Device and Method for the Surgical Treatment of Ischemic Mitral Regurgitation
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Abstract
A device for the treatment of ischemic mitral regurgitation of a damaged left ventricle having an opposing papillary muscles displaced laterally or axially relative to the mitral annulus. The device includes a lateral limb configured to extend between opposing papillary muscles of a left ventricle and first and second axial limbs extending from spaced points on the lateral limb to form an essentially U-shaped configuration. The first and second axial limbs are configured to extend between the lateral limb and a mitral annulus. A method for the treatment of mitral regurgitation comprises extending a first segment of the lateral limb of the device across opposing sides of a ventricle near opposing papillary muscles. The segment of the first lateral limb is shortened as needed to put the first and second papillary muscles into a substantially normal lateral position relative to the mitral annulus and the length of the segment of the first lateral limbs is fixed. The method further includes extending a segment of the first axial limb between the lateral limb and the mitral annulus and extending a segment of the second axial limb between the lateral limb and the mitral annulus. The first and second axial limb segments are then shortened, as needed, to put opposing papillary muscles into a substantially normal axial position relative to the mitral annulus and the lengths of the segments of the first and second axial limbs are fixed.
207 Citations
87 Claims
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1-67. -67. (canceled)
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68. A method for the treatment of mitral regurgitation of a damaged left ventricle of a heart, the left ventricle having at least one of first and second opposing papillary muscles displaced laterally or axially relative to a mitral annulus as compared to normal lateral and axial positions of the opposing papillary muscles relative to a mitral annulus of a healthy heart, the method comprising:
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a) halting beating of the heart; b) attaching opposing ends of a first lateral limb to opposing sides of the ventricle at locations whereby the first and second opposing papillary muscles can be drawn laterally together by shortening the segment of the first lateral limb; c) shortening the first lateral limb as needed to put the at least one of the first and second opposing papillary muscles into a substantially normal lateral position relative to the mitral annulus and fixing the length of the segment of the first lateral limb; d) extending a first axial limb attached to the first lateral limb and operatively associating a distal end of the first axial limb with the mitral annulus; e) extending a second axial limb attached to the first lateral limb and operatively associating a distal end of the second axial limb with the mitral annulus; and shortening the first and second axial limbs as needed to put the at least one of the first and second opposing papillary muscles into a substantially normal axial position relative to the mitral annulus and fixing the length of the first and second axial limbs. - View Dependent Claims (69, 70, 71, 73)
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72. The method of 71 further comprising:
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g) resuming beating of the heart; h) adjusting the length of the first lateral limb as needed by unsecuring the drawstring from the outside surface of the ventricle wall and moving the ventricle wall inward or outward, as needed, and resecuring the drawstrings to the outside surface of the heart; and i) adjusting the length of the first axial limb and the second axial limb as needed by unsecuring the first or second drawstring from the outside surface of the ventricle wall and drawing the first and second drawstrings into or out of the ventricle to lengthen or shorten the first and second axial limbs, respectively, as needed and resecuring the first or second drawstrings on the outside surface of the ventricle wall. - View Dependent Claims (74)
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75. A device for treatment of ischemic mitral regurgitation of a damaged left ventricle having first and second opposing papillary muscles displaced laterally or axially relative to a mitral annulus as compared to a normal lateral and axial positions of opposing papillary muscles relative to a mitral annulus in a healthy heart, the device comprising:
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a lateral limb configured to extend between opposing sides of a left ventricle, the lateral limb further being configured to provide for an adjustable length thereof; and first and second axial limbs extending from spaced points on the lateral limb to form an essentially U-shaped configuration, the first and second axial limbs being configured to extend between the lateral limb and a mitral annulus and the axial limbs further being configured to provide for an adjustable length thereof. - View Dependent Claims (76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87)
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Specification