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Nat Biomed Eng. 2017;1:818-825. doi: 10.1038/s41551-017-0142-5. Epub 2017 Oct 10.

A Growth-Accommodating Implant for Paediatric Applications.

Author information

1
Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
2
Engineering in Medicine Division, Department of Medicine, Center for Regenerative Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Harvard Stem Cell Institute, Harvard-MIT Division of Health Sciences and Technology, 60 Fenwood Road, Boston, MA, 02115, USA.
3
School of Mechanical and Materials Engineering, University College Dublin Centre for Biomedical Engineering, and University College Dublin Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Belfield, Dublin 4, Ireland.
4
Department of Cardiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA.
5
Engineering in Medicine Division, Department of Medicine, Center for Regenerative Therapeutics, Brigham and Women's Hospital, Harvard Medical School, Harvard Stem Cell Institute, Harvard-MIT Division of Health Sciences and Technology, 60 Fenwood Road, Boston, MA, 02115, USA. bwhkarp@gmail.com.
6
Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA. pedro.delnido@cardio.chboston.org.

Abstract

Medical implants of fixed size cannot accommodate normal tissue growth in children, and often require eventual replacement or in some cases removal, leading to repeated interventions, increased complication rates and worse outcomes. Implants that can correct anatomic deformities and accommodate tissue growth remain an unmet need. Here, we report the design and use of a growth-accommodating device for paediatric applications that consists of a biodegradable core and a tubular braided sleeve, with inversely related sleeve length and diameter. The biodegradable core constrains the diameter of the sleeve, and gradual core degradation following implantation enables sleeve and overall device elongation in order to accommodate tissue growth. By using mathematical modeling and ex vivo experiments using harvested swine hearts, we demonstrate the predictability and tunability of the behavior of the device for disease- and patient-specific needs. We also used the rat tibia and the piglet heart valve as two models of tissue growth to demonstrate that polymer degradation enables device expansion and growth accommodation in vivo.

Conflict of interest statement

Competing interests E.N.F., Y.L., E.D.O., N.V.V., D.P., P.E.H., H.Y., V.A., J.M.K., P.J.d.N. have a provisional patent application entitled ‘Autonomously Growing Implantable Device’ (USSN 62/295,768).

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