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Clinical Innovation: Beating heart surgery

beating heart sugery illu

Problem
When surgeons perform heart surgery on a baby, they have to open the infant's chest and stop her heart—an invasive, lengthy procedure that can cause life-threatening complications. Pedro J. del Nido, MD, Children's Hospital Boston's chairman of Cardiac Surgery, had to perform surgery on his patients using this method or come up with a way to improve it.

Innovative solution
Dr. Del Nido decided to develop a way to perform surgery on a still-beating heart. But he needed two things that didn't exist: superior imaging tools that could show the structures inside the heart while it's beating, and tiny instruments to perform the intricate surgery. So he borrowed technology from the videogame industry and developed stereo-rendered 3-D ultrasound imaging that allows surgeons to see inside the beating heart as a hologram.

He also designed new instruments. One is a millimeter-sized tool that extends into the heart through needle-sized incisions. Using a joystick controller and real-time imaging, a surgeon can navigate through the beating heart's chambers to remove blockages, repair faulty valves and close leaks. He also developed a cardioport device that allows instruments to be safely introduced into the cardiac chambers without the usual risks of blood loss or an air embolism.

Results
Dr. Del Nido's 3-D tool appears to not only provide superior imaging, but also yields faster surgery times: When researchers used it while operating on pigs with congenital heart disease, they performed the procedure 44 percent faster. His cardioport will soon be tested in clinical trials and will facilitate further development of similar instruments for this novel heart repair.

 
 
 

Cardiac Surgery

 

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