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Medicine United Kingdom Science

Engineer Designs His Own Heart Valve Implant 151

nametaken writes "In 2000, Tal Golesworthy, a British engineer, was told that he suffers from Marfan syndrome, a disorder of the connective tissue that often causes rupturing of the aorta. The only solution then available was the pairing of a mechanical valve and a highly risky blood thinner. To an engineer like Golesworthy, that just wasn't good enough. So he constructed his own implant that does the job better than the existing solution--and became the first patient to try it."
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Engineer Designs His Own Heart Valve Implant

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  • Karma Beating.. (Score:2, Interesting)

    by nanospook ( 521118 ) on Wednesday January 26, 2011 @11:12PM (#35016372)
    It's good to be born for a purpose..
  • by Mahonrimoriancumer ( 302464 ) on Wednesday January 26, 2011 @11:34PM (#35016468) Homepage

    Stories like this make me proud of my alma mater, Colorado School of Mines, for having a bio-medical engineering minor for mechanical engineers. We need more engineers working in medicine.

  • by demonlapin ( 527802 ) on Wednesday January 26, 2011 @11:46PM (#35016522) Homepage Journal
    There's no need - and hasn't been for a long time, at least 15-20 years - to put in a mechanical valve just for aortic valve disease. There are cadaveric (organ-donor) valves and porcine (pig-heart) valves available. They don't last as long as the mechanical ones, but they don't need anticoagulation. Given that he had Marfan syndrome, however, it's quite likely that the problem was a valve-and-aortic-root problem, just like the Bentall procedure I did the anesthesia for today, which does better with a mechanical valve. His solution is impressive: no quibbles on that here. Imaging a heart to get dimensions is hideously difficult. Getting a 3D model of the aorta is some fine engineering in itself.

    However, he has mostly transferred the problem downstream - the root of the aorta is the most elastic part of a very elastic vessel, and transmitting the higher pressure downstream (which his aorta-corset will do) will lead to increased ballooning of the segment closest to the heart. The hard part is to make sure that that segment can handle it for the remainder of his expected lifespan.
  • What BS (Score:5, Interesting)

    by Jack9 ( 11421 ) on Thursday January 27, 2011 @12:12AM (#35016638)

    I have had 3 aortic valves implanted throughout my lifetime. Starting at the age of 2. I've also survived a Konno procedure and aortic stem reformation the last time around.

    First of all, Warfarin is pretty fucking safe. If I take an extra 5mg pill once a week, nothing happens. Out of all the thinners, it's not exactly aspirin mild, but it's not horrendously dangerous. Like all drugs, bodies react differently and while I'm ridiculously allergic to tetracycline, I'm middle of the road for reactions to warfarin (over 30 years of it). It's always shock and awe so a news story can give infotainment. Within my lifetime thinners have gained a lot of traction (due to aging boomers). Look up replacements for warfarin. It's big money and the idea that I'll be on warfarin for the rest of my life is unrealistic. Yes I'll be on something, but that's par for a mechanical valve.

    The prosthetic design he came up with, is for his specific problem, weak aortic tissue which involves the stem. As mentioned in the article, a prosthetic aorta isn't a new idea. I'm not exactly sure it's any better an idea than it used to be, nor is anyone else, with a sample size of 30ish. The meat of the story is how the prosthetic is customized. Scan, 3d model, manufacture, affordably. That is pretty radical, from the perspective of current internal medicine. This whole thing sounds like a medical device ad. What I'm more interested in, aortic valves and thinners, they demonize or don't talk about at all. Pity.

  • by Anonymous Coward on Thursday January 27, 2011 @12:21AM (#35016704)

    Thanks for the link. Wish /. did more 'informative' linking when it calls for it, as it does here.

    As for the story, this guy is BADASS, and I applaud the medical community in this case for keeping an open mind. Using MRI, CAD, RP (rapid prototyping) would probably seem pretty obvious for a lot of possible medical solutions, especially after diagnosis.

    Onto the gripes.... Is there REALLY that much of a disconnect between the medical industry, bio-engineering, if this falls within that scope, and giving patients better options than mechanical implementations and blood thinners? As was the motivation here. Is the medical industry, not healthcare, really become this myopic with regard to the use of technology, and implementing new procedures and solutions? Guess it's hard to push your field into the unknown when the pharmaceutical industry is knocking on your door with the latest re-patent that's twice the price, and a medical mal-practice suit just a phone call away.

    There's a reason the call it practicing medicine. There is a difference between a mistake while under the knfe, and a forced 18 hour surgical rotation to keep up the 'standard' of innitiation. I just wish more people would remember that, with any field that deals with personal matters, communication is key. This story illustrates what should be standard form in our current technologica era.

  • by Chas ( 5144 ) on Thursday January 27, 2011 @12:53AM (#35016858) Homepage Journal

    Okay, I'm a big fan of good engineering and all, but you gotta have some SERIOUSLY heavy-metal nards to be the first guy on the table for your own device for something like this!

    Talk about putting your money where your mouth is!

    Kudos and major man points!

  • Physics (Score:5, Interesting)

    by Roger W Moore ( 538166 ) on Thursday January 27, 2011 @01:03AM (#35016886) Journal

    the root of the aorta is the most elastic part of a very elastic vessel, and transmitting the higher pressure downstream (which his aorta-corset will do)

    I'm not a medic but I am a physicist and what you say does not make sense from a physics point of view. If you take a bulge in a pipe containing a flowing liquid and squeeze it back down to the diameter of the rest of the pipe you do not increase the pressure lower down. In fact, if anything, you will reduce it because the narrower pipe will have a larger pressure drop along it due to viscous flow.

    This is not the same as squeezing a closed, static system, like a balloon where squeezing it at one point reduces the volume considerable which does increase the pressure causing the unrestricted part to bulge. Yes, technically there is a volume change by restricting the aorta but surely this is only a small fraction of the total circulatory system and even then wouldn't this just cause the body to eventually reduce the amount of blood in circulation by that amount?

    So unless, I have over simplified something (not taking account of the pulsed flow for example), I don't see from a purely physics perspective how it would make the pressure lower down any higher and so make the situation worse. There may be medical reasons for for increased concern but not the pressure reason you state above.

  • by guruevi ( 827432 ) <evi&evcircuits,com> on Thursday January 27, 2011 @01:33AM (#35016980) Homepage

    Yes, they have really nice sales representations when a lot of data is collected, processed and interpolated (which can be done almost on the fly these days). In the field it doesn't work that well, there are still quite some artifacts and issues where doctors will miss things because they weren't visible. It works good enough to see big things like growths or major defects but I wouldn't trust it to make a precise valve replacement.

  • by pbhj ( 607776 ) on Thursday January 27, 2011 @11:18AM (#35020082) Homepage Journal

    Roald Dahl apparently co-invented a shunt that was fitted to his daughter to drain a fluid build up. []

    Perhaps that can be bedtime story for tonight. (I heard about it on a BBC Radio4 programme during the recent Roald Dahl season).

"An open mind has but one disadvantage: it collects dirt." -- a saying at RPI