process engineer i know all about boilers and incinerators and
fabric filters and cyclones and things
and most importantly
commit you to a
lifetime of anticoagulation therapy
normally warfarin
the thought of the
surgery was not
attractive the thought of the warfarin was
really quite frightening so i said to myself i 'm an engineer i 'm in r and d this is just a plumbing problem i can do this i can change this so i set out to change the entire
treatment for aortic dilation
the
project aim is really quite simple the only real problem with the ascending aorta in people with marfan syndrome is it lacks some tensile strength
so the
possibility exists to simply
externally wrap the pipe and it would remain
stable and
operate quite happily if your high
pressure hose pipe or your high
pressure hydraulic line bulges a little you just wrap some tape around the outside of it it really is that simple in
concept though not in execution
the great
advantage of an
external support for me was that i could
retain all of my own bits all of my own endothelium and valves and not need any anticoagulation therapy
this is a
it 's quite a difficult
structure to produce
when we produced that model
we turn it into a solid plastic model as you can see using a rapid prototyping
technique another
engineering technique
we then use that former to manufacture a
perfectly bespoke porous
textile mesh which takes the shape of the former and
perfectly fits the aorta so this is
absolutely personalized medicine at its best really every patient we do has an
absolutely bespoke implant
once you 've made it the
installation 's quite easy john
pepper bless his heart professor of cardiothoracic surgery
if you compare our new
treatment to the existing
alternative the so called composite aortic root graft there are one of two
startling comparisons which i 'm sure will be clear to all of you two hours to
install one of our devices compared to six hours for the existing treatment
the existing
treatment requires as i 've said the heart and lung bypass machine and it requires a total body cooling we don 't need any of that we work on a
beating heart he opens you up he accesses the aorta while your heart is
beating all at the right temperature
and in fact if you speak to people who are on long term warfarin it is a serious
compromise to your quality of life and even worse it
inevitably foreshortens your life
back to the theme of the
presentation in multidisciplinary
research how on earth does a process engineer used to
working with boilers end up producing a
medicaldevice which transforms his own life well the answer to that is a multidisciplinary team
this is a list of the core team and as you can see there are not only two
principaltechnical disciplines there medicine and
engineering but also there are various specialists from within those two disciplines
from which to make the cad model
warren thornton who still does all our cad models for us had to write a bespoke piece of cad code to produce this model from this really rather difficult
input data set
the medics
amongst you if there are any will recognize the first two but there will be nobody else in this room that understands all of those four words
taking the jargon out was very important to ensure that
everyone in the team understood
what was meant when a particular
phrase was used
and then we realized that it was
actually a mirror image of the real aorta and it was a mirror image because
professional jealousies there were people on the
research and
ethics committee who really didn 't want to see john
pepper succeed again because he 's so successful and they made extra problems for us
we had to get past the nice problem we now have a great clinical
guidance out on the net so any of the hospitals interested can come along read the nice report get in touch with us and then get doing it themselves
funding barriers another big area to be
concerned with
a big problem with understanding one of those perspectives when we first approached one of the big u k
charitable organizations that funds this kind of stuff what they were looking at was
essentially an
engineering proposal they didn 't understand it they were doctors they were next to god it must be rubbish
they simply want to do
whatever they 've done before and in fact there are many surgeons in the u k still
waiting for one of our patients to have some sort of
episode so that they can say ah i told you that was no good
the results can be
spectacular you can find novel solutions really novel solutions that have never been looked at before very very quickly and easily you can shortcut huge amounts of work simply
by using the
extended knowledge base you have and as a result it 's an entirely different use of the technology and the knowledge around you
for a one off patient than the cost of us getting from my dream to my reality
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