Soft robotic devices for cardiovascular medicine

Conventional, rigid simulators and therapeutic devices for cardiovascular disease have several fundamental limitations, such as poor biomimetic fidelity, substantial surgical invasiveness and mismatch at the tissue-device interface. Soft robotic devices, with tissue-like materials, structures and functions, are emerging as promising alternatives. In this Review, by matching clinical demands to technological breakthroughs, we identify three emerging complementary frontiers in which soft robotic devices are redefining cardiovascular medicine - soft robotic simulators, such as in vitro ventricular simulators and in vivo assistive simulators; soft robotic interventional instruments, such as percutaneous instruments, endovascular continuum instruments and untethered mini-scale robots; and soft robotic implants for vascular disease, arrhythmia and heart failure. We describe the unique advantages of soft robotic devices as well as their applicable scope and technical implementation. Finally, we highlight promising technological opportunities for next-generation soft cardiac devices, evaluate the clinical maturity of existing devices and propose a translational roadmap for the coming decade. With this Review, we aim to foster further integration of soft robotics into cardiovascular medicine by identifying device solutions with translational potential to address unmet clinical needs.