Heart Disease Surgery: Robotic Operation Encourages Tissue Growth After Infective Endocarditis

A reconstructive surgery technique may offer hope to patients suffering from infective endocarditis.

The potentially fatal bacterial heart disease affects the heart's tricuspid valve, often resulting in permanent tissue damage.

But a pioneering robotic operation, which repairs the heart valve using bio-scaffold CorMatrix® (an extracellular matrix (ECM) material), may enable new tissue to grow.

Robotic surgery is a ground-breaking tool in medicine that has been both celebrated for its benefits and criticised for its high cost and high-profile failures.

But according to Dr. Guy (one of only about a dozen cardiovascular surgeons to perform complete tricuspid valve repair procedures using CorMatrix®), the benefits of endoscopic robotic heart surgery are two-fold.

Not only does the surgery minimise the size of incisions made in the chest, but also takes advantage of the ability of surgeons - using robotic-assisted tools and techniques - to make precise minute movements.

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Recently, Dr. Guy performed a robotic repair by first removing nearly all of the damaged valve from the patient's heart. He then used what he calls the 'cylinder technique' to repair the damaged tissue with a sheet of bio-scaffolding that had been fashioned into a tube. The tube effectively served as a new valve.

"We used a CorMatrix® bio-scaffold to completely reconstruct the valve," Dr. Guy explained.

CorMatrix® bio-scaffolds consist of a sheet of ECM, an acellular meshwork of fibres and carbohydrate polymers that facilitates reconstruction by giving patients' own cells a framework on which to build new tissue. Because ECM is made of natural materials, it is eventually replaced by the patient's own cells and absorbed by the body. It also has a low likelihood of rejection, since it does not contain foreign cells or proteins that could precipitate an immune response.

"Temple Cardiovascular Surgery has had a big presence at the meeting this year," Dr. Guy said.

The surgery is being offered to patients at Temple University Hospital, Philadelphia.