NEW ORLEANS — Innovations in brain cooling and augmented reality were featured, among other projects, at this year’s Society of Thoracic Surgeons meeting.
Following the keynote lecture on technological innovation and entrepreneurship by Mark Cohen, MD, of University of Michigan in Ann Arbor, four contestants lined up their pleas for investment in front of judges and audience members at the conference’s “Shark Tank” session.
The informal winner was a balloon catheter with a cooling pump that is designed to prevent ischemic injury to the brain during cardiac arrest or stroke. The project won 45% of audience votes (with only 20 people having voted, however).
Brain Cooling
Presenter Robert Schultz, MD, a resident in cardiac surgery at Alberta Health Services in Calgary, said that cooling in aortic surgery decreases strokes by 97% and the question was how to make this available to all surgeons, not just cardiac surgeons.
The device from his start-up, Voyage Biomedical, makes it possible to initiate cooling outside the operating room, cool the head by 10 °C in 10 minutes, and leave the rest of the body warm (never below 32 °C) and the heart beating, Schultz told the audience.
Eventually, the goal is to get the brain cooling device on ambulances and in ICUs. So far, it has been tested in pigs and human cadavers.
A judge during the session, Steven Bolling, MD, of University of Michigan Hospital in Ann Arbor, expressed concern about the intellectual property protection on Schultz’s cooling balloon pump when he could easily recreate the technology at his own institution.
Nevertheless, Voyage already has enough money offered by investors to get to first-in-human trials by 2023, Schultz said.
Other projects presented during the “Shark Tank” session sought to solve different problems.
Cardiac Assist Sans Blood Contact
CorInnova’s cardiac assist device is designed to provide biventricular and diastolic assist in acute heart failure. It is unique in that it does not make contact with the patient’s blood, allowing it to be used in people who cannot tolerate anticoagulation, for example, according to George Letsou, MD, of Baylor College of Medicine and Texas Heart Institute in Houston.
The pump is mounted on a collapsible nitinol wire frame for “easy deployment” and cups over the heart, its inner chamber filling with fluid to compress the heart without touching blood, Letsou said. The pericardium holds it in place so it doesn’t slip off the organ even without sutures.
Responding to a question by M. Blair Marshall, MD, of Brigham and Woman’s Hospital in Boston, regarding the device and people with aneurysmal heart disease or previous infarcts, the presenter noted that it would come in “different sizes for different-size problems” given that operators would need to assess the diameter of the left ventricle preoperatively.
Ex vivo studies give the device 30 days of durability. With large animal studies complete, the first-in-human use is expected in about 3 years, according to Letsou.
Chest Drainage With CO2 Detector
The Eckardt Leakage Detector is an inexpensive chest drainage unit that can detect air leaks indicative of pneumothorax and quantify them according to a CO2 liquid color scale.
Importantly, it also tells whether the patient has a false air leak attributable to atmospheric air around or within the drainage system — potentially reducing chest tube duration and risk of complications, said device inventor Jens Eckardt, MD, of Odense University Hospital in Denmark.
The chest drainage unit has been tested in several pigs and humans. It would cost just $10 more than a standard competing device, Eckardt said.
Bollinger pointed out that “chest tubes are incredibly cheap, so the margin on this would be low,” inhibiting his enthusiasm for it as a venture capitalist.
Augmented Reality
Finally, there was a mixed-reality application enabling the operator to project radiological data onto the same field of vision as their patient during thoracic surgery.
With Microsoft’s HoloLens 1 virtual reality headset, the user is able to see scans mapped to scale on the patient and manipulate his or her view without wires or cursors — therefore never having to break scrub or walk away to double-check the image on a monitor, according to Brooke Krajancich, a PhD student in electrical engineering at Stanford University in California.
She showed a video demonstrating how the app shrinks lung anatomy by 50% to approximate lung deflation.
This was a computational problem in the eyes of both Marshall and Bolling: the former said that it’s known that the periphery deflates more than central structures, and the latter that not every lung deflates the same way given that some lung cancers will lead to adhesions in the anatomy.
Moreover, the utility of this virtual reality technology was questioned by Marshall, who said that it is only once or twice a year that she cannot find a small lung nodule by conventional methods.
“I don’t think your experience is going to translate across thoracic surgery. If you look at people going in younger, with less experience, they’re going to have [trouble] finding small nodules,” maintained Mark Berry, MD, also of Stanford, and the project’s leader.
Last Updated January 26, 2021