Epicardial LAA Occlusion with Repositionable Expandable Cuff
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Solution Overview
Problem
Conventional left atrial appendage closure devices are difficult to precisely position and lack repositioning and adjustment capabilities, leading to incomplete occlusion of the left atrial appendage, which increases the risk of thrombo-embolic events and other vascular problems.
Innovation Solution
Epicardial implants with a positioning device and expandable cuffs that can be repositioned and adjusted to securely occlude the base of the atrial appendage, allowing for precise placement and complete occlusion, either through open-chest or percutaneous procedures.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If conventional closure devices are used to occlude the left atrial appendage, then the procedure can be performed, but the device cannot be precisely positioned at the LAA base resulting in incomplete occlusion
Solution Approach 1:
The delivery device incorporates a repositioning mechanism that allows the occlusion device to be dynamically adjusted and repositioned after initial placement. This enables the operator to refine the position of the occlusion device at the LAA base, ensuring complete occlusion while maintaining the ability to correct positioning errors.
Solution Approach 2:
The system separates the delivery device from the occlusion device, allowing independent positioning and placement. The delivery device can be positioned first, then the occlusion device is deployed and can be independently adjusted, enabling precise positioning at the LAA base without moving the entire assembly.
2Adaptability or versatility
If conventional closure devices are used, then the procedure can be performed, but the devices lack repositioning capabilities leading to failed complete occlusion
Solution Approach 1:
The occlusion device is designed with dynamic adjustment capabilities through the repositioning mechanism, allowing it to be moved, adjusted, and repositioned multiple times during the procedure. This adaptability ensures that the device can be optimally positioned for complete LAA occlusion regardless of initial placement accuracy.
Solution Approach 2:
The delivery device is positioned and secured at the LAA base before deploying the occlusion device. This preliminary positioning action provides a stable platform from which the occlusion device can be deployed and subsequently repositioned if needed, ensuring both adaptability and reliability.
3Ease of operation
If the surgical closure point is spaced from the base of the LAA, then the procedure can be completed, but incomplete occlusion of the LAA results
Solution Approach 1:
The system replaces traditional mechanical suturing or clipping methods with a deployable occlusion device that can be precisely positioned at the LAA base. The occlusion device is delivered through a catheter-based system that allows navigation to and precise placement at the target site, eliminating the need for spaced closure points and achieving complete occlusion.
Solution Approach 2:
The delivery device acts as an intermediary between the operator and the occlusion device, providing a mechanism to transport, position, and deploy the occlusion device precisely at the LAA base. This intermediary system enables accurate placement that would be difficult to achieve with direct surgical manipulation alone.
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
The epicardial implants enable precise and complete occlusion of the left atrial appendage, reducing the risk of clot formation and embolic events, and can be securely anchored to prevent blood clots from entering the left atrium.
Implementation Method 1
The at least one expandable cuff may be expandable into at least a portion of the open interior of the positioning device following placement of the at least one expandable cuff into the desired position
Implementation Method 2
The at least one expandable cuff may be configured to physically occlude a base of the atrial appendage when expanded
Data Source
AI summary
An epicardial implant having a positioning device that defines an open interior. The positioning device is configured to be detachably coupled with an implant delivery device such that the positioning device may be detached from the implant delivery device after the implant is in place about an atrial appendage. The positioning device has first and second sides with a distal end that couples the first and second sides. The implant includes an expandable cuff coupled with the positioning device. The positioning device is configured to selectively move the expandable cuff toward and away from an atrial appendage to position the expandable cuff in a desired position relative to the atrial appendage. The expandable cuff is expandable into at least a portion of the open interior of the positioning device to physically occlude a base of the atrial appendage following placement of the expandable cuff into the desired position.