Percutaneous ASD Closure Device with Movable Jaws
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Solution Overview
Problem
Current methods for closing atrial septal defects (ASD) either require cardiopulmonary bypass, which has adverse effects, or involve deploying bulky devices that are hindered by defect size and anatomical constraints, and lack effective minimally invasive solutions without radiation exposure.
Innovation Solution
A surgical device and method using a minimally invasive approach via a right minithoracotomy to deploy a pericardial patch under transesophageal echocardiography guidance, featuring a movable head with distal and proximal jaws and suture-guide channels to secure the patch without cardiopulmonary bypass, allowing for all sizes and types of secundum ASD closure.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If conventional surgical method is used for ASD closure, then reliable closure is achieved, but cardiopulmonary bypass is required which causes adverse effects including microemboli generation and inflammatory response
Solution Approach 1:
The surgical procedure is segmented into distinct phases: accessing the pericardial space through minithoracotomy, deploying the patch independently without cardiopulmonary bypass, and using separate suture-passing mechanisms. This segmentation allows reliable closure while avoiding the harmful effects of full cardiopulmonary bypass by isolating the critical closure function from the bypass requirement.
Solution Approach 2:
A pericardial patch serves as an intermediary element to achieve ASD closure. Instead of directly suturing the defect under cardiopulmonary bypass, the patch acts as a mediator that can be deployed through minithoracotomy and secured using suture-passing devices, thereby achieving reliable closure without exposing the patient to cardiopulmonary bypass-related harms.
2Ease of operation
If percutaneous device transcatheter closure is used, then minimally invasive approach is achieved, but deployment is hampered by defect size and circumferential margins adjacent to superior and inferior venae cavae, pulmonary vein, mitral valve, and aortic sinus
Solution Approach 1:
The pericardial patch and suture-passing device system is designed with universal applicability to accommodate various ASD sizes and anatomical configurations. The patch can be customized in size and shape, and the suture-passing mechanism can adapt to different circumferential margins near venae cavae, pulmonary veins, mitral valve, and aortic sinus, providing both minimally invasive access and versatile adaptability.
Solution Approach 2:
The surgical approach employs dynamic adaptability where the patch size, shape, and suture placement can be adjusted in real-time based on the specific anatomical constraints encountered. The minithoracotomy approach allows direct visualization and dynamic adjustment of the closure technique to suit varying defect characteristics and surrounding anatomical structures.
3Measurement precision
If robotically assisted surgical system is used, then precision of minimally invasive cardiac surgery is enhanced, but cardiopulmonary bypass is still required and procedure cost increases
Solution Approach 1:
The invention employs disposable or single-use suture-passing devices and patches that can be deployed through minithoracotomy without requiring expensive robotic systems or cardiopulmonary bypass. These relatively simple, disposable instruments achieve sufficient precision for ASD closure while maintaining the advantage of avoiding cardiopulmonary bypass, offering a cost-effective alternative to robotic assistance.
4Shape
If minimally invasive approach with small incision is used, then cosmetic results are improved, but surgical access and device deployment become more challenging
Solution Approach 1:
The surgical approach transitions from a traditional anterior chest incision to a lateral minithoracotomy incision. This dimensional change in incision placement achieves superior cosmetic results by positioning the scar in a less visible location, while the small incision size is compensated by using flexible, adaptable suture-passing devices that can navigate the limited access space effectively.
Data Source
AI summary
A device for percutaneous transcathetral closure of Atrial Septal Defect by deploying a pericardial patch without ardiopulmonary bypass includes a guide, and a head including a distal jaw and a proximal jaw. The guide includes guide knobs which move guide levers of the guide forward and backward via a rod and control the head. Each of the distal jaw and the proximal jaw includes a plurality of alms which closes when a distal disc moves forward and a proximal disc moves backward. The aims of the distal jaw and the arms of the proximal jaw open through a pressure when the distal disc moves backward and the proximal disc moves forward. When the arms of the distal jaw and the aims of the proximal jaw are completely open, pins located on the arm of the distal jaw engage with sockets located on the arm of the proximal jaw.