Maria Pereira tells us that 40,000 babies are born in the USA every year with congenital heart defects, yet there is no method to close holes between the chambers of their heart. A concerning fact that led her team at Gecko Biomedical to come up with a revolutionary glue-coated adhesive that will allow sutures to become a thing of the past. At 29, Pereira has already been named by Time magazine as a Next Generation Leader, as part of Forbes’ 30 under 30 most innovative healthcare entrepreneurs and a top innovator for MIT. In her own words Pereira explains to us how she and her team came about this revolutionary technology.
In 2009, Dr. del Nido, chief of cardiac surgery at Boston Children’s Hospital, contacted my PhD advisor to develop an approach to seal holes inside a beating heart. Right now internal wound closure is achieved using sutures or a limited number of adhesives/sealants. Both methods are ineffective for minimally invasive procedures. They are technically challenging and are often associated with tissue damage or toxicity.
To address the problem of internal wound closure, we envisioned a glue coated patch that could be placed into the body part requiring repair, including the beating heart, and would be pushed up against the hole. Once in place, the adhesive properties of the material would be activated, generating a flexible bond. Then, over time, the patient’s own cells could migrate over and into this material and create a tissue bridge as the material completely disappeared.
We needed to ensure the glue wouldn’t dilute or react with blood or other body fluids. We couldn’t figure out a way around it, so we turned to nature for inspiration. We looked at creatures on the land and in the sea that exist in wet dynamic environments, and we found something pretty cool. There are sandcastle worms in the sea and slugs and snails on land that do something remarkable. All of these creatures have viscous secretions and these secretions stay put like honey on a plate, even with rain or surf hitting it. They contain hydrophobic components which actually repel water. We asked ourselves what would happen if we could develop an adhesive like that – one that was entirely hydrophobic.
In the academic setting, we showed that this material could seal the carotid artery and aorta of pigs, holes in the hearts of rats, and we showed that the glue can be used to attach a patch inside a beating pig heart.
The company Gecko Biomedical was created in Paris, in 2013, aiming to bring new sealants and adhesives compatible with minimally invasive surgery to the bedside of patients. Gecko is scheduled to be first used in human procedures later this year with its first sealant indicated as adjunct to sutures in vascular reconstruction.
You applied this to the heart of the pig in clinical trials, what was the response when you saw the results?
The work done in pigs were pre-clinical studies. The key for us was to evaluate the safety and performance of our materials before moving to the clinics. The successful results were a tremendous achievement to us, and a big motivation to continue working in the project and bring the technology to the benefit of patients.
The development of this technology was possible due to the close synergistic collaboration of a highly multidisciplinary team involving scientists, engineers and physicians. As typical in research, we had ups and downs, we had to overcome many challenges throughout the inventive process. But the creativity, resilience and team spirit of all the members involved in the work is what drives us forward.
What are some future applications for it, perhaps even outside healthcare?
Gecko’s vision is to provide clinicians with a new way of performing surgery, not relying on sutures and staples which can be technically challenging, especially in difficult to access anatomies or minimally invasive procedures. We expect that the addition of our technology to the surgeon’s toolbox will enable shorter operative times and minimized surgical complications (e.g. infection, tissue handling), as well as reduced costs. There is a multitude of applications we can go after in the surgical field, and we are trying to focus on the ones that can have a higher impact. Of course, there are applications outside medicine that we have thought of, but for now what excites me more is to work on contributing to the quality of life of patients worldwide.
What has been the response from the medical and scientific community so far from your invention?
We are already working with several physicians who have tested our products in animals and have never seen something so effective. We will start our first clinical trials in Europe early next year (2016), for the use of our sealant as an adjunct to sutures in vascular reconstruction.