As advances in medical implants help children with structural heart defects live longer, healthier lives, a challenge of treatment has been the implants’ size: fixed, and unable to expand as children grow. As a result, these children have had to endure a multitude of life-saving surgeries, such as mitral and tricuspid valve repairs, to re-repair or replace leaking heart valves. 

For a team of researchers from Boston Children’s Hospital and Brigham and Women’s Hospital, this surgical status quo was untenable. They set out to redesign the implant used in these procedures, demonstrating the potential unleashed when top medical minds come together to solve a practical problem and change lives for the most vulnerable patients.

To create the new device, Pedro del Nido, MD, chief of cardiac surgery at Boston Children’s and the William E. Ladd professor of child surgery at Harvard Medical School, partnered with Jeff Karp, PhD, a bioengineer and principal investigator at the Brigham whose expertise in chemical engineering and biopolymer materials proved instrumental to the research. After vetting several concepts for a growth-accommodating implant, the team, inspired by the expanding design of a Chinese finger trap, selected their first proof-of-concept device: a tricuspid valve annuloplasty ring implant.

Following adjustments to the design and materials, and based on promising in vivo experimental data presented by Dr. del Nido and Dr. Karp, biomedical device company CryoLife is now developing the concept into a growth-accommodating annuloplasty ring implant for pediatric heart valve repair. In addition to enhancing the durability of pediatric heart valve repairs while accommodating a child’s growth—and decreasing the number of surgeries endured as a result—the joint project could also have tremendous impact in other surgical areas, the researchers say.

“This concept could be adapted for many different clinical applications, with exciting potential to be converted into an actively—rather than a passively—elongating structure that could act as a tissue scaffold encouraging growth,” says Eric Feins, MD, a member of the research team and now a cardiothoracic surgery fellow at Massachusetts General Hospital.

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Image credit: Brigham and Women’s Hospital

Tags: patient safety, research and discovery