Method and devices for heart treatment
First Claim
1. A method of treating a patient at risk of loss of cardiac function by cardiac ischemia, comprising (a) imaging the patient'"'"'s heart, or a portion thereof, to identify (i) an underperfused region of cardiac muscle, (ii) a source of oxygenated blood that is proximate a boundary of the underperfused region, and (iii) a target area that includes said underperfused-region boundary and a tissue expanse lying between said oxygenated blood supply and said boundary;
- (b) at each of a plurality of sites throughout the target area, introducing a stimulus effective to stimulate angiogenesis in myocardial tissue and form a capillary network from the source of oxygenated blood to the underperfused region, wherein the stimulus is an injury produced by a stimulus selected from the group consisting of a mechanical, laser, chemical, thermal, or ultrasonic injury; and
(c) sustaining a demand for oxygen at the underperfused region for a period sufficient to covert the capillary network into an arterial network.
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Abstract
Various methods and devices for treating a patient who has lost, or is at risk of losing cardiac function by cardiac ischemia are disclosed. Treatment includes first imaging a patient'"'"'s heart, or a portion thereof, to identify underperfused regions of cardiac muscle, and a source of oxygenated blood that is proximate to the underperfused region. Between the underperfused regions and the oxygenated blood source, a target area is selected where thermal or mechanical injury is introduced, and optionally reintroduced, to convert initial capillary blush, resulting from the injury.
74 Citations
8 Claims
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1. A method of treating a patient at risk of loss of cardiac function by cardiac ischemia, comprising
(a) imaging the patient'"'"'s heart, or a portion thereof, to identify (i) an underperfused region of cardiac muscle, (ii) a source of oxygenated blood that is proximate a boundary of the underperfused region, and (iii) a target area that includes said underperfused-region boundary and a tissue expanse lying between said oxygenated blood supply and said boundary; -
(b) at each of a plurality of sites throughout the target area, introducing a stimulus effective to stimulate angiogenesis in myocardial tissue and form a capillary network from the source of oxygenated blood to the underperfused region, wherein the stimulus is an injury produced by a stimulus selected from the group consisting of a mechanical, laser, chemical, thermal, or ultrasonic injury; and
(c) sustaining a demand for oxygen at the underperfused region for a period sufficient to covert the capillary network into an arterial network. - View Dependent Claims (2, 3)
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4. A method of treating a patient at risk of loss of cardiac function by cardiac ischemia, comprising
(a) imaging the patient'"'"'s heart, or a portion thereof, to identify (i) an underperfused region of cardiac muscle, (ii) a source of oxygenated blood that is proximate a boundary of the underperfused region, and (iii) a target area that includes said underperfused-region boundary and a tissue expanse lying between said oxygenated blood supply and said boundary; -
(b) at each of a plurality of sites throughout the target area, introducing a stimulus effective to stimulate angiogenesis in myocardial tissue and form a capillary network from the source of oxygenated blood to the underperfused region, wherein the source of oxygenated blood is one in which arteries less than about 1 mm branch into surrounding arterioles, and in which the arterioles with inner lumen diameters between about 50-200 microns are plentiful, and said sites are spaced from one another at spacing of between 0.5 to 1 cm; and
(c) sustaining a demand for oxygen at the underperfused region for a period sufficient to covert the capillary network into an arterial network.
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5. A method of treating a patient at risk of loss of cardiac function by cardiac ischemia, comprising
(a) imaging the patient'"'"'s heart, or a portion thereof, to identify (i) an underperfused region of cardiac muscle, (ii) a source of oxygenated blood that is proximate a boundary of the underperfused region, and (iii) a target area that includes said underperfused-region boundary and a tissue expanse lying between said oxygenated blood supply and said boundary, wherein the underperfused region is in a myocardial region of either of the patient'"'"'s ventricles, the source of oxygenated blood is the interior of the underperfused heart ventricle region, the target area includes the region of ventricle endocardium underlying the underperfused region, and said stimulus is a mechanical injury produced by forming at selected target sites in the target area, elongate channels in the endocardium of the ventricle, where the depth and width of said channels, combined with the blood turbulence produced within the ventricle, is such as to minimize accumulation of blood clot material in the channels; -
(b) at each of a plurality of sites throughout the target area, introducing a stimulus effective to stimulate angiogenesis in myocardial tissue and form a capillary network from the source of oxygenated blood to the underperfused region; and
(c) sustaining a demand for oxygen at the underperfused region for a period sufficient to covert the capillary network into an arterial network. - View Dependent Claims (6, 7, 8)
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Specification