Expandable ECMO Extension Cannula for Pulsatile Aortic Perfusion

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Solution Overview

Problem

Current venous-arterial extracorporeal membrane oxygenation (VA-ECMO) systems cause complications such as kidney injury, stroke, and increased mortality due to high arterial pressure and non-pulsatile blood flow, with existing solutions either invasive or limited by small lumen diameters and vascular access challenges.

Innovation Solution

A kit and method using an extension cannula with a flexible conduit that transitions from a collapsed to an expanded state within the patient's vasculature, allowing direct delivery of oxygenated blood to the thoracic aorta, maintaining systemic arterial pulsatility, and reducing the risk of perfusion injury, while providing enhanced blood flow to the brain and kidneys.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Reliability

If conventional VA-ECMO systems are used to provide circulatory support, then oxygenated blood delivery is achieved, but high arterial pressure and non-pulsatile flow cause kidney injury, stroke, and increased mortality

Engineering Contradiction:

Improvepatient survival rateVSAvoidperfusion injury to kidneys and brain

Core Design Contradiction:

ReliabilityVSObject-affected harmful factors

Solution Approach 1:

The aorta is segmented into different zones for targeted blood flow delivery. The extension cannula divides the single oxygenated blood stream into multiple delivery paths: one portion flows directly into the thoracic aorta above the renal arteries to supply the brain and upper body, while another portion flows into the abdominal aorta below the renal arteries to supply the lower body, mimicking natural pulsatile flow distribution and reducing pressure damage to renal vessels

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The extension cannula acts as an intermediary device between the ECMO pump and the aortic system. It includes a flexible conduit with expandable support structures that mediate the transition from non-pulsatile pump flow to pulsatile-like flow patterns in the aorta, and it provides a pathway for natural pulsatile flow from the heart to continue reaching the abdominal aorta and lower body

Inventive Principle:

Principle #24Intermediary (Mediator)

2Productivity

If large-bore cannulas are used to achieve high flow rates for systemic perfusion, then adequate oxygen delivery is maintained, but the risk of bleeding, vascular trauma, and acute limb ischemia increases

Engineering Contradiction:

Improveblood flow rateVSAvoidvascular trauma and bleeding risk

Core Design Contradiction:

ProductivityVSObject-affected harmful factors

Solution Approach 1:

The single large-bore cannula is functionally segmented into two smaller effective lumens within the extension cannula: one lumen delivers blood to the thoracic aorta and another lumen delivers blood to the abdominal aorta. This segmentation allows adequate total flow rates to be maintained while each individual lumen has a smaller diameter, reducing vascular trauma and bleeding risk at the access site

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The problem is solved by adding a spatial dimension to the flow delivery system. Instead of using a single large-diameter cannula inserting deeply into the aorta, the extension cannula creates a distributed delivery system with multiple exit points along the aortic length, effectively transforming a one-point high-trauma insertion into multiple lower-trauma delivery points

Inventive Principle:

Principle #17Another dimension (Dimensionality change)

3Power

If peripherally cannulated VA-ECMO is used to support heart failure, then circulatory support is provided, but the entire aorta is pressurized increasing ventricular wall stress and myocardial oxygen consumption

Engineering Contradiction:

Improvecirculatory support capabilityVSAvoidventricular wall stress

Core Design Contradiction:

PowerVSStress or pressure

Solution Approach 1:

Circulatory support is applied locally rather than globally. The extension cannula delivers oxygenated blood directly to specific segments of the aorta (thoracic and abdominal portions) rather than pressurizing the entire aortic system from the periphery. This localized delivery reduces the pressure load on the ventricles while maintaining adequate perfusion to vital organs

Inventive Principle:

Principle #3Local quality

Solution Approach 2:

Instead of allowing the ECMO pump to pressurize the entire aortic system from the femoral artery (conventional approach), the invention inverts the approach by delivering blood directly into the aorta at multiple levels, allowing natural cardiac pulsation to distribute blood forward while the ECMO provides supplemental oxygenated flow, thereby reducing ventricular workload

Inventive Principle:

Principle #13The other way round (Inversion)

Data Source

PatentUS12186469B2Expandable ECMO extension cannula system

Publication Date: 2025.01.07 TUFTS MEDICAL CENTER INC

AI summary

An extension cannula for use with a conventional ECMO return cannula is provided. The extension cannula includes a flexible conduit transitionable between a collapsed insertion state and an expanded deployed state when in communication with blood flow from an ECMO machine via the ECMO return cannula. The extension cannula may be positioned through a conventional ECMO return cannula such that the proximal end of the flexible conduit is disposed within and proximal to the end of the ECMO return cannula, while the distal end of the flexible conduit is disposed in a patient's thoracic aorta to deliver oxygenated blood directly to the patient's thoracic aorta via one or more pores at the distal region of the flexible conduit to improve cerebral oxygenation, maintain systemic arterial pulsatility, and reduce the potential for end-organ injury.