The Procedure

The PEARS procedure is available at the Royal Brompton Hospital, St Thomas’s Hospital and the London Bridge Hospital in London and at a growing number of other centres in the UK, Europe and Australia. Prospective patients can be referred by their consultant or general practitioner directly to the appropriate surgical lead. See a list of surgical centres and surgical leads.

Patients may be regarded as suitable for this procedure if they have Marfan syndrome or a related condition. They must also have a dilated aorta (i.e. an aorta which is larger than the “normal” 3.2 to 3.6 cm as measured atop the aortic valve cusps) and be asymptomatic with a functional aortic valve.

In preparation for this procedure, the patient receives a CT scan to produce the images and data from which a 3-dimensional model of the aorta can be made. From this model, the technique of 3-D printing is used to create a plastic former that exactly matches the patient’s individual aorta.  This former is used to provide the shape to a soft and pliable textile used in the manufacture of the ExoVasc® PEARS implant.

The procedure to fit the ExoVasc® support involves open chest surgery and takes about two hours. Cardiopulmonary bypass using a heart lung machine is not usually necessary, the procedure is carried out on the beating heart and the aorta and aortic valve remain intact. The ExoVasc® support is removed from its former and is placed around the aorta and sutured into place without interrupting the circulation or cutting into the aorta.