Locking Suture Delivery for Beating-Heart Mitral Valve Repair
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Solution Overview
Problem
Conventional cardiac valve surgeries, particularly mitral valve repairs, are invasive, require cardiac arrest, and are technically challenging, posing significant risks and complications.
Innovation Solution
A locking suture delivery and deployment device that allows for minimally invasive, beating-heart cardiac valve repairs by remotely securing two or more sutures together using a locking suture to approximate targeted tissues, such as mitral valve leaflets, without the need for additional foreign objects within the heart.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If conventional open-heart surgery is performed for mitral valve repair, then complete access to the heart and valve is achieved, but the procedure becomes highly invasive requiring cardiac arrest and prolonged recovery
Solution Approach 1:
A delivery device acts as an intermediary to deliver the locking suture to the target site within the heart. The device includes a delivery catheter that can be advanced through blood vessels to position the locking suture at the mitral valve, eliminating the need for open surgical access while maintaining the ability to perform the repair function
Solution Approach 2:
The patent replaces the mechanical open-surgery approach with a minimally invasive delivery system that uses a delivery catheter and locking suture mechanism. This substitution allows the repair to be performed through small incisions or even percutaneously, replacing the need for sternotomy and cardiopulmonary bypass with a less invasive mechanical system
2Reliability
If conventional surgical methods are used to secure sutures during mitral valve repair, then reliable tissue approximation is achieved, but the procedure becomes technically challenging and labor-intensive
Solution Approach 1:
The locking suture is pre-formed with a specific configuration including a locking mechanism and delivery configuration before being inserted into the patient's body. This preliminary preparation allows the suture to be easily deployed and locked into position at the target site, simplifying the surgical procedure while ensuring reliable tissue approximation without requiring complex intraoperative manipulation
Solution Approach 2:
The locking suture incorporates a self-locking mechanism that automatically secures the suture in place once deployed. The suture design includes features that allow it to lock onto itself or onto the tissue without requiring additional surgical instruments or complex tying procedures, thereby reducing technical complexity while maintaining reliable fixation
3Reliability
If additional foreign objects or devices are introduced into the heart during valve repair, then secure suture fixation is achieved, but the risk of complications and interference with heart function increases
Solution Approach 1:
The locking mechanism is integrated directly into the suture itself rather than requiring a separate fixation device to be introduced into the heart. The suture contains the locking functionality as an inherent feature, allowing the suture to secure itself without needing additional foreign objects that could complicate the procedure or interfere with heart function
Solution Approach 2:
The patent combines the suture and locking mechanism into a single integrated component. The locking suture merges the function of tissue approximation with the function of secure fixation in one element, eliminating the need for separate devices and reducing the number of foreign objects introduced into the heart while maintaining reliable suture fixation
Data Source
Figure 1
Figure 2A~2C
Figure 2D
AI summary
Described herein are methods and apparatus for approximating targeted tissue using locking sutures. The locking sutures can be configured to receive suture ends that are interweaved through portions of the locking sutures. In a pre-deployment configuration, a locking suture can slide along suture tails and can be positioned at a target location within a target region. Once a desired position and/or tension is achieved, the locking suture can be transitioned to a post- deployment configuration where the locking suture constricts around the suture tails to inhibit relative movement between the suture tails and the locking suture.