Helical Mitral Valve Anchoring for Transcatheter Implantation
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Solution Overview
Problem
Dilation of the mitral valve annulus leads to incomplete coaptation of valve leaflets, resulting in regurgitation and decreased cardiac output, necessitating a prosthetic valve replacement.
Innovation Solution
A prosthetic valve support system is anchored to the native mitral valve commissures using guide members and expandable anchors, facilitating the deployment of a collapsible prosthetic valve that expands to contact the native leaflets, thereby replacing the native valve.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a prosthetic valve is implanted to replace the native mitral valve, then regurgitation is reduced and cardiac output is improved, but the procedure complexity increases and requires specialized anchoring mechanisms
Solution Approach 1:
The anchoring system is divided into multiple independent components: guide members for positioning, separate anchors for securing, and a prosthetic valve for replacement. This segmentation allows each component to perform its specific function independently, simplifying the overall implantation process while maintaining reliability.
Solution Approach 2:
Guide members are advanced to the native valve commissures before the prosthetic valve is deployed. This preliminary positioning action establishes the correct orientation and location for the prosthetic valve, ensuring proper coaptation without requiring complex real-time adjustment mechanisms during implantation.
2Reliability
If expandable anchors are used to secure the prosthetic valve to native valve commissures, then anchoring reliability is improved, but the device complexity and implantation difficulty increase
Solution Approach 1:
The anchors are nested within the prosthetic valve support structure during delivery. The anchors are advanced through the catheter system in a compressed state, then deployed in sequence as the prosthetic valve is expanded. This nesting approach allows multiple anchoring points to be delivered through a single access point, simplifying the implantation procedure while maintaining anchoring stability.
Solution Approach 2:
The anchors transition from a compressed, deliverable state to an expanded, stable anchoring state. This dynamic transformation allows the anchors to adapt to the native valve tissue, improving anchoring reliability while maintaining ease of delivery through the catheter system.
3Object-affected harmful factors
If a collapsible prosthetic valve support is used for minimally-invasive delivery, then the invasiveness of the procedure is reduced, but the structural complexity of the valve support increases
Solution Approach 1:
The valve support structure transitions from a collapsed, deliverable configuration to an expanded, functional configuration. This dynamic transformation allows the valve support to provide adequate structural support for the prosthetic valve while being delivered through a minimally-invasive catheter approach. The expandable design reduces invasiveness while maintaining necessary structural integrity.
Data Source
AI summary
A method, for use at a mitral valve of a heart of a subject, is provided which includes advancing a transluminal sheath into a femoral vein of the subject, through an inferior vena cava of the subject, into a right atrium of the subject, and transseptally into a left atrium of the subject. A surrounding-sheath is advanced out of a distal end of the transluminal sheath, into the left atrium, and toward a commissure of the mitral valve. An anchor is implanted by advancing the anchor out of the surrounding-sheath into a left ventricle of the subject, such that the anchor helically wraps around left ventricular mitral valve tissue. The surrounding-sheath is then extracted from the heart and then, a guide wire is advanced through the transluminal sheath. Other embodiments are also described.