Physiologic Tricuspid Annuloplasty Ring with Waveform Flexibility
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Solution Overview
Problem
Current tricuspid annuloplasty rings face challenges in harmonizing with the physiologic features of the tricuspid annulus, leading to issues such as dehiscence, suture pull-out, and conduction tissue disorders due to their rigidity, which complicates tricuspid valve repair and increases the risk of arrhythmias.
Innovation Solution
A physiologic tricuspid annuloplasty ring with a waveform configuration and selective flexibility, featuring a titanium core with varying cross-sections and a suture-permeable interface, is designed to adapt to the dynamic motion of the tricuspid annulus, reducing stress on anatomical structures and minimizing the risk of arrhythmias and dehiscence.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a rigid annuloplasty ring is used to maintain structural stability, then the ring can provide strong support for the valve annulus, but it causes stress concentration on anatomical structures leading to dehiscence and suture pull-out
Solution Approach 1:
The annuloplasty ring is designed with dynamic flexibility to adapt to the natural motion of the tricuspid annulus during cardiac cycles. The ring can flex and deform elastically in response to physiological forces, transforming from a static rigid structure to a dynamic adaptive structure that moves with the heart tissue, thereby reducing stress concentration and preventing suture failure
Solution Approach 2:
The ring incorporates variable material properties along its structure, with different sections having different flexibility characteristics. The material parameters are optimized to provide appropriate stiffness in certain regions for structural support while allowing greater flexibility in other regions to accommodate anatomical motion, resolving the contradiction between strength and reliability
2Shape
If a rigid annuloplasty ring is used to maintain annular shape, then the valve geometry can be preserved, but it restricts the natural motion of the tricuspid annulus leading to conduction tissue disorders and arrhythmias
Solution Approach 1:
The ring is designed to dynamically adapt its shape during cardiac cycles, allowing the tricuspid annulus to undergo its natural physiological deformations. The ring flexes and changes configuration in response to heart motion, preserving the overall annular geometry while accommodating local tissue movement, thereby preventing conduction system compression and arrhythmia induction
Solution Approach 2:
Different portions of the ring are designed with different flexibility characteristics to match the local physiological requirements of various annular regions. Certain areas allow greater motion to protect conduction tissues, while other areas maintain stricter geometric control, resolving the contradiction between shape preservation and harm reduction
3Reliability
If a flexible material is used to reduce stress on anatomical structures, then the risk of dehiscence is reduced, but the ring may deform under physiological loads compromising structural integrity
Solution Approach 1:
The annuloplasty ring is constructed as a composite structure combining materials with different mechanical properties. The composite design integrates materials that provide structural strength with materials that offer flexibility and stress distribution, allowing the ring to maintain structural integrity while reducing stress concentration on surrounding tissues, thereby preventing both deformation and dehiscence
Data Source
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Figure 5A~5D
AI summary
A prosthetic tricuspid remodeling annuloplasty ring for use in tricuspid valve repairs to provide support after annuloplasty surgery. The ring maintains a fixed maximum annular dimension to prevent excessive dilatation of the natural valve annulus while adapting to the dynamic motion of the tricuspid annulus during the cardiac cycle. An exemplary ring features a waveform contour and may be constructed of a titanium core having a varying cross-section for selective flexibility for good Z-axis or out-of plane movement. The "waveform" contour and selective flexibility of the different segments of this ring are designed to adapt to the complex motion of the annulus. This reduces the stress on the anatomical structures and therefore minimizes the risk of arrhythmia and ring dehiscence.