A panel of 60 Cleveland Clinic doctors announced its Top 10 Medical Innovations for 2010, with half being medical devices and the others being processes and drugs and research findings. The announcement came during the 2009 Cleveland Clinic Medical Innovations Summit held earlier this month at which 900 healthcare senior executives, investors, entrepreneurs and clinicians gathered.

The five devices were:

• Mini digital audio system that transmits sound via the teeth for those with single-sided deafness. The system consists of a small microphone unit worn behind the ear on the deaf side and a removable retainer-like device that contains electronics, a sealed rechargeable battery, wireless capability that picks up sound transmissions from the microphone unit, and an actuator that converts those signals into vibratory energy.

 • Tracheal tub cuff to reduce ventilator-associated pneumonia. The device provides continuous effective airway seals. It can be left in place for 30 days. The device is expected to replace current cuff devices that provide only a partial seal, which leads to secretions passing into the lungs.

• Continuous-flow ventricular assist devices. Three-ounce pump attaches alongside the heart and runs on rechargeable batteries connected through the abdomen. The device takes over the pumping ability of the heart’s left ventricle and provides continuous blood flow through the circulatory system using one moving part – a rotary pumping mechanism. The device is intended to be “a bridge” for patients awaiting heart transplants and could eventually provide “sole support” of the heart without transplantation.

• Sleep-monitoring devices for out-patient diagnosis of sleep apnea. These devices are worn on the patient’s wrist and use a non-invasive finger-mounted probe to measure signals that indicate changes in the autonomic nervous system caused by respiratory disturbances during sleep. Signals are stored in a removable memory card in the device to be downloaded to a computer in the doctor’s office for automatic analysis using proprietary algorithms. In addition to the respiratory signal, the devices also record pulse, oxygen saturation, and rest-activity cycles.

• Implants to reduce stroke risk. Device alternatives to long-term use of blood thinners can prevent clots from developing in patients with atrial fibrillation without the drug’s side effect or need for constant patient monitoring. One is an umbrella-shaped mesh device that is snaked up via a catheter through a blood vessel in the groin into the right atrium of the heart and implanted permanently behind or at the opening of the left atrial appendage. The body forms tissue over the implant, closing off the appendage and eliminating the risk of blood clots. A second device is a clip that is place over the left atrial appendage.

The Top 10 resulted from a field of 100 nominations that were evaluated according to four criteria:

• Significant clinical impact – high patient-benefit improvement in comparison to current practices and high user-related functionality for improved healthcare delivery.

• High probability of commercial success.

• In or exiting clinical trials and likely to be available on the market in 2010.

 • Sufficient data to support its application, benefits, and impact on society.