Papillary Muscle Attachment for Left Ventricular Reduction

• US 20090099410A1
• Filed: 05/19/2006
• Published: 04/16/2009
• Est. Priority Date: 06/09/2005
• Status: Abandoned Application

• Current Assignee: Miami University
• Original Assignee: Miami University
• Inventors: De Marchena, Eduardo
• Application Number:
  US11/920,365
• Publication Number:
  US 20090099410A1
• Time in Patent Office: Days
• US Class Current: 600/37
• 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 17/0401 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 17/0487 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 17/083 Clips, e.g. resilient
• CPC Class Codes: A61B 17/10 for applying or removing wound clamps, e.g. containing only one clamp or staple A61B17/076 takes precedence; containing multiple wound clamps A61B17/068; Wound clamp magazines containers, packaging elements or packages specially adapted for particular articles or with special means for dispensing contents B65D83/00, B65D85/00
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses

Abstract

The surgical implantation of a link, which may be in the form of a tether or a looped band, is proposed to connect and reduce the spacing between papillary muscles, to reduce dilation of the left ventricle. The implanted link thus improves heart function by reducing left ventricular failure.

Claims

1. A method of reducing a transventricular size and improving ventricular geometry in a patient having dilated cardiomyopathy comprising:

securing at least one tether structure to opposed, facing portions of first and second papillary muscles within the left ventricle of said patient'"'"'s heart; and

reducing a distance between said papillary muscles by drawing said facing portions of said papillary muscles towards each other with said at least one tether structure to reduce a transventricular size and geometry of the patient'"'"'s heart, thereby to mitigate the affects of the dilated cardiomyopathy.

2. A method as in claim 1, further comprising, before said securing, accessing the patient'"'"'s vasculature remote from the heart, and advancing a guide catheter through the patient'"'"'s vasculature so that a distal end thereof is disposed in one of the left atrium and the left ventricle of the patient'"'"'s heart.

3. A method as in claim 2, further comprising, before advancing said guide catheter, creating a trans-septal opening.

4. A method as in claim 3, wherein said trans-septal opening is created with a needle knife disposed through a catheter.

5. A method as in claim 1, wherein each said tether structure comprises a clip having a suture filament secured thereto, and wherein said securing comprises securing at least one said clip to each said papillary muscle adjacent a base thereof.

6. A method as in claim 5, wherein said suture filament is secured to said clip before said clip is secured to the respective papillary muscle.

7. A method as in claim 2, wherein each said tether structure comprises a clip having a suture filament secured thereto, and further comprising advancing a clip applying device carrying at least one said clip through said guide catheter.

8. A method as in claim 7, wherein said suture filament is secured to said clip before said clip applying device is advanced through said guide catheter.

9. A method as in claim 2, further comprising orienting said distal end of said guide catheter is directed towards at least one of said papillary muscles.

10. A method as in claim 1, further comprising visualizing the papillary muscle and adjacent ventricular structures during said securing and reducing steps.

11. A method as in claim 10, wherein visualization comprises fluoroscopy, or intra-cardiac ultrasound.

12. A method as in claim 1, wherein said reducing said distance between said papillary muscles realigns the papillary muscles to decrease mitral regurgitation.

13. A method of treating dilated cardiomyopathy comprising:

securing at least one tether structure to opposed, facing portions of first and second papillary muscles within a ventricle of the heart of a patient having dilated cardiomyopathy; and

reducing a length of said at least one tether structure so as to draw said facing portions of said papillary muscles towards each other to reduce a transventricular dimension of said heart.

14. A method as in claim 13, further comprising, before said securing, accessing the patient'"'"'s vasculature remote from the heart, and advancing a guide catheter through the patient'"'"'s vasculature so that a distal end thereof is disposed in one of the left atrium and the left ventricle of the patient'"'"'s heart.

15. A method as in claim 14, further comprising, before advancing said guide catheter, creating a trans-septal opening.

16. A method as in claim 15, wherein said trans-septal opening is created with a needle knife disposed through a catheter.

17. A method as in claim 13, wherein each said tether structure comprises a clip having a suture filament secured thereto, and wherein said securing comprises securing at least one said clip to each said papillary muscle adjacent a base thereof.

18. A method as in claim 17, wherein said suture filament is secured to said clip before said clip is secured to the respective papillary muscle.

19. A method as in claim 14, wherein each said tether structure comprises a clip having a suture filament secured thereto, and further comprising advancing a clip applying device carrying at least one said clip through said guide catheter.

20. A method as in claim 19, wherein said suture filament is secured to said clip before said clip applying device is advanced through said guide catheter.

21. A method as in claim 14, further comprising orienting said distal end of said guide catheter so that it is directed towards at least one of said papillary muscles.