Mitral Valve Annuloplasty Implant with Segmented Contraction
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Solution Overview
Problem
Ischemic heart disease leads to mitral regurgitation due to papillary muscle dysfunction and left ventricle dilation, causing the mitral valve annulus to dilate and preventing proper valve closure, resulting in blood backflow and cardiac output reduction.
Innovation Solution
An implantable structure comprising a flexible sleeve with a contracting assembly that can be longitudinally contracted to tighten the posterior portion of the mitral valve annulus, while preserving the anterior portion, using tissue anchors and a linking member to prevent long-term dilation, and a closure mechanism to secure the sleeve around the annulus.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Shape
If a partial annuloplasty ring is implanted to tighten the mitral valve annulus, then the posterior portion of the annulus is contracted, but the anterior portion may dilate over time
Solution Approach 1:
The annuloplasty ring is divided into a rigid posterior portion and a flexible anterior portion, allowing differential behavior: the rigid part provides immediate structural support and contraction where needed, while the flexible part adapts to anterior annular movements and prevents dilation over time
Solution Approach 2:
The annuloplasty ring transitions from a static structure to a dynamic one by incorporating a flexible anterior portion that can move and adapt, allowing the implant to respond to physiological changes and prevent long-term dilation while maintaining posterior contraction
2Reliability
If the entire annulus is contracted, then the valve closure improves, but the anterior annulus tissue (part of heart skeleton) is damaged
Solution Approach 1:
The annuloplasty ring applies different properties to different regions: a rigid contracting portion for the posterior annulus where contraction is therapeutic, and a flexible non-contracting portion for the anterior annulus where tissue preservation is critical, achieving localized treatment
3Stability of the object's composition
If a rigid annuloplasty ring is used, then the annulus is tightly constrained, but the implant cannot adapt to physiological movements
Solution Approach 1:
The ring is segmented into rigid and flexible portions, allowing the rigid segment to provide stable size control while the flexible segment provides physiological adaptation, combining both functions in a single implant
Data Source
AI summary
An annuloplasty implant is provided for treating a native atrioventricular valve of a patient, the annuloplasty implant including a plurality of tissue anchors, which are configured to anchor the annuloplasty implant around at least a portion of a valve annulus of the native atrioventricular valve. The annuloplasty further includes a contracting assembly, which includes an elongate contracting member; and a contracting mechanism, which is coupled to the elongate contracting member, and which is configured, upon actuation thereof, to apply a longitudinal contracting force to the elongate contracting member that longitudinally contracts at least a portion of the annuloplasty implant, thereby circumferentially tightening the valve annulus. The annuloplasty further includes a force-distributing element, which includes a longitudinally-non-compressible tightly-coiled element, and which is configured to distribute the longitudinal contracting force over at least two of the tissue anchors. Other embodiments are also described.