Stress reduction apparatus and method

• US 20050143620A1
• Filed: 02/17/2005
• Published: 06/30/2005
• Est. Priority Date: 07/29/1998
• Status: Active Grant

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Myocor, Inc. (Edwards Lifesciences Corporation)
• Inventors: Vidlund, Robert M., Mortier, Todd J., Schweich, Cyril J. Jr.
• Granted Patent: US 8,439,817 B2
• Time in Patent Office: Days
• US Class Current: 600/37
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/2481 Devices outside the heart wall, e.g. bags, strips or bands
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints

Abstract

The device and method for reducing heart wall stress. The device can be one which reduces wall stress throughout the cardiac cycle or only a portion of the cardiac cycle. The device can be configured to begin to engage, to reduce wall stress during diastolic filling, or begin to engage to reduce wall stress during systolic contraction. Furthermore, the device can be configured to include at least two elements, one of which engages full cycle and the other which engages only during a portion of the cardiac cycle.

Claims

1-9. -9. (canceled)

10. A method of treating a heart, the method comprising:

providing a member configured to be implanted proximate the heart;

implanting the member relative to the heart so as to contact chordae of the heart; and

displacing at least one of the chordae, papillary muscles, and a wall of the heart during at least a portion of a cardiac cycle.

11. The method of claim 10, wherein the displacing at least one of the chordae, papillary muscles, and the wall of the heart includes drawing at least one of the chordae, papillary muscles, and the wall of the heart inward with respect to a chamber of the heart.

12. The method of claim 11, wherein the chamber includes a left ventricle.

13. The method of claim 10, wherein displacing at least one of the chordae, papillary muscles, and the wall of the heart includes displacing at least one of the chordae, papillary muscles, and the wall of the heart during diastole.

14. The method of claim 10, wherein providing the member includes providing a ring-like member.

15. The method of claim 14, wherein implanting the ring-like member includes encircling the ring-like member around the chordae.

16. The method of claim 15, wherein the chordae include chordae associated with two papillary muscles.

17. The method of claim 10, wherein displacing at least one of the chordae, papillary muscles, and the wall of the heart includes displacing at least one of the chordae, papillary muscles, and the wall of the heart throughout the cardiac cycle.

18. A device for treating a natural heart having a plurality of chambers and a cardiac cycle comprising isovolumic contraction, systolic ejection, isovolumic relaxation, and diastolic filing, the device comprising:

a plurality of members adapted to inwardly displace portions of a wall of one chamber of the natural heart; and

a connector adapted to maintain the members in a closely spaced relationship to reconfigure a chamber of the natural heart during at least a portion of systolic ejection;

wherein cyclical forces are applied to the wall of the one chamber of the natural heart to reduce adverse effects caused by reconfiguring the chamber during diastolic filling.

19. The device of claim 18 wherein the plurality of members comprises two members spaced approximately 180 degrees apart, which members are adapted to inwardly displace underlying portions of a wall of one chamber of the natural heart.

20. The device of claim 18 wherein the cyclical forces are applied by the members adapted to inwardly displace portions of a wall of one chamber of the natural heart during at least a portion of the cardiac cycle.

21. The device of claim 18 further comprising an energy transfer mechanism that stores energy expended by the natural heart during one portion of the cardiac cycle and releases energy to reposition the members such that the chamber is substantially more restricted during another portion of the cardiac cycle.

22. The device of claim 20, the plurality of members comprising first and second members, wherein said first and second members are positioned adjacent the epicardial surface of the chamber wall in a spaced relationship relative to each other about 180 degrees apart.

23. The device of claim 20, the plurality of members comprising a first member configured to be positioned adjacent the anterolateral surface of the chamber and a second member configured to be positioned adjacent the posteromedial surface of the chamber.

24. The device of claim 20, comprising at least one fixation device configured to maintain contact between the members and a specific surface of the chamber.

25. A method of treating a natural heart having a plurality of chambers and a cardiac cycle comprising isovolumic contraction, systolic ejection, isovolumic relaxation, and diastolic filing, the method comprising:

inwardly displacing portions of a wall of one chamber during at least a portion of a cardiac cycle; and

applying a cyclical force to the wall of the one chamber to reduce adverse effects on diastolic filling caused by displacing portions of the wall.

26. The method of claim 25 wherein the wall is inwardly displaced by restraining bars during at least most of systolic ejection.

27. The method of claim 26 wherein the cyclical force is applied by the restraining bars to reposition the restraining bars to a closely spaced relationship prior to systolic ejection and the restraining bars are positioned in a distantly spaced relationship applying a lesser force during at least most of diastolic filling.

28. The method of claim 27 wherein the restraining bars are repositioned into a closely spaced relationship prior to systolic ejection by an energy transfer mechanism.

29. The method of claim 27 wherein the restraining bars are allowed to reposition into a distantly spaced relationship prior to diastolic filling.

30. A device for treating a natural heart, comprising:

a plurality of members pressing inwardly on a chamber wall of the heart to reconfigure the chamber into at least two contiguous communicating portions of truncated ellipsoids during at least most of systolic ejection; and

an energy transfer mechanism configured to reduce adverse effects of reconfiguration during at least most of diastolic filling.

31. A cyclical device for treating a natural heart, comprising:

a plurality of members configured to be positioned adjacent the epicardial surface of a chamber of the heart; and

a connector fixing the members in a first spaced relationship during at least most of systolic ejection and allowing the heart to move the members to a second spaced relationship prior to diastolic filling, wherein the second spaced relationship provides a greater chamber radius than the first spaced relationship.

32. A clasp configured to be placed about a chamber of a natural heart for treatment of the natural heart, the clasp comprising:

a plurality of restraining bars adapted to be placed adjacent a chamber wall external to the chamber and to reconfigure the chamber as contiguous truncated portions of ellipsoids when positioned in a closely spaced relationship to each other;

a connecting component adapted to allow the restraining bars to be positioned in either of a closely spaced relationship and a distantly spaced relationship; and

an energy-storage member adapted to reposition the restraining bars from the distantly spaced relationship to the closely spaced relationship.

33. A method for stabilizing an atrioventricular valve, said method comprising:

capturing chordae attached to at least one leaflet of the valve while the heart is beating by surrounding the chordae with a capture device; and

positioning or configuring the capture device so as to tension at least a portion of the chordae to modify movement of the leaflet.

34. A device for use as an external heart stabilizer, wherein the heart has a base and an apex, comprising a strip of biocompatible, implantable material having a predetermined width adapted to encompass the base of the heart and not the apex of the heart to prevent basal dilation during all cardiac cycle phases.

35. The device of claim 34, further comprising a top edge, a bottom edge and a center portion.

36. The device of claim 35, wherein the center portion further comprises an open mesh.

37. The device of claim 35, wherein the center portion further comprises a fabric mesh.

38. The device of claim 35, further comprising means for attaching the device to the heart.

39. The device of claim 35, further comprising attachment members.

40. The device of claim 39, wherein the attachment members further comprise eyelets.

41. A method for treating heart disorders comprising epicardially placing a device according to claim 35 around the base of the heart.

42. The method according to claim 41, further comprising placing the device in the atrio-ventricular groove.