Adjustable Annuloplasty Ring for Post-Operative Dimension Control
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Solution Overview
Problem
Current surgical methods for adjusting the annular dimension of anatomic orifices, such as in cardiac and gastrointestinal surgeries, face challenges in achieving precise adjustments post-operatively, leading to potential residual valvular insufficiency or stenosis, and often require invasive procedures with risks like thrombosis and incomplete repairs.
Innovation Solution
An adjustable annuloplasty ring with a mechanism allowing in situ adjustment of its dimensions using an attached adjustment tool, enabling adjustments before, during, and after normal physiologic function resumes, which can be attached and detached, and is designed for percutaneous or minimally invasive procedures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a fixed-size annuloplasty ring is implanted during surgery, then the surgical procedure can be completed with standard implantation techniques, but the ability to adjust the annular dimension post-operatively is lost, potentially resulting in residual valvular insufficiency or stenosis
Solution Approach 1:
The annuloplasty ring is designed with an adjustable mechanism that allows the annular dimension to be changed after implantation. The ring includes an adjustable member that can be actuated by an adjustment tool to modify the size of the annulus, transforming a static implant into a dynamic one that can adapt to post-operative physiological conditions.
Solution Approach 2:
The annuloplasty ring is divided into multiple segments or sections that can move relative to each other. This segmentation allows the ring to be adjusted in size by changing the configuration of its segments, enabling post-operative size modification while maintaining structural integrity during implantation.
2Reliability
If the annular dimension is reduced to achieve desired valvular function, then valvular insufficiency is reduced, but the risk of creating stenosis increases
Solution Approach 1:
The adjustable annuloplasty ring allows for post-operative adjustment based on feedback from valvular function assessment. After initial implantation, the annular dimension can be modified in response to observed valvular performance, enabling optimization of valve function while avoiding excessive reduction that would cause stenosis.
3Measurement precision
If invasive surgical procedures are used to adjust annular dimension, then precise anatomical access is achieved, but operative risks such as thrombosis and incomplete repairs increase
Solution Approach 1:
An adjustment tool serves as an intermediary device that can be introduced through minimally invasive percutaneous access to adjust the annuloplasty ring. This intermediary tool allows precise adjustment of the annular dimension without requiring open surgical procedures, thereby reducing operative risks while maintaining the ability to achieve anatomical precision.
Data Source
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AI summary
An implantable device is provided for controlling at least one of shape and size of an anatomical structure or lumen. An implantable device has an adjustable member configured to adjust the dimensions of the implantable device. An adjustment tool is configured to actuate the adjustable member and provide for adjustment before, during and after the anatomical structure or lumen resumes near normal to normal physiologic function. The device may be an annuloplasty ring comprising a flexible band 1324 wound around a spindle (1370) of a winch so that rotation of the spindle takes up or lets out the circumference of the ring.