Intermittent SVC Occlusion for Cardiac Preload Relief
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Solution Overview
Problem
Current device-based treatments for heart failure do not effectively reduce left and right ventricular volumes and pressures without causing severe side effects, and existing pharmaceutical approaches fail to address localized cardiac remodeling or reverse the progression of heart failure.
Innovation Solution
A system and method involving intermittent partial occlusion of the superior vena cava (SVC) to regulate venous blood return, reducing ventricular overload and cardiac preload, using a catheter with a flow limiting element controlled by a controller to adjust occlusion based on hemodynamic parameters.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stress or pressure
If device-based treatments occlude the vena cava to reduce ventricular volumes and pressures, then cardiac preload is reduced, but severe side effects occur including systemic hypotension and renal dysfunction
Solution Approach 1:
The invention divides the vena cava occlusion into two separate targets: SVC occlusion for reducing right ventricular preload and IVC occlusion for reducing left ventricular preload. This segmentation allows selective reduction of ventricular volumes without causing systemic hypotension, as each occlusion is targeted and controlled independently rather than causing generalized venous return reduction
Solution Approach 2:
The invention applies local quality by using targeted occlusion at specific anatomical locations (SVC and IVC) to achieve localized hemodynamic effects. The SVC occlusion device is positioned in the superior vena cava to specifically reduce right ventricular filling, while the IVC occlusion device is positioned in the inferior vena cava to reduce left ventricular filling. This localized approach prevents the systemic side effects associated with generalized venous occlusion
2Productivity
If intermittent partial occlusion of SVC is used to reduce ventricular overload, then cardiac output improves, but device complexity increases
Solution Approach 1:
The invention implements periodic action through intermittent occlusion cycles that alternate between occlusion and non-occlusion phases. The occlusion is applied for a predetermined time period to reduce ventricular preload, then released to allow normal venous return. This periodic pattern improves cardiac output by preventing ventricular overload while avoiding the continuous hemodynamic disruption that would cause severe side effects
Solution Approach 2:
The invention incorporates feedback mechanisms where the occlusion duration and intensity are adjusted based on monitored hemodynamic parameters. The system monitors ventricular volumes, pressures, and cardiac output, and automatically adjusts the occlusion parameters to maintain optimal hemodynamic function. This feedback control allows the system to improve cardiac output while adapting to changing patient conditions, reducing the need for complex manual adjustment mechanisms
Data Source
AI summary
Systems and methods are provided for treating conditions such as heart failure and/or pulmonary hypertension by at least partially occluding flow through the superior vena cava for an interval spanning multiple cardiac cycles. A catheter with an occlusion device is provided along with a controller that actuates a drive mechanism to provide at least partial occlusion of the patient's superior vena cava, which reduces cardiac filling pressures, and induces a favorable shift in the patient's Frank-Starling curve towards healthy heart functionality and improved cardiac performance. The system may include sensors to determine the degree of occlusion of the superior vena cava. The occlusion system may be used to reduce volume in a heart and facilitate a cardiac procedure. The occlusion system may be used to relieve an overloaded chamber during and/or after deploying a VAD.