Ana Redondo and Conal Austin publish a paper on Ross PEARS

Ana Redondo and Conal Austin have released the first published paper on the Ross PEARS application entitled ‘Our 7-year experience supporting the Ross autograft with the novel technique of PEARS’ in JTCVS Techniques 2024.

In this paper the benefits using ExoVasc® as part of the free root Ross procedure are discussed.

You can watch a webcast of their presentation on the paper at the American Association for Thoracic Surgery (AATS) meeting on the AATS website.

Exstent’s new Australian distributor and sponsor, BTC Cardio Pty, sponsors the Marfan and Aortopathy conference in Brisbane

Exstent’s new Australian Distributor and Sponsor, BTC Cardio Pty, Australia is sponsoring the Marfan and Aortopathy conference on Saturday 20 April at The Prince Charles Hospital, Brisbane.

This special one-day conference is dedicated to raising awareness of Marfan Syndrome, aortopathy and associated conditions.

PEARS surgeons Dr Livia Williams, Dr Nelson Alphonso and Dr Homayoun Jalali are presenting. Further information on the conference can be found on The Common Good website

1,000th patient receives an ExoVasc® Personalised External Aortic Root Support

Exstent Ltd, developer and manufacturer of the ExoVasc® Personalised External Aortic Root Support (PEARS), has just announced that 1,000 patients have received the device.

The device offers an alternative to valve sparing root replacement (VSRR) and total root replacement (TRR) by supporting the aortic wall, preventing further dilatation and negating the requirement for lifelong anti-coagulants. It can also be used to support the pulmonary autograft when the native aortic valve is replaced as part of the Ross procedure.

Victoria Sharpe, Managing Director of Exstent, said: “One thousand patients represents a significant milestone for Exstent and for patient choice.”

Tal Golesworthy, founder of Exstent and inventor of the ExoVasc®, was the first patient to receive the device to treat his dilating aorta. He commented: “As well as the 1,000 patient milestone I celebrate the 20th anniversary of my own PEARS surgery on 24 May 2024. The past 20 years have been an interesting journey showing the power of real multi-disciplinary teams: in this case, a patient-engineer, CAD engineers, cardiothoracic surgeons, a cardiac morphologist, radiologists, cardiologists.”

During PEARS surgery a custom-made ExoVasc® device is fitted around the patient’s aorta, which remains intact. The surgery offers several benefits over VSRR and TRR. Operation times for the PEARS procedure are typically around two to three hours. PEARS surgery for patients with uncomplicated aortic anatomy has been carried out on a beating heart without cardiopulmonary bypass in approximately 79% of cases.

This contrasts well with VSRR and TRR where patients might expect to be anaesthetised for between four and seven hours and require cardiopulmonary bypass.

This shorter procedure time and hospital stay has a beneficial impact on overall costs and should improve patient experience and recovery.

Patients have been invited to have annual cardiac MRI and none have shown any sign of further dilatation, where the device has been correctly implanted. This demonstrates stability of the aortic dimensions and aortic morphology within the ExoVasc® implant over a significant period.

A routine coronary angiogram carried out on Tal Golesworthy in 2011 (seven years post-PEARS surgery) showed smooth coronary lumens and widely patent coronary orifices where the coronary arteries pass through the soft, pliant textile of the ExoVasc® implant. (For details, see Interactive CardioVascular and Thoracic Surgery: External aortic root support for the Marfan aorta: anatomically normal coronary orifices imaged seven years after surgery.)

Not only does the ExoVasc® PEARS implant become incorporated into the adventitia, but the media within the implant recovers. While it remains fibrillin-deficient (eg, in Marfan syndrome patients), the media assumes a normal histological appearance. This is entirely consistent with the repetitive tensile load having been removed from the media and handled by the implant. (For details, see European Journal of Cardio-Thoracic Surgery: Histology of a Marfan aorta 4.5 years after personalized external aortic root support.)

Surgical evidence from five patients undergoing surgery after their PEARS surgery suggests that the textile/living tissue composite that is created around the ExoVasc® some months post PEARS surgery is amenable to normal surgical cutting techniques and should present no barrier to follow-up surgery on the aorta.

PEARS surgery is available in over 40 centres and 14 countries globally.

Poster prize at SCTS 2024

The team at Royal Victoria Hospital Belfast has won a prize at SCTS 2024 for its poster ‘A Case Study: Application of Personalised External Aortic Root Support to Overcome a Failing Ross Procedure’.

For more information on the annual meeting, which is being held 17 to 19 March in Newport, Wales, visit the SCTS website.

ExoVasc PEARS at AATS Aortic Symposium

Multiple presentations will be given on ExoVasc PEARS at the AATS Aortic Symposium 2024, which runs 24 to 26 April 2024 in New York.

Prof John Pepper will give an invitational presentation on ‘Personalized External Aortic Root Support (PEARS).

Conal Austin and Ana Redondo will present on ‘Our Experience with the Ross-PEARS Procedure in Patients with Failing Aortic Valve Surgery’ and ’20 Years of Personalised External Aortic Root Support Experience: What we have learnt so far’.

Alastair Graham will give a poster presentation on ‘Can 3D Printed Models of Coronary Anatomy Reduce the Risk of Major Complications During Personalized External Aortic Root Support (PEARS) surgery? A Pilot Study’.

Abstracts and links to the full program can be found on the Aortic Symposium website.