Transvalvular Pump Unloading Before Reperfusion in Myocardial Infarction

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Solution Overview

Problem

Current therapies for acute myocardial infarction (AMI) fail to effectively limit myocardial damage and ischemic heart failure due to ischemia-reperfusion injury, despite rapid reperfusion efforts, necessitating improved cardioprotective strategies.

Innovation Solution

A method involving mechanical circulatory support devices, such as transvalvular pumps, are used to unload the left ventricle before reperfusion, reducing myocardial oxygen demand for a defined period, followed by reperfusion therapy to reduce infarct size and prevent heart failure.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Speed

If primary reperfusion is performed rapidly to restore coronary artery blood flow, then myocardial oxygen supply is re-established, but ischemia-reperfusion injury worsens myocardial damage

Engineering Contradiction:

Improvereperfusion speedVSAvoidischemia-reperfusion injury

Core Design Contradiction:

SpeedVSObject-affected harmful factors

Solution Approach 1:

The patent applies preliminary mechanical unloading of the left ventricle before reperfusion to precondition the myocardium. By reducing myocardial oxygen demand and wall stress prior to restoring blood flow, the heart is prepared to withstand the reperfusion process, thereby limiting ischemia-reperfusion injury while maintaining rapid reperfusion benefits

Inventive Principle:

Principle #10Preliminary action

Solution Approach 2:

The patent implements preliminary anti-action by mechanically counteracting the harmful effects of ischemia-reperfusion injury before reperfusion occurs. The mechanical support device pre-reduces myocardial oxygen consumption and wall stress, creating a protective effect that opposes the damaging reperfusion processes when blood flow is restored

Inventive Principle:

Principle #9Preliminary anti-action

2Reliability

If mechanical circulatory support devices are used to unload the left ventricle before reperfusion, then myocardial oxygen demand is reduced and infarct size is limited, but device complexity increases

Engineering Contradiction:

Improvecardioprotection efficacyVSAvoidmechanical support system

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The patent introduces a mechanical circulatory support device as an intermediary between the ischemic myocardium and the reperfusion process. This intermediary device temporarily assumes the function of reducing myocardial oxygen demand and wall stress, enabling cardioprotection without requiring direct modification of the coronary circulation or complex surgical interventions

Inventive Principle:

Principle #24Intermediary (Mediator)

Solution Approach 2:

The patent replaces physiological mechanisms with mechanical support to achieve cardioprotection. Instead of relying on pharmacological agents or complex physiological modifications, a mechanical device directly unloads the left ventricle, substituting mechanical force for biological processes to reduce myocardial oxygen demand and limit infarct size

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

3Reliability

If reperfusion is delayed to allow mechanical unloading, then infarct size is reduced, but time to restore myocardial oxygen supply increases

Engineering Contradiction:

Improvemyocardial salvageVSAvoiddoor to balloon time

Core Design Contradiction:

ReliabilityVSLoss of time

Solution Approach 1:

The patent performs preliminary mechanical unloading during the reperfusion process rather than requiring delay before reperfusion. The mechanical support device is activated and begins reducing myocardial oxygen demand while reperfusion proceeds, allowing simultaneous achievement of cardioprotection and timely restoration of blood flow without extending door-to-balloon time

Inventive Principle:

Principle #10Preliminary action

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

This approach significantly reduces infarct size and prevents heart failure by promoting cardioprotective mechanisms, including altering protein and enzyme levels in cardiac tissue, thereby stabilizing the heart and reducing maladaptive remodeling.

Implementation Method 1

a mechanical circulatory support device, such as a transvalvular pump, is used to unload the left ventricle before reperfusion

Methodology Applied

Scientific EffectMechanical pumping: Pump

Data Source

PatentUS12544553B2Systems and methods for left ventricular unloading in treating myocardial infarction

Publication Date: 2026.02.10 ABIOMED INC

AI summary

We provide herein a method of preventing or limiting the effects of heart failure in a human patient that has sustained myocardial infarction by reducing maladaptive cardiac remodeling in the patient. The method comprises percutaneously inserting a transvalvular blood pump, comprising a rotor and a cannula, into the patient's vasculature and positioning the cannula across the aortic valve of the patient's heart, with a distal end of the cannula located in the left ventricle of the heart and a proximal end of the pump located in the aorta. The method then comprises, prior to reperfusing the heart, operating the positioned pump to unload the left ventricle at a pumping rate of at least 2.5 L/min of blood flow for a support period between at least 30 minutes and less than 60 minutes. Then, after the support period, the method comprises applying coronary reperfusion therapy to the heart.