Percutaneous Tissue Anchors for Tricuspid Annulus Plication
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Solution Overview
Problem
Current methods for treating tricuspid valve regurgitation often require invasive surgeries and lack effective percutaneous solutions for reducing the circumference of the tricuspid annulus, which can lead to prolonged recovery times and increased pain.
Innovation Solution
A method involving the percutaneous deployment of tissue anchors and fasteners connected by a tensioning member to reduce the circumference of the tricuspid annulus, utilizing a series of catheters and wires to position and secure the anchors across the annulus, allowing for plication of the tissue and reduction of regurgitation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If open-heart surgery is performed for tricuspid valve repair, then the valve can be properly repaired with annuloplasty ring, but the patient experiences prolonged recovery time and increased post-operation pain
Solution Approach 1:
A percutaneous delivery system serves as an intermediary mechanism to deliver the annuloplasty ring through the venous system rather than requiring direct surgical access to the heart. The system includes a delivery catheter that navigates through the inferior vena cava to position the ring at the tricuspid annulus, eliminating the need for sternotomy and cardiopulmonary bypass while maintaining repair effectiveness
Solution Approach 2:
The patent replaces the mechanical surgical approach (open-heart surgery with direct visualization and suturing) with a less invasive percutaneous approach using a delivery catheter system. The annuloplasty ring is pre-formed and self-expanding, allowing it to be delivered in a compressed state and automatically expand to the correct configuration once deployed, eliminating complex surgical manipulation
2Reliability
If open-heart surgery is performed for tricuspid valve repair, then the valve can be properly repaired, but the patient experiences increased post-operation pain
Solution Approach 1:
The percutaneous delivery system acts as an intermediary that avoids direct trauma to the chest wall and sternum. By accessing the heart through the venous system (femoral or jugular vein), the procedure eliminates the need for chest incisions, sternum splitting, and muscle dissection, thereby preventing the source of post-operative pain while still achieving effective valve repair
3Loss of time
If percutaneous approach is used for valve repair, then recovery time is reduced and pain is minimized, but the ability to reduce tricuspid annulus circumference is limited
Solution Approach 1:
The annuloplasty ring is designed with dynamic properties - it is self-expanding and can be delivered in a compressed state through a small catheter, then automatically expands to its full anatomical configuration once deployed. This dynamic transformation allows the device to overcome the size limitation of the delivery catheter while achieving the therapeutic effect of annulus circumference reduction
Solution Approach 2:
The annuloplasty ring is nested within the delivery catheter in a compressed state, similar to a nested doll structure. The ring can be collapsed to fit within the small-bore catheter for percutaneous delivery, then expanded to its full functional size once positioned at the target site, enabling minimally invasive delivery of a device that requires large anatomical dimensions for effectiveness
Data Source
AI summary
The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices and methods of identifying a suitable location on the tricuspid annulus, placing a wire across the tricuspid annulus at such an identified location, deploying a tissue anchor across such an identified location, deploying two or more tissue anchors and coupling the tissue anchors with a flexible tensioning member, and applying tension to a flexible tensioning member that is coupled with the two or more tissue anchors, plicating tissues between each pair of the two or more tissue anchors, and reducing the circumference of the tricuspid annuls. As a result, a regurgitation jet is reduced or eliminated.