Adjustable Artificial Chordae Tendineae with Spool Tensioning
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Solution Overview
Problem
Ischemic heart disease leads to mitral regurgitation due to papillary muscle dysfunction and left ventricle dilatation, causing displacement and tethering of mitral valve leaflets, which results in incomplete coaptation and decreased cardiac output, and existing repair methods face challenges in accurately adjusting chordae tendineae tension during open-surgery.
Innovation Solution
A subvalvular apparatus comprising adjustable repair chords with proximal loops and a spool assembly that allows for bidirectional tension adjustment, anchored to cardiac tissue, enabling precise adjustment of chordae tendineae length and distribution of tension across the leaflet, thereby restoring normal valve function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If traditional open-surgery chordae replacement is used, then valve repair can be achieved, but accurate adjustment of chordae tension cannot be made during the procedure
Solution Approach 1:
The patent applies the dynamics principle by creating an adjustable support pad with a tensioning line that can be dynamically adjusted during surgery. The tensioning line is threaded through the support pad and can be tightened or loosened to precisely control chordae tension, allowing real-time optimization of valve repair during the surgical procedure rather than being fixed beforehand.
Solution Approach 2:
The patent uses an adjustable support pad as an intermediary device between the surgeon and the chordae tendineae. This support pad with its tensioning line mechanism serves as a mediator that enables precise tension adjustment without requiring direct manipulation of the chordae, thereby improving adjustment accuracy and ease of operation during surgery.
2Adaptability or versatility
If fixed-length artificial chordae are used, then the repair procedure is simple, but the valve cannot be optimized under different loading conditions
Solution Approach 1:
The patent applies dynamics by replacing fixed-length artificial chordae with an adjustable tensioning system. The tensioning line can be dynamically adjusted to optimize valve function under different loading conditions, such as varying cardiac output requirements or pressure gradients, while maintaining a relatively simple overall device structure.
Solution Approach 2:
The patent utilizes parameter changes by allowing the tensioning line length and tension to be adjusted during or after the surgical procedure. This enables optimization of the valve repair for specific patient conditions, such as changing the chordae tension to match different cardiac loading states, without significantly increasing device complexity.
3Adaptability or versatility
If multiple separate tensioning lines are used for each chordae, then independent adjustment is possible, but the device complexity increases
Solution Approach 1:
The patent applies universality by designing an adjustable support pad that can accommodate multiple tensioning lines or serve multiple functions. The support pad structure can be configured to handle several chordae simultaneously, providing independent adjustment capability for each while using a single integrated platform, thereby reducing overall device complexity compared to separate tensioning mechanisms for each chordae.
Data Source
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AI summary
Apparatus (20, 220) is provided, including an artificial-chordeae-tendineae-adjustment mechanism (40) and at least one primary artificial chordea tendinea (60) coupled at a distal portion thereof (67) to the artificial-chordeae-tendineae-adjustment mechanism (40). A degree of tension of the at least one primary artificial chordea tendinea (60) is adjustable by the artificial-chordeae-tendineae-adjustment mechanism (40). One or more loops (66) are coupled at a proximal portion (65) of the at least one primary artificial chordea tendinea (60). The one or more loops (66) are configured to facilitate suturing of the one or more loops (66) to respective portions of a leaflet of an atrioventricular valve of a patient. Other applications are also described.