Intracardiac cage and method of delivering same

• US 20070066993A1
• Filed: 09/16/2005
• Published: 03/22/2007
• Est. Priority Date: 09/16/2005
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Kreidler, Marc
• Granted Patent: US 7,972,359 B2
• Time in Patent Office: Days
• US Class Current: 606/213
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00597 Implements comprising a membrane
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00615 Implements with an occluder on one side of the opening and holding means therefor on the other
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61F 2/0108 Both ends closed, i.e. legs gathered at both ends
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0071 spherical
• CPC Class Codes: A61F 2230/0076 ellipsoidal or ovoid

Abstract

A method of preventing ingress of material into the left atrium of a heart includes providing a delivery sheath, advancing the sheath distal end through an opening between the right atrium and the left atrium of the heart, providing an expandable cage, delivering the expandable cage to the left atrium, and expanding the expandable cage within the left atrium. The expandable cage includes a proximal end, a distal end, and a plurality of supports extending therebetween. The expandable cage also includes a first membrane provided at its proximal end and a second membrane provided at its distal end. The expandable cage has a collapsed configuration so that it can be received within the lumen of the delivery sheath, and an expanded configuration for deployment within the heart. When expanded, the first membrane is positioned at an opening between the left and right atria of the heart, and the second membrane is positioned at the ostium of the left atrial appendage. The first membrane substantially prevents passage of blood between the atria and the second membrane prevents passage of embolic material from the left atrial appendage into the left atrium of the heart.

Claims

1. A method of preventing ingress of material into the left atrium of a heart, comprising:

providing a delivery sheath having a sheath proximal end, a sheath distal end, and a lumen extending therethrough, to the right atrium of the heart atrium;

advancing the sheath distal end through an opening between the right atrium and the left atrium;

providing an expandable cage, having a proximal end, a distal end, a plurality of supports extending therebetween, a first membrane provided at the proximal end, and a second membrane provided at the distal end, the expandable cage having a collapsed configuration to be received within the lumen of the delivery sheath, and an expanded configuration for deployment within the heart;

delivering the expandable cage to the left atrium of the heart through the delivery sheath; and

expanding the expandable cage within the left atrium, the expandable cage when expanded positioning the second membrane at the ostium of the left atrial appendage, wherein the second membrane prevents passage of embolic material from the left atrial appendage into the left atrium, and positioning the first membrane at an opening between the left atrium and a right atrium of the heart, where the first membrane substantially prevents passage of blood between the atria.

2. The method of claim 1, wherein the opening is a natural opening.

3. The method of claim 1, wherein the opening is formed by piercing the atrial septum.

4. The method of claim 1, wherein the opening is a patent foramen ovale.

5. The method of claim 1, wherein the opening is a septal defect.

6. The method of claim 1, wherein the cage is self expanding

7. The method of claim 1, wherein the cage is expanded by retracting the delivery sheath proximally.

8. The method of claim 1, wherein the delivering step comprises pulling the delivery sheath proximally with respect to the expandable cage prior to said expanding step.

9. The method of claim 1, wherein the delivering step comprises pushing the expandable cage past the sheath distal end prior to said expanding step.

10. The method of claim 1, wherein said delivering the expandable cage comprises positioning the cage distal of the distal end prior to said expanding step.

11. The method of claim 1, further comprising verifying the position of the expandable cage within the left atrium, wherein said verifying is performed prior to said expanding step.

12. The method of claim 1, further comprising repositioning said cage within the left atrium.

13. The method of claim 1, further comprising retrieving said cage from the left atrium.

14. A method of preventing ingress of material to a chamber of a heart, comprising:

providing an expandable cage to a chamber of a heart, wherein said chamber has at least two openings, and wherein said expandable cage comprises a proximal end, a distal end, a plurality of supports extending therebetween, and at least one membrane, the expandable cage having a collapsed configuration for delivery to the heart, and an expanded configuration for deployment within the heart; and

expanding said expandable cage within the chamber of the heart, wherein said at least one membrane is positioned at one of said at least two openings of the chamber to prevent ingress of material into the chamber.

15. The method of claim 14, wherein said one of said at least two openings is an ostium to a left atrial appendage.

16. The method of claim 14, wherein said one of said at least two openings is a patent foramen ovale.

17. The method of claim 14, wherein said one of said at least two openings is a septal defect.

18. The method of claim 14, wherein said membrane filters blood from a left atrial appendage.

19. The method of claim 14, wherein said membrane substantially prevents blood flow from a right atrium into a left atrium the heart.

20. An expandable cage for preventing ingress of material to a chamber of a heart, comprising:

a frame comprising a proximal end, a distal end, and a plurality of supports extending therebetween, wherein said cage has a collapsed configuration for delivery to a chamber of the heart, and an expanded configuration for deployment within the heart; and

at least one membrane provided at at least one of said proximal and said distal ends, wherein a length between said proximal and distal ends when at least partially expanded generally approximates the distance between an ostium of a left atrial appendage and a septum of the heart.

21. The expandable cage of claim 20, wherein said at least one membrane comprises a proximal membrane provided at said proximal end and a distal membrane provided at said distal end.

22. The expandable cage of claim 20, wherein said at least one membrane has a diameter corresponding to the dimensions of a patent foramen ovale.

23. The expandable cage of claim 20, wherein said at least one membrane has a diameter corresponding to the dimensions of an ostium of a left atrial appendage.

24. The expandable cage of claim 20, wherein said proximal end comprises supports that extend proximally, distally, and proximally from an apex to a proximal hub.

25. A system for preventing ingress of material to a chamber of a heart, comprising:

the expandable cage of claim 20;

and

a transseptal sheath for delivering the expandable cage to the chamber.