Methods and apparatus for remodeling an extravascular tissue structure

• US 20060116757A1
• Filed: 01/13/2006
• Published: 06/01/2006
• Est. Priority Date: 01/31/2000
• Status: Abandoned Application

• Current Assignee: David Taylor, Jan Lau, Matthew Birdsall, Randall Lashinski
• Original Assignee: David Taylor, Jan Lau, Matthew Birdsall, Randall Lashinski
• Inventors: Taylor, David, Birdsall, Matthew, Lashinski, Randall, Lau, Jan
• Application Number:
  US11/331,671
• Publication Number:
  US 20060116757A1
• Time in Patent Office: Days
• US Class Current: 623/2.110
• 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

Abstract

A medical apparatus and method for remodeling a mitral valve annulus adjacent to the coronary sinus includes an elongate body having a proximal end and a distal end. The elongate body is movable from a first, flexible configuration for transluminal delivery to at least a portion of the coronary sinus to a second configuration for remodeling the mitral valve annulus.

Claims

1. A method of manipulating the mitral valve, comprising:

providing a prosthesis having a proximal section, a central section and a distal section;

inserting the prosthesis into the venous system;

transluminally advancing the prosthesis into a coronary sinus; and

manipulating the prosthesis from a location outside the venous system to deflect the central section laterally with respect to the proximal and distal sections to selectively apply a compressive force along a region of tissue in the coronary sinus.

2. A method as in claim 1, wherein the prosthesis further comprises a forming element for manipulating the prosthesis.

3. A method as in claim 1, wherein the prosthesis further comprises a proximal anchor disposed on the proximal section and a distal anchor disposed on the distal section, and wherein the proximal and distal anchors are expanded to engage an inner wall of the coronary sinus before manipulating the prosthesis.

4. A method as in claim 1, further comprising measuring the coronary sinus and selecting an appropriately sized prosthesis prior to inserting the prosthesis into the venous system.

5. A method as in claim 1, further comprising measuring hemodynamic function after manipulating the prosthesis.

6. A method as in claim 5, further comprising determining an ongoing drug therapy after measuring the hemodynamic function.

7. A method of providing a therapeutic compressive force against a tissue structure which is adjacent to a vessel wall, comprising:

providing an elongate body having a forming element attached thereto;

positioning the elongate body in the vessel;

manipulating the forming element to cause a central section of the elongate body to move laterally with respect to a proximal and a distal section of the elongate body, thereby exerting a force against the adjacent tissue structure; and

detaching the forming element from the elongate body.

8. A method as in claim 7, wherein the positioning step is accomplished percutaneously.

9. A method as in claim 7, wherein the tissue structure comprises the mitral valve annulus.

10. A method as in claim 7, wherein the tissue structure comprises the left ventricle.

11. A method as in claim 7, wherein the vessel comprises a vein.

12. A method of performing annuloplasty of the mitral valve comprising:

positioning a prosthesis in a curved portion of a coronary sinus;

engaging a proximal tissue anchor and a distal tissue anchor on the device into tissue on an inside radius of the curve;

manipulating a first portion of the device with respect to a second portion of the device to provide a compressive force on the inside radius of the curve in between the first and second anchors; and

securing the device to maintain the compressive force within the coronary sinus.

13. A method as in claim 12, further comprising the step of percutaneously accessing the venous system prior to the positioning step.

14. A method as in claim 13, wherein the accessing step is accomplished by accessing one of the internal jugular, subclavian and femoral veins.

15. A method as in claim 12, wherein the securing step comprises providing an interference fit.

16. A method as in claim 12, wherein the securing step comprises providing an adhesive bond.

17. A method as in claim 12, wherein the securing step comprises providing a knot.

18. A method as in claim 12, further comprising the steps of first measuring the coronary sinus and then selecting an appropriately sized prosthesis prior to the positioning step.

19. A method as in claim 12, further comprising the step of measuring hemodynamic function following the manipulating step.

20. A method as in claim 19, further comprising the step of determining an ongoing drug therapy taking into account the post implantation hemodynamic function.