Stories about: cardiology

8 steps to succeed at a risky medical “first”

James Lock, MD, Cardiologist-in-Chief, Children's Hospital Boston

Ever since second grade, when he was suspended from school, Jim Lock has challenged the status quo — in sixth grade pulling off the much harder feat of being expelled. Today, the Cardiologist-in-Chief at Children’s Hospital Boston is credited with a long list of pioneering cardiac procedures going back to 1979, many of them in children with congenital heart defects. More recently, these have included fetal interventions, like reversal of hypoplastic left heart syndrome and implanting a stent in a fetal heart. Nearly all are now established procedures in pediatric cardiology.

These procedural innovations didn’t arise from a rare flash of inspiration, Lock argues, but from perception of a medical need followed by methodical vetting and sometimes years of due diligence.

“Innovation is not a completely random event,” Lock told the Innovators’ Forum at Children’s last week, sponsored by the Innovation Acceleration Program.  “It’s a process.”

Here’s Lock’s instruction set for safe and successful clinical firsts:

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Guiding devices to market, and mending broken hearts

A biodegradable patch for repairing ventral septal defects (VSDs).

Imagine: You’re a pediatric cardiologist who for years has worked on the design of a device that could revolutionize the treatment of a severe atrial arrhythmia. But while you can find a lot of assistance and advice for bringing devices for adults to market, you find little help for devices intended for infants and children. What can you do?

The U.S. Food and Drug Administration could be your best friend. Better known for its role in establishing and enforcing regulations for drug and device safety and information, the FDA is also an advocate, helping bring innovative devices for pediatric treatment into clinical practice. Pedro del Nido, chief of cardiac surgery at Children’s Hospital Boston, outlined the FDA’s advocacy role last week at the monthly Innovators’ Forum hosted by the Children’s Innovation Acceleration Program.

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Beating-heart surgery and the search for a killer app

Concept for a new kind of surgical robot (click to enlarge)

Inventors and engineers tend to come up with ideas and technologies first, then say, “This is cool, what’s it good for?” Clinicians tend to say, “Here’s my clinical problem, how can I solve it?”

This was roughly the thinking that brought together Boston University engineer Pierre Dupont and Pedro del Nido, chief of Cardiac Surgery at Children’s Hospital Boston.

Dupont had a vision for a next-generation surgical robot. del Nido had a vision of doing complex cardiac repairs in children while their hearts are still beating. Could they create a viable technology?

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TEDMED here we come

Move over, Ozzy Ozbourne. Next Wednesday, October 27th, Children’s neurologist-neuroscientist and TEDMED speaker Frances Jensen will compare and contrast the developing infant brain with the highly paradoxical teen brain – which is also developing rapidly, all the way to age 25 or so. Infant and teen brains are at opposite ends of the developmental spectrum — almost different species, Jensen says – but they’re both extremely dynamic and exquisitely sensitive to environmental factors (drugs and alcohol in teens and brain injury and seizures in infants).

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