Introducing PEARS
London Bridge Hospital is proud to host Mr Conal Austin, one of the UK’s leading Consultant Cardiothoracic Surgeons specialising in congenital heart conditions. Here he performs, amongst other complex cardiac surgeries, the ground-breaking ExoVasc® Personalised External Aortic Root Support (PEARS) procedure for patients with conditions such as Marfan syndrome, Loeys-Dietz Syndrome and genetic mutations like ACTA2.
The impact of genetic mutations
In the case of some genetic mutations the connective tissue can be involved, hence why the aortic root can become dilated over time, with significant impact on day to day life. Traditionally in the case of a steadily dilating aortic root, patients are monitored and scanned annually, and are then forced to wait until the dilation has reached typically over 4.5mm diameter. At this point surgical intervention becomes necessary given the threat of aortic dissection.
What the PEARS procedure involves
The PEARS procedure represents a major advance over conventional surgical approaches. It can be carried out before patients reach this delicate stage of dilation – given its less invasive and less radical approach. The first stage of treatment involves a CT scan of the heart which is used to construct an exact 3D model of the aortic root and ascending aorta. From this a bespoke external aortic root support, which fits precisely the patient’s aortic anatomy, is produced. This is then surgically placed around the aortic root to prevent further dilation.
No replacement of the aorta and adjacent valve are required - which are the case in traditional valve sparing aortic root repairs, or complete replacement of the aortic root and valve. With PEARS, quite simply, the mesh sleeve bonds to the aortic root maintaining the structure of the aorta and vessels.
The benefits of PEARS
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Aortic support surgery can be performed earlier than traditional surgery, thereby reducing the risk of aortic root rupture
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The operation time is shorter (typically under four hours). It is usually without cardiopulmonary bypass, which reduces the recovery time
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No requirement for anticoagulant drugs (and their associated side effects), unlike traditional aortic root surgery
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The root support dramatically reduces the likelihood of further surgery
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It offers total repair of the aorta, allowing patients to return to normal activity and life
This procedure is simple and elegant and it’s going to change my life.
The London Bridge Hospital Team
Alan Rayner
Chief Clinical Perfusionist, manages the London Bridge Hospital cardiac surgical programme. He oversees the PEARS programme. Email Alan with any enquiries: Alan.Rayner@hcahealthcare.co.uk
Caring for our PEARS patients
Suzanne O’Connor, Cardiac Surgical Nurse Specialist, is there to support patients throughout their journey and stay, and monitor their recovery as an inpatient on a daily basis. Suzanne specialises in pre-operative assessment and post-operative follow up.
As a cardiac Clinical Nurse Specialist, she has deep clinical knowledge along with the time to support and care for patients and their families; answering any questions and keeping them informed at all times. After discharge patients are always able to contact Suzanne or our cardiac nurses 24 hours a day, through our cardiac ward.
Suzanne O'Connor
Cardiac Surgical Nurse Specialist
The patient journey
PEARS is available to patients in the UK and around the world. Once accepted onto the PEARS programme diagnostics can take place with your own cardiologist at least six weeks prior to travel. A CT scan can be carried out at your local hospital (to a PEARS CT protocol) to assess viability for the PEARS procedure, and to provide measurement for the ExoVasc® support. Imaging will be reviewed at London Bridge Hospital by Mr Austin and the cardiac radiology team. CT images are then sent to ExoVasc® for the production of the aortic root support. This process is managed by Alan Rayner.
Day 1:
Pre-operative tests and consultations with Mr Austin and Suzanne O’Connor, Cardiac Surgical Nurse Specialist.
Day 2:
Admitted to London Bridge Hospital. Patients are given introductions to the cardiac team who will help treat them.
Day 3:
Day of surgery (typically under 4 hours operation time), followed by a night in our intensive care unit.
Day 4 to 7:
Patient transferred to the cardiac ward for approximately three to four days.
Day 8:
Discharge from hospital once deemed ready by Mr Austin, with personalised rehab programme and follow up consultations arranged.
Days 9 to 28:
International patients remain in the UK, with access to the team, prior to returning home.
After leaving hospital, Suzanne O’Connor will continue to provide ongoing support with weekly follow-up calls, usually for the first six weeks. If any additional assistance and support is required, patients are always able to contact our cardiac nurses 24 hours a day, through our cardiac ward.
The wider cardiac team
The origins of the PEARS procedure
The PEARS procedure was conceived by Tal Golesworthy (pictured), a Chartered Engineer who was born with Marfan syndrome and diagnosed with a dilated aorta. Faced with the prospect of open heart surgery and a lifetime of anticoagulant medication, the engineer decided to create his own life-saving solution. He designed the ExoVasc®
Tal Golesworthy underwent the first PEARS procedure in 2004 after years developing his prosthetic in collaboration with scientists and surgeons. Up until then patients with this life limiting condition had to wait until their aorta became sufficiently dilated before a complex and life-altering operation was undertaken. And clearly living with the knowledge of a potentially catastrophic cardiac event had a significant impact on day to day life. Tal Golesworthy now has annual scans and his aorta’s diameter hasn’t changed a millimetre since his surgery.
The future of PEARS
Our location
St. Olaf House
27 Tooley Street
London SE1 2PR
Contact us
The London PEARS Centre is situated in London Bridge Hospital.