Treatments for a patient with congestive heart failure

• US 7,373,207 B2
• Filed: 12/06/2002
• Issued: 05/13/2008
• Est. Priority Date: 12/08/2001
• Status: Expired due to Fees

• Current Assignee: Transcardiac Therapeutics Incorporated
• Original Assignee: Transcardiac Therapeutics Incorporated
• Inventors: Lattouf, Omar M.
• Primary Examiner(s): Layno; Carl
• Assistant Examiner(s): MALAMUD, DEBORAH LESLIE
• Application Number:
  US10/313,198
• Publication Number:
  US 20030120264A1
• Time in Patent Office: 1,985 Days
• Field of Search: 607 3- 5, 607 9- 10, 607129-131, 600 16- 17
• US Class Current: 607/130
• 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 17/0401 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 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00398 using powered actuators, e.g. stepper motors, solenoids
• CPC Class Codes: A61B 2017/00539 hydraulically
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/22068 : Centering
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2017/306 : holding by means of suction
• CPC Class Codes: A61B 2017/320064 : with tissue or sample retaining means
• CPC Class Codes: A61B 2017/3425 : for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3488 : Fixation to inner organ or inner body tissue
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61F 2/06 : Blood vessels
• 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: A61N 1/056 : Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/0573 : chacterised by means penetrating the heart tissue, e.g. helix needle or hook
• CPC Class Codes: A61N 1/0587 : Epicardial electrode systems; Endocardial electrodes piercing the pericardium
• CPC Class Codes: A61N 2001/0578 : having means for removal or extraction
• CPC Class Codes: A61N 2001/058 : Fixing tools
• CPC Class Codes: Y10S 623/904 : Heart

Abstract

The invention is directed to devices for two minimally invasive therapeutic procedures, particularly for patients with congestive heart failure. One procedure involves providing a valve to form a passageway through the patient'"'"'s left ventricular wall at the apex of the patient'"'"'s heart and configured to advance instruments through the valved passageway to connect the valve leaflets of the patient'"'"'s heart valve, e.g. the mitral valve, in a “Bow-Tie” configuration to prevent or minimize regurgitation through the valve. The second procedure is directed to a pacing lead with a housing and a pacing lead implanting device which are configured to pass through a trocar in the patient'"'"'s chest and implanting the pacing lead on an exposed epicardial region of the patient'"'"'s heart wall. The pacing lead has a penetrating electrode which is secured within the heart wall. One or both procedures may be performed on a patient with CHF. Other improved instruments include a leaflet connector with an artificial cordae tendenae strand secured to an end of the leaflet connector.

Claims

1. A minimally invasive method of treating a patient'"'"'s heart, comprising:

a. accessing an exterior region of the patient'"'"'s heart wall which defines in part the left ventricle;

b. providing a pacing lead which has an attached housing with opposed grasping surfaces and which has a tissue penetrating electrode extending distally from the housing in electrical conducting relationship with the pacing lead;

c. advancing the pacing lead through a small opening in the patient'"'"'s chest cavity to the accessed region of the patient'"'"'s heart wall;

d. providing a pair of rotatable tongs configured to grasp and rotate the pacing lead housing;

e. grasping the opposed grasping surfaces of the housing with the pair of rotatable tongs;

f. securing the pacing lead to the accessed region of the patient'"'"'s heart wall by pressing the penetrating electrode of the pacing lead against the accessed exterior region of the patient'"'"'s heart wall with the tongs and rotating the grasped pacing lead housing with the tongs while pressing the penetrating electrode against the accessed region to drive the penetrating electrode into the heart wall so as to remain therein when the tongs are released; and

g. delivering electrical pulses through the pacing lead to the penetrating electrode of the pacing lead within the heart wall to control the contraction of the heart wall to which the pacing lead is secured.

2. The method of claim 1 wherein a trocar is disposed in the small opening in the patient'"'"'s chest to gain access to the patient'"'"'s chest cavity.

3. The method of claim 1 wherein the electrical pulses have a frequency, duration, current and voltage sufficient to control the contraction of the patient'"'"'s left ventricle to increase the output thereof.

4. The method of claim 1 wherein a second pacing lead is disposed in the right ventricle of the patient'"'"'s heart and electrical pulses are emitted from an electrode on a distal portion of the second pacing lead having a frequency, duration, current and voltage sufficient to control the contraction of the right ventricle to increase the output thereof.

5. The method of claim 1 wherein an elongated delivery tube is provided which has a proximal end, a distal end configured to pass through the small opening in the patient'"'"'s chest and an inner lumen extending to the distal end and configured to slidably receive the pacing lead when the pacing lead is advanced to the exposed region of the patient'"'"'s heart wall.

6. The method of claim 5 wherein the delivery tube has a securing pod on the distal end thereof to releasably secure the distal end of the delivery tube to the exposed region of the patient'"'"'s heart wall.

7. The method of claim 6 wherein the securing pod has a vacuum chamber and at least one vacuum conduit extending between the vacuum chamber and the leading surface of the securing pod and the securing pod is secured against the exposed region of the patient'"'"'s heart wall by vacuum from within the chamber.

8. The method of claim 6 wherein the tongs are secured to a driving member associated with the delivery tube which is configured to close the tongs to engage the pacing lead housing and to rotate the housing in order to drive the penetrating electrode of the pacing lead into the exposed region of the patient'"'"'s heart wall to secure the penetrating electrode within the heart wall.

9. The method of claim 8 wherein the driving member is an inflatable balloon which is disposed within the expanded distal end of the delivery tube.