Toggle Anchor for Minimally Invasive Heart Valve Repair
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Solution Overview
Problem
Current minimally invasive heart valve repair techniques face challenges in securely anchoring artificial chordae sutures due to the difficulty in applying sufficient force for stable insertion into the heart muscle using flexible catheters, which can lead to improper suture tension and valve function.
Innovation Solution
The development of 'toggle' anchors that transition from a delivery position to an anchoring position, providing the necessary force for insertion into the heart wall, ensuring the anchor remains securely embedded and resistant to accidental withdrawal during valve operation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If traditional suture anchors are used with flexible catheters for transcatheter procedures, then the procedure is minimally invasive, but the anchor cannot be securely inserted into the heart muscle due to insufficient insertion force
Solution Approach 1:
The anchor is designed with a dynamic toggle mechanism that transitions from a linear delivery configuration to a perpendicular anchored configuration. The anchor tip pivots approximately 90 degrees relative to the anchor shaft upon deployment, transforming from a passive delivery state to an active anchoring state that resists pull-out forces during heart valve operation
Solution Approach 2:
The anchor deployment utilizes the periodic cardiac cycle forces. As the heart contracts and the valve leaflet moves, the suture experiences cyclic tension that drives the toggle mechanism into its final perpendicular position, ensuring secure anchoring through the natural mechanical environment of the beating heart
2Reliability
If the suture is too short or has too much tension to anchor securely, then the anchor can be firmly inserted, but the valve leaflets may not properly close
Solution Approach 1:
The toggle mechanism fundamentally changes the geometric parameters of anchor insertion. By transitioning from a linear to a perpendicular orientation, the effective anchoring depth and angle are optimized to achieve both secure fixation and appropriate suture tension, allowing the valve leaflets to close properly without excessive force
3Ease of operation
If the suture is too long or has too little tension to allow proper valve closure, then the valve function is maintained, but the anchor may be subject to prolapse and accidental withdrawal
Solution Approach 1:
The dynamic toggle configuration creates a mechanical advantage that converts the natural motion of the heart valve into a locking action. The perpendicular orientation of the anchor tip relative to the shaft creates resistance against withdrawal forces while maintaining flexibility for proper valve function during the cardiac cycle
4Reliability
If open heart surgery is performed to securely anchor the suture, then reliable anchoring is achieved, but the procedure becomes highly invasive with significant trauma and recovery time
Solution Approach 1:
The anchor system is self-deploying through the natural mechanical environment of the beating heart. The toggle mechanism automatically transitions from delivery to anchoring configuration using the cardiac cycle forces, eliminating the need for complex external deployment mechanisms or open surgical exposure while achieving secure anchoring
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 toggle anchors enable secure anchoring of sutures as artificial chordae, maintaining proper valve function by ensuring appropriate tension and preventing suture displacement, even during systole, thus improving the efficacy of transcatheter procedures.
Implementation Method 1
Each of the disclosed anchor embodiments 'toggles' from a first position for delivery of the anchor to the heart wall and a second position for insertion of the anchor into the heart wall. In some embodiments, it is the 'toggle' to the second position that provides the necessary insertion force for inserting the anchor into the heart muscle
Data Source
AI summary
Various embodiments of anchors are configured to be inserted into a heart wall of a patient to anchor a suture as an artificial chordae under an appropriate tension for proper valve function. Each of the disclosed anchor embodiments “toggles” from a first position for delivery of the anchor to the heart wall and a second position for insertion of the anchor into the heart wall. In some embodiments, it is the “toggle” to the second position that provides the insertion force for inserting the anchor into the heart muscle sufficient to retain the anchor from accidental withdrawal from the heart wall during normal valve operation (e.g., when a valve leaflet pulls on the suture attached to the anchor during systole). Such anchors are particularly suitable for use in intravascular, transcatheter procedures as described above given the inherent difficulties in providing sufficient force for insertion of an anchor into the heart wall with a flexible catheter.