Devices and Methods for Treating Cardiomyopathy
First Claim
1. An adjustable in vivo tensioning actuator for connecting at least two implantable tissue tethers, comprising:
- a housing having one or more apertures capable of accepting an implantable tissue tether or a tissue tether comprising a band or sling, and an adjustment mechanism that attaches to each tissue tether during an in vivo endoscopic procedure and secures the tether to define the length of the tether and thereby the distance between the tissue attachments, wherein the tensioning actuator is reversibly adjustable without need for reattachment of the tethers to the tissues being manipulated.
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Accused Products
Abstract
This application relates to cardiac medical devices, and specifically to adjustable tensioning devices for tissue anchors, to the intraventricular cardiac anchoring or banding devices themselves, to devices and methods for controlling the depth of penetration of tissue anchors, to devices and methods for the joining of both papillary muscles to the mitral valve, to devices and methods for non-invasive “sling” or “loop” tethering of papillary muscles, to devices and methods for establishing suction prior to and during tissue anchor implant, to a double-barreled needle delivery device, and to a method of remodelling the heart muscle by implanting one or more tethers, and then periodically reducing the tether distance over time.
136 Citations
28 Claims
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1. An adjustable in vivo tensioning actuator for connecting at least two implantable tissue tethers, comprising:
- a housing having one or more apertures capable of accepting an implantable tissue tether or a tissue tether comprising a band or sling, and an adjustment mechanism that attaches to each tissue tether during an in vivo endoscopic procedure and secures the tether to define the length of the tether and thereby the distance between the tissue attachments, wherein the tensioning actuator is reversibly adjustable without need for reattachment of the tethers to the tissues being manipulated.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 20)
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11. A tissue anchor for implantable tethers, comprising:
- an anchor housing having a tip end, a wire-access end, and a tether fastening means, said housing defining an external shell and an inner cavity, at least one channel within said inner cavity, said at least one channel having a release wire partially disposed therein, said release wire having at one terminus a release loop located outside the anchor housing, and at the other release wire terminus the release wire is attached to a slidable filament core within said inner cavity, said slidable filament core having one or more filaments moveably attached thereto and extending from said inner cavity to outside the anchor housing for mechanical interaction with the tissue such that when the one or more moveable filaments are in a fully-extended open position they operate to secure the anchor to the tissue and when the one or more moveable filaments are in a folded closed position they do not securely engage the tissue, the slidable filament core having a disengagable locking mechanism such that when the release wire is pulled away from the anchor housing the slidable filament core slides within said inner cavity and the moveable filaments retract to a folded closed position enabling removal of the tissue anchor.
- View Dependent Claims (12, 13, 14, 15, 16, 17, 18)
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19. A method of tethering cardiac papillary muscles, comprising the step of:
- threading a sling or band made of medically implantable material around a papillary muscle, wherein said threading allows tethering of said papillary muscle, either to another papillary muscle or to other tissue within the ventricle, wherein said threading provides tethering without requiring implantation anchors or other elements requiring the piercing of muscle tissue.
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21. An anchor system for allowing synchronous movement of tethered tissue, comprising:
- two or more medically implantable tissue anchors in combination, wherein said tissue anchors have one or more hook or drawstring elements attached thereby allowing each tissue anchor to become interjoined with at least one opposing tissue anchor, wherein said one or more hook or drawstring elements allow the tissue to completely join together, allowing the tissue to move in a synchronous manner.
- View Dependent Claims (22)
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23. A medically implantable tissue anchor that forms a circle or semi circle upon implantation, wherein the tissue anchor possesses barbs that form a full 360 degree circle, wherein there is no part of the barb exposed to inside of the heart or tissue should a partial implant be the result of the implantation procedure.
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24. An anchor system for reduction of mitral regurgitation, comprising:
- at least two tethers that are attached using tissue anchors to the posterior and the anterior papillary muscle, and a third anchor attached to the top of the left ventricle between the aortic valve and the mitral valve or across the left ventricle to the septum, and an adjustor on that third tether that allows the papillary muscle tethers to be drawn toward the mitral valve, wherein the reduction in papillary to mitral valve distance reduces/eliminates mitral regurgitation.
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25. A method of implanting a tissue anchor using suction to verify target muscle and reduce damage to surrounding tissue, comprising:
- providing suction within the implantation canula of an endoscopy system during a cardiac tethering procedure, wherein the suction provides enhanced muscle contact with the implantation canula.
- 26. An adjustable tether implant, with a slidable core, adjustable whether by tensioning or loosing, that is implanted for 30-45 days prior to tightening to allow for the formation of adequate fibrous tissue, increasing the tensile strength of the anchor, that is adjustable in 1 mm increments via an adjustor mechanism on subsequent procedures for the purpose of tightening or loosening the tensile strength of the device, for the purpose of resisting diastolic pressure on the heart.
Specification