Transcatheter Aortic Stent-Valve Graft for Precise Ascending Deployment
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Solution Overview
Problem
Existing treatments for thoracic aortic aneurysms and dissections, particularly in the ascending aorta, are invasive and risky, especially for patients with comorbidities, and there is a need for a minimally invasive, safe, and effective method to deliver a cardiac prosthesis.
Innovation Solution
A self-expanding, partially coated transcatheter endoluminal prosthesis with a stent-valve and stent-graft design, featuring distal and proximal locking mechanisms, is delivered using a specialized system that allows deployment on a beating heart, ensuring precise alignment and anchoring in the ascending aorta and aortic valve.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If open heart surgery is performed for ascending aortic aneurysm or dissection, then the aortic valve and ascending aorta can be replaced, but the procedure carries high risks especially in older patients
Solution Approach 1:
The prosthesis is divided into distinct functional segments: a stent-graft portion for anchoring in the ascending aorta, a valve portion for replacing the aortic valve, and an intermediate connecting portion. This segmentation allows each component to be optimized independently and deployed in a controlled sequence, reducing procedural risk compared to traditional open surgery
Solution Approach 2:
The prosthesis components are nested within a delivery catheter system during transport. The stent-graft, valve, and connecting portions are collapsed together inside the catheter, allowing minimally invasive delivery through peripheral vessels. Upon deployment, the components expand in sequence from the nested configuration to their functional shapes
2Reliability
If a minimally invasive transcatheter approach is used, then morbidity and mortality risks are reduced, but precise deployment and anchoring of the prosthesis becomes more challenging
Solution Approach 1:
The prosthesis is pre-assembled as an integrated unit within the delivery catheter, with the stent-graft, valve, and connecting portions already positioned relative to each other. Locking mechanisms are pre-configured to control the sequence of deployment. This preliminary preparation ensures that when the prosthesis is deployed in the patient's body, the components expand in the correct sequence and orientation, achieving precise placement without requiring complex real-time adjustments
Solution Approach 2:
The delivery system incorporates markers and imaging capabilities that provide feedback to the operator during deployment. Radiopaque markers on the prosthesis components allow real-time visualization under fluoroscopy, enabling the operator to monitor the expansion and positioning of each segment. This feedback loop ensures precise deployment and proper anchoring of the stent-graft in the ascending aorta
3Object-affected harmful factors
If the prosthesis is fully coated to reduce thrombosis risk, then thrombogenicity is reduced, but the locking mechanisms cannot function properly
Solution Approach 1:
The prosthesis employs selective coating: the stent-graft portion and valve portion are covered with a thromboresistant coating material to reduce thrombosis risk, while the distal and proximal locking mechanisms remain uncovered. This local differentiation allows the coating to provide its protective function where needed while leaving the locking mechanisms exposed and functional for anchoring the prosthesis in the ascending aorta
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The prosthesis provides a safe and effective minimally invasive treatment for thoracic aortic diseases, reducing morbidity and mortality risks by allowing precise deployment and anchoring without open heart surgery.
Implementation Method 1
A self-expanding, covered at least partially by a coating, endoluminal prosthesis
Data Source
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Figure 5~6
AI summary
The subject of the invention is a self-expanding, covered at least partially by a coating (16), endoluminal prosthesis, comprising: - a stent-valve part (1"), containing a metal frame (10) and an aortic valve (14) secured inside it, - a stent-graft part (1'), containing a metal frame (8, 8'), - an intermediate part (4), joining the stent-valve part (1") with the stent-graft part (1') and having less stiffness than the stent-valve part (1") and the stent-graft part (1'), wherein the stent graft part (1') comprises a tapered section (13) narrowing inwardly towards the intermediate part (4), the tapered section (13) is equipped with at least one branch (5', 5") covered by a coating (16).