Prosthetic Tricuspid Valve Frame with Chord-Recruiting Arms
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Solution Overview
Problem
Tricuspid valve regurgitation occurs due to improper closure of the tricuspid valve, causing blood to flow back into the right atrium, often resulting from right ventricle dilation and subsequent annulus dilation, which affects the coaptation of valve leaflets.
Innovation Solution
A prosthetic tricuspid valve frame with anchoring and chord-recruiting arms is deployed, featuring a valve-frame body supporting prosthetic leaflets, where chord-recruiting arms extend to the anterior and posterior leaflets, and an anchoring arm is used at the septal leaflet, with a coronary-sinus anchor for anchoring within the coronary sinus, to correct valve alignment and prevent regurgitation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If the tricuspid valve annulus dilates due to right ventricle dilation, then the valve leaflets fail to coapt properly causing regurgitation, but adding more structural support to the valve frame increases device complexity
Solution Approach 1:
The valve frame is divided into multiple functional arms: a first arm extending to the first leaflet, a second arm extending to the second leaflet, and a third arm extending to the third leaflet. Each arm can be independently positioned and secured to recruit specific chords, allowing targeted support for each leaflet's coaptation without requiring complete structural reinforcement of the entire valve annulus.
Solution Approach 2:
Chord-recruiting arms are introduced as intermediary structures between the valve frame and the chordae tendineae. These arms selectively engage with specific chords to transmit mechanical support forces, enabling precise control over leaflet positioning and coaptation without directly reinforcing the dilated annulus.
2Manufacturing precision
If chord-recruiting arms are added to extend to multiple leaflets, then valve alignment and coaptation improve, but the device complexity and number of components increases
Solution Approach 1:
Each arm of the valve frame is designed with multi-functionality: they serve as both structural support elements and chord-recruiting mechanisms. The arms can be positioned to engage different chords depending on the specific leaflet being supported, allowing a single arm structure to perform multiple functions of alignment, support, and chord engagement without requiring separate specialized components.
Data Source
AI summary
Apparatus and methods are described for use with a native tricuspid valve of a heart of a mammalian subject. A valve frame (22) includes a valve-frame body (32) that is configured to support prosthetic valve leaflets (20) within the native tricuspid valve. Chord-recruiting arms (30) are configured to extend from the valve-frame body at circumferential regions corresponding to the anterior leaflet and the posterior leaflet of the native tricuspid valve. An anchoring arm (28) is configured to extend from the valve-frame body at a circumferential region corresponding to the septal leaflet of the native tricuspid valve, the anchoring arm (28) being longer than each of the chord-recruiting arms (30). Other applications are also described.