Transcardiac Cannula Access Cuff for ECMO
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Solution Overview
Problem
Current cannula technology for ECMO support limits duration and mobility due to complications at entry sites and inefficient oxygen delivery, particularly in patients with pulmonary hypertension and right ventricular dysfunction.
Innovation Solution
A system featuring an access cuff with a compression assembly and a multi-lumen cannula for transcardiac access, allowing secure attachment to the heart muscle and efficient blood perfusion, along with a closure device for hemostatic sealing after cannula removal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Duration of action of moving object
If conventional percutaneous cannulas are placed via right internal jugular vein or femoral vein for ECMO support, then venous access is achieved, but the duration is limited due to complications at cannula entry sites and patient mobility limitations
Solution Approach 1:
The patent extracts the cannula entry site from the conventional percutaneous approach (jugular or femoral vein) and relocates it to the right ventricular apex. This extraction eliminates the problematic external entry sites and their associated complications, allowing for prolonged ECMO support without the limitations of percutaneous access.
Solution Approach 2:
The patent introduces a specialized cannula design with a flared tip and specific geometric features that acts as an intermediary between the blood flow and the right ventricular apex. This intermediary structure enables safe transcardiac placement and stable positioning, resolving the contradiction between duration and reliability by providing a reliable anchoring mechanism that prevents complications.
2Productivity
If conventional cannulas are used for VV-ECMO, then venous access is established, but oxygen delivery efficiency is reduced due to recirculation where oxygenated blood is withdrawn from the outflow source before transiting pulmonary circulation
Solution Approach 1:
The patent changes the spatial dimension of cannula placement by moving from peripheral veins to the right ventricular apex. This dimensional change allows the outflow cannula to be positioned at the apex while the inflow cannula can be positioned in the right atrium or superior vena cava, creating a configuration that prevents recirculation and improves oxygen delivery efficiency by ensuring oxygenated blood transits through pulmonary circulation before being re-infused.
3Duration of action of moving object
If Berlin Heart EXCOR cannulas are used for long-term ECMO support, then duration is extended beyond 5 months, but full median sternotomy and cardiopulmonary bypass are required for insertion and removal
Solution Approach 1:
The patent applies local quality by designing a cannula with specific geometric features (flared tip, specific dimensions) that enable targeted placement at the right ventricular apex through a less invasive approach. This localized optimization of cannula design allows for prolonged support while reducing the overall surgical complexity compared to full sternotomy and cardiopulmonary bypass.
4Reliability
If pulmonary hypertension is present impairing right ventricular function, then ECMO support is needed, but return flow right ventricular dysfunction complicates cannula placement and function
Solution Approach 1:
The patent effectively copies the function of a normal right ventricle by using the ECMO system to provide the pumping function that the dysfunctional right ventricle cannot perform. The transcardiac cannula placement at the right ventricular apex allows the ECMO system to assume the role of the right ventricle, maintaining pulmonary blood flow despite the patient's underlying right ventricular dysfunction from pulmonary hypertension.
Data Source
AI summary
Devices, systems and methods for cardiac and vascular access configured to allow for intracardiac access to conduct medical procedures. The devices, systems and methods are particularly useful in trans-cardiac extra-corporeal membrane oxygenation (ECMO) procedures, ventricular assist procedures, cardiopulmonary bypass, or other medical procedures where intracardiac access may be required.