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17.11.2015

“Now I lead a full life”

 

Eight-year-old Dominika Zhurkina from Russia was born with only one heart ventricle. It was very soon clear that she would not survive without medical intervention.

At a hospital in Moscow, Dominika had her first heart operation when she was only seven months old. Dominika got through surgery well, led a normal life, and had a check-up each year in Moscow. But then the problems began. Her mother recounts:

“After the first operation, she felt fine. In the beginning, Dominika’s condition didn't really place any particular limitations on her standard of life. For quite a long time she was virtually completely normal. But in the years up to her fifth birthday, problems started. We would be going to the shop, and I’d hold her hand. After about a hundred meters she’d already be saying: “Mum, let’s stop and rest, I’m tired”. It was hard for her just to walk, let alone run. She couldn’t even climb the stairs to the second floor, where we live, without a rest.”

Heart conduit that develops in the child’s body

But good luck came along with misfortune, for Dominika was accepted into a clinical trial, and today she is the first patient worldwide to be treated with a novel type of heart conduit as part of her second surgery. The key feature of this new special implant is that, step by step, the conduit becomes bioabsorbed as new natural tissue grows. Native tissue develops overtime into a functioning heart conduit. The artificial implant is designed to get eventually bioabsorbed, reducing the risk of complications such as inflammation normally caused by external material in the body, and the risk of repeated surgeries.

It was purely by chance that Dominika was the first patient in the clinical trial, as her mother reports: 

“When Dominika was six years old, we went for her scheduled check-up at the Bakoulev Center in Moscow. The doctors told us she was ready for the operation. The cardiologist explained that the surgery would be performed by Professor Leo Bokeria, a world-famous heart surgeon and the director of the center. We were told to gather up our documents and come to the hospital in two days. So it really was a coincidence. They even put us on television afterwards.”

Improving the standard of care

Today, surgeons or cardiologists implant prostheses made of plastics or animal-based tissue. These techniques save lives, but they have a number of disadvantages, such as possible rejection responses, narrowing of the blood vessels, calcifications, and chronic infections. In addition these implants do not grow with the patient, because they are made of dead material. As a consequence, children have to undergo several dangerous surgeries and frequently require medications throughout their lives. Dominika could be spared all of this if everything continues to develop as desired, however this remains to be proven in the coming years.
Since her operation in October 2013, she has been followed up every three months.

“Dominika feels fine: she can walk around outside on her own and runs around with the other kids. She doesn’t have to stop anymore when we walk together. She doesn’t run as hard as the others, but she does manage to play “tag” and “stuck-in-the-mud” with them. She doesn’t look or sound any different than the other children; the only difference is that she doesn’t take part in gymnastics.”
 And above all Dominika is happy about the successful procedure:

“Before, I always stayed at home, I didn’t go to kindergarten, my parents wanted to keep me safe for the next operation. They were worried that I would become sick. My grandmothers and my mother stayed with me. Now I lead a full life. My parents go to work. And I’m getting ready to attend the art school. Everything is going really well.”
The new technology was developed by Xeltis, a medical device company based in Zurich, Switzerland, and in Eindhoven, The Netherlands. In the world’s first clinical trial, the company’s conduit has successfully treated a total of five children born with a congenital heart malformation – Dominika is one of them. Currently, Xeltis is developing a pulmonary valve for children born with a congenital heart malformation affecting approximately 80,000 children worldwide. 

Triggering the body’s natural healing response 

The Xeltis technology, called Endogenous Tissue Restoration (ETR) is based on Nobel prize-winning science of “supramolecular chemistry” and stems from world-leading work in chemistry of materials, biomechanics and microstructure from the Eindhoven University of Technology, and their teams. In the procedure, surgeons implant a novel heart valve or blood vessel made of a special polymer and structured as a porous matrix that allows the body’s natural healing process to pervade it with natural and functioning tissue. As the natural heart valve or blood vessel forms, the implanted matrix biodegrades, which may reduce the risk of complications normally caused by foreign material and the risk of repeated procedures, therefore lowering healthcare costs compared to conventional treatment.

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