Percutaneous mitral annuloplasty and cardiac reinforcement

• US 20020103533A1
• Filed: 01/30/2001
• Published: 08/01/2002
• Est. Priority Date: 01/31/2000
• Status: Active Grant

• Current Assignee: Edwards Lifesciences AG (Edwards Lifesciences Corporation)
• Original Assignee: EV3 Santa Rosa, Inc. (Medtronic Plc)
• Inventors: Burg, Eric van der, Lesh, Michael D., Langberg, Jonathan J.
• Granted Patent: US 6,537,314 B2
• Time in Patent Office: Days
• US Class Current: 623/2.37
• CPC Class Codes: A61F 2/2451 Inserts in the coronary sinus for correcting the valve shape
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61N 2001/0585 Coronary sinus electrodes

Abstract

A mitral annuloplasty and left ventricle restriction device is designed to be transvenously advanced and deployed within the coronary sinus and in some embodiments other coronary veins The device places tension on adjacent structures, reducing the diameter and/or limiting expansion of the mitral annulus and/or limiting diastolic expansion of the left ventricle. These effects may be beneficial for patients with dilated cardiomyopathy.

Claims

1. A medical device for remodeling an extravascular tissue structure adjacent to a vessel in a patient, comprising:

an elongate body extending between a proximal end and a distal end, and that is adjustable between a first configuration having a first shape such that the elongate body is adapted to be delivered at least in part into the vessel and a second configuration having a second shape such that the elongate body is adapted to exert a force from within the vessel onto the extravascular tissue structure in order to remodel the extravascular tissue structure.

2. A medical device as in claim 1, wherein

the elongate body is adapted to be positioned in the first configuration at least in part within a coronary sinus and is adapted to remodel a mitral valve annulus adjacent to the coronary sinus when the elongate body is located at least in part within the coronary sinus and is adjusted to the second configuration.

3. A medical device as in claim 2, further comprising:

a forming element that is secured to the elongate body at a point of attachment and that is moveable relative to the elongate body in order to adjust the elongate body within the coronary sinus between the first and second configurations.

4. A medical device as in claim 3, wherein the elongate body is adjustable from the first configuration to the second configuration principally by applying a force from the forming element to the elongate body.

5. A medical device as in claim 4, wherein the forming element is adapted to adjust the elongate body from the first configuration to the second configuration at least in part by providing a rotational force along at least a portion of the forming element.

6. A medical device as in claim 5, wherein the forming element comprises:

a rotational force transmission member with a proximal end portion and a distal end portion;

a rotational coupler with a proximal end portion coupled to the distal end portion of the rotational force transmission member; and

an axial force transmission member with a proximal end portion coupled to the distal end portion of the rotational coupler and a distal end portion coupled to the elongate body,

wherein the proximal end portion of the rotational force coupler is adapted to be positioned externally of the patient when the elongate body is positioned within the coronary sinus such that rotational forces may be imparted onto the rotational force transmission member, and the rotational coupler is adapted to convert rotational force from the rotational force transition member to axial force onto the axial force transmission member, and the elongate body is adjustable from the first configuration to the second configuration in response to the axial force from the axial force transmission member.

7. A medical device as in claim 3, wherein the elongate body is adapted to be uncoupled in the second configuration from at least a portion of the forming element as a permanent implant located at least in part within at least the coronary sinus.

8. A medical device as in claim 7, wherein the forming element is adapted to be severed while the elongate body is positioned at least in part within the coronary sinus in the second configuration.

9. A medical device as in claim 8, wherein

the proximal extension of the forming element comprises a proximal member;

the forming element further comprises a distal member that is coupled to the proximal member and is attached to the elongate body at the point of attachment;

the proximal member is adapted to transmit an applied force from outside the patient to the distal member while the elongate body along the midportion is located within the coronary sinus;

the distal member is adapted to substantially transmit the applied force from the proximal member to the elongate body in order to adjust the elongate body from the first configuration to the second configuration within the coronary sinus;

and the distal member is detachable from the proximal member while the elongate body is in the second configuration at least in part within the coronary sinus in order to thereby sever the forming element.

10. A method of performing annuloplasty of the mitral valve comprising positioning a prosthesis in the coronary sinus.