When Dr. Pedro del Nido operates on an infant’s or small child’s heart, he closes the surgical cuts the old-fashioned way: with needle and thread.
As tried and true as it is, sewing a patch onto a child’s heart is difficult and risky: It has to be done fast, and in a small area; the needle has to pierce healthy tissue but avoid the cluster of cells that operate as the heart’s natural pacemaker.
Frustrated by these limitations, del Nido, head of the cardiac surgery department at Boston Children’s Hospital, and medical researchers in Boston have come up with a replacement that, conceptually at least, is as simple as needle and thread: glue.
This surgical glue is nontoxic, biodegradable, and fast-drying even in the presence of blood, forming a bond that is strong enough to close a hole on a beating heart. The glue is the invention of Jeffrey Karp, a bioengineer at Brigham and Women’s Hospital, and MIT super scientist Robert S. Langer, who nearly four years ago took up del Nido’s challenge to find a safer way to close surgical cuts.
The pair have formed a company, Gecko Biomedical Co., to develop the glue into a product that can be tested in people. On Wednesday they and del Nido published a paper in Science Translational Medicine showing that the glue works in the harsh conditions of a surgical site.
Though adhesives have long been used in treating wounds, none has proved to work well in edge-of-life situations such as heart surgery or sealing blood vessels. Current glues are either too toxic or too fast-acting, work only in the absence of blood, or are not strong enough to hold moving tissue together.