Timed Therapeutic Delivery via Aortic Valve Closure Detection

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Solution Overview

Problem

Conventional methods for delivering therapeutic and diagnostic agents to the heart result in a significant portion of the agent being lost to systemic circulation, necessitating excessive dosing and potential unintended effects on peripheral tissues, due to inefficient delivery during coronary perfusion.

Innovation Solution

A medical device that detects the closure of the aortic valve using sensors and processors to initiate timed delivery of therapeutic and diagnostic agents during diastolic coronary perfusion, ensuring a controlled amount enters the coronary vasculature rather than the systemic circulation.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Loss of substance

If therapeutic and diagnostic agents are delivered to the heart using conventional bolus delivery techniques, then the agents can be administered to the heart, but a significant portion of the agent is lost to systemic circulation, necessitating excessive dosing

Engineering Contradiction:

Improveloss of therapeutic agentVSAvoiddose of therapeutic agent

Core Design Contradiction:

Loss of substanceVSQuantity of substance

Solution Approach 1:

The system performs preliminary action by detecting aortic valve closure before delivering the therapeutic agent. This timing ensures the agent is delivered precisely when coronary perfusion begins, maximizing uptake by the heart and minimizing loss to systemic circulation. The detection and timing mechanism prepares the delivery system in advance of actual agent administration.

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The system employs dynamic timing based on real-time detection of aortic valve closure events. Rather than using fixed or continuous delivery, the system dynamically adjusts delivery timing to coincide with the physiological window of diastolic coronary perfusion, optimizing the balance between heart uptake and systemic circulation loss.

Inventive Principle:

Principle #15Dynamics

2Reliability

If a bolus includes substantially more than a therapeutically effective amount of the therapeutic agent to compensate for loss to systemic circulation, then sufficient agent reaches the heart, but the cost of treatment increases

Engineering Contradiction:

Improvedelivery efficacy to heartVSAvoidtreatment cost

Core Design Contradiction:

ReliabilityVSEase of manufacture

Solution Approach 1:

The system detects aortic valve closure in advance to time the delivery of the therapeutic agent precisely when coronary perfusion begins. This preliminary detection and timing mechanism ensures that the full therapeutically effective amount of agent is delivered to the heart without requiring excessive dosing, thereby maintaining delivery efficacy while reducing treatment cost.

Inventive Principle:

Principle #10Preliminary action

3Loss of substance

If therapeutic and diagnostic agents are delivered to the heart during diastolic coronary perfusion timed to aortic valve closure, then a controlled amount of the agent enters the coronary vasculature, but the system complexity increases due to the need for sensors and processors

Engineering Contradiction:

Improvesystemic circulation lossVSAvoiddelivery system complexity

Core Design Contradiction:

Loss of substanceVSDevice complexity

Solution Approach 1:

The system achieves multi-functionality by integrating detection and delivery capabilities into a single unified system. The same device that detects aortic valve closure also controls the timing of therapeutic agent delivery, eliminating the need for separate monitoring and delivery systems. This reduces overall system complexity while maintaining the ability to time delivery precisely with coronary perfusion.

Inventive Principle:

Principle #6Universality (Multi-functionality)

4Reliability

If the portion of the delivered therapeutic agent lost to systemic circulation is reduced through timed delivery, then treatment efficacy is optimized, but the requirement for precise timing detection increases the difficulty of detecting and measuring

Engineering Contradiction:

Improvetreatment efficacyVSAvoidaortic valve closure detection

Core Design Contradiction:

ReliabilityVSDifficulty of detecting and measuring

Solution Approach 1:

The system uses an intermediary approach by detecting the closure of the aortic valve as a proxy indicator for the beginning of diastolic coronary perfusion. Rather than directly measuring coronary perfusion, the system uses the easily detectable aortic valve closure event as a timing reference, simplifying the detection process while maintaining precise delivery timing for optimized treatment efficacy.

Inventive Principle:

Principle #24Intermediary (Mediator)

Data Source

PatentUS7951129B2Diastolic coronary perfusion detection for timed delivery of therapeutic and/or diagnostic agents

Publication Date: 2011.05.31 MEDTRONIC INC

AI summary

During diastolic coronary perfusion, blood perfuses through the heart via the coronary arteries. Delivery of a therapeutic and/or diagnostic agent to the heart during diastolic coronary perfusion allows the therapeutic and/or diagnostic agent to efficiently perfuse through the heart. A medical device according to the invention detects closure of the aortic valve of a heart, and initiates delivery of a therapeutic and/or diagnostic agent upon detection of aortic valve closure. The medical device detects aortic valve closure by processing a signal. Exemplary signals used by the medical device to detect aortic valve closure include left or right ventricular accelerometer signals, left or right ventricular flow signals, left or right ventricular pressure signals, aortic pressure signals, pulse pressure signals, systemic arterial pressure signals, electrogram signals, and phonocardiogram signals