James F Antaki
The majority of my professional career has been devoted to development of blood-wetted medical devices. Equally important as the devices themselves, my research focuses on the methodology by which they are designed, and used clinically. For example, my group was one of the pioneers in physiological feedback control of implanted ventricular assist devices. We also developed one of the first decision support programs for identifying heart failure patients who could potentially recover with the acute mechanical circulatory assistance. Over the past 24 years, I have contributed to the development of several heart-assist devices used clinically, including the Heartmate-II, Novacor, Ventracor, TandemHeart, and Levacor. In 1997, I directed a multidisciplinary team that produced the Streamliner heart-assist device - the world's first magnetically levitated rotodynamic blood pump to be tested in-vivo.
The current emphasis of my research involves five application areas: circulatory support systems for children, decision-support tools for severe heart failure, diagnostic technology for the home and point-of-care to improve patient engagement, multi-scale modeling of thrombosis in artificial circulation, and development of medical devices for global health. A nascent, overarching project aims to accelerate medical innovation by professional networking between physicians, medical product designers, and patients. In summary, although my interest and experience is diverse, they share a common theme of improving healthcare though biomedical engineering.
Mechanical Circulatory Assistance (1991 - present): This is a unifying theme throughout my research career. It has entailed multifaceted, multi-disciplinary research that has culminated in the development of the world's first implantable magnetically-levitated ventricular-assist device, named the Streamliner. In many ways, this project was analogous to a moonshot, inasmuch as the underlying physics and physiology were unknown at the time of its inception, but had to be developed. Accordingly, it had spawned research into the interaction of blood with artificial materials under extreme flow conditions, feedback-control algorithms to regulate the hemodynamics of implanted devices, novel cannulation strategies, and other peripheral spinoff programs. A novel aspect of this research is the concept of coupling numerical optimization with computer simulation to achieve superior safety and efficacy without the time-consuming and costly demands of trial-and-error.
In 1998, the Streamliner became the first maglev rotary pump to be implanted in animals. In 1999, this research was recognized by IEEE who granted their annual Control Systems Award to Antaki and BE Paden.
Since 1999 to present day, this work has evolved into development of next-generation magnetically levitated blood pumps, including the Levacor (WorldHeart, formerly MedQuest), the PediaFlow heart-assist system for infants, and the HemoGlide for toddlers and young children. The Pediaflow program, a collaboration between UoP, CMU, CHP, WorldHeart, and LaunchPoint was one of four contracts by the National Institutes of Health (NHLBI) to develop innovative heart- and lung-assist technologies for pediatric patients. The contract extended from 2003 through 2012 but was interrupted right before beginning clinical trials due to the unanticipated acquisition of WorldHeart by their competitor, HeartWare. To this day (2016), we have been battling to regain control of the IP to continue on this mission.
Decision Guidance System for Mechanical Circulatory Assistance (2001-present) - to optimize ventricular assist device (VAD) as destination therapy (DT) in treating end-stage heart failure. This project, titled CORA: Cardiac Outcomes Risk Assessment - a Virtual Counsellor for Severe Heart Failure, aims to develop a web-based application that supports key decision points in the course of treatment. The application provides physicians with prognostic assessment based on a fusion of patient-specific data, expert knowledge, and retrospective meta-analysis. The patient-facing portion of this project aims to improve engagement in their decision making through education and alignment of treatment strategies with their core values and personal needs.
Breast Palpation Aid for Home and Primary Care (2013-pres.) Based on current incidence rates, one out of every eight women born in the United States today will develop breast cancer at some time during their lives. Despite advances in imaging technologies and clinical practice, breast cancer screening has shown an inconsistent impact in decreasing breast cancer-associated deaths while accumulating nearly $8bn in associated annual costs. This project aims to address shortcomings of breast self-examination and mammographic screening with a cost-effective, sensitive, easy-to-use palpation aid, PalpAid, for the home and point of care. PalpAid, targets both clinical and home settings: both for initial screening and subsequent monitoring of palpable breast lesions. Successful employment of the PalpAid, device would help educate and empower patients and reduce over-treatment of breast lesions through cost-effective monitoring in the home.
Multi-scale Model of Thrombosis in Artificial Circulation Blood Rheology, Trauma, and Thrombosis (1991-present): This has been a collaborative effort with Dr. Kameneva (University of Pittsburgh) to develop a multi-scale mathematical model to describe and predict the trafficking of blood cells, primarily in artificial circulation, but also in the cardiovascular system. Micro-scale computer simulations and experiments of individual cells are used to motivate and calibrate meso- and macro-scale simulations that may be used in the design of blood-wetted devices. It was supported by a 6-year R01 from NIH from 2008-2015, and is currently under review for 4-year renewal.
Devices for the Treatment and Diagnosis and Treatment of Malaria (2010-pres.). This research represents an amalgamation of my expertise in microfluidics, blood rheology, and magnetics to develop devices to selectively isolate malaria-infected red blood cells. This involves a novel blood filtration system, mPharesis, (malaria-apheresis) and a point-of-care diagnostic test, pScreen,.
Aqueous Immersion Surgery (2008-pres.): This project aims to develop a surgical system for minimizing surgical bleeding by immersing the surgical field in an aqueous medium. The initial applications were neurosurgery and spinal surgery. However the technology has found an unique application for micro-gravity and zero-gravity surgery in space. We are now collaborating with NASA and U Louisville to develop a system as part of NASA's mission to Mars.
Identifying and Optimizing Ventricular Function and Recovery (1985-2012): The prospect of developing a "cure" for heart failure is a holy grail for medicine. It is likely that future efforts to "remodel" or restore the diseased heart will entail some form of temporary mechanical circulatory assistance - while adjuvant therapies are provided, or the heart recovers by itself. This research aims to (1) develop diagnostic tests that can identify which patients are likely to benefit from temporary cardiac support, and (2) develop strategies to optimize ventricular "reloading" to provide maximal rehabilitative effect.
- 2012. "The Future of Mechanical Circulatory Support." In Mechanical Circulatory Support: A Companion to Braunwald's Heart Disease , edited by RL Kormos & L Miller , 333-335. . .
- 2010. "PediaFlow, Maglev Ventricular Assist Device: A Prescriptive Design Approach." Cardiovascular Engineering Technology 1 (1). .
- 2014. "A numerical study of blood flow using mixture theory." International Journal of Engineering Science Volume 76: 56-72. .
- 2007. "Investigation of platelet margination phenomena at elevated shear stress." Biorheology 44 (3): 161-177. .
- 2015. "A new Bayesian network-based risk stratification model for prediction of short-term and long-term LVAD mortality." ASAIO Journal 61 (3): 313-323. .
Selected Awards and Honors
- Steven Fenves Award for Systems Research 2009
- August H. Koyanagi Young Investigator Award (11th Congress of the International Society for Rotary Blood Pumps) 2003
- Fellow (American Institute for Medical and Biological Engineering (AIMBE)) 2002
- IEEE Control System Technology Award (shared with BE Paden, UCSB) for development of Streamliner maglev heart assist pump (IEEE) 2001
- Elected one of "Pittsburgh Magazine 40 under 40" the top leaders in Pittsburgh under age 40. (Pittsburgh Magazine) 1999
- BS (Mechanical Engineering), Rensselaer Polytechnic, 1985
- Ph D (Mechanical Engineering), University of Pittsburgh, 1991