Closure prothesis for transcatheter placement

• US 5,947,997 A
• Filed: 06/30/1997
• Issued: 09/07/1999
• Est. Priority Date: 11/25/1992
• Status: Expired due to Term

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: William Cook Europe ApS (Cook Group Incorporated)
• Inventors: Pavcnik, Dusan, Wallace, Sidney, Wright, Kenneth C.
• Primary Examiner(s): Buiz, Michael
• Assistant Examiner(s): Trinh, Vikki
• Application Number:
  US08/885,306
• Time in Patent Office: 799 Days
• Field of Search: 606/213, 606/215, 606/198, 606/151, 606/190, 623/1, 623/11, 623/12, 604/11, 604/13, 604/15-16
• 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 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening

Abstract

A closure prosthesis and transcatheter delivery system are disclosed, wherein the closure prosthesis seals across an opening of a fluid passageway within a living body. The closure prosthesis is a flexible disk including a flexible ring and diaphragm having a plurality of hollow flexible wire segments attached thereto. Delivery of the closure prosthesis is accomplished using a hollow sheath and a pusher catheter slidable within the sheath, wherein filaments are looped through the wire segments to releasably connect the disk to the pusher catheter. The disk is resiliently compressed within the sheath and, upon release therefrom, the disk resiliently expands into a larger, unrestrained shape. Tension applied to the filaments resiliently bends the wire segments so that they may be drawn through the opening of the defect. Upon releasing the filaments from the disk, the wire segments resiliently expand to trap the disk in place to seal across the opening.

Claims

1. A closure prosthesis for sealing an opening in a fluid passageway within a living body, comprising:

a resiliently flexible sealing element;

at least one flexible restraining element fixedly attached and extendable along at least a portion of one side of said sealing element, said restraining element and said sealing element defining an integral closure element;

said integral closure element compressible into a reduced insertion configuration suitable for insertion through the fluid passageway and the opening but tending to self-expand to a relatively thin shape with a surface area capable of covering the opening; and

said fixedly attached restraining element having a first insertion form suitable for insertion through the fluid passageway and a second insertion form for passage through the opening, said restraining element tending to self-expand to a restraining configuration extending adjacent said one side of said sealing element such that said integral closure element pinches an edge of the opening between a portion of said restraining element and said sealing element.

2. The closure prosthesis of claim 1 wherein said sealing element is disk shaped.

3. The closure prosthesis of claim 2 wherein:

said sealing element has a center portion; and

said at least one flexible restraining element is attached to said center portion of said sealing element.

4. The closure prosthesis of claim 3 wherein:

said sealing element has a diameter; and

each of said at least one flexible restraining element has a length, wherein said length is configured to remain within the diameter of said sealing element.

5. The closure prosthesis of claim 1 wherein:

said sealing element comprises a resiliently flexible ring and a flexible diaphragm attached across said ring.

6. The closure prosthesis of claim 5 wherein:

said at least one flexible restraining element is attached to said flexible diaphragm.

7. The closure prosthesis of claim 1 wherein:

in an unrestrained condition, said sealing element defines a substantially planar configuration.

8. A flexible closure prosthesis and transcatheter delivery system, wherein said closure prosthesis seals across an opening of a fluid passageway within a living body, comprising:

a flexible sealing element;

a flexible restraining element attached to said sealing element, said sealing element and said restraining element defining an integral closure prosthesis;

a hollow sheath;

a pusher catheter slidable within said sheath;

said integral closure prosthesis deformable into a first insertion form constrainable within said sheath for delivery adjacent the opening, said closure prosthesis being self-expandable upon release from said sheath into a first operational form that is larger than said first insertion form; and

said flexible restraining element deformable into a second insertion form, said flexible restraining element self-expanding upon release into a second operational form that is larger than said second insertion form, wherein said sealing element seals across the opening and said restraining element restrains said closure prosthesis across the opening.

9. The apparatus of claim 8, further including a means for deforming said restraining element into said second insertion form.

10. The apparatus of claim 9, wherein said means is a filament releasably connecting said restraining element to said pusher catheter.

11. The apparatus of claim 10 wherein:

said pusher catheter is a double lumen catheter having an inner lumen and an outer lumen; and

said filaments attach at an end of said pusher catheter opposite said closure prosthesis and are routed through said outer lumen to said closure prosthesis, releasably connect to said restraining element, and extend through said inner lumen to attach to a pull ring.

12. The apparatus of claim 11, wherein said restraining element includes at least one aperture and said filament is slidably received through said aperture.

13. The apparatus of claim 9, wherein said means for deforming comprises:

a pull ring, said pull ring being larger in diameter that said pusher catheter to prevent passage therethrough;

at least one filament releasably connect to said restraining element, said filaments connected at one end to said pusher catheter and at another end to said pull ring; and

wherein pulling of said pull ring causes said filament to deform said restraining element.

14. A method for delivering a closure prosthesis for sealing across an opening of a fluid passageway within a living body, comprising:

providing a closure prosthesis including a flexible sealing element and a flexible restraining element attached thereto;

inserting the closure prosthesis into a living body adjacent the opening, the closure prosthesis maintained in a reduced size first insertion form;

deploying the closure prosthesis, the closure prosthesis self-expanding into a first operational form larger than said first insertion form and sized to prevent passage through the opening;

after deploying, compressing the restraining element portion of the closure prosthesis into a second insertion form for passage through the opening;

moving the restraining element portion of the closure prosthesis through the opening; and

releasing the restraining element portion of the closure prosthesis, the restraining elements self-expanding into a second operational form larger than the second insertion form, wherein said sealing element seals across the opening and said restraining element restrains said closure prosthesis in place across the opening.

15. The method of claim 14, further including providing a transcather delivery system having an outer sheath and a pusher catheter slidable within said outer sheath, wherein inserting includes advancing the outer sheath having the closure prosthesis maintained in a reduced insertion form through a body to the opening and deploying includes maintaining the position of the pusher catheter with respect to the outer sheath and withdrawing the outer sheath, thereby urging the closure prosthesis out of the outer sheath.