Treating dysfunctional cardiac tissue

• US 9,486,206 B2
• Filed: 03/02/2015
• Issued: 11/08/2016
• Est. Priority Date: 10/03/2007
• Status: Active Grant

• Current Assignee: Bioventrix, Inc.
• Original Assignee: Bioventrix, Inc.
• Inventors: Annest, Lon S., Argento, Claudio, Butler, William, Heflin, Ernest
• Primary Examiner(s): Stice, Paula J
• Application Number:
  US14/636,068
• Publication Number:
  US 20150238182A1
• Time in Patent Office: 617 Days
• Field of Search: 600/16, 600/37
• US Class Current: 1/1
• 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 17/0057 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 17/0401 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 17/06066 Needles, e.g. needle tip configurations making needles B21G1/00
• 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 2017/00469 for insertion of instruments, e.g. guide wire, optical fibre
• CPC Class Codes: A61B 2017/00561 creating a vacuum
• CPC Class Codes: A61B 2017/00601 Implements entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0237 for heart surgery
• CPC Class Codes: A61B 2017/0404 Buttons
• CPC Class Codes: A61B 2017/0408 Rivets
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06052 : Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/0608 : J-shaped
• CPC Class Codes: A61B 2017/061 : hollow or tubular
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61B 50/30 : Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2002/249 : Device completely embedded in the heart wall
• CPC Class Codes: A61M 25/0138 : having flexible regions as a result of weakened outer material, e.g. slots, slits, cuts, joints or coils
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Medical devices, systems, and methods reduce the distance between two points in tissue, often for treatment of congestive heart failure and often in a minimally invasive manner. An anchor is inserted along an insertion path through a first wall of the heart. An arm of the anchor is deployed and rotationally positioned according to a desired alignment. Application of tension to the anchor may draw the first and second walls of the heart into contact along a desired contour so as to effect a desired change in the geometry of the heart. Additional anchors may be inserted and aligned with the first anchor to close off a portion of a ventricle such that the ventricle is geometrically remodeled and disease progression is reversed, halted, and/or slowed.

Claims

1. A catheter for treating a heart of a patient, the heart having a chamber bordered by a wall, the catheter comprising:

an elongate catheter body having a flexible distal end, the elongate catheter body being insertable within a patient so that the flexible distal end is positioned adjacent the wall of the heart; and

a director member coupled with the flexible distal end, the director member comprising;

a main body that is slidably coupled with a proximal portion of the flexible distal end such that the flexible distal end is advanceable distally of the main body;

a distal body that is fixedly coupled with a distal portion of the flexible distal end; and

an elongate body that connects the distal body to the main body, the distal body being connected to the elongate body via an articulated hinge;

wherein the director member is configured to adjust an orientation of the flexible distal end relative to the elongate catheter body by advancing the flexible distal end distally of the main body while the distal body maintains the distal portion of the flexible distal end in place thereby adjusting a length of the flexible distal end between the main body and the distal body and thereby reorienting the distal body relative to the main body via the articulated hinge;

wherein adjusting the orientation of the flexible distal end comprises reorienting the flexible distal end from a relatively straight configuration to a curved configuration wherein the proximal portion of the flexible distal end curves away from the wall of the heart and the distal portion of the flexible distal end curves back toward the wall of the heart.

2. The catheter of claim 1, wherein the distal body is positioned on an exterior surface of the flexible distal end.

3. The catheter of claim 1, wherein the articulated hinge is positioned proximally of a distal most tip of the flexible distal end.

4. The catheter of claim 1, wherein a length of the elongate body between the main body and the distal body is unchanged as the flexible distal end is reoriented from the relatively straight configuration to the curved configuration.

5. The catheter of claim 1, wherein an alignment of the elongate body and the main body is maintained as the flexible distal end is reoriented from the relatively straight configuration to the curved configuration.

6. The catheter of claim 1, wherein the distal body is positioned adjacent a tip of the flexible distal end, the tip having an aperture, and wherein adjusting the orientation of the flexible distal end causes the aperture to reorient to a lateral position.

7. The catheter of claim 1, wherein the wall is a septum of the heart, the orientation of the flexible distal end being adjustable within the chamber of the heart to position a tip of the flexible distal end adjacent the septum.

8. The catheter of claim 7, wherein a component is insertable through the septum with the tip of the flexible distal end positioned adjacent the septum.