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."
Karma Beating.. (Score:2, Interesting)
Re:Karma Beating.. (Score:5, Funny)
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Then he should have been doing his work in Soviet Russia, as he's actually putting something into his heart.
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Inventor CV (Score:5, Informative)
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It's more of a legal requirement for taking other people out hunting in the UK. If you get yourself into trouble, tough shit. If you get other people into trouble then there are certain repercussions.
Link to Original Article (Score:5, Informative)
Re:Link to Original Article (Score:4, Informative)
'It seemed to me to be pretty obvious that you could scan the heart structure, model it with a CAD routine, then use RP [rapid prototyping] to create a former on which to manufacture a device,' explained Golesworthy. 'In a sense, conceptually, it was very simple to do. Actually engineering that was significantly more complex.'
Golesworthy believes that projects such as this demonstrate that the interface between engineers and the rest of the world isn't functioning in the way it should. 'When it does function, huge advances can be made in a very short time period, on very little money,' he said. 'We have changed the world for people with aortic dilation and we have done it on a fraction of the cost.'
In May 2004, Golesworthy became the first recipient of his own invention after undergoing surgery at the Royal Brompton Hospital. Since then, 23 patients have successfully had the implant fitted and another seven are hoping to undergo the procedure. According to Golesworthy, the technique will soon replace the Bentall procedure and could be used to treat other heart conditions.
Wrapping the aorta with artificial material isn't a new idea. More than 20 years ago, US surgeon Francis Robicsek attempted to fashion an external, hand-tailored support for the aorta. The proposal was made before the widespread use of CAD, MRI and RP. Materials such as polypropylene, nylon and knitted Dacron were proposed, with Dacron being the most popular. However, attempting to accurately recreate the shape of the aorta using material cut during surgery proved extremely difficult and the technique never caught on. Instead, off-the-shelf composite valve conduits were offered as a more realistic solution. 'Technology has allowed us to revisit the idea,' said Golesworthy. 'The aorta is such an extraordinary shape that you can't possibly do it by a "taking a yoghurt pot I prepared earlier'. The only way was to bring scanning, CAD and RP together.'
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"...interface between engineers and the rest of the world..."
What interface?
Re:Link to Original Article (Score:4, Insightful)
Communications. The people that design your meds and implants are doctors and PhD's. They actually have very little understanding of solving problems in the real world. I work in the field as a support staff but actually graduated in industrial electronics. I recently had to explain 3 PhD's from the EE department how to interface a 10MHz optical signal with a coax cable - they were going to rework the whole link, I recommended they buy a media converter.
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It seems to me that our general body of knowledge is growing so large, and economic competition is so fierce, that people are being forced to specialize on particular areas, to the point that they lack even introductory knowledge about other fields of study. Case in point: this paper [diabetesjournals.org], where a doctor basically rediscovered calculus.
Um... (Score:2)
In May 2004, Golesworthy became the first recipient of his own invention after undergoing surgery at the Royal Brompton Hospital.
In May 2004...? Kudos to the guy and all, but this "news" is older than Youtube. Bush was still in his first term of office, and Slashdot had a usable interface.
Re:Um... (Score:4, Insightful)
But in 2004, they couldn't have had this bit:
Since then, 23 patients have successfully had the implant fitted and another seven are hoping to undergo the procedure.
and without that it's just lucky.
Re:Um... (Score:4, Informative)
In May 2004, we wouldn't have known if the procedure was actually successful. The fact that they tried a new technique isn't news. That he's still alive 7 years later is news.
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You missed this quote
'My aorta was dilating all through that period,' said Golesworthy. 'When you've got the scalpel of Damocles hanging over your sternum, it motivates you into making things happen and so they do...to me it seemed like a ridiculously obvious solution. The only way to do this was with CAD and RP. It shouldn't have taken an engineer to realise that, but it did.'
Read more: http://www.theengineer.co.uk/in-depth/analysis/uk-engineer-develops-own-life-saving-implant/1006877.article#ixzz1CE3SD5am [theengineer.co.uk]
That's really putting your life on the line, you don't see bravery like that very often.
I also quite like the code which took the quote and links back to the original article with a standard copy and paste
Re:Link to Original Article (Score:4, Insightful)
Golesworthy believes that projects such as this demonstrate that the interface between engineers and the rest of the world isn't functioning in the way it should.
On the contrary, I feel that the interface between doctors and the rest of the world isn't functioning in the way it should. Much of engineering is focused on customer needs, where as doctor's tend to have an attitude of superiority that breaks down communication. The field of biomedical engineering [wikipedia.org] aims to fix that.
Re:Link to Original Article (Score:4, Funny)
(Warning: graphic photographs)
I sure hope so; all these ascii photographs around the webs have been driving me nuts.
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I hate you.
Thanks,
MyLongNickName
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Nothing to see here... move^W read along (Score:5, Informative)
It's a perineum gangrene (pubic area) acording to the internet. Grangrenes are painful rotting of living tissue and require amputation lest you get infected from the necrotic tissue; I suppose its picture has lots of black tissue where you expect skin colors, pus, gore, lots of rotting and hanging skin, and unkempt pubic hairs, and badly decayed sexual organs; male and female.
We see tons of hearts on TV, and they're beating --not rotting-- while being operating on, unhealthy as they may be at the moment. No, there's no need to see a picture of your proposed comparison to sober up. But thanks for letting us inspect how bad things can get.
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Hey, it could be worse [slashdot.org].
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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 patie
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A hardware hacker extraordinaire.
My hat is off to him
Anyone can do it (Score:5, Funny)
I knew a conceptual artist who tried the same thing.
I miss him.
Hardcore... (Score:2)
Re:Hardcore... (Score:4, Insightful)
Implanting a heart valve of your own design into your own chest would only be made sweeter if it had been fabricated on your own 3D printer.
yay for engineers! (Score:5, Funny)
I myself suffer from a physical... ahem.. shortcoming.
So, just like this engineer, I designed and constructed a solution using a banana and some duct tape.
My wife loves it!
After reading this article, I am thinking I will go ahead and publicize my invention.
Another yay for engineers!
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Do you ever get to join in?
Liar (Score:1)
Engineers don't have wives.
But the Sheep will love it I bet.
More medical engineers (Score:4, Interesting)
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.
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They should have a full Biomedical Engineering major program of study. Then you can be proud.
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By any chance was this guys actual name... (Score:4, Funny)
Like God said (Score:4, Funny)
Do it yourself ;-)
Not really the whole story... (Score:5, Interesting)
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.
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As long as it handles it without fail for the rest of his life, isn't that long enough? Oh, wait...
Re:Not really the whole story... (Score:4, Funny)
"Give a man a fire and he's warm for the day, but set fire to him and he's warm for the rest of his life."
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Build a man a fire and he's warm for the day;
set a man afire and he's warm for the rest of his life.
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Not true.
I've been on fire (literally), and I'm bitterly cold during the winters. The assumption is that one cannot be "on fire" and survive. I'm proof that is not true.
BTW, Stop Drop n Roll doesn't always work. Sometimes it just lights the ground on fire.
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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.
But they do need immunosuppressants. That's still a heck of a trade-off!
I guess that anticoagulants might be worse than immunosuppressants but they both introduce plenty of complications.
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But they do need immunosuppressants
Organs, yes. Cadaveric valves, no. Porcine, yes. That's why the cadaveric valves have become more popular. Sorry, I should have made that more clear.
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Organs, yes. Cadaveric valves, no. Porcine, yes.
Ahh, I wasn't aware that the cadaveric valves didn't require immunosuppressants. How do they achieve that? I imagine they can somehow strip off the markers which would trigger an immune response.
That definitely makes a great case for using a cadaveric valve, I wonder why they didn't go that route.
Re:Not really the whole story... (Score:4, Informative)
When you transplant an organ, it is connected to blood vessels and thus is exposed to the immune system. When you put in biologic valves, no blood vessels are connected and there is no immune rejection. We do not understand completely why they are not rejected, because obviously they do get some blood, since they aren't ischemic, but I believe it has to do with the lack of good blood supply.
BTW, as far as I know Porcine valves also do not need immunosuppresion, same as corneal implants.
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Whow. . . no wonder your gas-passer. . . no bedside manner--at all!
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Re:Not really the whole story... (Score:4, Interesting)
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.
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Physics (Score:5, Interesting)
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.
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Re:Physics (Score:4, Informative)
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Having said that, how
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I'm not a doctor nor a physicist. That won't stop me from using my intuition, though. By preventing aorta expansion, this should actually increase back pressure on the aorta. The heart will not be able to squeeze down as much, due to the increased back pressure, leading to less liquid escaping. The reduced volume of liquid going through the aorta will decrease pressure further on in the system.
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I'm not a doctor, not a physicist and not an engineer, but... Wait, I am a doctor... and I like physics, although I'm not a physicists. And what does an engineer do?
What was I saying?
damn
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Well, the issue isn't so much that there's more pressure than normal - it's that the existing part couldn't cope with the pressure. Reinforcing it shouldn't pose any issues as long as the pressure level was normal to begin with.
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A cadaveric valve lasts for about 8 years, give or take. I didn't see anywhere the engineer's age, but I can assume he is somewhere in his 40's or 50's. That means he will have to replace the valve about 4-5 times, assuming he reaches 80. I myself wouldn't like the idea of another 4-5 open heart surgeries in my lifetime. OTOH, at an older age, the valve may last longer (10-15y), and thus there might not be a need to replace it.
Today a biological valve is usually reserved for older patients, while younger on
Re:Not really the whole story... (Score:4, Informative)
The life expectancy of someone with Marfan syndrome was 32 +/- 16 years in 1972, and is now 41 +/- 18 years [nih.gov] (all you need to see from that link is the abstract). If I could guess that the increase has to do with improved treatment technology (rather than improved management strategies), then someone getting surgery for Marfan syndrome is probably in their 20s or 30s, because they're unlikely to live too much longer than their late 30's or early 40's without surgery.
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As Walter Sobchak said to The Dude: "I did not know that".
Thanks.
Engineering seems slow in this area (Score:2)
Re:Engineering seems slow in this area (Score:5, Informative)
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What BS (Score:5, Interesting)
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.
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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.
I agree. I've been on it for 25 years without incident. The most I've ever taken extra was 2.5mg, but I have forgotten to take my 10mg dose 2 days in a row, and had no problems as a result. Perhaps other people react differently, but from my experience, I have a hard time thinking of it as risky or dangerous.
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I don't believe that the implant is a prosthetic aorta at all; rather, it is wrapped around the aorta to prevent further dilation. In that light, it seems like a huge advance for people facing this problem because they will no longer need a replacement of any kind. Warfarin may not be as bad as the article makes it out to be, but I'm sure that it would be better to not be taking any thinners if you didn't have to.
The new method may not address the same problem that you have but it's certainly a worthwhile i
Warfarin (Score:2)
Future Clot? (Score:1)
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As it is an external stent, around the outside of the arota, not inside it like a endovascular stent, I wouldn't think that thrombosis would be an issue.
In related news, Firefox's spell-check doesn't know much about things medical.
engineer 1 medical science 0 (Score:1)
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Because there's no reward like a talking plague?
Lucky he wasn't a (Score:4, Funny)
software engineer!
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A new heart valve and a set of 12" brass balls! (Score:5, Interesting)
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!
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Do note this was back in 2004. Since then, at least 23 other patients have benefit from his pioneering!
Not only is his pair cast iron, but they've helped others live as well! Shit!
damn. (Score:2)
talk about packing your own parachute...
The attitude here saddens me (Score:5, Insightful)
Just a few comments, and all the negative comments already: big deal, there is nothing new here.
You know what, when I hear news like that, it really gives me more confidence in technical people (engineers, scientists, geeks, etc). The guy got a heart problem, he got the skills (with the help of doctors and others, probably) to design the best solution for himself, and in the meantime, for other people too. And guess what, he even got the ball to install it on himself first. And it seems to work just fine. What can be more cool, more geeky, more nerdy than that? Sure, it's only "a small sample of 30ish", as someone said here. So what? Even if this solution only applies to one person, it is still a fucking cool solution.
For me, I'd like to hear news like that everyday, that's news for nerds, stuff that matters. If I had kids, I would tell them this, and other similar stories, as bed-time stories everyday.
Re:The attitude here saddens me (Score:4, Interesting)
Roald Dahl apparently co-invented a shunt that was fitted to his daughter to drain a fluid build up.
http://en.wikipedia.org/wiki/Wade-Dahl-Till_valve [wikipedia.org]
Perhaps that can be bedtime story for tonight. (I heard about it on a BBC Radio4 programme during the recent Roald Dahl season).
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s/daughter/son
rock it roman style (Score:2)
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My supervisor used to work for Boeing and apparently they had a rule that if you designed something for civilian aircraft you had to be on the flight when it was tested. Presumabbly for this reason.
Obligatory Simpsons (Score:3)
Marge: Oh Homer, that was just a beer can with a whistle glued to it...
doctors protect doctors (Score:2)
Re:doctors protect doctors (Score:4, Insightful)
This is an anomaly. The medical community(doctors in particular) doesn't cotton to these sorts of antics from outsiders. Just wait to this becomes more widely known amongst the Doctor fraternity. It will become like mid-wifery - a fringe practice prone to potentially costing your baby its life.
To clarify, you mean how many Obstetricians consider mid-wifery "a fringe practice prone to potentially costing your baby its life", despite the overwhelming evidence to the contrary?[1]
[1] See Google, really
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Well, doctors tend to be a conservative bunch for a number of very good reasons. New ideas take time before they get traction, and there is enough experience to make them confident recommending it to their patients. Some doctors are more comfortable recommending experimental techniques...I'm not sure if that makes them better doctors. I would prefer established practices unless there was a compelling reason to try something different (as in the article's case).
As for the OB comment, I just had a baby daught
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You'll note I said "many" OBs, not all. But if you are around much you will find in some circles an incredibly arrogant and ignorant attitude among some OBs.
I suggest if you have another child you (well, your wife and kid) would benefit from looking at the real situation with mid-wifery, and the real outcome statistics since in the end that's all anyone (should) care about. Many types of complication can be dealt with by midwives, others are just as easy to take care of when they co-ordinate with the hosp
Warfarin (Score:2)
Warfarin is a cheap drug and does not seem to affect one's health, even long-term (comparing notes with a friend who is on a lifelong prescription due to heart valve replacement). It however IS quite a b*tch for someone who loves to tinker in the workshop or garden. The sligh
Red Cross? (Score:2)
It's gonna suck (Score:2)
when he gets a cease and desist order from some submarine patent holder that vaguely mentions something similar.
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...heal thyself!
Engineer - repair thyself!
Re:Well, how does it work? (Score:4, Informative)
From reading the theengineer.co.uk article, it seems that it is a precisely created wrapping around the outside of the bulging aorta, supporting it. The 'breakthrough' is using medical imaging and 3D printing to make a model of his aorta, so the wrapping can be made accurately before the operation. Previous attempts where the aorta had to be measured and the support created during the operation had been tried unsuccessfully.