Catheter Annuloplasty Tensioning for Mitral Annulus Reshaping
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Solution Overview
Problem
Existing methods for treating mitral valve regurgitation, such as annuloplasty procedures, are inadequate in effectively reducing the anteroposterior diameter of the mitral annulus to prevent backflow, particularly due to dilation issues.
Innovation Solution
An annuloplasty system involving a catheter-based deployment of members anchored to the mitral valve annulus, with flexible tensile members to draw the posterior and anterior sides into closer approximation, allowing for adjustable tension to reshape the annulus.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a percutaneous approach is used to deliver an annuloplasty device, then the procedure can be performed with current technology, but the device must traverse the skin and subcutaneous tissue which increases the risk of infection and tissue damage
Solution Approach 1:
The patent introduces an internal iliac artery as an intermediary vascular pathway to deliver the annuloplasty device. Instead of traversing skin and subcutaneous tissue directly, the device is delivered through the internal iliac artery, which serves as a protected conduit within the vascular system, thereby reducing infection risk and tissue damage while maintaining procedural feasibility
2Object-affected harmful factors
If the annuloplasty device is delivered through the internal iliac artery, then tissue damage and infection risk are reduced, but the device must be retrieved and repositioned if not properly positioned
Solution Approach 1:
The patent incorporates imaging guidance systems and positioning sensors that provide real-time feedback on device position within the aortic valve. This feedback mechanism allows the operator to verify proper positioning immediately after delivery, eliminating the need for device retrieval and repositioning operations while maintaining the benefits of arterial delivery
3Reliability
If the annuloplasty device is made larger to ensure proper positioning, then positioning reliability improves, but the risk of vascular damage during delivery increases
Solution Approach 1:
The patent employs expandable annuloplasty devices that are delivered in a compressed state through the internal iliac artery and then expanded to their full size at the aortic valve location. This dynamic size change allows the device to pass through narrow vascular pathways without causing damage while still providing adequate positioning support once deployed
Data Source
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AI summary
An exemplary method of performing an annuloplasty procedure includes introducing a catheter into a left atrium of a heart, deploying a first member from the catheter, anchoring the first member to a posterior side of a mitral valve annulus in the left atrium, deploying a second member from the catheter, anchoring the second member to an anterior side of the mitral valve annulus in the left atrium, deploying a flexible tensile member from the catheter, attaching the tensile member to both the first member and the second member and applying tension to the tensile member to draw the first member and the second member toward one another and bring the posterior side and the anterior side of the mitral valve annulus into closer approximation. Annuloplasty systems and components are also disclosed.