Tricuspid Valve Delivery via Lubricated Cable and Eye Hook
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Solution Overview
Problem
Current minimally invasive techniques for treating the tricuspid valve are limited due to the difficulty in percutaneously delivering a replacement tricuspid valve, primarily because of the large size and stiffness of the delivery system, which requires anchoring a wire to tissue.
Innovation Solution
A system utilizing an eye hook/eyelet device and a cable with a lubricious coating, allowing the tricuspid valve delivery system to be advanced through the venous vasculature without anchoring the wire to tissue, using an eye hook device to facilitate movement and articulation within the heart's tricuspid valve ring.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If a delivery system is made large and stiff to carry a tricuspid valve replacement, then the structural strength and stability are improved, but the ease of percutaneous delivery through the venous vasculature deteriorates
Solution Approach 1:
The delivery system is divided into multiple segments: a delivery catheter, a valve replacement, and a delivery wire. This segmentation allows each component to be optimized independently - the catheter can be made flexible for delivery while the valve replacement maintains its structural integrity for function.
Solution Approach 2:
A delivery wire acts as an intermediary element that provides flexibility and navigability through the venous vasculature, while the valve replacement is carried on the wire. The wire serves as a mediator between the flexible delivery path and the rigid valve structure.
2Stability of the object's composition
If a wire is anchored to tissue to provide stable delivery, then the stability and control are improved, but the complexity of the procedure and potential tissue damage increase
Solution Approach 1:
The anchoring function is extracted from the delivery system. Instead of anchoring the wire to tissue, the system uses the natural anatomy of the heart - specifically the tricuspid valve ring - as the anchoring point for the valve replacement itself, eliminating the need for separate wire anchoring procedures.
Solution Approach 2:
The tricuspid valve ring itself serves as the anchoring structure for the valve replacement. The native valve anatomy provides the stable foundation needed for delivery and positioning, eliminating the need for external anchoring mechanisms or additional tissue interaction.
3Ease of operation
If the delivery system is made flexible to navigate the venous vasculature, then the ease of delivery is improved, but the structural strength and stability deteriorate
Solution Approach 1:
The system separates the flexible delivery components (catheter and wire) from the rigid valve replacement. This allows the delivery pathway to remain flexible for navigation while the valve replacement maintains its structural strength for function.
Solution Approach 2:
The delivery catheter and wire are designed with flexible structures that can navigate the venous vasculature. The flexibility is achieved through appropriate material selection and structural design, allowing the delivery system to bend and flex without compromising the integrity of the carried valve replacement.
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
Enables safe and effective percutaneous delivery of a replacement tricuspid valve by minimizing resistance and friction, allowing proper orientation and deployment within the native valve ring without tissue anchoring, thus overcoming the challenges of large and stiff delivery systems.
Implementation Method 1
A cable (106) is threaded through a tricuspid valve delivery system (104). The cable (106) has a lubricious coating
Data Source
AI summary
To percutaneously deliver a replacement tricuspid valve, a cable is percutaneously positioned with a first end extending out of the venous vasculature at the neck, and a second end extending out of a femoral access point. An eyehook device is positioned over the first end. A tricuspid valve delivery device (TVDD) is advanced over the second end, and then advanced through an IVC into a right atrium. The eyehook device is advanced into the right ventricle, drawing an intermediate portion of the cable into the right ventricle. Contact between the distal end of the eyehook device and the right ventricle is maintained while the TVDD is pushed from the femoral vein. The intermediate portion of cable applies a force to a distal nose of the TVDD that causes the distal nose to be steered into a tricuspid valve annulus as the TVDD is advanced.