Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen

• US 20070016287A1
• Filed: 06/07/2006
• Published: 01/18/2007
• Est. Priority Date: 03/25/2005
• Status: Active Grant

• Current Assignee: St. Jude Medical Cardiology Division Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: St. Jude Medical Cardiology Division Incorporated (Abbott Laboratories Incorporated)
• Inventors: Lee, Leonard, Cartledge, Richard, Fann, James
• Granted Patent: US 8,864,823 B2
• Time in Patent Office: Days
• US Class Current: 623/2.110
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2448 D-shaped rings
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61F 2250/0004 adjustable

Abstract

An implantable device is provided for controlling shape and/or size of an anatomical structure or lumen. The implantable device has an adjustable member configured to adjust the dimensions of the implantable device. The implantable device is housed in a catheter and insertable from a minimally invasive surgical entry. An adjustment tool actuates the adjustable member and provide for adjustment before, during or after the anatomical structure or lumen resumes near normal to normal physiologic function.

Claims

1. An implantable device for controlling at least one of shape and size of an anatomical structure or lumen, comprising:

an implantable device that has an adjustable member configured to adjust the dimensions of the implantable device, the implantable device being housed in a catheter and insertable from a minimally invasive surgical entry; and

an adjustment tool configured to actuate the adjustable member and provide for adjustment before, during or after the anatomical structure or lumen resumes near normal-to-normal physiologic function.

2. The device of claim 1, further comprising:

a plurality of tensioned attachment clips configured to be coupled to the implantable device.

3. The device of claim 1, wherein the implantable device includes at least a first closure portal to receive a closure coil.

4. The device of claim 1, wherein the implantable device includes at least a first closure portal to receive a coil and a track.

5. The device of claim 4, wherein the track guides the coil.

6. The device of claim 5, wherein the coil at least partially follows contours of walls of the implantable device.

7. The device of claim 6, wherein the coil follows a substantially spiral path.

8. The device of claim 5, wherein in response to the implantable device being pressed against the anatomical structure or lumen sufficient advancement of the coil results in a coursing of the coil into the anatomical structure or lumen tissue until the coil is advanced for a desired length.

9. The device of claim 1, further comprising:

a track at a periphery of the implantable device by track carriers.

10. The device of claim 9, further comprising:

a coil configured to be advanced on the track carriers.

11. The device of claim 1, further comprising:

a coil advanceable over a guide wire.

12. The device of claim 11, wherein the coil is advanceable by manual action of an operator.

13. The device of claim 11, wherein the coil is advanceable non-manually

14. The device of claim 1, further comprising:

a coil to attach the implantable device to a beating heart.

15. The device of claim 14, wherein the coil is advanceable over a guide wire and configured to allow detachment of the guide wire from the coil after the coil has been deployed.

16. An implantable device delivery system, comprising:

a housing sheath;

a catheter assembly that includes an actuating catheter disposed within the housing sheath and a core catheter located within the actuating catheter; and

an implantable device that has an adjustable member configured to adjust the dimensions of the implantable device, the implantable device being housed in the catheter assembly and insertable from a minimally invasive surgical entry.

17. The system of claim 16, wherein the catheter assembly is a coaxial catheter assembly.

18. The system of claim 16, wherein the core catheter has one or more central lumens.

19. The system of claim 16, wherein the actuating catheter and the core catheter are separate structures.

20. The system of claim 16, wherein the actuating catheter and the core catheter are combined.

21. The system of claim 16, wherein the actuating catheter and the core catheter are a continuous structure.

22. The system of claim 16, further comprising:

one or more touchdown sensors.

23. The system of claim 16, further comprising:

radial support arms and at least one of the radial implant support arms is a touchdown sensor with a distal end that extends beyond the implantable device.

24. The system of claim 16, further comprising:

one or more release elements for the implantable device.

25. The system of claim 24, wherein the one or more release elements are selected from, suture, fiber and wire-like member.

26. The system of claim 16, wherein an expansion of the implantable device is achieved by sliding movement of the housing sheath, the actuating catheter and the core catheter.

27. The system of claim 16, wherein attachment tabs are provided in the actuation catheter.

28. The system of claim 27, wherein the attachment tabs are a site of attachment of a first pivotable joint.

29. The system of claim 28, wherein the actuation catheter includes retention tabs are in a lumen of the actuation catheter.

30. The system of claim 29, wherein the core catheter has one or more lumens with release elements or adjustment elements.

31. The system of claim 22, wherein each touchdown sensor includes a distal segment, an intermediate segment, and a proximal segment.

32. The system of claim 31, wherein the distal segment has a distal tip.

33. The system of claim 32, wherein the distal segment is spring mounted.

34. The system of claim 32, wherein the distal segment is configured to provide telescoping displacement over the intermediate segment to achieve a seamless junction with the proximal segment upon maximal displacement.

35. The system of claim 34, wherein when the implantable device is seated against a periphery of an anatomical opening, the proximal segment of the touchdown sensor is compressed against the distal segment of the touchdown sensor.

36. The system of claim 31, wherein the distal and proximal segments of the touchdown sensors are associated with a radio opaque marker.

37. The system of claim 31, wherein activation of the touchdown sensors is monitored through sensor indicators located outside of a surgical incision.

38. An implantable device delivery system, comprising:

an implantable device that has an adjustable member configured to adjust the dimensions of the implantable device; and

a delivery system configured to provide for percutaneous delivery of the implantable device to an anatomical site.

39. The system of claim 38, wherein the percutaneous delivery is for percutaneous access to a heart.

40. The system of claim 39, wherein the percutaneous delivery is in a jugular vein.

41. The system of claim 39, wherein the percutaneous delivery is in a femoral vein.

42. A method for controlling at least one of shape and size of an anatomical structure or lumen of a patient, comprising:

implanting an implantable device to the anatomical structure or lumen of the patient, the implantable device having an adjustable member configured to adjust the dimensions of the implantable device;

bringing the patient'"'"'s heart rate and blood pressure back to normal while the patient is still in the operating room; and

using an adjustment tool to provide adjustment of the implantable device after the patient'"'"'s heart rate and blood pressure are brought substantially to normal levels.