Steerable lesion excluding heart implants for congestive heart failure

• US 9,744,040 B2
• Filed: 07/05/2016
• Issued: 08/29/2017
• Est. Priority Date: 08/19/2005
• Status: Active Grant

• Current Assignee: Bioventrix, Inc.
• Original Assignee: Bioventrix, Inc.
• Inventors: Annest, Lon S., Bertolero, Arthur A., Chin, Sing-Fatt, Swanson, David K.
• Primary Examiner(s): LACYK, JOHN P
• Application Number:
  US15/202,394
• Publication Number:
  US 20160310276A1
• Time in Patent Office: 420 Days
• Field of Search: 600 16- 18
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• 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 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2017/00044 Sensing electrocardiography, i.e. ECG
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/00986 Malecots, e.g. slotted tubes, of which the distal end is pulled to deflect side struts
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0462 One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle hollow suture needles A61B2017/061
• CPC Class Codes: A61B 2017/06176 with protrusions, e.g. barbs
• CPC Class Codes: A61B 2017/22054 : with two balloons
• CPC Class Codes: A61B 2017/22069 : Immobilising; Stabilising
• CPC Class Codes: A61B 2018/00392 : Transmyocardial revascularisation
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints

Abstract

Devices, systems, and methods for treating a heart of a patient may make use of one or more implant structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart.

Claims

1. A system for treating a heart, the heart having a first chamber bordered by a septum and a wall, wherein the chamber comprises a left ventricle of the heart, the heart having a second chamber separated from the first chamber by the septum, the system comprising:

a first anchor that is affixable to the septum at a first location;

a second anchor that is affixable to the wall at a second location;

a first tension member that extends from the first anchor to the second anchor and that tensionalby couples the first anchor and the second anchor when said anchors are affixed to the septum and wall respectively, the first tension member traversing through a penetration in the septum adjacent the first anchor and through a penetration in the wall adjacent the second anchor;

a third anchor that is affixable to the wall at a third location that is laterally offset from the second location; and

a second tension member that extends from the first anchor to the third anchor and that tensionalby couples the first anchor and the third anchor when said anchors are affixed to the septum and wall respectively such that a plurality of anchors are positionable adjacent the wall and are tensionably coupled with the first anchor, the second tension member traversing through the penetration in the septum adjacent the first anchor and through a penetration in the wall adjacent the third anchor, wherein;

the first anchor, the second anchor, and the third anchor are tensionable, via tensioning the first tension member and the second tension member, by an amount sufficient to bring the wall and septum into engagement; and

the second and third anchors are separated so as to, in combination, effectively exclude regions of the wall and septum from the left ventricle with scar tissue extending along the excluded regions.

2. The system of claim 1, wherein the third anchor is angularly offset from the second anchor.

3. The system of claim 1, further comprising a probe that is configured to engage tissue near the first location or the second location to characterize the engaged tissue.

4. The system of claim 3, wherein the probe includes an electrode that is configured to pace the engaged tissue to characterize the engaged tissue.

5. The system of claim 1, wherein the anchors are affixable by radially expanding the anchors and engaging axially-oriented surfaces of the anchors with tissue adjacent the perforations.

6. The system of claim 1, wherein at least one of the anchors comprises a plurality of arms that are deployable against the surface of the septum or wall.

7. The system of claim 1, wherein the second anchor is slidable along the first tension member toward the first anchor, and wherein the third anchor is slidable along the second tension member toward the first anchor.

8. A system for treating a heart, the heart having a chamber bordered by a first wall and a second wall, the system comprising:

a first anchor that is affixable to the first wall;

a second anchor that is affixable to the second wall at a first location;

a first tension member that tensionalby couples the first anchor and the second anchor;

a third anchor that is affixable to the second wall at a second location that is laterally offset from the first location; and

a second tension member that tensionalby couples the first anchor and the third anchor such that a plurality of anchors are tensionably coupled with the first anchor;

the first anchor, the second anchor, and the third anchor being tensionable, via the first and second tension members, to apply tension to the first wall and the second wall.

9. The system of claim 8, wherein the second anchor is angularly offset from the third anchor.

10. The system of claim 8, further comprising a probe that is configured to engage tissue of the first wall or the second wall to characterize the engaged tissue.

11. The system of claim 10, wherein the probe includes an electrode that is configured to pace the engaged tissue to characterize the engaged tissue.

12. The system of claim 8, wherein the first anchor, the second anchor, and/or the third anchor are affixed by radially expanding said anchors and engaging axially-oriented surfaces of said anchors with tissue of the first wall and/or second wall.

13. The system of claim 8, wherein at least one of the first anchor, the second anchor, or the third anchor comprises a plurality of arms that are deployable against the surface of the first wall or second wall.

14. The system of claim 8, wherein the first wall is a septum of the heart.

15. A heart anchor system for tensioning a first wall and a second wall of a heart, the first wall and the second wall being separated by a chamber of the heart, the heart anchor system comprising:

a first anchor;

a second anchor;

a first tension member that extends between the first anchor and the second anchor;

a third anchor;

a second tension member that extends between the first anchor and the third anchor;

the first anchor being positionable adjacent the first wall of the heart and the second anchor and the third anchor being positionable adjacent the second wall of the heart with the second anchor and third anchor laterally; and

the first anchor, the second anchor, and the third anchor being tensionable, via the first tension member and the second tension member, to apply tension to the first wall and the second wall.

16. The heart anchor system of claim 15, wherein the third anchor is angularly offset from the second anchor.

17. The heart anchor system of claim 15, further comprising a probe that is configured to engage tissue of the first wall or the second wall to characterize the engaged tissue.

18. The heart anchor system of claim 17, wherein the probe includes an electrode that is configured to pace the engaged tissue to characterize the engaged tissue.

19. The heart anchor system of claim 15, wherein the first anchor, the second anchor, and the third anchor are affixed by radially expanding said anchors and engaging axially-oriented surfaces of the anchors with tissue adjacent the first wall or the second wall.

20. The heart anchor system of claim 15, wherein at least one of the first anchor, the second anchor, or the third anchor comprises a plurality of arms that are deployable against the surface of the first wall or the second wall.