Therapeutic methods and devices following myocardial infarction

• US 8,827,892 B2
• Filed: 08/22/2013
• Issued: 09/09/2014
• Est. Priority Date: 08/01/2002
• Status: Expired due to Term

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Cardiokinetix Incorporated
• Inventors: Nikolic, Serjan D., Khairkhahan, Alexander
• Primary Examiner(s): Matthews, Christine
• Assistant Examiner(s): LANNU, JOSHUA DARYL DEANON
• Application Number:
  US13/973,868
• Publication Number:
  US 20130338695A1
• Time in Patent Office: 383 Days
• Field of Search: 600/37
• US Class Current: 600/37
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00615 Implements with an occluder on one side of the opening and holding means therefor on the other
• CPC Class Codes: A61B 2017/00632 Occluding a cavity, i.e. closing a blind opening
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/12095 Threaded connection
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2002/2484 Delivery devices therefor

Abstract

Described herein are methods of treating a patient to prevent or correct cardiac remodeling following myocardial infarction. In general these methods may include inserting or implanting a device in a heart chamber to support the affected region within 72 hours after myocardial infarction. The device may be a support device (e.g., a resilient frame) and/or a partitioning device.

Claims

1. A method for treating a chamber of a patient'"'"'s heart having a myocardial rupture or septal defect, comprising:

identifying a region of the chamber of the patient'"'"'s heart exhibiting the myocardial rupture or septal defect;

delivering a device having a reinforced membrane to the patient'"'"'s heart chamber exhibiting the myocardial rupture or septal defect, the device being delivered to the patient'"'"'s heart chamber in an unexpanded configuration and the reinforced membrane having a distal facing side and a proximal facing side; and

deploying the device in the chamber of the patient'"'"'s heart by expanding the device to a deployed configuration within the heart chamber and with the distal facing side of the reinforced membrane facing the region of the chamber of the patient'"'"'s heart exhibiting the myocardial rupture or septal defect, wherein the device remains entirely within the chamber of the patient'"'"'s heart; and

isolating a portion of the chamber having the myocardial rupture or septal defect from a remainder of the chamber.

2. The method of claim 1, wherein the deployed device has a periphery sealed against a chamber wall surface defining in part the chamber of the patient'"'"'s heart.

3. The method of claim 1, wherein the chamber of the patient'"'"'s heart is a ventricular chamber.

4. The method of claim 1, wherein the reinforced membrane is configured to isolate the portion of the chamber having the myocardial rupture or septal defect from the rest of the chamber when the device is expanded in a deployed configuration.

5. The method of claim 4, wherein the membrane of the device is formed at least in part of flexible material.

6. The method of claim 5, wherein the device is deployed in the patient'"'"'s heart chamber so that the flexible material of the device forms a seal about a periphery of the membrane against a ventricular wall surface defining in part the heart chamber.

7. The method of claim 6, wherein the device has an outwardly biased strand which is secured to the periphery of the membrane to seal a peripheral edge of the device to the ventricular wall surface defining in part the heart chamber.

8. The method of claim 1, wherein the step of delivering the device to the patient'"'"'s heart chamber comprises percutaneously delivering the device to the patient'"'"'s heart chamber.

9. A method for treating a chamber of a patient'"'"'s heart having a ventricular rupture or septal defect, comprising:

identifying a region of a ventricle having the ventricular rupture or septal defect;

delivering a partitioning device having a reinforced membrane to a patient'"'"'s ventricle exhibiting the ventricular rupture or septal defect; and

deploying the partitioning device in the chamber of the patient'"'"'s ventricle, wherein the reinforced membrane is configured to form a recess in the reinforced membrane when the partitioning device is expanded to a deployed configuration; and

partitioning the heart chamber into a productive portion and a nonproductive portion such that the ventricular rupture or septal defect is located in the nonproductive portion.

10. The method of claim 9, further comprising identifying a region of the ventricle having one or more indicators of myocardial infarction, wherein the ventricular rupture or septal defect is associated with the myocardial infarction.

11. The method of claim 9, further comprising verifying that the ventricular rupture or septal defect is located on an apical portion of the ventricle.

12. The method of claim 9, wherein the partitioning device further comprises a hub with a non-traumatic foot.

13. The method of claim 12, further comprising positioning the non-traumatic foot against an apical portion of the ventricle wall.

14. The method of claim 9, further comprising deploying fillers in the nonproductive portion.

15. The method of claim 14, wherein the fillers are bioresorbable.

16. The method of claim 14, wherein the fillers accelerate thrombosis.

17. The method of claim 14, wherein the fillers accelerate tissue growth.

18. The method of claim 14, wherein the fillers are nonreactive.

19. The method of claim 9 , wherein the membrane of the partitioning device is formed at least in part of flexible material.

20. The method of claim 19, wherein the partitioning step further comprises forming a seal about a periphery of the membrane against a ventricular wall surface defining in part the heart chamber.

21. The method of claim 20, wherein the partitioning device has an outwardly biased strand which is secured to the periphery of the membrane to seal a peripheral edge of the partitioning device to the ventricular wall surface defining in part the heart chamber.

22. A method for treating a chamber of a patient'"'"'s heart having a myocardial rupture or septal defect, comprising:

identifying a region of a heart chamber wall surface exhibiting the myocardial rupture or septal defect;

delivering to the patient'"'"'s heart chamber exhibiting the myocardial rupture or septal defect a device having a reinforced membrane and an outwardly biased strand secured to a periphery of the reinforced membrane;

deploying the device in the chamber of the patient'"'"'s heart;

sealing the periphery of the reinforced membrane to the heart chamber wall surface with the outwardly biased strand; and

isolating the region of the chamber having the myocardial rupture or septal defect from a remaining portion of the chamber.