Peripheral Left Ventricular Venting Catheter with Local Anticoagulation
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Solution Overview
Problem
During veno-arterial extra-corporeal membrane oxygenation (VA-ECMO) support, the left ventricle experiences reduced blood flow, leading to distention, pulmonary edema, thrombus formation, and increased risk of stroke due to stagnant blood, with conventional venting methods posing a risk of thrombus formation and requiring anticoagulation medications that may have adverse effects.
Innovation Solution
A catheter system with a major lumen for venting the left ventricle and a minor lumen for delivering anticoagulant medication directly into the heart, allowing peripheral insertion and reducing thrombus formation risks by localizing medication delivery and improving cardiac output.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Stress or pressure
If a catheter is inserted into the left heart to vent the left ventricle, then left ventricle distention is reduced, but the risk of thrombus formation increases
Solution Approach 1:
The catheter incorporates a thrombo-resistant coating on specific portions of its surface, particularly at the distal end and intake holes, to create localized thrombus-preventive properties without affecting the overall catheter structure. This allows the catheter to maintain its venting function while reducing thrombus formation risk at critical interfaces with blood flow.
Solution Approach 2:
The patent introduces an intermediary substance (thrombo-resistant coating material) between the catheter surface and the blood to prevent direct interaction that would otherwise promote thrombus formation. This coating acts as a mediator that allows the catheter to perform its venting function without directly causing thrombus formation.
2Object-affected harmful factors
If anticoagulation medications are administered intravenously, then thrombus formation is reduced, but systemic anticoagulant effects and adverse events increase
Solution Approach 1:
The catheter includes a dedicated lumen for localized delivery of anticoagulation medications directly into the left ventricle, creating a concentrated anticoagulant environment only where needed. This local delivery system allows for effective thrombus prevention in the left heart while minimizing systemic exposure and associated adverse events.
Solution Approach 2:
The catheter is divided into multiple functional lumens, with one specifically dedicated to medication delivery. This segmentation allows independent control of drug delivery to the left ventricle, enabling precise local anticoagulation without requiring high systemic doses that would cause adverse effects.
3Stress or pressure
If conventional venting catheters are used, then left ventricle distention is reduced, but thrombus formation risk increases due to foreign object presence
Solution Approach 1:
The catheter is constructed as a composite structure combining standard catheter materials with a thrombo-resistant coating layer. This composite design maintains the mechanical properties needed for effective venting while the coating layer provides thrombus-resistant surface properties, resolving the contradiction between foreign object presence and thrombus formation risk.
Data Source
AI summary
A catheter system with two lumens (e.g., a major lumen and a minor lumen) that can be inserted peripherally into the left heart. The major lumen is used for venting, or blood volume removal, and the minor lumen is used to deliver a treatment substance directly to the left heart. In particular, the minor lumen can be used to deliver an anticoagulation medication directly to the left ventricle. The major lumen can be incorporated into an ECMO system.