Curved-Blade Leaflet Resection for Valve-in-Valve Coronary Protection
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Solution Overview
Problem
During a valve-in-valve procedure, the leaflets of a previously implanted transcatheter heart valve can obstruct coronary blood flow by displacing towards the coronary ostia when a second transcatheter valve is deployed, necessitating a method to resect these leaflets to prevent obstruction.
Innovation Solution
A leaflet resection device with pivotably coupled jaws and linkage assemblies, featuring resection blades that move in a curved path to resect at least 50% of the leaflet, allowing for precise removal of leaflet tissue before deploying a second transcatheter valve.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Adaptability or versatility
If a second transcatheter valve is deployed within a previously implanted valve, then valve-in-valve procedure is achieved, but coronary artery obstruction occurs due to leaflet displacement towards coronary ostia
Solution Approach 1:
The leaflet resection device performs preliminary resection of the leaflet tissue before the second valve is deployed. The device navigates to the target valve, resects the leaflet portion that would otherwise obstruct coronary arteries, and only then is the second valve deployed. This preliminary action eliminates the harmful effect of coronary obstruction while preserving the adaptability of valve-in-valve procedures.
2Object-affected harmful factors
If leaflet resection is performed to prevent coronary obstruction, then coronary blood flow is protected, but device complexity increases due to linkage assemblies and pivotable mechanisms
Solution Approach 1:
The linkage assemblies employ dynamic pivotable connections that allow the resection blades to move along a curved path during actuation. The pivot points enable the blades to transition from a delivery configuration (aligned with the longitudinal axis) to a resection configuration (curved outward path), providing the necessary motion flexibility while maintaining a relatively compact device structure.
Solution Approach 2:
The resection device is divided into multiple independent components: first and second jaws, linkage assemblies with multiple arms, pivot points, and resection blades. This segmentation allows each component to perform its specific function independently while contributing to the overall resection capability, managing device complexity through modular design.
3Manufacturing precision
If resection blades move along a curved path to resect leaflet tissue, then precise resection is achieved, but the linkage assembly requires multiple pivot points and arms increasing structural complexity
Solution Approach 1:
The resection blades are designed to move along a curved path rather than a straight line, enabling precise resection of the leaflet tissue following the natural curvature of the valve structure. The curved trajectory is achieved through the arrangement of pivot points and arms in the linkage assembly, allowing the blades to contact and resect the leaflet at multiple points along the curve for precise tissue removal.
Data Source
Figure 1A~1B
Figure 1C
Figure 2A~2B
AI summary
A leaflet resection device includes a first jaw, a second jaw pivotably connected to the first jaw, a first linkage assembly coupled to the first jaw, and a second linkage assembly coupled to the second jaw. The second linkage assembly includes a first resection blade and a second resection blade that are configured to cut a leaflet of a native heart valve or a previously implanted valve prosthesis along a curved path when the first and second linkage assemblies are actuated.