Towards a Circular TAVI Procedure
A transition pathway for circularity in healthcare practice
E.R.E.M. van Hees (TU Delft - Industrial Design Engineering)
J.C. Diehl – Graduation committee member (TU Delft - Industrial Design Engineering)
C.P.J.M. Kroon – Mentor (TU Delft - Industrial Design Engineering)
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Abstract
Healthcare delivers major health benefits but also generates significant waste and emissions. In interventional cardiology, many products are used once and then incinerated as hazardous waste. This report focuses on the TAVI procedure as a representative example: a procedure in which high-value, single-use products containing high-quality polymers and precious metals are used. This results in a loss of material value and repeated demand for virgin resources.
The central problem addressed in this project is that improving end-of-life outcomes is not only a product challenge. Even if a device is technically recyclable, it can still be incinerated if the workflow, waste routing, contracts, and responsibilities remain unchanged. Circularity, therefore, requires system change.
This project aims to identify ways to improve the end-of-life of the TAVI products to reduce environmental impact and value loss while maintaining clinical safety and compatibility with the Cath lab. The work addresses this through a combined product-and-system approach. System-level analyses were done to understand how the end-of-life is shaped in practice.
Product-level analyses were done to identify environmental and material hotspots. These findings were translated into design requirements to identify realistic directions for intervention.
Based on these findings, a transition strategy is proposed. The near-term focus is on a recycling route that is compatible with the current system. This phase aims to reduce incineration and enable higher-quality material recovery through design-for-recycling and material transparency. The longer-term direction is partial reuse of the delivery system's handle, which offers higher value retention but requires additional conditions, such as validated sterilisation and inspection, traceability of use cycles, and a defined liability and quality contract. Co-creation sessions were used to test feasibility assumptions and to clarify what stakeholders need to implement such changes in practice.
The report concludes that a circular pathway for the TAVI delivery system is feasible only if product interventions and system interventions are developed together. The deliverable of this project is a booklet to help all stakeholders realise this transition.