Variable Coronary Sinus Occluder for Gradual Retrograde Revascularization
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Existing occluders and revascularization techniques fail to provide highly sensitive pressure gradient occlusion at target pressures, leading to inadequate retrograde oxygenated blood flow to the myocardium, and do not allow for venous system compensation in cases where a positive pressure gradient does not develop immediately.
Innovation Solution
A variable occluder is implanted in the coronary sinus region proximate the left atrium, configured to gradually increase blood flow restriction over time, allowing the venous system to compensate for increased pressure, and transition between states to enable retrograde oxygenated blood flow.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If a traditional occluder is used to block blood flow in the coronary sinus, then occlusion is achieved, but the occlusion is not sensitive enough to target pressures and does not allow for venous system compensation
Solution Approach 1:
The occluder device transitions from a static structure to a dynamic one that can change its occlusion state in response to pressure gradients. The device includes a pressure-sensitive membrane or diaphragm that automatically adjusts the occlusion level based on the pressure difference between the left atrium and coronary sinus, enabling sensitive pressure gradient detection and response.
Solution Approach 2:
The occluder incorporates a feedback mechanism where the pressure gradient across the coronary sinus is continuously monitored and used to adjust the occlusion level. When the pressure gradient reaches a target threshold, the device automatically modulates the occlusion to maintain venous system compensation, creating a closed-loop control system.
2Speed
If immediate occlusion is applied to achieve retrograde blood flow, then occlusion is achieved quickly, but the venous system cannot compensate for increased pressure
Solution Approach 1:
The occluder device is pre-configured with a pressure-sensitive mechanism that activates gradually as the target pressure gradient is approached. Instead of immediate full occlusion, the device begins with partial occlusion and progressively increases resistance as the pressure gradient develops, allowing the venous system time to compensate before full occlusion is achieved.
Solution Approach 2:
The occlusion process occurs in periodic stages rather than as a single immediate action. The device allows for incremental increases in occlusion resistance over time, with pause periods that enable venous system adaptation and compensation, preventing pressure-related harm while achieving the desired retrograde flow.
3Reliability
If coronary bypass surgery is performed to correct oxygen deficiency, then blood flow is improved, but complications and recovery time increase due to invasiveness
Solution Approach 1:
The occluder device acts as an intermediary mechanism that achieves revascularization without requiring open-heart surgery or grafting procedures. By occluding the coronary sinus to redirect blood flow through collateral vessels, the device provides a minimally invasive alternative to traditional bypass surgery while maintaining therapeutic effectiveness.
Solution Approach 2:
The invention replaces the mechanical complexity of surgical bypass grafting with a simpler, catheter-based occlusion device. Instead of requiring surgical anastomosis of blood vessels, the device uses a percutaneously deliverable occluder that achieves the same therapeutic goal of improving myocardial oxygenation through hemodynamic redirection.
4Reliability
If angioplasty is used to widen narrowed arteries, then blood flow is improved, but the procedure requires delivery of catheter balloon systems and may not be effective for all cases
Solution Approach 1:
Instead of attempting to widen or clear the coronary sinus as in traditional angioplasty, the invention inverts the approach by occluding the coronary sinus to redirect blood flow. This alternative mechanism achieves myocardial revascularization through hemodynamic redirection rather than luminal dilation, simplifying the procedural approach for suitable candidates.
Data Source
AI summary
Devices, systems, and methods for causing retrograde oxygenated blood flow in at least a portion of the venous system of the myocardium are disclosed. Devices and methods include a method for causing retrograde oxygenated blood flow in at least a portion of the venous system of the myocardium, the method comprising: implanting a variable occluder in a coronary sinus region proximate a left atrium, wherein the variable occluder is configured to gradually increase a level of blood flow restriction over a period of days to enable a venous system of the myocardium to compensate for increased pressure caused by the gradual increase in the level of blood flow restriction; and following venous system compensation, shunting oxygenated blood flow into the coronary sinus to cause retrograde flow of oxygenated blood in at least a portion of the venous system of the myocardium to thereby enable revascularization of the myocardium.