‘Shark Tank’ Pitches Address Unmet Needs

The growing prevalence of cardiovascular disease and advances in technology have led to exponential growth in the cardiothoracic device market. Three physician-innovators are hoping to be part of that burgeoning market and pitched their cutting-edge products and novel devices during yesterday afternoon’s STS/AATS Tech-Con Joint Session: Robotic Cardiothoracic Innovations and “Shark Tank”—Rapid-Fire Pitches of Revolutionary Technology.

James H. Mehaffey, MD describes his idea on how to improve ventricular assist devices.

Jeffrey L. Port, MD, of Weill Cornell Medical Center in New York, led off the pitch session by discussing a device designed to address the clinical challenge of identifying small nodules, especially during minimally invasive surgery. He said that his novel microshell marker offers many benefits over other tools, such as hookwires and dyes, including lack of migration or dispersion, intraoperative ultrasound visibility, long-term (30 days or more) duration, elimination of the need for a localization procedure, and bioresorbability.

Steven F. Bolling, MD, of the University of Michigan in Ann Arbor, William E. Cohn, MD, Vice President for Johnson & Johnson Medical Device Companies, and Arjun (J.J.) Desai, MD, Vice President, Innovation, Johnson & Johnson, served as the “sharks” to evaluate the pitches and offer advice.

Drs. Bolling and Cohn commended Dr. Port and his team for the device but noted that the presentation fell short of a pitch; because of this, they opted not to invest. Dr. Desai agreed but said he would be “in as an advisor.”

In the second pitch, James H. Mehaffey, MD, of the University of Virginia in Charlottesville, discussed the important role of ventricular assist devices (VADs), while noting that suction events due to low-flow states and malposition of the inflow cannula result in significant morbidity. In addition, leftward shift results in distorted right ventricular geometry, leading to late right ventricular dysfunction as a sequela of adverse remodeling. Dr. Mehaffey said that his device, VADStent, addresses these issues by aligning the inflow cannula with the mitral valve and maintaining the left ventricular cavity.

Dr. Cohn noted that VADStent addressed an unmet need and said he would be interested in investing, but Drs. Desai and Bolling said that they preferred to “watch and wait.” Dr. Bolling applauded the strong intellectual property position, a valuable asset for a start-up company.

In the third pitch, Bryan M. Burt, MD, of Baylor College of Medicine in Houston, described a problem for all surgeons who perform minimally invasive procedures: debris deposits on the videoscope lens, which impair visualization of the operative field. Cleaning requires manual removal and cleaning of the scope, which prolongs operative time, frustrates the surgeon, and compromises patient safety. Dr. Burt noted that other proposed solutions have been insufficient and described his device, a trocar with wash and dry functions. He said that the scope can be cleaned within the trocar itself in one forward and backward movement, in under 2 seconds.

Dr. Burt acknowledged that Dr. Cohn was involved in the design of the prototype of the invention, noting that Dr. Cohn agreed to be a judge before knowing that the trocar would be pitched. “I am emotionally in,” said Dr. Cohn. Dr. Bolling agreed that a dirty scope is irritating and that he, too, was in. Dr. Desai, however, said, “Nobody spends money to save money,” and he urged Dr. Burt to identify his true customer and capture the value of the device to that customer base.

The judges’ perspectives on the three pitches demonstrated the challenges of launching new devices, even when they address an unmet need.

Earlier in the day, the role of robotics in cardiothoracic surgery was debated for both cardiac and general thoracic procedures.

T. Sloane Guy, MD, of Weill Cornell Medicine in New York, and David H. Adams, MD, of Mount Sinai Hospital in New York, presented the pros and cons, respectively, of robotic mitral valve repair. Dr. Guy said that a new value equation factors in a positive patient experience and low cost in addition to quality and safety, whereas Dr. Adams pointed to the positive outcomes with sternotomy using his approach of a shorter incision, direct access, and a modified retractor.

In debating the role of robotics in general thoracic surgery, Mark S. Allen, MD, of the Mayo Clinic in Rochester, MN, focused on the cost, operating room space, and learning curve associated with robotics, and Robert J. Cerfolio, MD, MBA, of NYU Langone Medical Center in New York, countered that surgeons should consider value rather than cost, adding that robotics offers the best educational tool and extends surgeons’ careers.