Mitral Valve Repair Device Subannular Anchoring
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Solution Overview
Problem
Current methods for percutaneous mitral valve repair face challenges due to the mitral valve's irregular shape, lack of radial support, and the need for invasive surgical procedures, which result in limited durability and effectiveness in treating mitral valve regurgitation.
Innovation Solution
A prosthetic heart valve repair device with a support structure that can be implanted in a subannular position, expanding to engage the interior surface of the heart wall and the leaflet, thereby repositioning the mitral valve leaflets to improve coaptation and reduce regurgitation, while being designed for minimally invasive delivery and anchoring.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional surgical approaches (open thoracotomy) are used for mitral valve repair, then durability and effectiveness are improved, but patient trauma and recovery time increase significantly
Solution Approach 1:
The device is divided into separate components: a support structure with anchors that can be independently positioned on the ventricular side, and a leaflet repositioning mechanism. This segmentation allows percutaneous delivery of individual components that work together to achieve durable repair without open surgery
Solution Approach 2:
The support structure is designed to be nested within the mitral valve annulus, with anchors embedded in the ventricular wall and the main body positioned within the valve plane. This nested configuration enables minimally invasive implantation while maintaining structural integrity for long-term durability
2Object-affected harmful factors
If percutaneous approaches are used for mitral valve repair, then patient trauma is reduced, but anchoring stability and long-term durability worsen
Solution Approach 1:
The anchors are designed with specific local properties - barbed or hooked structures that engage the ventricular wall tissue mechanically. This localized mechanical engagement provides strong anchoring stability at the implantation site while maintaining overall percutaneous approach benefits
Solution Approach 2:
The support structure incorporates curved or saddle-shaped elements that conform to the three-dimensional geometry of the mitral valve annulus. This curved design enhances stability by distributing forces across the annular tissue, preventing displacement while allowing percutaneous delivery
3Reliability
If the mitral valve annulus is cinched using traditional methods, then leaflet coaptation is improved, but the irregular shape and lack of radial support make device placement difficult
Solution Approach 1:
The support structure is designed with asymmetric geometry that specifically addresses the D-shaped or kidney-like shape of the mitral valve annulus. The device incorporates varying curvature radii and anchor distribution patterns that match the asymmetric anatomy, simplifying placement while achieving effective coaptation
Solution Approach 2:
The device transitions from a two-dimensional flat structure to a three-dimensional configured support that engages the ventricular wall in the radial dimension. This three-dimensional anchoring overcomes the lack of radial support in the mitral annulus by providing external radial force to maintain coaptation
4Reliability
If prosthetic mechanical valves are implanted, then valve function is restored, but lifetime anticoagulation therapy and stroke risk increase
Solution Approach 1:
The device uses the patient's own native valve leaflets and surrounding cardiac structures to perform the valve function. By repositioning and supporting the native leaflets rather than replacing them with foreign material, the heart's own physiology handles valve operation without requiring mechanical components that would trigger anticoagulation requirements
Data Source
Figure 1A~1B
Figure 2~3
Figure 4~5
AI summary
A repair device (101) for repairing a native mitral valve having an anterior leaflet and a posterior leaflet between a left atrium and a left ventricle comprises a support (110) having a contracted configuration and an extended configuration, and an appendage (135), such as a flap or apron extending from the support. In the contracted configuration, the support is sized to be inserted under the posterior leaflet between a wall of the left ventricle and chordae tendineae. In the extended configuration, the support is configured to project anteriorly with respect to a posterior wall of the left ventricle by a distance sufficient to position at least a portion of the posterior leaflet toward the anterior leaflet, and the appendage is configured to extend beyond an edge of the posterior leaflet toward the anterior leaflet.