Percutaneous Left Ventricular Reconstruction via Catheter Tissue Differentiation
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Solution Overview
Problem
Current treatments for congestive heart failure associated with dilated left ventricles are invasive and cannot effectively differentiate between infarcted and viable myocardium during minimally invasive procedures, leading to inefficient heart reconstruction and increased wall tension.
Innovation Solution
A minimally invasive method using a catheter to detect and exclude infarcted tissue, reduce left ventricular volume, and realign the apex of the heart to improve cardiac function, employing techniques such as pacing, angiography, echocardiography, and tissue Doppler for tissue identification, and suturing devices for thoracoscopic placement.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If open-chest surgery is used for left ventricular reconstruction, then the surgeon can directly visualize and differentiate infarcted from viable myocardium, but the procedure becomes highly invasive with increased trauma and risk
Solution Approach 1:
The patent replaces the mechanical/open surgical approach with a catheter-based electrical sensing system. The sensing catheter uses electrical properties (impedance, voltage) to differentiate infarcted from viable myocardium without requiring mechanical exposure of the heart, thus eliminating the need for open-chest surgery while maintaining tissue differentiation capability
Solution Approach 2:
The sensing catheter acts as an intermediary tool that indirectly measures tissue characteristics through electrical signals. Instead of direct visual inspection requiring open surgery, the catheter mediates the detection process by sensing electrical properties of the myocardium through the catheter tip, enabling infarct identification through minimally invasive percutaneous access
2Object-affected harmful factors
If minimally invasive catheter-based procedures are used, then surgical trauma is reduced, but the ability to differentiate infarcted from viable myocardium is lost
Solution Approach 1:
Visual inspection is replaced with electrical sensing. The catheter uses electrical impedance and voltage measurements to differentiate tissue types, substituting the mechanical/visual approach with an electrical field-based detection system that works effectively through minimally invasive catheter contact
Solution Approach 2:
The patent creates an electrical signature map of the myocardium that copies the tissue differentiation information normally obtained visually. By mapping electrical properties (impedance, voltage patterns) across the myocardium, the system reproduces the tissue characterization capability of open surgery in a minimally invasive manner
3Device complexity
If infarcted tissue is not properly excluded, then the reconstruction procedure is simplified, but wall tension increases and cardiac function deteriorates
Solution Approach 1:
The sensing catheter performs preliminary identification and mapping of infarcted tissue boundaries before the reconstruction procedure begins. This advance detection allows the surgeon to plan and execute the exclusion of infarcted tissue with precision, ensuring proper reconstruction geometry that reduces wall tension while maintaining procedural efficiency
Data Source
AI summary
A method for reducing left ventricular volume, which comprises identifying infarcted tissue during open chest surgery; reducing left ventricle volume while preserving the ventricular apex; and realigning the ventricular apex, such that the realigning step comprises closing the lower or apical portion of said ventricle to achieve appropriate functional contractile geometry of said ventricle in a dyskinetic ventricle of a heart.