Spacemaker technology
To further enhance CART-Tech’s portfolio of products, the patented Spacemaker and Suction Knife technologies have been licensed from UMC Utrecht earlier this year.

The “Spacemaker” is a novel multipurpose inflatable medical device that facilitates minimal invasive access and maneuverability for endoscopic instruments and therapies.

Traditional heart and lung surgery is highly invasive and involves opening of the chest for exposure of surgical targets. High quality repair is achieved but considerable procedural related health risks and major discomfort are encountered by about 40% of patients after open-thoracic surgery. On the other hand, catheter-based procedures are less invasive but lack robustness and efficacy for many interventions, such as mitral valve replacement.

Recently, minimal invasive (key hole) cardiac surgery has gained more interest, because it reduces operative trauma and patients will have fewer scars with efficacy comparable to open heart surgery.

We are currently active in two main areas of development with two different designs of the Spacemaker:


Chesterfield model
Current methods to expose the heart minimal invasively are one-side lung ventilation or the lungs are crunched by high pressure gas insufflation. Although access and exposure of the heart is now obtained, cardiac performance and lung function are depressed during and after the procedure. In the aging population, the vulnerable elderly with heart failure and chronic obstructive lung disease will not tolerate it. Therefore, with current strategies, keyhole cardiothoracic surgery will not be widely adopted with great negative impact on patients’ outcome in the aging population.

With the use of the Spacemaker (Chesterfield model), reduction of risk and operative morbidity in key-hole surgery can be achieved. A first clinical fit study with a Chesterfield prototype is currently under preparation at Maastricht UMC (Prof. Jos Maassen and Prof. Mark La Meir).

Spacemaker, Chesterfield model


In a second approach, the “Snailhouse”, a Spacemaker variant for sub-xiphoidal (just below the sternum) access to the pericardium is developed for the fast growing field of arrhythmia surgery. In this areas the space between the pericardial sac and the surface of the heart needs to be increased to facilitate or enable the procedure.

We have recently performed a number of successful Left Atrial Appendage clipping procedures with one of the recently introduced clipping devices.

Spacemaker, Snailhouse model

Spacemaker, Snailhouse model

Prof. Paul Gründeman (UMC Utrecht) is leading the efforts in this field and is also the main inventor of the Spacemaker technology.