Devices for reducing the size of an internal tissue opening

• US 9,220,487 B2
• Filed: 08/08/2007
• Issued: 12/29/2015
• Est. Priority Date: 08/09/2006
• Status: Active Grant

• Current Assignee: Coherex Medical, Inc. (Johnson & Johnson)
• Original Assignee: Coherex Medical, Inc. (Johnson & Johnson)
• Inventors: Davis, Clark C., Miles, Scott D., Fox, DeWayne C., Edmiston, Daryl R., Linder, Richard J.
• Primary Examiner(s): Shi, Katherine M
• Assistant Examiner(s): MENDOZA, MICHAEL G
• Application Number:
  US11/836,016
• Publication Number:
  US 20080039953A1
• Time in Patent Office: 3,065 Days
• Field of Search: 606/151, 606/153, 606/213, 623/1.15, 623/1.3
• US Class Current: 1/1
• 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 17/0487 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 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12168 having a mesh structure A61B17/1214 takes precedence
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00407 Ratchet means
• 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 2017/00588 Rigid or stiff implements, e.g. made of several rigid parts linked by hinges
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00597 Implements comprising a membrane
• CPC Class Codes: A61B 2017/00601 Implements entirely comprised between the two sides of the opening
• 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 2017/0061 Implements located only on one side of the opening
• CPC Class Codes: A61B 2017/00619 Locking means for locking the implement in expanded state
• CPC Class Codes: A61B 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00858 high friction, non-slip on handles A61B2017/00429
• CPC Class Codes: A61B 2017/00862 : elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61B 2017/00867 : shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00884 : enhancing wound closure
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/12054 : Details concerning the detachment of the occluding device from the introduction device

Abstract

A medical system for treating an internal tissue opening can include a closure device and associated delivery device. The closure device can include a body portion operatively associated with a first anchor and a second anchor. The body portion can include a plurality of segments defining a multi-cellular structure. A segment can define a variable width along a length of the segment to have a substantially equal stress level along the length when deflected. The closure device can be configured to apply lateral force to tissue of the internal tissue opening to bring tissue together for closure. The closure device can have a substantially flat aspect, and have a depth thickness that is substantially greater than the thickness or width of a majority of the members forming the closure device. The closure device can also include a member adapted to induce tissue growth.

Claims

1. A medical device deployable at least partially within a hole defined in a tissue structure, the hole defining an axis oriented axially through the hole, the medical device comprising:

a catheter configured to be positioned adjacent the hole defined in the tissue structure; and

a framework configured to maintain a substantially flat configuration as said framework transitions and self-expands from a non-deployed state within the catheter to an intended, as deployed state from the catheter, said framework oriented substantially parallel to, or extending substantially along, the axis of the hole when in the intended, as deployed state within the tissue structure, said framework comprising a central portion and at least one anchor extending from said central portion, said central portion including central frame struts having a length and a width, wherein the width of at least one of said central frame struts varies along at least a portion of the length of said at least one of said central frame struts in a tapered configuration, said tapered configuration tapering to a tapered end such that said tapered end directly interconnects to another portion of the framework.

2. A medical device as recited in claim 1, wherein said central portion is configured to preferentially expand from a collapsed orientation to the state for intended deployment within the tissue structure.

3. A medical device as recited in claim 1, wherein said framework comprises a multi-cellular structure.

4. A medical device as recited in claim 1, wherein said central frame struts have substantially equal lengths.

5. A medical device as recited in claim 1, wherein said at least one central frame struts is configured to have a substantially uniform stress along said at least a portion of said length when deflected.

6. A medical device as recited in claim 1, further comprising a tissue growth promoting member associated with the framework.

7. A medical device as recited in claim 6, wherein said tissue growth promoting member is attached to said framework such that said tissue growth promoting member extends substantially out of plane from said substantially flat configuration.

8. A medical device deployable at least partially within a hole defined in a tissue structure, the hole defining an axis oriented axially through the hole, the medical device comprising:

a catheter configured to be positioned adjacent the hole defined in the tissue structure; and

a framework configured to maintain a substantially flat configuration as said framework transitions and self-expands from a non-deployed state within the catheter to an intended, as deployed state from the catheter, said framework oriented substantially parallel to, or extending substantially along, the axis of the hole when in the intended, as deployed state within the tissue structure, said framework comprising a central portion and at least one anchor extending from said central portion, said central portion including a plurality of central frame periphery struts defining a central frame periphery and a plurality of central frame internal struts extending internally from the central frame periphery, the central frame periphery struts and the central frame internal struts defining a multi-cellular structure of the central portion of the framework, at least one of said plurality of central frame internal struts including a first strut portion and a second strut portion, said first strut portion having a greater rigidity than said second strut portion.

9. A medical device as recited in claim 8, wherein said central portion comprises a multi-cellular structure.

10. A medical device as recited in claim 8, wherein said central portion is adapted to apply lateral force to the tissue of the tissue structure.

11. A medical device as recited in claim 8, further comprising a tissue growth promoting member associated with said framework.

12. A medical device as recited in claim 11, wherein said tissue growth promoting member is attached to said framework such that said tissue growth promoting member extends substantially out of plane from said substantially flat configuration.

13. A medical device as recited in claim 8, wherein said first strut portion has a width that is greater than the width of said second strut portion.

14. A medical device as recited in claim 8, wherein said at least one anchor comprises a first anchor and a second anchor, said first anchor configured to extend in a first atrium adjacent the tissue structure and said second anchor configured to extend in a second atrium adjacent the tissue structure, the first anchor and the second anchor having structures that are substantially coplanar with each other.

15. A medical device as recited in claim 8, wherein said central frame internal struts of said central portion comprise substantially equal lengths.

16. A medical device deployable at least partially within a hole defined in a tissue structure, the hole defining an axis oriented axially through the hole, the medical device comprising:

a catheter configured to be positioned adjacent the hole defined in the tissue structure; and

a framework configured to maintain a substantially flat configuration as said frame transitions and self-expands from a non-deployed state within the catheter to an intended, as deployed state from the catheter, said framework oriented substantially parallel to, or extending substantially along, the axis of the hole when in the intended, as deployed state within the tissue structure, said framework comprising a central portion and at least one anchor extending from said central portion, said central portion including central frame struts, at least one of said central frame struts including a longitudinal length dimension and having an aspect ratio of a depth dimension to a lateral width dimension of at least 2 to 1, wherein said depth dimension is defined to extend substantially perpendicular relative to said substantially flat configuration of said framework.

17. A medical device as recited in claim 16, further comprising a tissue growth promoting member associated with the framework.

18. A medical device as recited in claim 17, wherein said tissue growth promoting member is attached to said framework such that said tissue growth promoting member extends substantially out of plane from said substantially flat configuration.

19. A medical device as recited in claim 16, further comprising a second anchor operably associated with said central portion, wherein said first anchor comprises a proximal anchor and wherein said second anchor comprises a distal anchor.

20. A medical device as recited in claim 16, wherein said aspect ratio is between about 2:

1 and 10;

1.

21. A medical device as recited in claim 16, wherein said aspect ratio is about 4:

1.

22. A medical device as recited in claim 16, wherein said central frame struts are configured to resist movement out of plane of the substantially flat configuration.

23. A medical device as recited in claim 16, wherein said central portion comprises a multi-cellular structure.