Infra-annular Support for Mitral Valve Regurgitation Repair
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Solution Overview
Problem
Current surgical methods for treating mitral regurgitation, such as annuloplasty, often lead to recurrence due to left ventricle dilation and remodeling, resulting in continued valve leaflet tethering and regurgitation.
Innovation Solution
An apparatus comprising a substantially annular support member and infra-annular support members that provide sub-valvular leaflet support, allowing for simultaneous annular and sub-annular cardiac remodeling to normalize leaflet coaptation and prevent regurgitation, without the need for leaflet resection or annulus plication.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional annuloplasty is used to treat mitral regurgitation, then valve leaflet coaptation is improved, but recurrence of regurgitation occurs due to left ventricle dilation and remodeling
Solution Approach 1:
The invention extends support from the traditional annular plane to include infra-annular portions that reach into the ventricular cavity, adding a third spatial dimension to the support structure. This allows the support members to counteract ventricular dilation and leaflet tethering by providing support both at the annular level and within the ventricular space, thereby addressing the root cause of recurrence.
Solution Approach 2:
The infra-annular support members are positioned to prevent ventricular remodeling before it can cause recurrent regurgitation. By extending into the ventricular cavity and providing early structural support, the device proactively counteracts the dilatory forces that would otherwise lead to leaflet tethering and repair failure over time.
2Reliability
If complete annular support is provided to reduce regurgitation, then valve function is improved, but subvalvular structures may be compromised
Solution Approach 1:
The support members have varying cross-sectional shapes along their length, with the infra-annular portions featuring concave inner surfaces that locally adapt to specific subvalvular structures. This localized geometric customization allows the device to provide support where needed while accommodating and protecting chordae tendineae and papillary muscles in different regions of the ventricle.
Data Source
Figure 1A~1B
Figure 1C~1D
Figure 1E
AI summary
An apparatus (10) is provided for treating regurgitation of blood flow through a diseased heart valve. The diseased heart valve includes an annulus, anterior and posterior valve leaflets, and a subvalvular apparatus. The apparatus includes a substantially annular support member (40) and at least one infra - annular support member (42) securely connected thereto. The substantially annular support member has at least a first intermediate portion, a second intermediate portion, and a posterior end portion extending between the first and second intermediate portions. The posterior end portion is dimensioned for attachment to a posterior portion of the annulus of the diseased heart valve. The at least one infra - annular support member is securely connected to the substantially annular support member at a first location. The at least one infra - annular support member is dimensioned to extend below at least one of the posterior and anterior valve leaflets and across or behind at least one subvalvular structure.