Methods and devices for improving cardiac function in hearts

• US 6,406,420 B1
• Filed: 10/21/1999
• Issued: 06/18/2002
• Est. Priority Date: 01/02/1997
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Myocor, Inc. (Edwards Lifesciences Corporation)
• Inventors: Kallok, Michael J., McCarthy, Patrick M., Keith, Peter T., Mortier, Todd J., Schweich, Cyril J. Jr.
• Primary Examiner(s): Jastrzab, Jeffrey R.
• Application Number:
  US09/422,328
• Time in Patent Office: 971 Days
• Field of Search: 600/16-18, 600/37, 623/3.11, 623/3.1, 128/897, 601/153
• US Class Current: 600/16
• 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 17/04 for suturing wounds; Holders or packages for needles or suture materials suture materials A61L17/00
• 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 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0435 the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0446 Means for attaching and blocking the suture in the suture anchor
• 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 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2090/392 Radioactive markers
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• 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

Abstract

Various methods and devices are disclosed for improving cardiac function in hearts having zones of infarcted (akinetic) and aneurysmal (dyskinetic) tissue regions. The methods and devices reduce the radius of curvature in walls of the heart proximal infarcted and aneurysmal regions to reduce wall stress and improve pumping efficiency. The inventive methods and related devices include splinting of the chamber wall proximal the infarcted region and various other devices and methods including suture and patch techniques.

Claims

1. A method for treating a heart having a zone of infarcted tissue in a chamber thereof, comprising the steps of:

providing a tension member having a first end and a second end, each of said ends provided with an anchor member; and

positioning said tension member transverse to said chamber to reduce the radius of curvature of a wall of the chamber that includes the infarcted tissue.

2. The method of claim 1, further comprising the step of positioning said anchor members exterior to the chamber.

3. The method of claim 2, wherein said heart chamber comprises healthy tissue adjacent said infarcted tissue and each of said anchor members are positioned exterior to the heart chamber approximately between said healthy and infarcted tissue.

4. The method of claim 2, wherein one of said anchors is positioned on a septum wall of the heart.

5. The method of claim 2, wherein one of said anchors is positioned on the infarcted tissue.

6. The method of claim 2, wherein said infarcted tissue is located in a region of a left ventricle of the heart proximal a mitral valve and said tension member draws papillary muscles of the mitral valve together.

7. The method of claim 6, wherein said tension member is curved between said anchor members.

8. The method of claim 1, wherein the positioning step includes positioning said tension member diametrically across the infarcted tissue.

9. A method for treating a heart having a zone of infarcted tissue in a chamber thereof, comprising the steps of:

positioning a tension member having a first end and a second end, each of said ends provided with an anchor member; and

positioning said tension member transverse to said chamber to draw walls containing the infarcted tissue together.

10. The method of claim 9, further comprising the step of positioning said anchor members exterior to the chamber.

11. The method of claim 10, wherein said heart chamber comprises healthy tissue adjacent said infarcted tissue and each of said anchor members are positioned exterior to the heart chamber approximately between said healthy and infarcted tissue.

12. The method of claim 10, wherein one of said anchors is positioned on a septum wall of the heart.

13. The method of claim 10, wherein one of said anchors is positioned on the infarcted tissue.

14. The method of claim 10, wherein said infarcted tissue is located in a basal region of a left ventricle of the heart proximal a mitral valve and said tension member draws papillary muscles of the mitral valve together.

15. The method of claim 14, wherein said tension member is curved between said anchor members.

16. The method of claim 9, wherein the positioning step includes positioning said tension member diametrically across the infarcted tissue.

17. A method of treating a heart having a zone of infarcted tissue in a chamber thereof, comprising the steps of:

providing a tension member having a first end and a second end, each of said ends provided with an anchor member;

positioning one of said anchor members on an outer wall of the infarcted tissue; and

positioning said tension member through the heart chamber such that the infarcted tissue is drawn toward an interior of the heart chamber.

18. The method of claim 17, wherein positioning said anchor member includes positioning said anchor member substantially at a center of the infarcted tissue.

19. The method of claim 17, further comprising the step of positioning the other of said anchor members on an outer wall of the heart chamber located approximately opposite to the infarcted tissue, with the tension member extending transverse to the chamber between said anchor members.

20. A method of treating a heart having a zone of infarcted tissue in a chamber thereof, comprising the steps of:

removing the infarcted tissue;

suturing the chamber wall separated as a result of said removing step;

providing a tension member having a first end and a second end, each of said ends provided with an anchor member; and

positioning said tension member transverse to said chamber to reduce a radius of curvature of the chamber wall proximal to the suturing.

21. The method of claim 20, wherein the infarcted tissue includes a first region having infarcted tissue that extends through an entire wall thickness of the heart chamber and a second region, adjacent said first region, having infarcted tissue that does not extend through the entire wall thickness, and said removing step includes removing the infarcted tissue from the second region so that a thin wall region of the heart chamber remains, and said positioning step includes positioning said tension member transverse the thin wall region.

22. The method of claim 21, wherein said heart chamber comprises regions of thick walls adjacent said thin wall region and said anchor members are positioned on the outer wall of the heart approximately between said thick wall regions and said thin wall regions.

23. A method for treating a heart having a zone of infarcted tissue in a chamber thereof, comprising the steps of:

deforming a wall of the chamber that includes the infarcted tissue such that a radius of curvature of the wall is reduced.

24. The method of claim 23, wherein deforming the wall also reduces the radius of curvature of the wall in non-infarcted tissue zones located adjacent to the infarcted zones.

25. The method of claim 23, wherein deforming the wall includes positioning a splint with respect to the heart chamber.