A spin-off from University of Pittsburgh, Ension Inc is developing pediatric heart pumps. Ension was developing a device for a market that has yet to materialize. Nevertheless, fetal perfusion systems do appear to be a necessary outgrowth of the ongoing research and desire to develop more advanced surgical techniques in order to prevent even more severe congenital heart diseases from manifesting after birth. Currently, 32,000 babies are born every year with a congenital birth defect. While only a small percentage of these patients would need a fetal surgical procedure, the prospect of being able to correct cardiac lesions safely before a child is born is appealing to many doctors. The focus of Ension was research and development activities associated with cardiopulmonary technology that the Founders had developed earlier in their careers. Gradually, the Company began expanding this focus to include technologies that addressed immediate market needs and, in the process, developed an infrastructure with much expertise and capability in product design, prototyping and testing. After the death of Dr. Litwak in 2004, Ension continued its evolution by increasing focus on spin out opportunities, expanding the design, fabrication, and testing capabilities of the company, and exploring new opportunities both inside and outside the medical products industry. The company has expanded its infrastructure to include biocompatible surface design and biomaterial modification, as well as blood compatible surfaces, regenerative scaffolds, non-fouling surfaces. Ension is headquartered in Pittsburgh, Pennsylvania and also maintains facilities in Cape Coral, Florida; Irvine, California; and Knoxville, Tennessee.