Transventricular implant tools and devices

• US 7,722,523 B2
• Filed: 07/09/2002
• Issued: 05/25/2010
• Est. Priority Date: 07/29/1998
• Status: Expired due to Fees

• Current Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Original Assignee: Edwards Lifesciences LLC (Edwards Lifesciences Corporation)
• Inventors: Vidlund, Robert M., Keith, Peter T., Mortier, Todd J., Schweich, Cyril J. Jr., Kusz, David A., Paulson, Thomas M.
• Primary Examiner(s): Woo; Julian W
• Application Number:
  US10/191,379
• Publication Number:
  US 20030032979A1
• Time in Patent Office: 2,877 Days
• Field of Search: 600/16, 600/37, 606/232
• 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 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• 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 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2250/0003 having an inflatable pocket filled with fluid, e.g. liquid or gas

Abstract

A method and implantation tools for placing a transventricular splint including a tension member. The method includes gaining access to the patient'"'"'s hearts and identifying entry or exit points for the tension member, marking those locations and delivering the tension member. Anchors for the tension member are also delivered. The length of the tensions member is measured and the walls of the heart drawn together. The pads are secured to the tension member and the tension member is trimmed to length. The pads are secured to the heart surface.

Claims

1. A method for reducing ventricular volume, comprising:

inserting a catheter into a ventricle of a patient'"'"'s heart;

deploying a tensile member from a leading end of said catheter;

attaching said tensile member to the patient'"'"'s heart; and

exerting tension on said tensile member to draw walls of the patient'"'"'s heart towards one another to reduce the volume of at least one ventricle of the patient'"'"'s heart.

2. The method defined in claim 1, wherein said tensile member is provided with at least one anchoring mechanism at a leading end, the attaching of said tensile member to the patient'"'"'s heart including embedding said anchoring mechanism in the patient'"'"'s heart.

3. The method defined in claim 2, wherein the anchoring mechanism is screw-shaped.

4. The method defined in claim 2, wherein the anchoring mechanism includes at least one projection approximately transverse to an axis of the tensile member.

5. The method defined in claim 1, wherein the tensile member is one of two tensile members.

6. The method defined in claim 5, further comprising attaching the other tensile member to the patient'"'"'s heart.

7. The method defined in claim 1, wherein inserting the catheter into the ventricle includes inserting the catheter through a heart valve leading to the ventricle.

8. The method defined in claim 7, wherein the ventricle is the left ventricle and the heart valve is the mitral valve.

9. The method defined in claim 7, wherein the ventricle is the left ventricle and the heart valve is the aortic valve.

10. The method defined in claim 9, wherein inserting the catheter through the aortic valve includes guiding the catheter through the aorta from an arterial access point.

11. The method defined in claim 1, wherein inserting the catheter into the ventricle includes inserting the catheter through a wall of the ventricle.

12. The method defined in claim 11, wherein inserting the catheter through a wall of the ventricle includes inserting the catheter through a wall at the apex of the heart.

13. The method defined in claim 1, wherein deploying the tensile member from the leading end of said catheter includes extending the tensile member through a heart wall to exterior the heart.

14. The method defined in claim 13, wherein attaching said tensile member to the patient'"'"'s heart includes providing an anchoring mechanism on an end of the tensile member.

15. The method defined in claim 1, wherein said tensile member is provided with at least one anchoring mechanism at a leading end of the tensile member.

16. The method defined in claim 15, wherein the anchoring mechanism is expandable.

17. The method defined in claim 16, wherein the anchoring mechanism is a balloon.

18. The method defined in claim 15, wherein the anchoring mechanism includes a pad.

19. The method defined in claim 18, wherein the pad is coiled.

20. The method defined in claim 15, wherein the anchoring mechanism includes hinged arms.

21. The method defined in claim 15, wherein the anchoring mechanism includes an adhesive.

22. The method defined in claim 1, wherein the ventricle is the left ventricle.

23. The method defined in claim 1, wherein the ventricle is the right ventricle.

24. The method defined in claim 1, wherein drawing walls of the heart towards one another alters the geometric shape of the at least one ventricle.

25. The method defined in claim 1, wherein drawing walls of the heart towards one another reduces a radius of curvature of the at least one ventricle.

26. The method defined in claim 1, wherein the catheter includes an elongate shaft defining a lumen.

27. The method defined in claim 26, wherein deploying the tensile member includes advancing the tensile member through the lumen.

28. The method defined in claim 1, wherein the tensile member includes a distal end sharpened to permit advancement through a wall of the ventricle.

29. A method for reducing ventricular volume, comprising:

inserting a catheter into a ventricle of a patient'"'"'s heart;

deploying a tensile member from a leading end of said catheter;

attaching said tensile member to the patient'"'"'s heart so that said tensile member is contained completely within the patient'"'"'s heart and does not protrude therefrom; and

exerting tension on said tensile member to draw walls of the patient'"'"'s heart towards one another to reduce the volume of at least one ventricle of the patient'"'"'s heart.

30. The method defined in claim 29, wherein said tensile member is provided with at least one anchoring mechanism at a leading end, the attaching of said tensile member to the patient'"'"'s heart including embedding said anchoring mechanism in the patient'"'"'s heart.

31. The method defined in claim 30, wherein the anchoring mechanism is screw-shaped.

32. The method defined in claim 30, wherein the anchoring mechanism includes at least one projection approximately transverse to an axis of the tensile member.

33. The method defined in claim 29, wherein the tensile member is one of two tensile members.

34. The method defined in claim 33, further comprising attaching the other tensile member to the patient'"'"'s heart.

35. The method defined in claim 29, wherein said walls are outer walls of the patient'"'"'s heart, the attaching of said tensile member to the patient'"'"'s heart and the exerting tension on said tensile member serving to compress and at least partially close portions of the at least one ventricle.

36. The method defined in claim 29, wherein at least one of said walls is an outer wall of the patient'"'"'s heart, the attaching of said tensile member to the patient'"'"'s heart and the exerting tension on said tensile member serving to compress and at least partially close a portion of exactly one ventricle.

37. A surgical method for assisting cardiac function, comprising:

inserting a device into a patient;

applying said device to a portion of the patient'"'"'s heart so as to compress and at least partially close a portion of at least one ventricle of the heart, said device including a wire provided at a free end with at least one anchoring mechanism, the applying of said device to the portion of the patient'"'"'s heart including;

inserting a catheter into a ventricle of the patient'"'"'s heart;

ejecting said free end of said wire from said catheter into the patient'"'"'s myocardium so that said free end and said at least one anchoring mechanism are embedded in the myocardium, surrounded thereby; and

exerting tension on said wire to pull walls of the patient'"'"'s heart towards one another so as to compress said portion of said at least one ventricle of the heart.

38. The method defined in claim 37, wherein the anchoring mechanism is screw-shaped.

39. The method defined in claim 37, wherein the anchoring mechanism includes at least one projection approximately transverse to an axis of the tensile member.

40. The method defined in claim 37, wherein said free end of said wire is one of a pair of free wire ends each provided with at least one anchoring mechanism, the applying of said device to the portion of the patient'"'"'s heart including:

ejecting said free wire ends from said catheter into the patient'"'"'s myocardium so that said free ends and the respective anchoring mechanism thereof are embedded in the myocardium, surrounded thereby, and

exerting tension on said wire ends to pull said walls of the patient'"'"'s heart towards one another so as to compress said portion of said at least one ventricle of the heart.

41. The method defined in claim 40, wherein said wire ends are terminal portions of wire segments.

42. The method defined in claim 40, wherein said walls are outer walls of the patient'"'"'s heart, the applying of said device serving to compress and at least partially close portions of said at least one ventricle.

43. The method defined in claim 40, wherein one of said walls is an outer wall of the patient'"'"'s heart, the applying of said device serving to compress and at least partially close a lower portion of exactly one ventricle.

44. The method defined in claim 37, wherein the ejecting said free end of said wire from said catheter into the patient'"'"'s myocardium includes forcing said free end of said wire into an outer wall of the patient'"'"'s heart, said walls including said outer wall, the applying of said device serving to compress and at least partially close a lower portion of exactly one ventricle.

45. The method defined in claim 37, wherein the inserting of said device includes inserting said device through a trocar.