METHOD OF RESHAPING A VENTRICLE

• US 20120029628A1
• Filed: 10/03/2011
• Published: 02/02/2012
• Est. Priority Date: 10/04/2006
• Status: Active Grant

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Edwards Lifesciences Corporation
• Inventors: Rowe, Stanton J.
• Granted Patent: US 8,870,936 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• CPC Class Codes: A61F 2/06 Blood vessels
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• 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 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2230/0041 J-shaped

Abstract

Methods for restoring the conical shape of a dilated heart ventricle, or at least reshaping the ventricle to a more conical shape to counter the effects of dilation, thereby improving pumping efficiency. In an exemplary embodiment, a reshaping apparatus comprises an implantable body that can be delivered to a dilated left ventricle via the patient'"'"'s vasculature in a minimally-invasive procedure. When deployed inside the left ventricle, the body is adapted to apply a longitudinal (downward) force against the inner surface of the left ventricle that causes the ventricle to distend or elongate downwardly relative to the base of the heart so as to at least partially restore the conical shape of the heart. In other embodiments, one or more tension members can be secured to heart tissue inside a heart chamber or on the outside of the heart and placed in tension to reshape the geometry of the heart.

Claims

1. A method of reshaping a dilated ventricle of a patient comprising applying a longitudinal force against an apex portion of the ventricle to elongate the ventricle.

2. The method of claim 1, wherein the act of applying a longitudinal force against an apex portion of the ventricle comprises deploying an implantable body in the ventricle, which then applies the longitudinal force against the apex portion of the ventricle.

3. The method of claim 2, wherein the implantable body is delivered percutaneously through the patient'"'"'s vasculature into the ventricle.

4. The method of claim 3, wherein the implantable body is advanced through the patient'"'"'s vasculature while contained in a lumen of a delivery sheath and then deployed in the ventricle by advancing the implantable body through the open distal end of the delivery sheath.

5. The method of claim 2, wherein the implantable body comprises a radially expandable frame coupled to a pusher member, and deploying the implantable body causes the frame to deploy within the left ventricular outflow tract and the pusher member to push against an inner surface of the apex portion.

6. The method of claim 5, wherein the frame mounts a prosthetic valve member.

7. The method of claim 1, wherein the act of applying a longitudinal force against an apex portion of the ventricle comprises securing a first end portion of a tension member to the outer surface of the apex portion and securing a second end portion of the tension member to a body part below the apex portion to draw the apex portion toward the body part, thereby elongating the ventricle.

8. The method of claim 7, wherein the second end portion is secured to a rib.

9. The method of claim 7, wherein the first end portion of the tension member is connected to an anchor member, and securing the first end portion of the tension member comprises deploying the anchor adjacent the outer surface of the apex portion to cause expandable prongs of the anchor member to engage and become anchored to the outer surface.

10. A method of reshaping a left ventricle of a human heart, comprising:

delivering an implantable body into the left ventricle by a delivery catheter, the implantable body having an anchor member and an elongate pusher member permanently fixed to the anchor member, the pusher member having a length sized to extend from a left ventricular outflow tract to an apex of the left ventricle, the anchor member having an expanded diameter sized for deployment in the left ventricular outflow tract, the pusher member in a deployed state extending along a longitudinal axis from the anchor member to the apex of the left ventricle, the pusher member having a distal end portion adapted to apply a longitudinal force along the apex of the left ventricle;

ejecting the implantable body from the delivery catheter;

expanding the anchor member for securing the anchor member to the left ventricular outflow tract; and

deploying the pusher member for applying the longitudinal force along the apex of the left ventricle to permanently elongate the left ventricle, thereby improving a pumping efficiency of the left ventricle.

11. The method of claim 10, wherein the anchor member comprises a radially expandable stent having an unobstructed lumen extending therethrough.

12. A method for reshaping a dilated ventricle of a patient comprising:

positioning a tension member having first and second ends in the ventricle;

securing the first end of the tension member to a first inner wall of the ventricle and securing the second end of the tension member to a second inner wall of the ventricle; and

tensioning the tension member to draw the inner walls toward each other.

13. The method of claim 12, wherein the tension member comprises a suture line.

14. The method of claim 12, wherein the first and second ends of the tension member are secured to the inner walls with respective expandable anchor members.

15. The method of claim 14, wherein each anchor member comprises radially expandable prongs that grab the tissue of the inner walls to secure the ends of the tension member in place.

16. The method of claim 12, wherein:

the tension member comprises a first tension member; and

the method further comprises securing the first end of a second tension member to the first inner wall, securing a second end of the second tension member to the second inner wall, tensioning the second tension member, and connecting the first and second tension members to each other at a location between the inner walls.