How churros inspired a new approach to heart surgery
That is changing for some patients. Ruel performs minimally invasive surgeries involving a small incision between the ribs without cutting the breastbone in about 200 open heart surgeries a year (including some CABG surgeries). But sternotomies remain common and so do the risks.
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The BEaTS Churro Project addresses both of those issues in a way that could change bypass surgery by creating grafts for patients without healthy blood vessels and by allowing surgery to be done without any cutting into the chest.
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Muñoz, Alarcon and their team created a miniature nozzle inspired by the churro nozzle. It is designed to extrude a synthetic vascular graft made from liquid biopolymer in real time, making 3D printed blood vessels on a miniature scale. The polymer passes through the nozzle and forms a tube with fibres aligned in a circular pattern, mimicking the structure of blood vessels. The polymer becomes a solid tube after it is cured using blue light — similar to what dentists use.
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That biomanufactured graft cues the body to invade and repopulate it with cells, turning it into a healthy graft.
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The team also developed a miniature 'landing pad' under the leadership of visiting international student Manuel Calderon that attaches to the aorta, a key step that in the future could enable doctors to produce synthetic grafts in real time using catheters.
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For Muñoz and team, being able to perform bypass surgery through catheters and without an incision in the chest is the dream outcome of the innovative research. Reaching that goal would be a world first, he said, and would allow patients to be released from hospital quickly with little post-operative risk.
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'It is a dream we hope for in the future,' he said. 'We see this as a major breakthrough in cardiac surgery for the future.'
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That could be 10 to 15 years down the road, he said, but the first steps toward that goal have been successful.
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The team patented and published a paper on the miniature nozzle which is able to make blood vessels but there is still work to be done to put the pieces together and to test them, he said.
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The BEaTS team is not the first to attempt to make vascular grafts for those whose own blood vessels are not suitable.
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Solving that puzzle would represent a major breakthrough for bypass surgery, he said.
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It is the kind of problem that called for a creative solution.
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Winnipeg Free Press
20 hours ago
- Winnipeg Free Press
NIH cuts spotlight a hidden crisis facing patients with experimental brain implants
Carol Seeger finally escaped her debilitating depression with an experimental treatment that placed electrodes in her brain and a pacemaker-like device in her chest. But when its batteries stopped working, insurance wouldn't pay to fix the problem and she sank back into a dangerous darkness. She worried for her life, asking herself: 'Why am I putting myself through this?' Seeger's predicament highlights a growing problem for hundreds of people with experimental neural implants, including those for depression, quadriplegia and other conditions. Although these patients take big risks to advance science, there's no guarantee that their devices will be maintained — particularly after they finish participating in clinical trials — and no mechanism requiring companies or insurers to do so. A research project led by Gabriel Lázaro-Muñoz, a Harvard University scientist, aimed to change that by creating partnerships between players in the burgeoning implant field to overcome barriers to device access and follow-up care. But the cancellation of hundreds of National Institutes of Health grants by the Trump administration this year left the project in limbo, dimming hope for Seeger and others like her who wonder what will happen to their health and progress. An ethical quagmire Unlike medications, implanted devices often require parts, maintenance, batteries and surgeries when changes are needed. Insurance typically covers such expenses for federally approved devices considered medically necessary, but not experimental ones. A procedure to replace a battery alone can cost more than $15,000 without insurance, Lázaro-Muñoz said. While companies stand to profit from research, 'there's really nothing that helps ensure that device manufacturers have to provide any of these parts or cover any kind of maintenance,' said Lázaro-Muñoz. Some companies also move on to newer versions of devices or abandon the research altogether, which can leave patients in an uncertain place. Medtronic, the company that made the deep brain stimulation, or DBS, technology Seeger used, said in a statement that every study is different and that the company puts patient safety first when considering care after studies end. People consider various possibilities when they join a clinical trial. The Food and Drug Administration requires the informed consent process to include a description of 'reasonably foreseeable risks and discomforts to the participant,' a spokesperson said. However, the FDA doesn't require trial plans to include procedures for long-term device follow-up and maintenance, although the spokesperson stated that the agency has requested those in the past. While some informed consent forms say devices will be removed at a study's end, Lázaro-Muñoz said removal is ethically problematic when a device is helping a patient. Plus, he said, some trial participants told him and his colleagues that they didn't remember everything discussed during the consent process, partly because they were so focused on getting better. Brandy Ellis, a 49-year-old in Boynton Beach, Florida, said she was desperate for healing when she joined a trial testing the same treatment Seeger got, which delivers an electrical current into the brain to treat severe depression. She was willing to sign whatever forms were necessary to get help after nothing else had worked. 'I was facing death,' she said. 'So it was most definitely consent at the barrel of a gun, which is true for a lot of people who are in a terminal condition.' Patients risk losing a treatment of last resort Ellis and Seeger, 64, both turned to DBS as a last resort after trying many approved medications and treatments. 'I got in the trial fully expecting it not to work because nothing else had. So I was kind of surprised when it did,' said Ellis, whose device was implanted in 2011 at Emory University in Atlanta. 'I am celebrating every single milestone because I'm like: This is all bonus life for me.' She's now on her third battery. She needed surgery to replace two single-use ones, and the one she has now is rechargeable. She's lucky her insurance has covered the procedures, she said, but she worries it may not in the future. 'I can't count on any coverage because there's nothing that says even though I've had this and it works, that it has to be covered under my commercial or any other insurance,' said Ellis, who advocates for other former trial participants. Even if companies still make replacement parts for older devices, she added, 'availability and accessibility are entirely different things,' given most people can't afford continued care without insurance coverage. Seeger, whose device was implanted in 2012 at Emory, said she went without a working device for around four months when the insurance coverage her wife's job at Emory provided wouldn't pay for battery replacement surgery. Neither would Medicare, which generally only covers DBS for FDA-approved uses. With her research team at Emory advocating for her, Seeger ultimately got financial help from the hospital's indigent care program and paid a few thousand dollars out of pocket. She now has a rechargeable battery, and the device has been working well. But at any point, she said, that could change. Federal cuts stall solutions Lázaro-Muñoz hoped his work would protect people like Seeger and Ellis. 'We should do whatever we can as a society to be able to help them maintain their health,' he said. Lázaro-Muñoz's project received about $987,800 from the National Institute of Mental Health in the 2023 and 2024 fiscal years and was already underway when he was notified of the NIH funding cut in May. He declined to answer questions about it. Ellis said any delay in addressing the thorny issues around experimental brain devices hurts patients. Planning at the beginning of a clinical trial about how to continue treatment and maintain devices, she said, would be much better than depending on the kindness of researchers and the whims of insurers. 'If this turns off, I get sick again. Like, I'm not cured,' she said. 'This is a treatment that absolutely works, but only as long as I've got a working device.' ____ The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
Ottawa Citizen
11-06-2025
- Ottawa Citizen
How churros inspired a new approach to heart surgery
Article content That is changing for some patients. Ruel performs minimally invasive surgeries involving a small incision between the ribs without cutting the breastbone in about 200 open heart surgeries a year (including some CABG surgeries). But sternotomies remain common and so do the risks. Article content The BEaTS Churro Project addresses both of those issues in a way that could change bypass surgery by creating grafts for patients without healthy blood vessels and by allowing surgery to be done without any cutting into the chest. Article content Article content Muñoz, Alarcon and their team created a miniature nozzle inspired by the churro nozzle. It is designed to extrude a synthetic vascular graft made from liquid biopolymer in real time, making 3D printed blood vessels on a miniature scale. The polymer passes through the nozzle and forms a tube with fibres aligned in a circular pattern, mimicking the structure of blood vessels. The polymer becomes a solid tube after it is cured using blue light — similar to what dentists use. Article content Article content That biomanufactured graft cues the body to invade and repopulate it with cells, turning it into a healthy graft. Article content The team also developed a miniature 'landing pad' under the leadership of visiting international student Manuel Calderon that attaches to the aorta, a key step that in the future could enable doctors to produce synthetic grafts in real time using catheters. Article content For Muñoz and team, being able to perform bypass surgery through catheters and without an incision in the chest is the dream outcome of the innovative research. Reaching that goal would be a world first, he said, and would allow patients to be released from hospital quickly with little post-operative risk. Article content 'It is a dream we hope for in the future,' he said. 'We see this as a major breakthrough in cardiac surgery for the future.' Article content That could be 10 to 15 years down the road, he said, but the first steps toward that goal have been successful. Article content Article content The team patented and published a paper on the miniature nozzle which is able to make blood vessels but there is still work to be done to put the pieces together and to test them, he said. Article content The BEaTS team is not the first to attempt to make vascular grafts for those whose own blood vessels are not suitable. Article content Solving that puzzle would represent a major breakthrough for bypass surgery, he said. Article content It is the kind of problem that called for a creative solution. Article content
CBC
31-03-2025
- CBC
Trump threats open 'floodgate' of inquiries from U.S. physicians about moving north
Social Sharing Renowned Ottawa heart surgeon Marc Ruel was planning a move to the United States last year, with the University of California, San Francisco "thrilled to announce" that he would be leading a heart division in their surgery department. But Donald Trump's threats toward Canada were such that Ruel has now decided to remain in Canada. "Canada is under duress right now," he told CBC. "I felt my role and duty at this point was to directly serve my country from within." Ruel is not the only medical professional now reluctant to work in the United States. That means Canada's health-care system could stand to benefit from the political upheaval unleashed by the U.S. president, as American physicians look to move north and Canadians forgo opportunities south of the border. 'I don't want to do politics' For over a decade, Ruel served as the head of cardiac surgery at the University of Ottawa Heart Institute, developing world-leading techniques in less invasive bypass surgery. Ruel says he considers his skills a product of Canada, abilities that he was ready to share globally when he accepted the position at UCSF last year. "In the western United States, no one does this more advanced, minimally invasive multiple bypass surgery," he said. Ruel has not previously spoken publicly about his decision to remain in Canada, partly to avoid wading into politics. "I don't want to do politics, I'm a surgeon, I'm not a politician and I respect every nation's choice to choose their own destiny," he said. But Trump's imposition of tariffs and threats to annex the the country that's historically been its closest ally has made geopolitics an unavoidable issue. "I had to most unfortunately change my decision," Ruel said. "I say unfortunately because there were patients there in California, I can tell you, who we're looking forward to having this type of surgery." Given the broader context, Ruel says staying put was the best decision. "I'm very happy to be here and to serve, as well as I can, my fellow Canadians," he said. Meanwhile in the U.S., many physicians are considering whether they can continue doing their jobs under a second Trump administration. CBC spoke with two American physicians seeking to relocate to Canada and a third who recently moved to B.C. The three declined to speak on the record, citing a fear of retribution for speaking critically of the Trump administration. But they shared concerns over health secretary Robert F. Kennedy Jr. advancing an anti-science and vaccine-skeptical agenda. This past week, U.S. media reported that Kennedy had hired David Geier, a vaccine skeptic, to study links between immunizations and autism. Geier, who was censured in 2012 for practising medicine without a license in Maryland, has previously published debunked claims about vaccines increasing the risk of autism, which critics say pre-ordain the outcome of any subsequent investigation led by him. On Thursday, Kennedy also announced plans to cut 10,000 jobs as part of a restructuring of federal public health agencies. A 'floodgate' opening Concerns over the political climate in the U.S. has opened a "floodgate" of inquiries about moving to Canada, according to recruiter Michelle Flynn. "The amount of interest has more than doubled over the last several months," she told CBC. The CEO of CanAm Physician Recruiting Inc., Flynn recruits U.S.-trained physicians to work in Canada and places Canadian specialists in roles in the U.S. Lately though, she has struggled to get any Canadians interested in moving south. "I started a position for an [obstetrician-gynecologist] in the U.S. before President Trump was elected," she said. "We since have had to scrap that idea totally. Nobody is going to the U.S." To deal with the influx of inquiries from American physicians wanting to come to Canada, Flynn said she is now conducting interviews five days a week, up from three days a week previously. "We're getting 60-plus physicians coming to and registering on our website a month," she said. Canada is now in a better position to welcome U.S.-trained physicians than in the past, as most provinces have removed barriers to licensing in recent years. Ontario in particular is well placed to receive American doctors, according to the provincial health ministry. "There is no doubt the U.S. is facing economic uncertainty at the hands of President Trump's tariffs," the Ministry of Health said in an emailed statement. "We have taken steps to break down barriers for internationally educated healthcare workers… working with the College of Physicians and Surgeons of Ontario (CPSO) to remove unnecessary red tape to allow physicians who are trained and Board Certified in the U.S. to practice in Ontario immediately." After introducing this new licensing pathway, the CPSO registered 351 U.S. physicians between 2023 and the end of 2024, a spokesperson said. So far this year, CPSO has received registration applications from 240 physicians who are U.S. educated. Most of them are currently practicing in the U.S., the spokesperson said. Given the disruption caused by Trump, Ruel believes Canada is "the best-situated" country to face an uncertain future.
