Boston, MA – When a child is born with a heart defect such as a hole in the heart, the highly invasive therapies are challenging due to an inability to quickly and safely secure devices inside the heart. Sutures take too much time to stitch and can cause stress on fragile heart tissue, and currently available clinical adhesives are either too toxic or tend to lose their sticking power in the presence of blood or under dynamic conditions, such as in a beating heart.
"About 40,000 babies are born with congenital heart defects in the United States annually, and those that require treatment are plagued with multiple surgeries to deliver or replace non-degradable implants that do not grow with young patients," says Jeffrey Karp, PhD, Division of Biomedical Engineering, BWH Department of Medicine, co-senior study author of a new study that may improve how surgeons treat congenital heart defects.
The study will be published on January 8, 2014, in Science Translational Medicine.
In the preclinical study, researchers from Boston Children's Hospital, BWH and Massachusetts Institute of Technology (MIT) developed a bio-inspired adhesive that could rapidly attach biodegradable patches inside a beating heart—in the exact place where congenital holes in the heart occur, such as with ventricular heart defects.
Recognizing that many creatures in nature have secretions that are viscous and repel water, enabling them to attach under wet and dynamic conditions, the researchers developed a material with these properties that also is biodegradable, elastic and biocompatible. According to the study authors, the degradable patches secured with the glue remained attached even at increased heart rates and blood pressure.
"This adhesive platform addresses all of the drawbacks of previous systems in that it works in the presence of blood and moving structures," says Pedro del Nido, MD, Chief of Cardiac Surgery, Boston Children's Hospital, co-senior study author. "It should provide the physician with a completely new, much simpler technology and a new paradigm for tissue reconstruction to improve the quality of life of patients following surgical procedures."
Unlike current surgical adhesives, this new adhesive maintains very strong sticking power when in the presence of blood, and even in active environments.
"This study demonstrated that the adhesive was strong enough to hold tissue and patches onto the heart equivalent to suturing," says the study's co-first author Nora Lang, MD, Department of Cardiac Surgery, Boston Children's Hospital. "Also, the adhesive patch is biodegradable and biocompatible, so nothing foreign or toxic stays in the bodies of these patients."
Importantly, its adhesive abilities are activated with ultraviolent (UV) light, providing an on-demand, anti-bleeding seal within five seconds of UV light application when applied to high-pressure large blood vessels and cardiac wall defects.
"When we attached patches coated with our adhesive to the walls of a beating heart, the patches remained despite the high pressures of blood flowing through the heart and blood vessels," says Maria N. Pereira, PhD, Division of Biomedical Engineering, BWH Department of Medicine, co-first study author.
The researchers note that their waterproof, light-activated adhesive will be useful in reducing the invasiveness of surgical procedures, as well as operating times, in addition to improving heart surgery outcomes.
"We are delighted to see the materials we developed being extended to new applications with the potential to greatly improve human life," said Robert Langer, ScD, MIT, study author.
The adhesive technology (and other related platforms) has been licensed to a start-up company, Gecko Biomedical, based in Paris. The company has raised 8 million Euros in their recently announced Series A financing round and expects to bring the adhesive to the market within two to three years.
This research was supported by the Center for Integration of Medicine and Innovative Technology, Technology Research Program grant from Boston Children's Hospital and the National Institutes of Health (HL73647, GM086433, DE013023).
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in New England and employs nearly 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $650 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative. For more information and resources, please visit BWH's online newsroom.
About Boston Children's Hospital
Boston Children's Hospital is home to the world's largest research enterprise based at a pediatric medical center, where its discoveries have benefited both children and adults since 1869. More than 1,100 scientists, including seven members of the National Academy of Sciences, 13 members of the Institute of Medicine and 14 members of the Howard Hughes Medical Institute comprise Boston Children's research community. Founded as a 20-bed hospital for children, Boston Children's today is a 395-bed comprehensive center for pediatric and adolescent health care grounded in the values of excellence in patient care and sensitivity to the complex needs and diversity of children and families. Boston Children's is also the primary pediatric teaching affiliate of Harvard Medical School. For more information about research and clinical innovation at Boston Children's, visit: http://vectorblog.org.
Science Translational Medicine