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Hannah F. Pietsch
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A Hospital Machinist

Houston, TX - 8/1/2013

Houston Methodist machinist prototyped DeBakey heart pump and other devices used in cutting edge cardiovascular research

 

Many drive by his office every day, but no one ever stops. The entrance does not draw a second glance from visitors driving through the second level of the Outpatient Center parking garage of Houston Methodist Hospital.

Through those doors is a machine shop run by Juan Fernandez. With advancements in technology being made every day, the fate of traditional machinists may be unclear. But not for Fernandez, whose talent with his hands is leading to solutions for physicians and their patients

After moving to Houston from Mexico with his family at the age of 7, Fernandez went on to receive his welder certification in high school before becoming an American citizen and joining the U.S. Marine Reserve. After working in the oil fields for more than a decade, Fernandez accepted a job with the Baylor College of Medicine to develop and manage their machine shop, where he designed and built projects for physicians and researchers throughout the Texas Medical Center (TMC).

One of my best projects was developing the prototype of the widely-used left ventricular assist device (LVAD) axial blood flow pump designed by world-renowned cardiovascular surgeon, Dr. Michael E. DeBakey,” said Fernandez.

After 25 years at Baylor, Fernandez came to Houston Methodist Hospital.

We wanted to bring him to Methodist because we recognized the importance of keeping a precision machine shop, not only for our patients, but for the entire TMC,” said Stephen Igo, director of the Entrepreneurial Institute for the Houston Methodist DeBakey Heart & Vascular Center, who was instrumental in bringing Fernandez to Houston Methodist. “It’s rare for a hospital to have a machine shop, but this unique capability contributes to Houston Methodist’s ability be at the forefront of Leading Medicine.”

Fernandez works with materials from plastics to metals and designs and builds everything from microscope slide holders to specialized surgical instruments. But, perhaps his most important contribution is the numerous components that he has designed and built for the Cardiovascular Hemodynamics Imaging Lab.

In the imaging lab, we have a heartbeat simulator device that is a model of the cardiovascular system,” explained Matthew Jackson, manager of the Cardiovascular Hemodynamics Imaging Lab at the Houston Methodist Research Institute. “This device allows us to simulate and study the flow of blood through heart valves and test the accuracy of clinical imaging techniques in assessing this blood flow.”

While clinical imaging techniques have vastly improved over the years, some inaccuracies still exist.

For example, due to disease, many people have heart valves that leak and cause backwards blood flow through the heart’s mitral valve,” Jackson said. “Echocardiography is commonly used by cardiologists to assess the severity of the backwards flow. Under specific conditions, we know that echocardiography underestimates the amount of backwards flow, but reference data to explain how much the flow is underestimated has not yet been developed.” 

With the heartbeat simulator, researchers imitate common conditions of backwards flow through the mitral valve and test different imaging technologies, such as echocardiography, computerized tomography (CT), and MRI. With these results, physicians can more accurately assess the severity of backwards flow in a patient’s heart and determine if the condition would be best treated by pharmaceuticals or surgery.

The equipment of the Cardiovascular Hemodynamics Imaging Lab, such as the heartbeat simulator, would not be where it is today without Juan’s work,” said Dr. Stephen Little, cardiologist and director of Houston Methodist DeBakey Heart & Vascular Center's Valve Clinic. “Version 1.0 of this lab started with a peanut butter jar.”

Juan provided crucial advice about material options and design specifications before actually building all of the components of the heartbeat simulator,” added Jackson. “The Cardiovascular Hemodynamics Imaging Lab strives to make gray areas in cardiology more black and white, so that physicians can make the best clinical decisions for their patients. Juan’s work is a direct contribution to this research.”

Igo cautions those who think machine shops will become obsolete.

“3D printing is great, but it can’t create an instrument out of surgical grade stainless steel like Juan can,” said Igo.

 “I don’t know if my work has ever saved a life, but I hope it has helped someone,” said Fernandez. “I still have a lot of work to do, and the possibility of helping Houston Methodist patients makes every day exciting.”

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