Heart Wall Line Trimming Tool for Ventricular Remodeling
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Solution Overview
Problem
Ischemic and systolic heart failure lead to ventricular dilation, causing increased tension and stress in the heart wall, which exacerbates mitral valve regurgitation due to changes in the mitral valve annulus and papillary muscle movement, further worsening heart dysfunction.
Innovation Solution
An implantable device is positioned within the heart to remodel heart walls, utilizing a trimming tool with an actuator, outer shaft, movable inner shaft, compressible member, and cutter to trim lines, and a handle with a two-stage trigger for manipulating the tool to improve heart function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Volume of moving object
If the left ventricle undergoes dilation to accommodate heart failure conditions, then the ventricular chamber volume increases, but the wall stress and tension increase, exacerbating the condition
Solution Approach 1:
The heart wall remodeling device segments the continuous heart wall into discrete anchor points by inserting multiple anchors at different locations. This segmentation allows localized remodeling of specific wall segments without affecting the entire heart structure, reducing overall wall stress while maintaining necessary chamber volume
Solution Approach 2:
The device performs preliminary action by pre-positioning anchors and lines before actual remodeling occurs. The anchors are inserted and lines are tensioned in advance to prepare the heart wall for controlled remodeling, allowing the chamber to maintain adequate volume while preventing excessive wall stress development
2Area of stationary object
If the mitral valve annulus size increases due to ventricular dilation, then the valve ring becomes larger, but valve coaptation area decreases, worsening regurgitation
Solution Approach 1:
The device applies local quality by targeting specific regions of the mitral valve annulus for remodeling rather than uniformly treating the entire annulus. Anchors are strategically positioned to remodel only the portions of the annulus that are contributing to poor coaptation, preserving necessary annulus area while improving valve sealing
Solution Approach 2:
The device introduces dynamics by using tensionable lines that can be adjusted after anchor insertion. The lines allow dynamic remodeling of the annulus geometry, enabling the valve structure to adapt and improve coaptation while maintaining adequate annulus area for proper valve function
3Shape
If papillary muscles move radially outward and downward during ventricular dilation, then the muscle position changes, but chordae lengths remain constant, compromising leaflet closure
Solution Approach 1:
The device applies asymmetry by positioning anchors and lines in asymmetric patterns that specifically address the asymmetric movement of papillary muscles during dilation. The non-uniform distribution of anchors compensates for the asymmetric displacement of papillary muscles, maintaining proper chordae tension and leaflet closure despite positional changes
Data Source
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AI summary
Several heart wall remodeling devices and methods are disclosed. One heart wall remodeling device includes a trimming tool for trimming a line within a patient. The trimming tool includes an actuator for manipulation by a user, a moveable inner shaft coupled to the actuator, and an outer sleeve coupled to the inner shaft. The outer shaft includes a backstop disposed along an inner wall of the outer sleeve and a channel disposed between a first end and a second end of the outer sleeve. The inner shaft includes an inner shaft, a compressible member, and a cutter.