Dynamic Annuloplasty Ring 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 prevent proper coaptation of valve leaflets, resulting in decreased cardiac output and ventricular weakening.
Innovation Solution
An implant structure with a sleeve, closure mechanism, and contracting mechanism is used to repair the dilated mitral valve annulus by anchoring tissue anchors around the valve annulus and adjusting the perimeter of an annuloplasty ring to tighten the valve, utilizing a rotatable structure and contraction-restricting elements to facilitate contraction and expansion.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If the annulus of the mitral valve is dilated, then the valve structure becomes more compliant with the enlarged ventricle, but the valve leaflets cannot fully coapt resulting in mitral regurgitation
Solution Approach 1:
The patent employs a dynamic annuloplasty ring with contracting members that can actively change the perimeter of the valve annulus. The ring transitions from a static support structure to a dynamic system capable of contraction and expansion, allowing the annulus to adapt its size while maintaining optimal geometry for leaflet coaptation. This resolves the contradiction by enabling the annulus to be both adaptable to ventricular enlargement and reliable for preventing regurgitation through active perimeter control.
Solution Approach 2:
The patent changes the physical parameter of the annulus perimeter by introducing contracting members that can actively reduce the circumference of the valve annulus. By modifying the perimeter parameter dynamically, the system maintains proper leaflet coaptation geometry even when the ventricle enlarges, thus resolving the contradiction between adaptability to enlargement and reliability of coaptation.
2Reliability
If a traditional annuloplasty ring is used to reduce the annulus perimeter, then leaflet coaptation is improved, but the device lacks the ability to adjust to ongoing ventricular remodeling
Solution Approach 1:
The patent transforms the static annuloplasty ring into a dynamic system with contracting members that can actively adjust the annulus perimeter. This dynamic capability allows the device to adapt to ongoing ventricular remodeling while maintaining reliable leaflet coaptation, resolving the contradiction between fixed coaptation support and adaptability to remodeling.
Solution Approach 2:
The contracting members are designed to be adjustable by the patient or clinician based on observed ventricular remodeling, allowing the device to self-adjust to changing cardiac conditions. This self-service capability enables the annuloplasty ring to maintain optimal coaptation geometry throughout the patient's recovery and remodeling process.
3Adaptability or versatility
If the annulus is allowed to remain dilated to accommodate ventricular enlargement, then ventricular compliance is maintained, but mitral regurgitation increases due to poor leaflet coaptation
Solution Approach 1:
The patent applies local quality by differentiating between the overall annulus size (which can remain enlarged to accommodate ventricular growth) and the local coaptation geometry (which must be maintained for proper leaflet sealing). The contracting members selectively reduce the perimeter in the region critical for coaptation while allowing the rest of the annulus to remain compliant with ventricular enlargement, thus resolving the contradiction between ventricular compliance and prevention of regurgitation.
Data Source
AI summary
Apparatus and methods are described including an implant structure configured to treat a native atrioventricular valve of a patient, the implant structure including a sleeve having a lumen and at least one end, the at least one end being shaped so as to define an opening. A closure element is disposed in a vicinity of the at least one end, the closure element being configured to facilitate closure of the opening. A contracting mechanism is coupled to the implant structure and configured to contract at least a contraction-facilitated portion of the implant structure. Other applications are also described.