Self-Expanding ECMO Extension Cannula for Aortic Blood Delivery
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Solution Overview
Problem
Existing VA-ECMO systems cause complications such as kidney injury, stroke, and vascular injury due to high blood flow rates and pressure, requiring additional vascular access for interventions, which increases mortality and morbidity.
Innovation Solution
A self-expanding extension cannula system that delivers oxygenated blood directly to the thoracic aorta, enhancing blood flow to the brain and reducing pressure on kidneys, while allowing for a single access point for additional interventions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If conventional VA-ECMO uses large-bore cannulas placed in femoral artery/vein to deliver high flow rates, then circulatory and gas exchange support is provided, but kidney injury, stroke, and vascular injury occur due to increased arterial pressure and non-pulsatile flow
Solution Approach 1:
The extension cannula divides the blood flow delivery into multiple outlets positioned at different locations along the cannula length, distributing flow to multiple arterial beds rather than concentrating it at a single site, thereby reducing pressure spikes in individual organs
Solution Approach 2:
The invention transitions from peripheral cannulation (femoral artery) to central cannulation (thoracic aorta) by extending the cannula through the aortic arch, changing the spatial dimension of blood delivery to improve cerebral perfusion while reducing renal pressure
2Productivity
If multiple large-bore cannulas are used to achieve high flow rates, then systemic perfusion is improved, but risk of bleeding, vascular trauma, and acute limb ischemia increases
Solution Approach 1:
Multiple flow delivery functions are merged into a single extended cannula structure with multiple outlets, eliminating the need for separate cannulas in different vascular beds and reducing the total number of vascular access sites
Solution Approach 2:
The extension cannula serves multiple functions simultaneously: delivering blood to cerebral arteries, abdominal arteries, and other distal arterial beds through its extended structure with multiple outlets, replacing what would traditionally require multiple specialized cannulas
3Productivity
If peripherally cannulated VA-ECMO delivers blood through femoral artery, then oxygenated blood is provided to arterial system, but aortic pressure increases causing fluid in lungs and acute lung injury
Solution Approach 1:
The cannula is extended through the aortic arch to deliver blood directly to the thoracic aorta and cerebral arteries, changing the delivery dimension from peripheral to central, which reduces downstream aortic pressure and prevents pulmonary edema
4Productivity
If conventional VA-ECMO cannulas deliver blood to distal aorta, then flow is provided to lower body, but cerebral oxygenation is compromised and stroke risk increases
Solution Approach 1:
The extension cannula reaches through the aortic arch to position outlets in the thoracic aorta and cerebral arteries, extending the delivery reach to the head and neck region, thereby improving cerebral oxygenation while maintaining distal flow
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
Improves cerebral oxygenation, maintains systemic arterial pulsatility, reduces end-organ injury, and facilitates interventional procedures without additional vascular access, thereby decreasing complications and healthcare costs.
Implementation Method 1
A self-expanding extension cannula system that delivers oxygenated blood directly to the thoracic aorta
Data Source
Figure 1A~2
Figure 3A~3B
Figure 4A~4D
AI summary
An extension cannula and in-line connector for use with a conventional ECMO return cannula is provided. The extension cannula includes a self-expanding conduit transitionable between a collapsed insertion state and an expanded, deployed state via a retractable sheath. The extension cannula may be inserted through a conventional ECMO return cannula such that the proximal end of the self-expanding conduit is disposed within and proximal to the end of the conventional ECMO cannula, while the distal end of the self-expanding conduit is disposed in a patient's thoracic aorta to improve cerebral oxygenation, maintain systemic arterial pulsatility, and reduce the potential for end-organ injury. The extension cannula and/or in-line connector may be used to permit delivery of additional interventional or vascular equipment using a single port of access, thereby avoiding complications associated with contemporary VA-ECMO.