Adjustable Support Pad for Beating Heart Chordae Tensioning
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Solution Overview
Problem
Current methods for repairing and replacing chordae tendineae in heart valves are complicated due to difficulties in accessing the surgical site, identifying dysfunctional chordae, and determining the proper length, especially since adjustments often need to be made on a beating heart while the final test is performed with the heart in a different state.
Innovation Solution
An adjustable support pad system with rotatable spool-like structures and locking mechanisms allows for the secure attachment and adjustment of tensioning elements, enabling surgeons to adjust chordae lengths on a beating heart, providing real-time monitoring and effective tensioning without retying sutures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If chordae tendineae replacement is performed on a beating heart, then real-time adjustment and monitoring are enabled, but the complexity of identifying and adjusting the proper length increases
Solution Approach 1:
A tensioning element is introduced as an intermediary component between the chordae tendineae and the adjustment mechanism. This tensioning element can be adjusted independently, allowing real-time modification of chordae length without directly manipulating the complex heart valve structure, thereby simplifying the adjustment process while enabling real-time monitoring on a beating heart
Solution Approach 2:
The system transitions from static chordae replacement to dynamic adjustment capability. The tensioning element can be continuously adjusted during the cardiac cycle, allowing the surgeon to optimize chordae length in real-time based on monitoring feedback, transforming a one-time adjustment procedure into a dynamic, real-time process
2Reliability
If tensioning elements are applied to reduce wall tension in dilated ventricles, then heart function is improved, but determining the proper tension becomes difficult
Solution Approach 1:
Real-time monitoring capabilities provide feedback on heart function and wall tension during the adjustment process. This feedback loop allows the surgeon to observe the effect of tensioning element adjustment on cardiac performance and modify the tension accordingly, making it easier to determine the optimal tension level that improves heart function without causing excessive stress
3Reliability
If chordae tendineae are made shorter during replacement, then valve closure is improved, but the risk of over-tensioning and damage increases
Solution Approach 1:
The tensioning element allows dynamic adjustment of chordae length during the procedure. The surgeon can gradually shorten the effective chordae length and observe the valve closure in real-time, stopping adjustment at the optimal point before over-tensioning occurs, thereby reducing the risk of damage while ensuring proper valve closure
Solution Approach 2:
The adjustable tensioning element acts as a cushioning mechanism that allows controlled, gradual shortening of the chordae. The system provides a safety margin by enabling incremental adjustment rather than single-step modification, allowing the surgeon to compensate for measurement errors or tissue variability and avoid excessive tension that could cause damage
Data Source
AI summary
An adjustable support pad for adjustably holding a tensioning line used to apply tension to a body organ. The adjustable support pad can include a locking mechanism for preventing slidable movement of the tensioning element in one or both directions. The locking mechanism may include spring-loaded locks, rotatable cam-like structures, and/or rotatable spool structures. The adjustable support pad may be formed from rigid, semi-rigid, and/or flexible materials, and may be formed to conform to the outer surface of a body organ. The adjustable support pad can be configured to adjustably hold one or more separate tensioning lines, and to provide for independent adjustment of one or more tensioning lines or groups thereof.