IMPLANTABLE PURSE STRING SUTURE TENSIONING DEVICE

• US 20100305609A1
• Filed: 10/20/2008
• Published: 12/02/2010
• Est. Priority Date: 10/18/2007
• Status: Active Grant

• Current Assignee: St. Jude Medical Cardiology Division Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical Cardiology Division Incorporated (Abbott Laboratories Incorporated)
• Inventors: Cartledge, Richard G., Cartledge, John P.
• Granted Patent: US 8,529,589 B2
• Time in Patent Office: Days
• US Class Current: 606/232
• CPC Class Codes: A61B 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/1142 Purse-string sutures

Abstract

An implantable purse string suture tensioning device is provided, such that a hemostatic seal can be maintained without further manual adjustment over a range of purse string circumferences, including that surrounding a minimally invasive device, or a control or guidewire, and after complete removal of objects within the purse string suture, wherein the device is sized and shaped for in-dwelling implantation in a patient.

Claims

1. An implantable purse string suture tensioning device comprising:

a) at least one compressible tensioning element having a proximal end and a distal end;

b) a suture guide element having a proximal surface and a distal surface and at least one passage therethrough for receiving a purse string suture, wherein the suture guide element stabilizes the suture adjacent to the tensioning element to permit absorption of excess suture length under predetermined pressure to maintain hemostatasis; and

wherein the device is sized and shaped for in-dwelling implantation in a patient.

2. The tensioning device of claim 1, wherein the passage through the guide element is linear.

3. The tensioning device of claim 1, wherein the passage through the guide element is non-linear.

4. The tensioning device of claim 1, wherein the suture enters the passage through the guide element substantially perpendicular to the plane of the tissue and exits the passage substantially parallel to the plane of the tissue.

5. The tensioning device of claim 1, wherein the guide element has two separate passages for receiving respective ends of the purse string suture.

6. The tensioning device of claim 1, wherein at least a portion of the guide element extends through the tensioning element.

7. The tensioning device of claim 1, wherein at least a portion of the tensioning element extends through the guide element.

8. The tensioning device of claim 1, further comprising a removable tension retaining element which retains the tensioning element in a compressed configuration.

9. The tensioning device of claim 1, wherein the suture guide element further comprises a plurality of telescoping elements permitting variable length of the suture passing therethrough.

10. The tensioning device of claim 1, further comprising a suture retaining element.

11. The tensioning device of claim 10, wherein the suture retaining element is a proximal septum between separate passages for each end of the purse string suture.

12. The tensioning device of claim 1, wherein the device seals a purse string suture through a range of tension required with and without an elongated medical device inserted into the purse string suture.

13. A method for sealing a purse string suture around an elongated medical device using the purse string suture tensioning device of claim 1, comprising:

a) inserting at least one end of the purse string suture through the distal surface of the guide element;

b) securing the at least one end of the purse string suture proximal to the tensioning element, wherein the tensioning element is in a compressed configuration while the at least one end of the purse string suture is being secured;

c) releasing compression on the tensioning element to provide tension throughout the purse string; and

d) closing tissue over the device.

14. The method of claim 13, wherein the tissue is the heart.

15. The method of claim 13, wherein the elongated medical device is a cannula.

16. The method of claim 13, wherein the tensioning element is secured in a compressed configuration by a tension retaining element, which is removed to release compression.

17. An implantable purse string suture tensioning device comprising:

a) a guide element having a proximal surface and a distal surface and at least one passage there through, for receiving a purse string suture,

b) a tensioning element, having a first lateral end and a second lateral end,

c) a plurality of passage elements, one attached to each end of the tensioning element, for receiving a respective end of the purse string suture;

wherein the device is sized and shaped for in-dwelling implantation in a patient.

18. The tensioning device of claim 17, wherein the passage through the guide element is linear.

19. The tensioning device of claim 17, wherein the guide element has a plurality of passages for receiving a purse string suture.

20. The tensioning device of claim 17, further comprising a suture retaining element attached to the tensioning element, adapted for securing the ends of a purse string suture.

21. The tensioning device of claim 17, wherein the tensioning element is substantially parallel to the plane of the tissue.

22. The tensioning device of claim 17, wherein the device seals a purse string suture through a range of tension required with and without an elongated medical device inserted into the purse string suture.

23. A method for sealing a purse string suture around an elongated medical device using the purse string suture tensioning device of claim 17, comprising:

a) inserting the ends of the purse string suture through the guide element;

b) threading each end of the purse string suture through a corresponding passage element;

c) securing the ends of the suture together, wherein the tensioning element is in a compressed configuration while the ends of the suture are being secured; and

d) closing tissue over the device.

24. The method of claim 23, wherein the tissue is the heart.

25. The method of claim 23, wherein the tensioning element is secured in a compressed configuration by a tension retaining element, which is removed to release compression.