Heart Valve Chordae Replacement Apparatus
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Solution Overview
Problem
Current methods for repairing heart valves, such as the thorascopic heart valve repair method, are invasive and require external equipment, and there is a need for a more efficient and less invasive approach to attach artificial chordae to heart valve leaflets without stopping the heart.
Innovation Solution
A hand-held apparatus with an elongated shaft and movable jaw surfaces for clamping tissue, along with a leaflet stabilization structure like a resiliently expandable wire mesh or inflatable balloon, is used to attach a tether between a heart valve leaflet and the ventricle wall, reducing blood leakage and allowing for adjustable tether length during the procedure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If a thorascopic heart valve repair method is used to attach artificial chordae, then the valve repair can be performed on a beating heart with less invasive access, but external equipment is required and the procedure complexity increases
Solution Approach 1:
The patent combines multiple functions (leaflet stabilization, tissue clamping, tether attachment) into a single integrated apparatus that can be inserted through the apex of the heart. This eliminates the need for external equipment and reduces procedural complexity while maintaining the benefit of performing repair on a beating heart.
Solution Approach 2:
The apparatus employs nested structures where the stabilizing element, jaw surfaces, and tether attachment mechanism are contained within a single insertable shaft. The stabilizing element can be deployed from within the shaft, similar to nested dolls, allowing compact delivery through minimal access while providing full functionality once deployed.
2Device complexity
If traditional suture methods are used to attach artificial chordae, then the procedure is simpler, but the heart must be stopped and full sternotomy is required
Solution Approach 1:
The procedure is segmented into distinct functional components: a stabilizing element to restrain leaflet movement, jaw surfaces to clamp tissue, and a tether attachment mechanism. This segmentation allows each component to perform its specific function efficiently, enabling minimally invasive repair on a beating heart while maintaining procedural simplicity through modular design.
3Ease of operation
If the leaflet is allowed to move freely during tether attachment, then the procedure is easier, but accurate tether placement and length adjustment become difficult
Solution Approach 1:
The stabilizing element is deployed before tether attachment to counteract and restrain leaflet movement. This preliminary action prevents the leaflet from moving during the tether attachment process, ensuring accurate placement and length adjustment while keeping the procedure straightforward for the operator.
4Ease of operation
If an insertable apparatus with stabilizing structure is used, then minimally invasive repair on beating heart is enabled, but blood leakage through the access aperture occurs
Solution Approach 1:
The apparatus employs a sealing structure as an intermediary element between the insertable shaft and the heart wall at the access aperture. This sealing structure prevents blood leakage through the aperture while allowing the shaft to remain in place for tether attachment, thus maintaining minimally invasive benefits without the harmful effect of blood loss.
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 apparatus enables minimally invasive attachment of artificial chordae to heart valve leaflets, improving valve performance by reducing prolapsing and enhancing coaptation, while allowing for real-time adjustment of tether length during the procedure without the need for external equipment or stopping the heart.
Implementation Method 1
The leaflet stabilization structure may include a resiliently expandable wire mesh structure
Implementation Method 2
The leaflet stabilization structure may include an inflatable balloon
Data Source
AI summary
Apparatus for attaching a prosthetic tether between a leaflet of a patient's heart valve and another portion of the patient's heart to help prevent prolapse of the leaflet and/or to otherwise improve leaflet function. The apparatus can be used with relatively low invasiveness of the patient's body. The apparatus releasably clamps the leaflet during attachment of the tether to the leaflet. The apparatus may include an integrated display for indicating how extensively the leaflet is being clamped, as well as structure for stabilizing the leaflet for better clamping. The apparatus may enter the heart through an aperture in the wall of the heart, and may include structure for helping to reduce blood leakage from that aperture. The apparatus may be able to enter the heart by following a guide wire. The apparatus may include various means for attaching the tether to the leaflet.