Intracardiac cage and method of delivering same

• US 9,445,895 B2
• Filed: 09/04/2015
• Issued: 09/20/2016
• Est. Priority Date: 09/16/2005
• Status: Active Grant

• Current Assignee: Atritech Inc. (Boston Scientific Corporation)
• Original Assignee: Atritech Inc. (Boston Scientific Corporation)
• Inventors: Kreidler, Marc S.
• Primary Examiner(s): Rosen, Eric
• Assistant Examiner(s): SZPIRA, JULIE ANN
• Application Number:
  US14/846,127
• Publication Number:
  US 20150374491A1
• Time in Patent Office: 382 Days
• 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 17/12022 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 2017/00579 Barbed implements
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00597 Implements comprising a membrane
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• 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 2017/00623 Introducing or retrieving devices therefor
• CPC Class Codes: A61F 2/0108 Both ends closed, i.e. legs gathered at both ends
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2002/018 made from tubes or sheets of material, e.g. by etching or laser-cutting
• CPC Class Codes: A61F 2230/0006 circular
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0071 spherical
• CPC Class Codes: A61F 2230/0076 ellipsoidal or ovoid

Abstract

A method of preventing ingress of material into the left atrium of a heart includes providing a delivery sheath, advancing the sheath distal end through an opening between the right atrium and the left atrium of the heart, providing an expandable cage, delivering the expandable cage to the left atrium, and expanding the expandable cage within the left atrium. The expandable cage includes a proximal end, a distal end, and a plurality of supports extending therebetween. The expandable cage also includes a first membrane provided at its proximal end and a second membrane provided at its distal end. The expandable cage has a collapsed configuration so that it can be received within the lumen of the delivery sheath, and an expanded configuration for deployment within the heart. When expanded, the first membrane is positioned at an opening between the left and right atria of the heart, and the second membrane is positioned at the ostium of the left atrial appendage. The first membrane substantially prevents passage of blood between the atria and the second membrane prevents passage of embolic material from the left atrial appendage into the left atrium of the heart.

Claims

1. A method of implanting an expandable intracardiac cage into a left atrium of a heart, comprising:

advancing intravascularly a delivery sheath having a sheath proximal end, a sheath distal end, and a lumen extending therebetween to a right atrium of a heart;

advancing the delivery sheath distal end through an opening between the right atrium and the left atrium

wherein the sheath distal end contains an expandable cage

having a proximal end, a distal end, and a plurality of supports extending therebetween,

wherein the expandable cage has a collapsed configuration sized and adapted to be received within the lumen of the sheath distal end, and an expanded configuration for deployment within the heart;

delivering the expandable cage to the left atrium through the delivery sheath; and

expanding the expandable cage within the left atrium,

the expandable cage when expanded positioning one end of the expandable cage at an ostium of the left atrium;

positioning the remaining end of the expandable cage at an opposed wall of the left atrium,

wherein the cage includes a plurality of tissue engaging anchors proximate at least one of the distal end or the proximal end of the cage such that at least a majority of the plurality of supports has at least one tissue engaging anchor fixedly attached thereto,

wherein the cage is sized and adapted to span the distance between opposed walls of the left atrium to maintain a degree of residual compression of the cage while contacting the opposed walls of the left atrium.

2. The method of claim 1, wherein the cage is self-expanding.

3. The method of claim 2, wherein at least some supports of the plurality of supports are branched into branches which provide mechanical coverage at least one end of the cage.

4. The method of claim 3, wherein one end of the cage is oriented within the left atrium in relation to a blood flow pathway such as the pulmonary vein or the mitral valve.

5. The method of claim 1, wherein the cage may be collapsed to a collapsed configuration while maintaining the distance between the proximal end and the distal end of the cage substantially constant.

6. The method of claim 5, wherein the plurality of supports fold to maintain the distance between the proximal end and the distal end of the cage substantially constant when the cage is collapsed to its collapsed configuration.

7. The method of claim 5, wherein the plurality of supports telescope to maintain the distance between the proximal end and the distal end of the cage substantially constant when the cage is collapsed to its collapsed configuration.

8. The method of claim 1, wherein the cage is collapsed to its collapsed configuration while reducing the distance between the proximal and distal ends of the cage.

9. The method of claim 8, wherein the plurality of supports fold to reduce the distance between the proximal and distal ends of the cage when the cage is collapsed to its collapsed configuration.

10. The method claim 8, wherein the plurality of supports telescope to reduce the distance between the proximal and distal ends of the cage when the cage is collapsed to its collapsed configuration.

11. The method of claim 1, wherein each support of the plurality of supports comprises a region having a serpentine curve.

12. The method claim 11, wherein each of the serpentine curve regions is spaced from the proximal end and from the distal end of the cage.

13. The method of claim 1, wherein at least some supports of the plurality of supports includes a hinge.

14. The method of claim 1, wherein when the cage expands from the collapsed configuration to the expanded configuration within the chamber of the heart, it expands not only radially outward, but also to increase the distance between the proximal end of the cage and the distal end of the cage.

15. The method of claim 1, wherein a region including one end of the cage is covered with a membrane or mesh which is occlusive to emboli.

16. The method of claim 15, wherein the region which is covered with a membrane or mesh which is occlusive to emboli is positioned at an ostium of the left.

17. The method of claim 1, wherein a region including one end of the cage is covered with a membrane or mesh which is occlusive to blood.

18. The method of claim 17, wherein the region which is covered with a membrane or mesh which is occlusive to blood is positioned at an ostium of the left.

19. The method of claim 17, wherein the region which is covered with a membrane or mesh which is occlusive to blood is positioned at fossa ovalis, a septal defect, or the patent foramen ovale of the left atrium.