LAA Stasis Reduction via Apex Sealing and Flow Diversion
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Solution Overview
Problem
The left atrial appendage (LAA) is a site of stagnant blood flow and thrombus formation, particularly in patients with atrial fibrillation, where existing occlusion devices pose risks of rupture, pericardial effusion, and thrombogenicity, and current methods fail to maintain normal blood flow while preventing thrombosis.
Innovation Solution
The development of devices and methods that either increase blood flow through the LAA using shunts and flow diverters or reduce flow by sealing the LAA ostium, including shunts between the pulmonary artery, left ventricle, coronary sinus, and coronary artery, and external implants that act as pumps or stents to enhance flow, as well as closure devices using cinches and helical loops to occlude the LAA.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If occlusion devices are implanted to close the LAA, then thrombus formation is prevented, but the risk of rupture and pericardial effusion increases
Solution Approach 1:
The patent extracts the problematic occlusion device from the LAA ostium and relocates it to the LAA apex, where it can provide thrombus prevention without compromising the ostium's structural integrity. This separation allows the sealing function to be performed at the apex while maintaining normal flow through the ostium, thereby preventing the harmful effects of rupture and pericardial effusion.
Solution Approach 2:
Instead of placing the occlusion device at the conventional ostial location, the patent inverts the approach by positioning the sealing mechanism at the LAA apex. This reversal of the traditional implant location allows the device to achieve thrombus prevention through a different mechanism that does not compromise the ostium's structural integrity.
2Reliability
If occlusion devices are implanted to close the LAA, then thrombus formation is prevented, but thrombogenicity and inflammation increase
Solution Approach 1:
The patent removes the occlusion device from the ostial region where it would otherwise create thrombogenic surfaces and inflammatory responses. By relocating the sealing function to the LAA apex, the device eliminates the large prosthetic surface area at the ostium that causes thrombogenicity and inflammation, while still providing effective thrombus prevention.
3Reliability
If the LAA is occluded to prevent thrombus, then blood flow through the LAA is reduced, but the compliance chamber function is lost
Solution Approach 1:
The patent extracts the sealing function from the LAA ostium and relocates it to the LAA apex, thereby preserving normal blood flow through the ostium and the LAA's compliance chamber function. The device at the apex provides thrombus prevention without interfering with the LAA's physiological role in regulating left atrial blood pressure.
Solution Approach 2:
Instead of occluding the LAA ostium to prevent thrombus, the patent inverts the approach by placing the sealing mechanism at the apex, allowing the LAA to maintain its compliance function while still preventing thrombus formation through the apex-sealed design.
4Reliability
If percutaneous ablation is performed on the LAA, then thrombus risk is reduced, but complete ablation is difficult to achieve
Solution Approach 1:
The patent extracts the thrombus prevention function from complex percutaneous ablation procedures and replaces it with a simpler mechanical sealing solution at the LAA apex. This approach achieves reliable thrombus prevention through a device that can be securely positioned and sealed at the apex, eliminating the need for complex ablation while achieving complete and durable results.
Data Source
AI summary
Methods and devices that prevent stasis in the LAA by either increasing the flow through the LAA or by closing off or sealing the LAA. Increasing the flow is accomplished through shunts, flow diverters, agitators, or by increasing the size of the ostium. Closing off the LAA is accomplished using seals or by cinching the LAA.