Venous Retroperfusion Conduit for Ischemic Myocardial Perfusion
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Solution Overview
Problem
Current treatments for ischemic cardiac regions, such as coronary artery bypass grafting and percutaneous transluminal coronary angioplasty, often fail to adequately perfuse the subendocardium and are limited by complications like the 'no-reflow' phenomenon and anatomical anomalies, leaving a significant population without effective options for re-establishing oxygenated blood flow to ischemic myocardial tissue.
Innovation Solution
A method and apparatus for fluid coupling the left ventricle of the heart to the anterior interventricular vein via venous retroperfusion, using a transmyocardial conduit and tri-directional coupler to control diastolic/systolic pressure within 20-50 mmHg, facilitating safe and controlled perfusion of oxygenated blood to stimulate collateral development in ischemic regions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional coronary artery bypass grafting or angioplasty is performed, then epicardial coronary arteries are treated, but subendocardial perfusion is inadequate and no-reflow phenomenon occurs
Solution Approach 1:
Instead of delivering blood through the traditional arterial system (anterior interventricular artery), this invention delivers oxygenated blood through the venous system (anterior interventricular vein) in reverse direction. The transmyocardial conduit creates a direct connection from the left ventricle to the anterior interventricular vein, enabling retrograde perfusion that bypasses occluded arterial segments and delivers blood directly to subendocardial tissue.
Solution Approach 2:
The transmyocardial conduit acts as an intermediary structure that facilitates blood flow from the left ventricle to the anterior interventricular vein. This conduit serves as a direct transport pathway, mediating the delivery of oxygenated blood to ischemic subendocardial regions without relying on the compromised arterial system.
2Productivity
If high pressure is applied during retroperfusion, then blood flow to ischemic tissue is improved, but damage to venous vasculature occurs
Solution Approach 1:
The system dynamically adjusts perfusion pressure to match the physiological characteristics of the venous system. Rather than applying constant high pressure, the device modulates pressure levels to remain within the safe operational range for venous vasculature (lower than arterial pressure requirements), ensuring effective perfusion without causing vascular damage.
Solution Approach 2:
The invention changes the pressure parameter from arterial-level pressures (required in traditional revascularization) to venous-level pressures (lower, safer for venous structures). This parameter adjustment is critical because venous walls are thinner and more susceptible to pressure-induced damage, yet still allows sufficient blood flow delivery to ischemic tissue.
3Quantity of substance
If arterial blood is delivered through coronary veins, then oxygenated blood reaches myocardium, but venous system is not designed for high pressure flow
Solution Approach 1:
The system adapts the delivery pressure to match the venous system's structural capacity. Rather than forcing arterial-level pressures through venous vessels, the device dynamically adjusts pressure to remain within safe limits while maintaining sufficient flow to deliver adequate oxygenated blood to the myocardium.
Solution Approach 2:
The invention fundamentally changes the pressure parameter from arterial to venous ranges, recognizing that the venous system cannot withstand high pressures. This parameter modification enables safe utilization of the venous pathway for oxygenated blood delivery without exceeding the structural strength limits of venous vasculature.
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 enables effective collateral development and perfusion of ischemic myocardial tissue, avoiding damage to the venous vasculature and addressing the limitations of traditional treatments by providing global support and fluid shear forces to promote tissue repair.
Implementation Method 1
fluid coupling of the left ventricle of the heart to the anterior interventricular vein to stimulate collateral development in ischemic regions via venous retroperfusion and operate at pressures to avoid damage to the venous vasculature
Data Source
AI summary
An apparatus for stimulation of collateral development in ischemic cardiac regions comprises a mechanism for fluid coupling of the left ventricle of the heart to the anterior interventricular vein to stimulate collateral development in ischemic regions. The fluid coupling of the left ventricle of the heart to the anterior interventricular vein includes a control of the diastolic/systolic pressure in the venous system to be within about 20-50 mmHg. The fluid coupling of the left ventricle of the heart to the anterior interventricular vein includes inserting a transmyocardial conduit into the left ventricle and a tri-directional coupler attached to the anterior interventricular vein. An associated method for stimulation of collateral development in ischemic cardiac regions via the fluid coupling of the left ventricle of the heart to the anterior interventricular vein is disclosed.