as if it never had heart failure to start with. In fact, it acts as a “cushion” on the damaged regions, and provides enough support for stem cells to repair the heart.
What makes this particularly significant is not just what the patch does, but how it can be inserted and attached.
Traditional cardiac surgery for a heart transplant requires opening the chest via a thoracotomy, which is a huge cut onto the chest of the patient. It is one of the most invasive operations a patient can go through, requiring an incision of up to 30 centimetres to access the chest cavity with patient recovery upwards of six months.
Our 3D printed “mini-heart” patch offers a far less invasive approach. The patch is foldable and flexible and capable of being delivered through a small incision using keyhole surgery and could redefine what heart surgery of the future looks like.
The development process has been thorough and it is the summary of a multidisciplinary team over 21 years across three continents, trialling a range of materials in combination with stem-cell based constructs in our search for the optimal balance of strength, elasticity, and biological compatibility.
The next step is to move from pre-clinical success into human clinical trials.
The goal is ambitious but within the next five to 10 years, our team hopes to see this technology in hospitals as a genuine alternative to transplantation for selected patients. In a further future, this could be a common procedure that does not require extensive laboratory testing anymore, with a clinic printing their own band-aids in the clinic. This would pave the way heart failure is treated, without the need for a donor organ to become available, any extensive waiting lists, and more patients being available to live a healthy life.
We are on the cusp of a breakthrough that could save lives and would also relieve an enormous burden on the health care system, which is also responsible for the extensive and expensive care required after a heart transplant.
Unfortunately, the gap between laboratory success and clinical implementation is where many breakthroughs stall. This is where urgency becomes as important as innovation.
The nation’s burden of heart failure is growing and time lost can be measured in lives lost.
We are not there yet. But for the first time, the pathway is visible and it is being woven from silk.
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