Fluoroscopic Prosthetic Valve Positioning at the Aortic Annulus
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Solution Overview
Problem
Existing prosthetic heart valves implanted via percutaneous catheterization face challenges in achieving precise and accurate placement at the orthotopic position, which is crucial for optimal performance and minimization of complications such as protrusion into the left ventricle, interference with cardiac conduction muscles, and obstruction of coronary ostia.
Innovation Solution
A prosthetic valve with a flexible support frame that exhibits alternating light and dark bands under fluoroscopy, allowing for precise positioning using the aortic annular plane as a reference, ensuring minimal protrusion and optimal alignment with the native aortic valve.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If a prosthetic valve is implanted via percutaneous catheterization, then the invasiveness of the procedure is reduced, but the precision and accuracy of placement at the orthotopic position deteriorates
Solution Approach 1:
The support frame is designed with alternating radiopaque and radiolucent bands that create a visible fluoroscopic pattern. This pattern allows the operator to visually identify the alignment between the aortic annular plane and the support frame bands, enabling precise positioning at the orthotopic location during percutaneous implantation without requiring open surgery.
2Reliability
If the prosthetic valve is positioned deeper to ensure secure fixation, then the fixation stability is improved, but the protrusion into the left ventricle increases causing interference with cardiac conduction muscles
Solution Approach 1:
The support frame is divided into multiple segments with alternating radiopaque and radiolucent bands. This segmentation allows for precise visual alignment during implantation, enabling the operator to position the frame exactly at the orthotopic location where the aortic annular plane aligns with specific bands, thereby achieving secure fixation without excessive protrusion into the left ventricle.
3Strength
If the support frame is made more rigid to maintain structural integrity, then the structural strength is improved, but the ability to reduce profile for catheter delivery deteriorates
Solution Approach 1:
The support frame is designed with a dynamic structure that allows it to be compressed to a low profile for catheter delivery and then expand to its full structural strength upon deployment. The alternating radiopaque and radiolucent bands maintain their structural function while enabling visual guidance during the dynamic transition from compressed to expanded state.
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
Enables accurate implantation at the orthotopic position, reducing protrusion into the left ventricle, minimizing interference with cardiac conduction muscles, and avoiding obstruction of coronary ostia, thereby enhancing the prosthetic valve's functionality and safety.
Implementation Method 1
A prosthetic valve with fluoroscopic properties for implantation in a human stenosed aortic orifice by locating it precisely at the orthotopic position using aortic annular plane as reference
Data Source
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AI summary
A prosthetic valve with fluoroscopic properties for precise placement of the prosthetic valve in a human stenosed aortic orifice is disclosed. The prosthetic valve comprises a support frame having a distal and a proximal end, and three adjacently placed rows of hexagonal cells (namely an upper, middle and a lower row). The upper row occupies 50-55% of total length of the support frame. The support frame of the prosthetic valve under fluoroscopy comprises a plurality of light bands and dark bands alternating with each other along the length of the support frame. Further, a second dark band from the distal end of the support frame is bisected by aortic annular plane on placement in orthotopic position of a human stenosed aortic orifice. The prosthetic valve offers advantages such as minimal protrusion in left ventricle and minimal obstruction of prosthetic valve to ostia of coronary arteries.