MED/GralInt-TED Talks-Franz Freudenthal: A new way to heal hearts without surgery

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Filmed February 2016 at TED2016

Franz Freudenthal: A new way to heal hearts without surgery



At the intersection of medical invention and indigenous culture, pediatric cardiologist Franz Freudenthal mends holes in the hearts of children across the world, using a device born from traditional Bolivian loom weaving. "The most complex problems in our time," he says, "can be solved with simple techniques, if we are able to dream."










































Transcript:





The most complex problems in our time can be solved with simple techniques, if we are able to dream.
As a child, I discovered that creativity is the key to cross from dreams to reality. I learned this from my grandmother, Dr. Ruth Tichauer, a Jewish refugee that settled in the heart of the Andes. That is how I grew up: encouraged to see beyond any limitation. So part of my education included helping her in remote, indigenous communities. I cherish those memories, because they helped me to understand life outside the city, a life with a lot of possibilities, without barriers, as language or culture.
During those trips, my grandmother used to recite a Kipling poem: "Something hidden. Go and find it. Go and look behind the Mountains. Something lost behind the mountains. Lost and waiting for you. Go!"
In the coming years, I became a medical student. One of every hundred children born worldwide has some kind of heart disease. There's a part of this problem I think I can solve -- the part of this problem I have spent my life working on.
The problem starts during pregnancy. The fetus needs to survive inside the mother. Survival depends on communication between the systemic and the pulmonary blood. At the moment of birth, this communication needs to stop. If it doesn't close, the baby has a hole in the heart. It is caused by prematurity and genetic conditions. But what we know today is that a lack of oxygen is also one of the causes. As you can see in the chart, the frequency of this kind of hole dramatically increases with altitude.
Video: (Baby crying)
When you look at patients with this condition, they seem desperate to breathe. To close the hole, major surgery used to be the only solution.
One night, my friend Malte, were camping in the Amazon region. The only thing that would not burn in the fire was a green avocado branch. Then came a moment of inspiration. So we used the branch as a mold for our first invention. The holes in children's hearts can be closed with it. A coil is a piece of wire wrapped onto itself. It maybe doesn't look so fancy to you now, but that was our first successful attempt to create a device for this major problem. In this video, we can see how a very tiny catheter takes the coil to the heart. The coil then closes the hole. After that moment of inspiration, there came a very long time of effort developing a prototype. In vitro and in vivo studies took thousands of hours of work in the lab. The coil, if it works, can save lives.
I returned from Germany to Bolivia, thinking that wherever we go, we have the opportunity to make a difference. With my wife and partner, Dr. Alexandra Heath, we started to see patients. After successfully treating patients with our coil, we felt really enthusiastic. But we live in a place that is 12,000 feet high. And, the patients there need a special device to solve their heart condition. The hole in altitude patients is different, because the orifice between the arteries is larger. Most patients cannot afford to be treated on time, and they die. The first coil could successfully treat only half of the patients in Bolivia. The search started again. We went back to the drawing board.
After many trials, and with the help of my grandmother's indigenous friends in the mountains, we obtained a new device. For centuries, indigenous women told stories by weaving complex patterns on looms, and an unexpected skill helped us for the new device. We take this traditional method of weaving and make a design made by a smart material that records shape. It seems this time, the weaving allows us to create a seamless device that doesn't rust because it's made of only one piece. It can change by itself into very complex structures by a procedure that took decades to develop.
As you can see, the device enters the body through the natural channels. Doctors have only to close the catheter through the hole. Our device expands, places itself and closes the hole. We have this beautiful delivery system that is so simple to use because it works by itself. No open surgery was necessary.
(Applause)
As doctors, we fight with diseases that take a long time and effort to heal -- if they do. This is the child from before, after the procedure. As you can see --
(Applause)
As you can see, once the device is in place, the patient is 100 percent healed. From start to finish, the whole procedure takes only 30 minutes. That's very rewarding from the medical and human point of view. We are so proud that some of our former patients are part of our team -- a team, thanks to added close interaction with patients that work with us. Together, we have only one idea: the best solutions need to be simple. We lost the fear of creating something new.
The path, it's not easy. Many obstacles arise all the time. But we receive strength from our patients. Their resilience and courage inspire our creativity. Our goal is to make sure that no child is left behind, not because of cost or access.
So we have to start a foundation with a one-to-one model. We will give one device for free to make sure that every child is treated. We are in many countries now, but we need to be everywhere. This whole thing began with one impossible idea as will continue it, really: No child is left behind.
Muchas gracias.
(Applause)