Methods and devices for improving cardiac function in hearts

• US 7,189,199 B2
• Filed: 05/02/2002
• Issued: 03/13/2007
• Est. Priority Date: 01/02/1997
• Status: Expired due to Fees

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Myocor, Inc. (Edwards Lifesciences Corporation)
• Inventors: McCarthy, Patrick M., Keith, Peter T., Mortier, Todd J., Schweich, Cyril J. Jr., Kallok, Michael J.
• Primary Examiner(s): ALTER, ALYSSA MARGO
• Application Number:
  US10/136,446
• Publication Number:
  US 20020169359A1
• Time in Patent Office: 1,776 Days
• Field of Search: 600/16, 600/37, 623/2.1, 623/2.33, 623/2.36, 623/3.1, 606/151, 128/898
• 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 of treating a heart valve, the method comprising:

providing a device having an elongate member, the elongate member having a first end and a second end;

positioning the elongate member transverse a heart chamber associated with the heart valve so as to reposition at least one leaflet associated with the heart valve,

wherein, when the elongate member is positioned transverse the heart chamber, the elongate member does not contact each of papillary muscles, leaflets, and an annulus associated with the heart valve; and

wherein the entire device is positioned solely above an apex of the heart and below an annulus associated with the heart valve.

2. The method of claim 1, further comprising fixing the elongate member in position transverse the heart chamber.

3. The method of claim 2, wherein fixing the elongate member in position includes fixing the elongate member via at least one anchoring mechanism configured to be secured to a wall surrounding the heart chamber.

4. The method of claim 3, wherein the anchoring mechanism is configured to be secured to an exterior surface of the wall.

5. The method of claim 2, wherein an anchoring mechanism is provided on each of the first end and the second end of the elongate member and fixing the elongate member in position includes securing the anchoring mechanisms to portions of a wall surrounding the heart chamber.

6. The method of claim 1, wherein positioning the elongate member includes positioning the elongate member transverse a left ventricle of the heart.

7. The method of claim 1, wherein the valve is a mitral valve.

8. The method of claim 1, wherein positioning the elongate member transverse the heart chamber includes positioning the elongate member so as to avoid internal structures of the heart chamber.

9. The method of claim 1, wherein providing the elongate member includes providing a tension member.

10. The method of claim 1, further comprising reducing a radius of curvature in at least a region of the heart chamber.

11. The method of claim 10, wherein reducing the radius of curvature in at least a region of the heart chamber includes reducing the radius of curvature at one of an aneurysmal and an infracted region of a wall surrounding the heart chamber.

12. A method of treating a heart valve, the method comprising:

providing a device configured to be implanted proximate the heart valve;

implanting the device such that a first portion of the device is positioned external to a heart chamber associated with the valve and closer to a first leaflet of the valve than to a second leaflet of the valve and such that a second portion of the device is positioned external to the heart chamber associated with the valve and closer to the second leaflet of the valve than the first leaflet of the valve; and

repositioning at least one of the first leaflet and the second leaflet of the valve,

wherein, when the device is implanted, the device does not contact each of papillary muscles, leaflets, and an annulus associated with the valve, and wherein the entire device is implanted solely above an apex of the heart and below an annulus associated with the heart valve.

13. The method of claim 12, further comprising drawing the first and second leaflets toward each other.

14. The method of claim 12, wherein the valve is a mitral valve.

15. The method of claim 12, wherein implanting the device includes implanting the device such that the first portion contacts a wall of the heart.

16. The method of claim 15, wherein implanting the device includes implanting the device such that the second portion contacts a wall of the heart.

17. The method of claim 16, wherein the wall surrounds a left ventricle of the heart.

18. The method of claim 16, wherein implanting the device includes implanting the device such that the second portion contacts an exterior surface of the wall of the heart.

19. The method of claim 15, wherein implanting the device includes implanting the device such that the first portion contacts an exterior surface of the wall of the heart.

20. The method of claim 12, wherein providing the device includes providing an elongate member.

21. The method of claim 20, wherein providing the elongate member includes providing a tension member configured to extend transverse a chamber of the heart.

22. The method of claim 20, wherein the elongate member has a first end and a second end and providing the device further includes providing an anchoring mechanism on each of the first end and the second end.

23. The method of claim 22, wherein implanting the device further comprises engaging the anchoring mechanisms with a wall of the heart.

24. The method of claim 22, wherein the first portion and the second portion of the device include the anchoring mechanisms.

25. A method of treating a heart valve having a first leaflet and a second leaflet, the method comprising:

providing a device configured to be implanted proximate the heart valve;

implanting the device such that a first portion of the device contacts heart structure located on a first side of a line defined by an intersection of the first leaflet and the second leaflet and such that a second portion of the device contacts heart structure located on a second side of the line opposite the first side; and

repositioning at least one of the first leaflet and the second leaflet of the valve,

wherein, when the device is implanted, the device does not contact each of papillary muscles, lealflets, and an annulus associated with the valve, and wherein the entire device is implanted solely above an apex of the heart and below an annulus associated with the heart valve.

26. The method of claim 25, further comprising drawing the first leaflet and the second leaflet toward each other.

27. The method of claim 25, wherein the valve is a mitral valve.

28. The method of claim 25, wherein implanting the device includes implanting the device such that the first portion contacts a wall of the heart.

29. The method of claim 28, wherein implanting the device includes implanting the device such that the second portion contacts a wall of the heart.

30. The method of claim 29, wherein the wall surrounds a left ventricle of the heart.

31. The method of claim 29, wherein implanting the device includes implanting the device such that the second portion contacts an exterior surface of the wall of the heart.

32. The method of claim 28, wherein implanting the device includes implanting the device such that the first portion contacts an exterior surface of the wall of the heart.

33. The method of claim 25, wherein providing the device includes providing an elongate member.

34. The method of claim 33, wherein providing the elongate member includes providing a tension member configured to extend transverse a chamber of the heart.

35. The method of claim 33, wherein the elongate member has a first end and a second end and providing the device further includes providing an anchoring mechanism on each of the first end and the second end.

36. The method of claim 35, wherein implanting the device further comprises engaging the anchoring mechanisms with a wall of the heart.

37. The method of claim 35, wherein the first portion and the second portion of the device include the anchoring mechanisms.