Method and device for percutaneous left ventricular reconstruction

• US 8,449,442 B2
• Filed: 12/20/2007
• Issued: 05/28/2013
• Est. Priority Date: 10/13/2004
• Status: Active Grant

• Current Assignee: Bioventrix, Inc.
• Original Assignee: Bioventrix, Inc.
• Inventors: Bertolero, Arthur, Annest, Lon S., Chin, Sing-Fatt Jr.
• Primary Examiner(s): STOKLOSA, JOSEPH A
• Application Number:
  US11/961,990
• Publication Number:
  US 20080097148A1
• Time in Patent Office: 1,986 Days
• Field of Search: 600/16, 600/17, 600/18, 600/37, 607/116, 607/129
• US Class Current: 600/16
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00106 ultrasonic
• 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 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0427 having anchoring barbs or pins extending outwardly from the anchor body
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 5/283 : Invasive
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• 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
• CPC Class Codes: A61F 2002/2484 : Delivery devices therefor
• CPC Class Codes: A61M 25/09 : Guide wires

Abstract

A method for reducing left ventricular volume, which comprises identifying infarcted tissue during open chest surgery; reducing left ventricle volume while preserving the ventricular apex; and realigning the ventricular apex, such that the realigning step comprises closing the lower or apical portion of said ventricle to achieve appropriate functional contractile geometry of said ventricle in a dyskinetic ventricle of a heart.

Claims

1. A method for reducing left ventricular volume in a congestive heart failure heart, the heart having a left ventricle, the method comprising the steps of:

a. identifying infarcted tissue during open chest surgery;

b. dilating said ventricle by applying suction to an epicardium of said ventricle;

c. reducing the left ventricle volume by clamping of the dilated portion of said ventricle so as to bring walls of the left ventricle together;

d. securing the clamped portion by stitching along the clamped portion with the stitching penetrating through the clamped walls to affix the walls of said ventricle together to achieve appropriate functional contractile geometry of said ventricle.

2. The method of claim 1, wherein said method comprises a minimally invasive surgery.

3. The method of claim 1, further comprising the step of sensing the infarcted tissue.

4. The method of claim 3, wherein the infarcted tissue is the myocardium.

5. The method of claim 1, further comprising realigning a ventricular apex by altering the geometry of the ventricle and decreasing wall tension.

6. The method of claim 3, wherein the step of sensing the infarcted tissue may be performed by a procedure selected from the group consisting of:

pacing, angiography, echocardiography, and tissue Doppler.

7. The method of claim 1, further comprising introducing a thoracoscope or camera into an incision to facilitate visualization of the epicardium during reducing of the left ventricle volume.

8. The method of claim 1, wherein securing the clamped portion further comprises the step of applying a patch on said dilated portion.

9. The method of claim 1, wherein the applying of suction comprises engaging an epicardium of the left ventricle with a suction device under thoracoscopic guidance so that the epicardium is drawn into the suction device and inner surfaces of the wall of the left ventricle are brought together.

10. The method of claim 8, wherein applying the patch comprises applying a woven material or an extracellular matrix along an epicardium of the left ventricle.