title: A light-reflecting balloon catheter for atraumatic tissue defect repair.
abstract: A congenital or iatrogenic tissue defect often requires closure by open surgery or metallic components that can erode tissue. Biodegradable, hydrophobic light-activated adhesives represent an attractive alternative to sutures, but lack a specifically designed minimally invasive delivery tool, which limits their clinical translation. We developed a multifunctional, catheter-based technology with no implantable rigid components that functions by unfolding an adhesive-loaded elastic patch and deploying a double-balloon design to stabilize and apply pressure to the patch against the tissue defect site. The device uses a fiber-optic system and reflective metallic coating to uniformly disperse ultraviolet light for adhesive activation. Using this device, we demonstrate closure on the distal side of a defect in porcine abdominal wall, stomach, and heart tissue ex vivo. The catheter was further evaluated as a potential tool for tissue closure in vivo in rat heart and abdomen and as a perventricular tool for closure of a challenging cardiac septal defect in a large animal (porcine) model. Patches attached to the heart and abdominal wall with the device showed similar inflammatory response as sutures, with 100% small animal survival, indicating safety. In the large animal model, a ventricular septal defect in a beating heart was reduced to <1.6 mm. This new therapeutic platform has utility in a range of clinical scenarios that warrant minimally invasive and atraumatic repair of hard-to-reach defects.
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA.
authors.forename: Ellen T
authors.initials: ET
authors.lastname: Roche
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. Department of Pediatric Cardiac Surgery, Alma Mater Studiorum, University of Bologna, Via Massarenti 9, 40126 Bologna, Italy.
authors.forename: Assunta
authors.initials: A
authors.lastname: Fabozzo
authors.affiliation: Division of Biomedical Engineering, 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, 65 Landsdowne Street, Cambridge, MA 02139, USA.
authors.forename: Yuhan
authors.initials: Y
authors.lastname: Lee
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Polygerinos
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Ingeborg
authors.initials: I
authors.lastname: Friehs
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA. Department of Mechanical Engineering, Technical University of Munich, Boltzmannstrasse 15, 85748 Garching n. Munich, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Schuster
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA.
authors.forename: William
authors.initials: W
authors.lastname: Whyte
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Alejandra Maria
authors.initials: AM
authors.lastname: Casar Berazaluce
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Alejandra
authors.initials: A
authors.lastname: Bueno
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Nora
authors.initials: N
authors.lastname: Lang
authors.affiliation: Division of Biomedical Engineering, 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, 65 Landsdowne Street, Cambridge, MA 02139, USA. Gecko Biomedical, 74 rue du Faubourg, Saint Antoine, 75012 Paris, France.
authors.forename: Maria J N
authors.initials: MJ
authors.lastname: Pereira
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Feins
authors.affiliation: Department of Biological Engineering, Massachusetts Institute of Technology, 500 Main Street, Cambridge, MA 02139, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Wasserman
authors.affiliation: Division of Biomedical Engineering, 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, 65 Landsdowne Street, Cambridge, MA 02139, USA. School of Mechanical and Materials Engineering, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Eoin D
authors.initials: ED
authors.lastname: O'Cearbhaill
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: Nikolay V
authors.initials: NV
authors.lastname: Vasilyev
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Mooney
authors.affiliation: Division of Biomedical Engineering, 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, 65 Landsdowne Street, Cambridge, MA 02139, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Karp
authors.affiliation: Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA. walsh@seas.harvard.edu pedro.delnido@cardio.chboston.org.
authors.forename: Pedro J
authors.initials: PJ
authors.lastname: Del Nido
authors.affiliation: School of Engineering and Applied Sciences, Harvard University, 29 Oxford Street, Cambridge, MA 02138, USA. Wyss Institute for Biologically Inspired Engineering at Harvard, 3 Blackfan Circle, Boston, MA 02115, USA. walsh@seas.harvard.edu pedro.delnido@cardio.chboston.org.
authors.forename: Conor J
authors.initials: CJ
authors.lastname: Walsh
mesh_terms: D000818:Animals; D057785:Catheters; D051381:Rats; D014945:Wound Healing