METHOD AND DEVICE FOR PERCUTANEOUS LEFT VENTRICULAR RECONSTRUCTION

• US 20080097148A1
• Filed: 12/20/2007
• Published: 04/24/2008
• Est. Priority Date: 10/13/2004
• Status: Active Grant

• Current Assignee: Bioventrix, Inc.
• Original Assignee: CHF Technologies Inc.
• Inventors: Bertolero, Arthur, Chin, Sing-Fatt, Annest, Lon
• Granted Patent: US 8,449,442 B2
• Time in Patent Office: Days
• US Class Current: 600/37
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• 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 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 5/283 : Invasive
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• 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
• CPC Class Codes: A61F 2002/2484 : Delivery devices therefor
• CPC Class Codes: A61M 25/09 : Guide wires

Abstract

A method for reducing left ventricular volume, which comprises identifying infarcted tissue during open chest surgery; reducing left ventricle volume while preserving the ventricular apex; and realigning the ventricular apex, such that the realigning step comprises closing the lower or apical portion of said ventricle to achieve appropriate functional contractile geometry of said ventricle in a dyskinetic ventricle of a heart.

Claims

1. A method for reducing left ventricular volume in a congestive heart failure heart, the method comprising the steps of:

a. identifying infarcted tissue during open chest surgery;

b. reducing left ventricle volume while preserving the ventricular apex; and

c. realigning the ventricular apex;

wherein said realigning step comprises closing of a lower or apical portion of said ventricle to achieve appropriate functional contractile geometry of said ventricle.

2. The method of claim 1, wherein said open chest surgery is a minimally invasive surgery.

3. The method of claim 1, further comprising the step of sensing the infarcted tissue.

4. The method of claim 3, wherein the infarcted tissue is the myocardium.

5. The method of claim 1, wherein the step of realigning the ventricular apex further comprises the steps of altering the geometry of the ventricle and decreasing wall tension.

6. The method of claim 1, wherein said steps of reducing left ventricle volume and realigning the ventricular apex are performed via the step of introducing a catheter into the right ventricle of the heart via the septum and passing said catheter into the left ventricle.

7. The method of claim 6, wherein the step of introducing a catheter comprises the step of making an incision at or near the femoral vein or artery through which the catheter is inserted.

8. The method of claim 6, wherein said catheter comprises a sensing element.

9. The method of claim 3, wherein the step of sensing the infarcted tissue may be performed by a procedure selected from the group consisting of:

pacing, angiography, echocardiography, and tissue Doppler.

10. The method of claim 1, further comprising the use of a thoracoscope or camera into an incision to facilitate visualization of the method.

11. The method of claim 1, further comprising the steps of:

e. applying suction to said left ventricle to cause dilation of said ventricle;

f. clamping the dilated portion of said ventricle; and

g. securing the clamped portion.

12. The method of claim 11, further comprising the step of applying a patch on said dilated portion.

13. A method for performing minimally invasive left ventricular volume reduction in a congestive heart failure heart, the method comprising the steps of:

a. perforating the septum of the heart by inserting a catheter through a right ventricle;

b. identifying infarcted tissue on the septum;

c. advancing the catheter through the infarcted tissue of the septum;

d. identifying infracted tissue on the left ventricular wall; and

e. bringing together the infracted tissue closer to each other and thereby minimizing the volume of the left ventricle.

14. A system for resizing a left ventricle of a heart, comprising:

a. a catheter inserted into the left ventricle via a puncture in the septum of the heart;

b. a first fixation member positioned on an external surface wall of said left ventricle; and

c. a second fixation member positioned on a surface of said septum external of said left ventricle, wherein said catheter connects said first and second fixation members and wherein tension applied on said catheter causes said second fixation member to pull said external surface wall of said left ventricle towards said septum to close off a lower or apical portion of said left ventricle.

15. The system according of claim 14, wherein said catheter further comprises a sensing element.

16. The system according to claim 14, wherein said sensing element is coextensive with said catheter.

17. The system according to claim 14, wherein said fixation members are disk shaped.

18. The system according to claim 14, wherein said fixation members are made of biocompatible materials.

19. The system according to claim 14, wherein said fixation members may be impregnated or loaded with angiogenic factors, drugs, gene-regulated viral vectors, cellular materials, or other substances.

20. The system according to claim 14, wherein said catheter is maneuverable by a medical professional.

21. The system according to claim 14, wherein said fixation members are provided with one or more retention features to facilitate and secure said fixation members in their appropriate positions on the septum and left ventricle.