Transcatheter Mitral Annuloplasty Segmented Delivery
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Solution Overview
Problem
Current methods for percutaneous repair of the mitral valve are inadequate in addressing mitral regurgitation caused by dilatation of the mitral valve annulus, leading to inefficient valve closure and subsequent cardiac complications.
Innovation Solution
A system and method for transcatheterally advancing an annuloplasty structure, such as an elongate segment of an annuloplasty ring, to the mitral valve annulus, using a steerable catheter and guide members for precise positioning, and anchoring it with helical or suture-based anchors to restore the normal configuration of the valve leaflets.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If percutaneous repair methods are used for mitral valve, then minimally invasive approach is achieved, but inadequate repair of annulus dilatation occurs
Solution Approach 1:
The annuloplasty ring is divided into multiple segments that can be delivered separately through catheters and assembled at the implantation site. This segmentation enables percutaneous delivery of a complete annuloplasty structure that can effectively address annulus dilatation while maintaining minimally invasive access.
Solution Approach 2:
The annuloplasty segments are nested within delivery catheters during transport, with each segment contained within its own catheter shaft. This nesting approach allows multiple components to be delivered through a single percutaneous access point while maintaining their individual configurations for proper assembly.
2Device complexity
If annuloplasty ring is delivered in linear configuration, then catheter delivery is simplified, but precise positioning at annulus is difficult
Solution Approach 1:
The annuloplasty segments are designed to transition from a linear configuration during delivery to a circular configuration at the implantation site. This dynamic transformation is achieved through controlled deployment mechanisms that reshape the segments once positioned at the annulus, ensuring both easy delivery and precise final positioning.
Solution Approach 2:
The annuloplasty segments are pre-formed with the geometric characteristics of the final circular configuration, but constrained in a linear state within the catheter. This preliminary preparation allows the segments to be delivered through the catheter in a simplified linear form while maintaining the structural integrity needed for accurate final positioning when deployed.
3Reliability
If traditional surgical repair is used, then complete annuloplasty can be achieved, but invasive surgery is required
Solution Approach 1:
The annuloplasty ring is extracted from the traditional open surgical delivery method and adapted for percutaneous delivery through catheters. This extraction allows the complete annuloplasty function to be achieved through minimally invasive access, eliminating the need for sternotomy or thoracotomy while maintaining the therapeutic effectiveness of complete annular repair.
Data Source
AI summary
Apparatuses, systems, and devices usable for annuloplasty are provided. These can include an annuloplasty system comprising a segment having a lumen therethrough, the segment being positionable in a vicinity of a surface of a heart valve of a heart. The system can include a tube having a distal portion that is movable through the lumen of the segment and a distal end passable through an opening in the segment that is in fluid communication with the lumen. One or more tissue anchors are deliverable through the tube, the tissue anchor(s) being shaped so as to define a tissue coupling element. The distal portion of the tube can be removably positioned within the lumen of the segment, and, while so positioned, to deploy the tissue coupling element from the distal end of the tube in order to penetrate the tissue coupling element into cardiac tissue. Other embodiments are also described.