Methods for intracardiac surgery and intracardiac delivery of therapies and devices
First Claim
1. A method, comprising:
- conducting controlled intermittent diastolic arrest (CIDA) comprising;
stimulating, by a stimulator, a vagal nerve for a first amount of time; and
applying, by an application device, at least one pharmacological agent, wherein the first amount of time and the at least one pharmacological agent are selected to achieve a diastolic distension volume of at least a portion of a heart for a second amount of time; and
restoring, by a restoring system, a heart beat of the heart after;
a third amount of time during which the at least a portion of the heart fills and expands to reach the diastolic distension volume; and
the second amount of time at which the least the portion of the heart is at the diastolic distension volume.
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Accused Products
Abstract
A method of performing an intracardiac procedure using controlled intermittent diastolic arrest (CIDA) to expand the chambers of the heart to a volume between about 75 to 200% of their normal end-diastolic volume. In one embodiment, CIDA is conducted so that cardiac arrest with cardiac distention is achieved in about 5 to 15 seconds and diastolic arrest is maintained for a time between about 5 and 90 seconds. Intracardiac procedures that are facilitated with CIDA include heart valve repair or replacement. The method involves the use of CIDA and wherein the procedure is performed in or on the heart with the use of a catheter or catheter-delivered device, therapy, or agent. In one aspect, the heart is accessed during CIDA via a left ventricular apical access port or device. In one aspect CIDA is conducted via stimulation of the vagal nerve alone or in combination with one or more of an acetylcholinesterase inhibitor, a β-adrenergic receptor blocker, and/or a calcium channel blocker.
4 Citations
20 Claims
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1. A method, comprising:
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conducting controlled intermittent diastolic arrest (CIDA) comprising; stimulating, by a stimulator, a vagal nerve for a first amount of time; and applying, by an application device, at least one pharmacological agent, wherein the first amount of time and the at least one pharmacological agent are selected to achieve a diastolic distension volume of at least a portion of a heart for a second amount of time; and restoring, by a restoring system, a heart beat of the heart after; a third amount of time during which the at least a portion of the heart fills and expands to reach the diastolic distension volume; and the second amount of time at which the least the portion of the heart is at the diastolic distension volume. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A method, comprising:
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conducting at least one trial controlled intermittent diastolic arrest (CIDA), comprising; conducting, by a CIDA system comprising at least a stimulator device and a restoring system, the at least one trial CIDA for an amount of time; and determining, by an imaging device, a degree of cardiac chamber distension during the at least one trial CIDA arrest; associating, by the CIDA system, an optimal degree of cardiac chamber distention for performing an intracardiac procedure with the amount of time where the determined degree of cardiac chamber distention is the optimal degree of cardiac distension; and performing, by the CIDA system, CIDA for an amount of time based on a selection of at least one of an optimal degree of cardiac chamber distention and the intracardiac procedure.
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14. A system for conducting controlled intermittent diastolic arrest (CIDA), comprising:
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a stimulator configured to stimulate a vagal nerve for a first amount of time; and an application device configured to apply at least one pharmacological agent, wherein the first amount of time and the at least one pharmacological agent are selected based on achieving a diastolic distension volume of at least a portion of a heart for a second amount of time; and a restoring system configured to restore a heartbeat of the heart after; a third amount of time during which the at least a portion of the heart fills and expands to reach the diastolic distension volume; and the second amount of time at which the least the portion of the heart is at the diastolic distension volume. - View Dependent Claims (15, 16, 17, 18, 19, 20)
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Specification