Annuloplasty Ring Rotation Tool for Mitral Valve Repair
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Solution Overview
Problem
Ischemic heart disease leads to mitral regurgitation due to papillary muscle dysfunction and left ventricle dilation, causing the mitral valve annulus to dilate and preventing proper coaptation of valve leaflets, resulting in decreased cardiac output and ventricular weakening.
Innovation Solution
An implantable structure with a contracting mechanism, comprising a rotatable structure and a longitudinal member, is used to deploy anchors around the mitral valve annulus, allowing for the placement of a partial annuloplasty ring that can be tightened to reduce annulus circumference and improve valve coaptation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a full annuloplasty ring is implanted around the entire mitral valve annulus, then comprehensive support and coaptation improvement are achieved, but the complexity of the procedure and device increases significantly
Solution Approach 1:
The patent divides the annuloplasty procedure into segments by implanting only a partial annuloplasty ring (e.g., posterior annulus) rather than a complete circumferential ring. This segmentation reduces procedural complexity while maintaining effective valve coaptation by addressing the most critical areas of annular dilation.
2Reliability
If anchors are deployed deep into the ventricular wall to secure the annuloplasty ring, then anchoring reliability is improved, but the risk of ventricular perforation and complications increases
Solution Approach 1:
The patent employs anchors with varying penetration depths and configurations tailored to specific anatomical locations around the annulus. Anchors are designed to engage the fibrous annular tissue and superficial ventricular layer without excessive penetration, providing secure fixation while minimizing perforation risk through location-specific anchor selection.
3Adaptability or versatility
If the annuloplasty ring is made adjustable post-implantation, then adaptability to patient anatomy is improved, but the device complexity and procedural time increase
Solution Approach 1:
The patent incorporates adjustable annuloplasty rings with mechanical adjustment mechanisms that allow post-implantation size modification. The ring includes features such as telescoping segments or adjustable connectors that enable clinicians to fine-tune the ring dimensions after initial deployment, adapting to patient-specific anatomy without requiring complete ring replacement.
4Loss of time
If a minimally invasive catheter-based approach is used for annuloplasty, then patient recovery time is reduced, but the precision of anchor deployment and ring positioning becomes more difficult
Solution Approach 1:
The patent utilizes a catheter-based delivery system with integrated positioning features and imaging guidance capabilities. The catheter acts as an intermediary tool that provides precise control over anchor deployment and ring positioning through minimally invasive access, combining the benefits of reduced patient trauma with improved placement accuracy through advanced catheter design and imaging integration.
Data Source
Figure 1A
Figure 1B
Figure 2~4
AI summary
Apparatus is provided including an implant structure (22, 500), which includes a contracting mechanism (40), which comprises a rotatable structure (46, 810, 936), arranged such that rotation of the rotatable structure (46, 810, 936) contracts the implant structure (22, 500). A longitudinal member (86) is coupled to the contracting mechanism (40). A tool (80) for rotating the rotatable structure (46, 810, 936) is configured to be guided along the longitudinal member (86), to engage the rotatable structure (46, 810, 936), and to rotate the rotatable structure (46, 810, 936) in response to a rotational force applied to the tool (80). Other applications are also described.