Personalized external aortic root support (PEARS) is an emerging technology. It is a pre-emptive operation to halt aortic root expansion and maintain aortic valve function in Marfan syndrome and is also applicable to aortic root aneurysms of other etiologies.
What is the PEARS Procedure?
Personalized external aortic root support (PEARS) is a procedure in which a 3D copy of the patient’s aorta is made by computer-aided design. Using that as a former, a mesh sleeve of the same shape and size is made to fit that patient’s aorta.
The possibility of preventive operation might be considered for other congenitally determined root aneurysms, PEARS may be considered for these patients because it spares the aortic valve, conserves the architecture of the aortic valve support, but presents no obstacle to further surgery. One might argue that ‘no bridges are burnt’ by this conservative surgery.
The chemical composition of the synthetic medical grade thread shares biocompatibility with tried and tested materials but differs in that the PEARS implant has a soft macroporous mesh structure rather than the rigid format used for vascular grafts. A similar mesh fabric has previously been shown to be fully incorporated in the human aorta, and the fabric itself appears from the previous experience of others to remain stable indefinitely.
Benefits compared to conventional operation.
The operation does not require interruption of the coronary blood flow because there is no need for the heart to be arrested or the aorta to be opened. Cardiopulmonary bypass is not usually required, but a degree of controlled hypotension facilitates dissection of the aorta, particularly proximal to the left coronary artery.
The operation has undergone Health Technology Appraisal under the auspices of NICE in England
Prof Adam El-Gamel
Wollongong Cardiac Centre
Suite 2, Ground Floor/3 Rawson St, Wollongong NSW 2500
Phone: (02) 4227 1840