Research & Innovation | Overview
The Midaortic Syndrome and Renovascular Hypertension Center at Boston Children's Hospital is at the forefront of innovative research and the creation of new therapeutic approaches to these conditions. These are just some of the remarkable advances our clinicians have developed that may benefit your child.
Pioneering treatments midaortic syndrome and renovascular hypertension
When midaortic syndrome is treated surgically, physicians have traditionally used a prosthetic graft made from synthetic material to perform an aortic bypass. While used successfully in adults, synthetic grafts can pose a number of challenges in children. Synthetic grafts don’t grow with the patient, which means that multiple surgeries may be necessary through the years to ensure appropriate graft size. Artificial grafts also carry a higher risk of thrombosis and infection.
Mesenteric Artery Growth Improves Circulation (MAGIC) is an innovative procedure that bypasses the aorta by using the mesenteric arteries (the arteries that supply blood to the intestines) rather than prosthetic graft material. This can help prevent the need for future graft replacement procedures because the child’s arteries will naturally grow as they get older. Even if a patient ultimately requires a synthetic graft, MAGIC doesn’t preclude that procedure. This approach was pioneered by surgeons at Boston Children’s and is not available anywhere else in the world. It is offered to all eligible patients.
For many children with severe midaortic syndrome, renovascular hypertension, or both, the most effective approach is to replace the damaged blood vessels with healthy vessels near the aorta. However, this has been difficult in the past because the healthy vessels tend to be too short to adequately "fill in" for the vessels they are replacing.
Responding to this challenge, Boston Children's experts have designed a new treatment called Tissue Expander Stimulated Lengthening of Arteries (TESLA).
This procedure is based on a known scientific phenomenon, stretch-induced growth. This means that when bodily tissue is stretched slowly and continuously over time, it will keep growing in the direction of the stretching.
To start the TESLA procedure, surgeons place a tissue-expanding device behind the child's aorta. Next, the tissue-expanding device is gradually filled with saline solution over a period of several weeks to months. This slowly stretches the aorta and its blood vessels.
Throughout the stretching period, doctors monitor the function and well-being of the aorta and its neighboring organs with blood tests, ultrasound, and CT scans. Once the aorta appears to be long enough, surgeons remove the narrowed area and replace it with the newly stretched vessels.
TESLA is a very new procedure that we are still studying closely. But the initial results are very encouraging, and we hope to use this major advance to make a difference for many other patients in the future. Read about TESLA.