Method and apparatus for closing intracardiac septal defects

• US 6,290,674 B1
• Filed: 11/22/1999
• Issued: 09/18/2001
• Est. Priority Date: 09/20/1999
• Status: Expired due to Term

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Appriva Medical, Inc. (Medtronic Plc)
• Inventors: Lesh, Michael D., Frazier, Andrew G. C., Roue, Chad C., van der Burg, Erik J.
• Primary Examiner(s): Mendez, Manuel
• Application Number:
  US09/444,904
• Time in Patent Office: 666 Days
• Field of Search: 604/107, 604/264, 606/213, 606/215, 606/216, 606/222, 606/223, 606/224, 606/225, 606/226, 606/227
• US Class Current: 604/107
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/0401 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• 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 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/00668 the implement being a tack or a staple
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/042 plastically deformed during insertion
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0472 : Multiple-needled, e.g. double-needled, instruments
• CPC Class Codes: A61B 2017/0477 : with pre-tied sutures
• CPC Class Codes: A61B 2017/048 : for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0645 : being elastically deformed for insertion
• CPC Class Codes: A61B 2017/0647 : having one single leg, e.g. tacks
• CPC Class Codes: A61F 2/24 : Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
• CPC Class Codes: A61F 2/2427 : Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints
• CPC Class Codes: Y10S 606/907 : Composed of particular material or coated

Abstract

Disclosed is a closure catheter, for closing a tissue opening such as an atrial septal defect, patent foreman ovale, or the left atrial appendage of the heart. The closure catheter carries a plurality of tissue anchors, which may be deployed into tissue surrounding the opening, and used to draw the opening closed. Methods are also disclosed.

Claims

1. A method of closing an opening in a wall of the heart, comprising the steps of:

advancing a catheter through the opening;

deploying at least two suture ends from the catheter and into tissue adjacent the opening;

retracting the catheter from the opening;

drawing the suture ends to reduce the size of the opening; and

securing the opening in the reduced size.

2. A method of closing an opening as in claim 1, wherein the advancing step comprises advancing the catheter through an atrial septal defect.

3. A method of closing an opening as in claim 1, wherein the deploying step comprises deploying at least three suture ends.

4. A method of closing an opening as in claim 3, wherein the deploying step comprises deploying at least three suture ends spaced circumferentially apart around the opening.

5. A method of closing an opening as in claim 1, wherein the suture ends are each provided with a tissue anchor, and the deploying step comprises advancing the tissue anchors into tissue adjacent the opening.

6. A method of closing an opening as in claim 5, wherein the advancing step comprises advancing the tissue anchors in a proximal direction into the tissue.

7. A method of closing an opening as in claim 1, wherein the suture ends are on the same suture.

8. A method of closing an opening as in claim 1, wherein each suture end is on a unique suture.

9. A method of closing an opening as in claim 8, wherein the drawing the suture ends toward each other step comprises drawing the suture ends toward each other to close the opening.

10. A method of closing an opening as in claim 8, wherein the securing step comprises clamping the sutures to retain the opening in the reduced size.

11. A method of closing an opening as in claim 8, wherein the securing step comprises adhesively bonding the sutures to retain the opening in the reduced size.

12. A method of closing an opening as in claim 8, wherein the securing step comprises adhesively bonding the tissue to retain the opening in the reduced size.

13. A method of closing an opening as in claim 8, wherein the securing step comprises tying the sutures to retain the opening in the reduced size.