LAA Suction Cup Inversion to Avoid Occlusion Implant Complications
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Solution Overview
Problem
Current surgical methods for closing the left atrial appendage in patients with atrial fibrillation involve implanting devices that risk dislodgement, migration, bleeding, and incomplete closure, and require stitching or clipping of heart tissue, posing significant complications.
Innovation Solution
A modified aspiration catheter with a self-expanding suction cup is used to invert the left atrial appendage by creating suction contact with its interior wall, pulling it partially inside out to prevent thrombus formation without implanting closure devices.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a closure device is implanted in the LAA to block the opening, then thrombus formation is prevented, but the risk of dislodgement, migration, bleeding, and incomplete closure increases
Solution Approach 1:
Instead of placing a device inside the LAA to block it from the inside, the invention inverts the LAA pouch outward through the ostium. This inversion transforms the LAA's orientation so that its apex and body are pulled outside the left atrium, effectively blocking the ostium from the outside while eliminating the need for internal closure devices that could dislodge or migrate.
Solution Approach 2:
The invention extracts the LAA pouch from its normal position within the left atrium and relocates it externally through the ostium. By pulling the LAA apex and body outward, the problematic portion containing stagnant blood is removed from the internal cardiac environment where it could cause thrombus formation, while avoiding implantation of foreign devices inside the heart.
2Reliability
If stitching or clipping is used to close the LAA, then closure is achieved, but tissue damage and surgical complexity increase
Solution Approach 1:
The invention replaces the mechanical stitching or clipping system with a suction-based inversion mechanism. Instead of using needles, threads, or clips to mechanically close the ostium, the method uses a suction catheter to create negative pressure that pulls the LAA pouch outside the heart, achieving closure through tissue inversion rather than mechanical fastening.
Solution Approach 2:
The invention employs pneumatic principles by using a suction catheter connected to a vacuum source. The negative pressure generated by the suction system creates the force necessary to invert the LAA pouch through the ostium, replacing the need for surgical stitching or clipping with a non-contact pneumatic mechanism.
3Reliability
If an external closure device is implanted, then LAA blocking is achieved, but the risk of pericardial effusion and infection increases
Solution Approach 1:
The inverted LAA pouch serves its own closure function by physically blocking the ostium from the outside. The inverted tissue itself acts as the barrier, eliminating the need for separate closure devices that would introduce foreign materials into the pericardial space and increase the risk of infection or effusion.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The method achieves effective thrombus prevention in the left atrial appendage by inverting it without stitching or clipping, reducing the risk of complications and maintaining a stable, inverted state without the need for additional closure devices.
Implementation Method 1
A modified aspiration catheter with a self-expanding suction cup is used to invert the left atrial appendage by creating suction contact with its interior wall
Data Source
AI summary
An aspiration catheter and method of use for inverting the left atrial appendage (LAA) of a patient's heart. The aspiration catheter can include a proximal portion for attachment to a negative pressure source, and a distal portion for making suction contact with the interior wall of the LAA. The distal portion is preferably in the form of a self-expanding suction cup adapted to transition between a collapsed state and an expanded state. The proximal and distal portions share a common internal lumen for transmitting externally applied negative pressure therethrough, and the suction contact created by the negative pressure can adhere the suction cup portion of the catheter to the interior LAA wall for pulling or inverting the LAA into the left atrium.