Device Could Eliminate Need for Open-Heart Procedures

Open-heart surgery is one of the most invasive and delicate of medical procedures, requiring fine precision from a steady hand. It’s very traumatic to the body, particularly the breastbone: In some cases, cardiac surgeons saw the breastbone in half, pry it apart and stretch muscles in the chest to lay the heart bare for the procedure (called a sternotomy).

Irish and American researchers, however, are aiming to make such trauma a distant memory with a device that promotes the bypass of arterial obstructions, potentially eliminating the need for open-heart surgery.

Professor Noel Caplice, a practising interventional cardiologist, led a research project at Ireland’s University College Cork (UCC) Centre for Research in Vascular Biology that involved collaborators from the Mayo Clinic in Rochester, Minn. Caplice began the project in the Mayo Clinic, where he and his colleagues designed a mesh device that could be attached to a stent capable of delivering millions of cells and promoting bypass in an obstructed artery.

Since his return to UCC in 2005, Caplice has further developed this technology to deliver it through a catheter.

The vascular cell delivery device can be inserted via a keyhole procedure through the artery to the site of the obstruction, according to the university. The implanted device can then promote micro-bypass of the obstruction over a four-week period, resulting in the return of normal heart function and a recovery of full exercise capacity.

The device has been tested successfully in a large animal model with similar-sized arteries to humans; the next phase of the research will involve testing on patients who require bypass surgery but have been deemed unfit to undergo the procedure.

About 3 million open-heart coronary bypass and peripheral artery bypass operations are performed each year worldwide. But roughly 20 percent of patients who need this surgery are unable to undergo the procedure due to poor status of arteries or a co-existing illness making the risk too great.

“If reproduced in humans, this device would offer an alternative to open surgical bypass operations with implications for treatment of patients who are currently inoperable,” said Caplice.
“It also has the potential to reduce costs and time spent in hospital,” he added.

The research, which could be a major step forward in the treatment of coronary disease, has been published in the journal Biomaterials.