Segmented Annuloplasty for Mitral Valve Repair
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Solution Overview
Problem
Current methods for repairing a dilated mitral valve, such as those caused by ischemic heart disease, often fail to effectively prevent mitral regurgitation due to incomplete coaptation of valve leaflets, leading to increased stroke volume and cardiac overload.
Innovation Solution
A percutaneous system using transcatheterally advanced annuloplasty segments, anchored to the mitral valve annulus with control wires and anchoring structures, which are then compressed to restore the normal configuration of the valve leaflets, reducing prolapse and regurgitation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a continuous annuloplasty ring is used to repair the mitral valve annulus, then the structural support is improved, but the device complexity and difficulty of percutaneous delivery increase
Solution Approach 1:
The annuloplasty ring is divided into multiple discrete segments that can be independently delivered and positioned. Each segment contains its own anchoring structures and can be deployed separately through catheters, reducing the complexity of delivering a complete continuous ring while maintaining structural support functionality
2Reliability
If traditional surgical approaches are used for mitral valve repair, then the repair effectiveness is improved, but the invasiveness and recovery time increase
Solution Approach 1:
Catheters and delivery systems serve as intermediaries to transport the annuloplasty segments through the vasculature to the heart. This allows the repair device to be delivered percutaneously rather than requiring open surgical access, reducing invasiveness while maintaining repair effectiveness
Solution Approach 2:
The traditional mechanical surgical approach involving direct manual manipulation and suturing is replaced with a minimally invasive system that uses catheter-based delivery, controlled expansion mechanisms, and self-anchoring structures to achieve the same repair outcome with reduced patient trauma
3Strength
If the annuloplasty segments are made rigid for structural support, then the annulus stabilization is improved, but the ability to conform to the native annulus geometry decreases
Solution Approach 1:
The annuloplasty segments are designed with dynamic characteristics, allowing them to transition from a compressed delivery state to an expanded functional state. The segments can flex and adapt to the native annulus geometry while maintaining rigidity sufficient for stabilization, achieving both conformability and structural support
Data Source
AI summary
Apparatus is provided for repairing a valve of a patient, the valve including an annulus and at least first and second leaflets. The apparatus includes at least a first discrete segment and a second discrete segment of an annuloplasty structure, each segment being shaped to provide a respective lateral wall, each lateral wall being shaped to define at least one lumen of the respective segment. The apparatus further includes at least a first and a second control wire, each control wire configured for sliding advancement through both the first and second segments. The first control wire is configured to control a relative disposition of a first end of the first segment and a first end of the second segment. The second control wire is configured to control a relative disposition of a second end of the first segment and a second end of the second segment. Other embodiments are also described.