METHODS AND DEVICES FOR ACCESSING AND DELIVERING DEVICES TO A HEART

• US 20140303721A1
• Filed: 06/19/2014
• Published: 10/09/2014
• Est. Priority Date: 04/13/2010
• Status: Active Grant

• Current Assignee: SentreHeart, LLC (Atricure, Inc.)
• Original Assignee: SentreHEART Incorporated (Atricure, Inc.)
• Inventors: FUNG, Gregory W., SEIBER, Russell A., STRASSER, Robert, HELMUTH, Ryan Douglas
• Granted Patent: US 9,486,281 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/12195 comprising a curable material
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00363 Epicardium
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/0212 : using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1407 : Loop
• CPC Class Codes: A61B 2018/1861 : with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61M 25/0127 : Magnetic means; Magnetic markers
• CPC Class Codes: A61N 7/00 : Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Described here are devices and systems for accessing and delivering devices to a heart. The left atrial appendage may be used as an access port to allow pericardial access to internal structures of the heart. Systems that may be used to provide access to the heart via the left atrial appendage may comprise a first access element with a first alignment member, a second access element with a second alignment member, a piercing element, and an exchange element. A piercing element may be advanced to pierce the wall of the left atrial appendage to form an access site therethrough. Optionally, an exchange element may be advanced to initiate a track between the inside and outside of the left atrial appendage, which may be used for device delivery. Some systems may further comprise a left atrial appendage stabilization device.

Claims

1. A method for cardiac valve treatment via a left atrial appendage, the method comprising:

piercing the left atrial appendage to access a cardiac valve site;

advancing a treatment device into the heart through the left atrial appendage to the cardiac valve site;

repairing or replacing the cardiac valve with the treatment device;

removing the treatment device through the left atrial appendage; and

closing the left atrial appendage.

2. The method of claim 1 wherein the treatment device comprises a cardiac valve repair device.

3. The method of claim 2 wherein the valve repair device comprises an annuloplasty band or ring.

4. The method of claim 2 wherein the valve repair device comprises a chordae tendinae replacement device.

5. The method of claim 1 wherein the treatment device comprises a cardiac valve replacement device.

6. The method of claim 1, further comprising advancing a suture device into the heart through a left ventricle access site.

7. The method of claim 1 wherein the cardiac valve is a mitral valve.

8. The method of claim 1 wherein the cardiac valve is a tricuspid valve.

9. The method of claim 1 wherein the cardiac valve is a semilunar valve.

10. The method of claim 1 further comprising advancing a guide element through the left atrial appendage.

11. The method of claim 1 wherein piercing the left atrial appendage to access a cardiac valve site comprises:

advancing a first guide intravascularly to the interior of the left atrial appendage, wherein the first guide comprises a first longitudinal lumen therethrough;

advancing a second guide through the pericardium to the exterior of the left atrial appendage, wherein the second guide comprises a second longitudinal lumen therethrough;

aligning the first and second guides such that the first longitudinal lumen is aligned with the second longitudinal lumen; and

advancing a piercing element through the left atrial appendage from the first longitudinal lumen to the second longitudinal lumen.

12. The method of claim 11 further comprising advancing a guide wire through the first longitudinal lumen.

13. The method of claim 11 wherein the first and second guides comprise alignment members.

14. The method of claim 13 wherein the alignment members comprise magnets.

15. The method of claim 13 wherein the alignment members comprise interconnecting members.

16. The method of claim 1 wherein closing the left atrial appendage comprises ligating the left atrial appendage with a suture loop.

17. The method of claim 1 wherein closing the left atrial appendage comprises occluding the left atrial appendage with an expandable member.

18. The method of claim 1 wherein closing the left atrial appendage comprises closing the left atrial appendage with a closure device, wherein the closure device comprises a closure element and a suture loop.

19. The method of claim 18 wherein the suture loop is releasably connected to the closure element.

20. The method of claim 1 further comprising advancing a guide element intravascularly into the left ventricle to assist in cardiac valve treatment.