It’s been a challenge to develop a surgical adhesive that sticks to wet surfaces and isn’t toxic. But it turns out a certain kind of slug is very good at secreting a sticky mucus that glues fast, apparently as a defense mechanism.
That provided the inspiration for a hydrogel “super” adhesive that could supplant surgical sutures, at least for some operations, and help medical devices stay in place. Researchers at the Wyss Institute for Biologically Inspired Engineering and Harvard’s School of Engineering and Applied Sciences (SEAS), led by David Mooney, PhD, report that the adhesive bound strongly to a variety of animal tissues, including skin, cartilage, artery, liver and heart.
Nikolay Vasilyev, MD, a coauthor on the paper, is interested in the adhesive’s potential for young patients with congenital heart disease. He is is a research scientist in Cardiac Surgery at Boston Children’s Hospital, and led cardiac studies in pig models. …
In 1962, the Harvard School of Public Health made a critical loan to Boston Children’s Hospital: the Harvard hyperbaric chamber. It established a new approach to pediatric heart surgery at Boston Children’s.
For many children — including a premature infant named Janet, born in 1964 with a heart murmur — the hyperbaric chamber would prove to be life-saving.
At that time, before the invention of the heart-lung bypass machine, hyperbaric chambers offered a way to operate on infants more safely. That’s because hyperbaric oxygenation, coupled with the effects of increased pressure on the respiratory system, seemed to give infants a better chance of surviving heart surgery. …
Cardiac surgery is reducing the use of plastic — starting with an operation for newborns who have life-threatening heart disease generally called single ventricle.
Single ventricle is so dangerous because it means only one of the heart’s two ventricles can adequately pump blood. Typically, affected infants undergo open-heart surgery to receive a Blalock shunt, which is a skinny tube made of PTFE — a synthetic polymer — that re-routes their blood flow to the lungs so enough oxygenated blood can get to their bodies. But when blood is exposed to foreign material, such as a plastic shunt, clots can form very easily.
This fall,a clinical trial at Boston Children’s Hospital will use patients’ own umbilical veins to create the shunt instead of plastic tubing. …
She’s small for a 6-month-old, but otherwise Avery Gagnon looks perfectly healthy. She smiles, kicks, laughs and grabs her toys and pacifiers. What you’d never know is that Avery has complex congenital heart disease and might not be alive today if it weren’t for an innovative procedure that used mitochondria from her own cells to boost her heart’s energy.
The procedure is the brainchild of James McCully, PhD, a cardiovascular research scientist at the Heart Center at Boston Children’s Hospital, who spent most of his career working to solve a common complication of heart surgery: damage to heart muscle cells. …
Tertiary care centers such as the Boston Children’s Hospital Heart Center have led the way in groundbreaking surgical innovations for years, pushing boundaries and correcting ever more complex abnormalities.
But innovation is also making a difference when it comes to more “common” procedures.
“We’re always trying to make the less complex procedures shorter and less invasive,” says Sitaram Emani, MD, director of the Complex Biventricular Repair Program at the Heart Center. “Making surgery and recovery less painful and disruptive for all of our patients is a priority.”
Jason Ayres, a family doctor in Alabama, was speechless as he held his adopted son Patrick’s heart in his hands. Well, a replica of his son’s heart — an exact replica, 3-D printed before the 3-year-old boy had lifesaving open-heart surgery.
Children undergoing heart surgery need strong sedation and pain medications. Weaning them off these medications is complicated; many have withdrawal symptoms that require additional medications. Unfortunately, says Patricia Lincoln, RN, MS, CCRN, CNS-BC, “the medications we use to manage withdrawal may keep patients in the hospital longer.”
Last spring, Lincoln and her nursing colleagues in the Boston Children’s Hospital Cardiac Intensive Care Unit (CICU) launched an initiative called Cardiac RESTORE to help wean patients from pain and sedation medications according to a carefully designed algorithm.
“Cardiac RESTORE helps us continually assess what patients need and regulate their physiologic response to changes,” says Lincoln. “Medication doses are constantly being titrated or weaned unless the patient has an acute deterioration.”
Early results show decreased usage of pain and sedation medications with no ill effects. …
Last year, cardiologists at Boston Children’s Hospital reported developing a groundbreaking adhesive patch for sealing holes in the heart. The patch guides the heart’s own tissue to grow over it, forming an organic bridge. Once the hole is sealed, the biodegradable patch dissolves, leaving no foreign material in the body.
As revolutionary as this device was, it still had one major drawback: implanting the patch required highly invasive open-heart surgery. But that may be about to change.
No two hearts are alike. It sounds like poetry, but this adage takes on a special meaning for pediatric cardiac surgeons.
Children born with congenital heart disease have unique cardiac anatomies. To correct them, surgeons need a nuanced understanding of each structure and chamber of the heart, and for decades have relied on (increasingly sophisticated) imaging technology.
Soon, though, they will be able to touch, turn and view replicas of their patients’ hearts up close. Researchers at Boston Children’s Hospital and MIT have jointly designed a computer program that can convert MRI scans of a patient’s heart into 3-D physical models. …
Hypoplastic left heart syndrome (HLHS) is a rare but serious form of congenital heart disease that leaves the left pumping chamber (ventricle) of the heart severely underdeveloped. Children born with HLHS can’t pump enough oxygenated blood from their heart to the rest of their body and need surgery as soon as possible to survive. Treatment ultimately involves three corrective surgeries throughout the infant and toddler years.
The first surgery, known as the Norwood procedure, is the riskiest of the three. Ideally performed within the first week of life, the procedure re-routes the heart’s plumbing to ensure enough oxygenated blood is circulated while the child grows big enough for the second surgery. A device called a graft is used to connect the fully-functional right ventricle to the aorta, bypassing the stunted left ventricle, for proper blood flow. However, with each ventricular contraction, the graft gets squeezed, which can cause it to shift or lose its shape over time. Repeat interventions to adjust the graft are often needed. …