Selective SVC Occlusion for Ambulatory Heart Failure Treatment
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Solution Overview
Problem
Current treatments for heart failure, including those involving venous occlusion, often exacerbate co-morbidities such as renal and hepatic complications, are impractical for ambulatory use, and fail to effectively arrest or reverse cardiac remodeling, leading to progressive deterioration in cardiac function.
Innovation Solution
A system and method for regulating venous blood return through the superior vena cava (SVC) using a catheter with a flow limiting element, controlled by a controller that intermittently occludes the SVC based on hemodynamic inputs, allowing ambulatory use and reducing ventricular overload without adverse effects on renal function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If venous occlusion is used to reduce ventricular preload, then cardiac function is improved, but renal and hepatic complications are exacerbated
Solution Approach 1:
The patent applies local quality by selectively occluding the superior vena cava (SVC) to reduce venous return to the right ventricle, while preserving inferior vena cava (IVC) flow to maintain renal and hepatic perfusion. This localized approach targets the cardiac preload reduction need without affecting organ blood supply, resolving the contradiction between improving cardiac function and avoiding renal/hepatic complications.
Solution Approach 2:
The patent segments the venous return system by independently controlling SVC and IVC flow. The SVC occlusion device operates separately from IVC flow, allowing selective reduction of right ventricular preload while maintaining systemic organ perfusion through the IVC. This segmentation enables targeted cardiac support without compromising renal and hepatic function.
2Reliability
If continuous venous occlusion is used to treat heart failure, then ventricular overload is reduced, but ambulatory use becomes impractical
Solution Approach 1:
The patent employs periodic action by implementing intermittent SVC occlusion rather than continuous occlusion. The system cycles between occlusion and non-occlusion phases, allowing venous return to be regulated in pulses. This periodic approach maintains therapeutic benefit for ventricular overload reduction while enabling patient mobility and ambulatory use, as the device does not require constant monitoring or adjustment.
Solution Approach 2:
The patent applies self-service through an automated control system that regulates SVC occlusion based on pre-programmed parameters or sensor feedback. The device autonomously adjusts occlusion timing and duration without requiring continuous manual intervention, making it suitable for ambulatory use. The system self-regulates venous return to optimize cardiac function while allowing patient mobility.
3Object-affected harmful factors
If conventional treatments are used for heart failure, then symptoms are palliated, but cardiac remodeling is not arrested or reversed
Solution Approach 1:
The patent applies preliminary action by reducing ventricular preload through SVC occlusion before irreversible cardiac remodeling occurs. By decreasing ventricular wall stress and oxygen demand in advance, the system creates favorable conditions for myocardial healing and prevents further structural deterioration. This proactive approach addresses the underlying remodeling process rather than merely treating symptoms, potentially arresting or reversing cardiac structural changes.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
The SVC occlusion system effectively reduces left and right ventricular pressures and volumes, improves cardiac output, and promotes myocardial healing, potentially reversing cardiac remodeling and improving quality of life for heart failure patients.
Implementation Method 1
a flow limiting element disposed on a distal region of the catheter, the flow limiting element selectively actuated to at least partially occlude flow through a superior vena cava of the patient
Data Source
AI summary
Systems and methods and devices are provided for treating conditions such as heart failure and/or pulmonary hypertension by at least partially occluding flow through the superior vena cava for an interval spanning multiple cardiac cycles. A catheter with an occlusion device is provided along with a controller that actuates a drive mechanism to provide at least partial occlusion of the patient's superior vena cava, which reduces cardiac filling pressures, and induces a favorable shift in the patient's Frank-Starling curve towards healthy heart functionality and improved cardiac performance. The occlusion device may include a lumen obstructed by a relief valve that may permit fluid flow through the occlusion device to release an excessive build-up of pressure.