Methods for accessing a left ventricle

• US 9,999,442 B2
• Filed: 04/26/2013
• Issued: 06/19/2018
• Est. Priority Date: 12/08/2001
• Status: Active Grant

• Current Assignee: Transcardiac Therapeutics Incorporated
• Original Assignee: Transcardiac Therapeutics Incorporated
• Inventors: Lattouf, Omar M.
• Primary Examiner(s): Templeton, Christopher L
• Application Number:
  US13/871,505
• Publication Number:
  US 20130253641A1
• Time in Patent Office: 1,880 Days
• Field of Search: 604506, 604509, 60410105, 600184, 606119, 606172, 606194, 607130, 623 114, 623 124, 623 126, 623 21, 623 211, 623 238
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0237 for heart surgery
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2442 Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/2454 Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
• CPC Class Codes: A61F 2/2457 : Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61M 2039/0646 : Duckbill-valve
• CPC Class Codes: A61M 39/06 : Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
• CPC Class Codes: A61N 1/059 : Anchoring means

Abstract

Two minimally invasive therapeutic procedures, particularly for patients with congestive heart failure, may be performed separately or together. One procedure involves providing a valved passageway through the patient'"'"'s left ventricular wall at the apex of the patient'"'"'s heart and advancing instruments through the valved passageway to connect the valve leaflets of the patient'"'"'s heart valve, e.g. the mitral valve. The second procedure involves advancing a pacing lead and a pacing lead implanting device through a trocar in the patient'"'"'s chest and implanting the pacing lead on an exposed epicardial region of the patient'"'"'s heart wall. The pacing lead has a penetrating electrode which is secured within the heart wall. Improved devices for these procedures include a minimally invasive grasping device for heart leaflets, a leaflet connector with artificial cordae tendenae and a pacing lead implant instrument.

Claims

1. A method for accessing a left ventricle of a heart, said method comprising:

placing a valve structure having a tissue-penetrating securing element through a passageway in an apical wall of the heart;

penetrating the securing element into tissue surrounding the valve structure in the apical wall to secure the valve structure in the passageway; and

introducing a tool through the valve structure into the left ventricle;

wherein the valve structure has an exit flush with an inner surface of the left ventricle and an entrance flush with an outer surface of the heart.

2. The method as in claim 1, wherein the securing element is attached to an outer surface of the valve structure.

3. The method as in claim 2, wherein the securing element is disposed circumferentially about a cylindrical wall of the valve structure.

4. The method as in claim 3, wherein the securing element comprises a plurality of hooks or barbs.

5. The method as in claim 1, wherein the valve structure comprises a one-way valve.

6. The method as in claim 5, wherein the one-way valve comprises a duck bill valve.

7. The method as in claim 1, wherein introducing the tool comprises engaging a heart valve.

8. The method as in claim 7, wherein engaging the heart valve comprises repairing an incompetent heart valve.

9. The method as in claim 8, wherein the incompetent heart valve comprises a mitral valve.

10. The method as in claim 1, wherein introducing the tool comprises a procedure selected from the group consisting of transmyocardial revascularization, aortic stenting for aortic dissections and aneurysm therapy, removal of clots and vegetations from prosthetic valves, excision of heart tumors, implantation of stem cell and vascular growth factors, and closure of ventricular septal defects.