John Pepper and Tal Golesworthy: How a Brompton patient pioneered his own surgical procedure

Tal Golesworthy was born with a genetic condition called Marfan syndrome which affects the body’s connective tissue and can lead to cardiovascular, skeletal and visual problems.

For Tal, an engineer by trade, the condition took a particular toll on his heart, weakening the walls of the aorta and causing them to expand. Surgical intervention would involve total root replacement of the aorta, including the valve, and re-implanting the coronary arteries.

The idea of major surgery, and the ensuing lifelong dependency on anticoagulant medicine to prevent blood clots, was enough for Tal to explore an alternative route.

With the help of Professor John Pepper, consultant cardiac surgeon at Royal Brompton Hospital, Tal drew on his expertise as an engineer to develop a prototype of a device – called a Personalised External Aortic Root Support (PEARS), pictured above – that could be placed around the ascending aorta and prevent aortic root expansion.

Four years on since conceiving the idea, in 2004 Tal became the first patient to undergo this surgical procedure, which was performed by Professor John Pepper himself.

In this episode of More than a Hospital, Tal and Professor Pepper recall the journey that led to that moment, and how they forged an unexpected partnership to help not only Tal, but the hundreds of lives that the revolutionary procedure would go on to benefit.

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