CA2617949A1 - Method for treating myocardial rupture - Google Patents

Method for treating myocardial rupture Download PDF

Info

Publication number
CA2617949A1
CA2617949A1 CA002617949A CA2617949A CA2617949A1 CA 2617949 A1 CA2617949 A1 CA 2617949A1 CA 002617949 A CA002617949 A CA 002617949A CA 2617949 A CA2617949 A CA 2617949A CA 2617949 A1 CA2617949 A1 CA 2617949A1
Authority
CA
Canada
Prior art keywords
heart
chamber
ribs
rupture
wall
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CA002617949A
Other languages
French (fr)
Other versions
CA2617949C (en
Inventor
Hugh R. Sharkey
Alexander Khairkhahan
Serjan D. Nikolic
Branislav Radovancevic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
CardioKinetix Inc
Original Assignee
Cardiokinetix, Inc.
Hugh R. Sharkey
Alexander Khairkhahan
Serjan D. Nikolic
Branislav Radovancevic
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiokinetix, Inc., Hugh R. Sharkey, Alexander Khairkhahan, Serjan D. Nikolic, Branislav Radovancevic filed Critical Cardiokinetix, Inc.
Publication of CA2617949A1 publication Critical patent/CA2617949A1/en
Application granted granted Critical
Publication of CA2617949C publication Critical patent/CA2617949C/en
Expired - Fee Related legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12122—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder within the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00579—Barbed implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00592—Elastic or resilient implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00597—Implements comprising a membrane
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00615—Implements with an occluder on one side of the opening and holding means therefor on the other
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00632—Occluding a cavity, i.e. closing a blind opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00898—Material properties expandable upon contact with fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00942—Material properties hydrophilic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A61B2017/12054—Details concerning the detachment of the occluding device from the introduction device
    • A61B2017/12095—Threaded connection

Abstract

A method and device for the treatment of a patient with heart disease and particularly a heart chamber having a myocardial rupture or characteristics of an incipient myocardial rupture. The heart chamber is partitioned so as to isolate a non-productive portion having a rupture or a region of an incipient rupture from a productive portion. The heart chamber is preferably partitioned with a reinforced membrane which has a pressure receiving surface that defines part of the productive portion of the heart chamber. The peripheral base of the reinforced membrane may have an eccentric configuration.

Description

METHOD FOR TREATING MYOCARDIAL RUPTURE

FIELD OF THE INVENTION
[0001] The present invention relates generally to the field of treating heart disease, particularly schemic coronary disease, and more specifically, to a method for partitioning a patient's heart chamber having a myocardial rupture or exhibiting characteristics of an incipient rupture.

BACKGROUND OF THE INVENTION
[0002] An acute myocardial infarction (AMI) may lead to myocardial rupture.
Myocardial rupture may also occur as a result of blunt and penetrating cardiac trauma, primary cardiac infection, primary and secondary cardiac tumors, infiltrative diseases of the heart, and aortic dissection. Mortality rates are extremely high unless early diagnosis and surgical intervention are provided rapidly. The consequences of myocardial rupture in the setting of AMI
can be cardiac pericardial tamponade, ventricular septal defect (VSD), acute mitral regurgitation (MR), or formation of a pseudoaneurysm.
[0003] Cardiac tamponade is a clinical syndrome caused by the accumulation of fluid in the pericardial space, resulting in reduced ventricular filling and subsequent hemodynamic compromise. Cardiac tamponade is a medical emergency. The overall risk of death depends on the speed of diagnosis, the treatment provided, and the underlying cause of the tamponade.
[0004] The pericardium, which is the membrane surrounding the heart, is comprised of two layers. The parietal pericardium is the outer fibrous layer and the visceral pericardium is the inner serous layer with the pericardial spaced formed therebetween. The pericardial space normally contains 20-50 mL of fluid. Pericardial effusions can be serous, serosanguineous, hemorrhagic, or chylous.
[0005] The hemodynamic changes in the case of cardiac tamponade have been described to include three phases. Phase one involves the accumulation of pericardial fluid causing increased stiffness of the ventricle, requiring a higher filling pressure In phase two fluid further accumulates resulting in reduced cardiac output. In phase three the pericardial and left ventricular (LV) filling pressures equilibrate, resulting in further decrease in cardiac output.
[0006] The development of tamponade may result in diminished diastolic filling as well as altered systemic venous return, both of which may result in reduced cardiac output.
[0007] Additionally, mechanical assist devices have been developed as intermediate procedures for treating patients in cardiogenic shock resulting from tamponade. Such devices include left ventricular assist devices and total artificial hearts. A left ventricular assist device incl'Cid'8 d rYie~li~e~1"p~~ fdr'"iri&edsing blood flow from the left ventricle into the aorta. Total artificial heart devices, such as the Jarvik heart, are usually used only as temporary measures while a patient awaits surgical repair of the lesion.
[0008] Surgical therapies for a hemodynamically unstable patient or one with recurrent tamponade include procedures such as pericardial centesis or surgical creation of a pericardial window involving open thoracotomy and/or pericardiotomy; creation of a pericardio-peritoneal shunt, and resection of the infarcted area and closure of the rupture zone with Teflon or Dacron patches or with the use of biological glues, are among the recommended surgical therapies. For a patient with a ventricular septal defect (VSD), surgical therapies include by directly closing or replacing of a patch, similar to treatment of tamponade. These procedures are highly invasive, risky and expensive and are commonly only done in conjunction with other procedures (such as heart valve replacement or coronary artery by-pass graft).

SUMMARY OF THE INVENTION
[0009] The present invention is directed to a method for the treatment of a patient's heart which has a myocardial rupture, and or stabilizing a traumatic rupture through the heart wall (e.g., stab wound).
[0010] A myocardial infraction, (MI), may result in myocardial ruptures leading to pericardial tamponade, VSD, acute mitral regurgitation (MR), or formation of a pseudoaneurysin. The present method is directed to treating a patient's heart having such a rupture (partial or complete); and/or an incipient rupture. The method includes separating the weakened or failed region to minimize the size and/or the effects of such a rupture or opening.
The present method at least partially restores of the hemodynamic competency of the chamber of the patient's heart which has or will soon have a rupture.
[0011] The amount of pericardial fluid needed to impair the diastolic filling of the heart depends on the rate of fluid accumulation and the compliance of the pericardium. Rapid accumulation of fluid may have a much greater impact on increasing the pericardial pressure, thus severely inlpeding cardiac output, than fluid accumulation over a longer period. The method device of the present invention, moreover, improves the diastolic function of the patient's heart.
[0012] In particular, the method of the present invention includes partitioning a chamber (e.g., left or/or right ventricles) of the patient's heart into a main productive portion and a secondary non-productive portion which has a rapture or which exhibits the characteristics of an incipient rupture. This partitioning closes off the portion of the heart having the rupture or incipient rupture to prevent loss of blood from the chamber and to reduce the total volume of the heaft ~'li 'ainbe:f''afici'"'tne'rebY' re'tlticirigthe stress applied to weakened tissue of the patient's heart wall. As a result, the ejection fraction of the chamber is improved.
[0013] One method embodying features of the invention includes the use of a partitioning device having a partitioning membrane, preferably a reinforced partitioning device, with a, pressure receiving surface, preferably concave, which defines in part the main productive portion of the partitioned heart chamber when disposed, preferably securely, within the patient's heart chamber.
[0014] The pressure receiving surface is preferably formed from a flexible membrane that is preferably reinforced by a radially expandable frame component formed of a plurality of ribs.
The ribs of the expandable frame have proximal ends which are preferably free, and distal ends which are preferably secured to a central hub to facilitate radial self expansion of the free proximal ends of the ribs away from a centerline axis. The distal ends of the ribs may be pivotally mounted to the hub and biased outwardly or fixed to the hub. The ribs are preferably formed from material such as superelastic NiTi alloy which allows for compressing the free proximal ends of the ribs toward the centerline axis and into a contracted configuration for delivery and self expansion when released for deployment upon release within the patient's heart chamber. The membrane may be of variable shape suitable to practice the present invention and aid in the treatment of the MI. In one embodiment the membrane has an eccentric shape to more particularly be configured for use in the upper portions of the ventricular septum.
[0015] The free proximal ends of the ribs are configured to engage, and preferably penetrate into, the tissue lining of the targeted heart chamber (i.e., heart chamber to be partitioned). The engagement, preferably penetration, of the proximal ends with the tissue lining of the heart chamber, enables the securing of a peripheral edge of the partitioning device to the heart wall and fixation of the partitioning device within the chamber so as to partition the chamber in a desired manner. Preferably, tissue penetrating proximal tips of the free proximal ends are configured to penetrate the tissue lining at an angle approximately perpendicular to the centerline axis of the partitioning device. The tissue penetrating proximal tips of the ribs may be provided with barbs, hooks and the like which prevent undesired withdrawal of the tips from the heart wall.
[0016] In another embodiment having features of the invention, an expansive member such as one or more strands and/or swellable pads extend between at least one pair of adjacent ribs at or close to an outer edge or periphery of the membrane to exert enough pressure to the flexible membrane periphery when the partitioning device is in an expanded configuration to provide an adequate seal between the membrane periphery and the lining of the heart wall.
In one embodiment, a single strand or strands extend around essentially the entire periphery of the of the membrane between each pair of ribs is effectively sealed against the heart wall. The expansive strand or strands are formed from material which is stiffer than the flexible, unsupported material of the membrane to provide an outward expansive force or thrust to prevent formation of undesirable inwardly directed folds or wrinkles when the ribs of the partitioning device are in a contracted configuration. Suitable strand or strands are formed from materials such as polypropylene suture or supereleastic NiTi alloy wires. Such strands are typically about 0.005 to about 0.03 inch (about 0.13 to about 0.76 mm) in diameter to provide the requisite outward expansive force when placed in a circular position such as around the periphery of the membrane in less than completely expanded configuration.
[0017] In another embodiment expandable pads are provided between each adjacent pair of ribs which are configured to swell upon contact with body fluids to provide an outward expansive force or thrust, as described above, to prevent formation of inwardly directed folds or wrinkles when the ribs of the portioiling device are in at least a partially contracted configuration. Preferably, the pads are formed froin expansive hydrophilic foam. Suitable swellable materials include collagen, gelatin, polylactic acid, polyglycolic acid, copolymers of polylactic acid and polyglycolic acid, polycaprolactone, and mixtures and copolymers thereof.
Other suitable swellable bioresorbable polymeric materials may be employed.
The expandable pads may also be formed so as to deliver a variety of therapeutic or diagnostic agents.
[0018] The ribs in their expanded configuration angle outwardly from the hub and the free proximal ends curve outwardly so that the membrane is secured to the ribs of the expanded frame forming a trumpet-shaped, pressure receiving surface.
[0019] The partitioning membrane in the expanded configuration generally has radial dimension from about 10 to about 160 mm, preferably from about 50 to about 100 mm, as measured from the centerline axis. The membrane is preferably formed from flexible material or fabric such as expanded polytetrafluoroethylene (ePTFE).
[0020] In an embodiment, the partitioning device is designed to be oversized with respect to the chamber in which it is to be deployed so that the ribs of the device are under compression so that they can apply an outward force against the chamber wall. When the partitioning device is collapsed for delivery, the outwardly biased strand or strands ensure that there are no inwardly directed folds or wrinkles and that none are formed when the partitioning device is expanded for deployment within the heart chamber.
[0021] In one partitioning device design useful in the practice of the methods of the present invention, the free ends of the expansive strand or strands may be secured together and/or to the partitioning device. Alternatively, in another device design, the expansive strand or strands may be sufficiently long so that one or both free ends thereof extend out of the patient to facilitate coll19p~e klcl Muff eVaT"''eif tlie'-f d,itid6fing device, if so desired.
Pulling on the free ends of the strand extending out of the patient closes the expanded portion, i.e. the ribs and membrane, of the partitioning device to collapse the device as well as retrieving the collapsed partitioning device into an inner lumen of a guide catheter or other collecting device such as that described in co-pending application filed concurrently herewith entitled "Peripheral Seal for a Ventricular Partitioning Device", assigned to the assignee of the present invention, and incorporated herein by reference in its entirety.
[0022] The partitioning device preferably includes a supporting component or stem which has a length configured to extend distally to the heart wall surface to support the partitioning device within the heart chamber. In an embodiment, the supporting component has a plurality of pods or feet, preferably at least three, which distribute the force of the partitioning device about a region of the ventricular wall surface to minimize, preferably avoid, immediate or long term damage to the tissue of the heart wall, particularly compromised or necrotic tissue such as tissue of a myocardial infarct (MI) and the like. Pods of the support component extend radially and preferably are interconnected by struts or planes which help distribute the force over an expanded area of the ventricular surface.
[0023] The partitioning device may be delivered percutaneously or intraoperatively. One particularly suitable delivery catheter has an elongate shaft, a releasable securing device on a distal end of the shaft for holding the partitioning device on the shaft distal end and an expandable member such as an inflatable balloon on a distal portion of the shaft proximal to the shaft distal end to expand the interior surface of the collapsed partitioning device formed by the pressure receiving surface to effectuate the tissue penetrating tips or elements on the periphery of the partitioning device to sufficiently engage, preferably penetrate, the heart wall and to hold the partitioning device in a desired position to effectively partition the heart chamber. A suitable delivery device is described in co-pending application Serial No. 10/913,608, filed on August 5, 2004, assigned to the assignee of the present invention.
[0024] The methods of the present invention are easy to perform and provide for a substantially improved treatment of a diseased heart. As a result of the method of the present invention, a more normal diastolic and systolic moveinent of a patient's diseased heart is achieved. Concomitantly, an increase in the ejection fraction of the patient's heart chamber is usually obtained. These and other advantages of the invention will become more apparent from the following detailed description of the invention and the accompanying exemplary drawings.

]Wff'~~~e'RIPTION OF THE DRAWINGS
[0025] Figure 1A is a schematic view of a patient's heart having a myocardial infarct which may exhibit characteristics of an incipient rupture in the ventricular septum.
[0026] Figure 1B is a schematic view of the patient's heart of Figu.re 1A with a ventricular septal defect resulting from a rupture in the heart wall.
[0027] Figure 1C is a schematic view of the patient's heart of Figure 1B after treatment according to a method of the present invention.
[0028] Figure 2A is a schematic view of a patient's heart exhibiting a myocardial infarct with free wall rupture of the left ventricular chamber.
[0029] Figure 2B is a schematic view of the patient's heart of Figure 2A with a left ventricular chamber tamponade.
[0030] Figure 2C is a schematic view of the patient's heart of Figure 2B after treatment according to a method of the present invention.
[0031] Figure 3 is an elevational view of a partitioning device embodying features of the invention in an expanded configuration.
[0032] Figare 4 is a plan view of the partitioning device shown in Figure 3 illustrating the upper surface of the device.
[0033] Figure 5 is a bottom view of the partitioning device shown in Figure 3.
[0034] Figure 6 is a perspective view of the non-traumatic tip of the distally extending stein of the device shown in Figure 3.
[0035] Figure 7 is a partial cross-sectional view of a hub of the partitioning device shown in Figure 4 taken along the lines 7-7.
[0036] Figure 8 is a transverse cross-sectional view of the hub shown in Figure 7 taken along the lines 8-8.
[0037] Figure 9 is a longitudinal view, partially in section of a reinforcing rib and membrane at the periphery of the partitioning device shown in Figure 3.
[0038] Figure 10 is a schematic elevational view, partially in section, of a delivery system for the partitioning device shown in Figures 3 and 4.
[0039] Figure 11 is a transverse cross-sectional view of the delivery system shown in Figure taken along the lines 11-11.
[0040] Figure 12 is an elevational view, partially in section, of the hub shown in Figure 7 secured to a helical coil of the delivery system shown in Figure 10.
[0041] Figures 13A-13E are schematic views of a patient's left ventricular chamber illustrating the deployment of the partitioning device shown in Figures 3 and 4 with the delivery systeri'i' shd''izf'Figu're pdrtition a patient's heart chamber (e.g., left ventricle) into a primary productive portion and a secondary, non-productive portion.
[0042] Figure 14 is a schematic view of the patient's heart after treatment according to a method of the present invention utilizing a device embodying features of the present invention having an reinforced membrane with an eccentric peripheral base.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION
[0043] Figure lA is a schematic illustration of a patient's heart 10 showing the right ventricle 11 and the left ventricle 12 with the mitral valve 13 and aortic valve 14. A pericardium membrane 15 is shown surrounding the heart 10. At least a portion of myocardium layer 17 of the left ventricle 12, as shown in Figure IA, is exhibiting an area of infarct 18 ("MI") extending along a portion of ventricular septum wall 19 which separates the right and left ventricles and exhibits characteristics of an incipient rupture. Figure 1B illustrates the advancing of the infarct leading to the generation of a rupture or opening 20 in the septum wall 19, a condition referred to as VSD. As shown in Figure 1B oxygenated blood 21 flows directly to the right ventricle 11 through the septum opening 20. As a result of this movement, or shunting, at least two consequences are reached, firstly, the right portion of the heart works harder pumping a greater voluine of blood than it normally would, and secondly, the amount of oxygenated blood in the left ventricle is reduced leading to a lower oxygen level to the other tissues of the body. Figure 1 C illustrates the left ventricle 12 of Figure 1B after it has been partitioned, with the use of a partitioning device 30 according to the present invention and as described further below, into a main productive or operational portion 23 and a secondary, essentially non-productive portion 24. As can be seen from Figure 1 C, with fluid path to the septum opening blocked or reduced, the normal flow of blood from the left ventricle to the rest of the body through the aortic valve is restored.
[0044] Figure 2A is a schematic illustration of the patient's heart 10 showing the right ventricle 11 and the left ventricle 12 with the mitral valve 13 and aortic valve 14.
[0045] The pericardium membrane 15 is shown surrounding the heart. A
pericardium (pericardial complex) consists of an outer fibrous layer and an inner serous layer. The pericardial space 16 normally contains 20-50 mL of fluid. At least a portion of the myocardium layer 17 of the left ventricle 12, as shown in Figure 2A, is exhibiting the area of infarct 18 ("MI") extending along a portion of the left ventricle 12 resulting in the free wall rupture or opening 201eading to a movement of blood 21 from the left ventricle into the pericardial space 16.
[0046] Figure 2B illustrates the advancing of the infarct leading to the rupture or opening 20 increasing in size. As shown in Figure 2B, the flow of the blood 21 into the pericardial space 16 incfea~'es" ove''r'''~Ei''me' 'ieadirig"'to", a gr"eater accumulation of blood in the pericardial space. This movement and accumulation of blood in the pericardial space, a condition referred to as ventricular tamponade, results in reduced ventricular filling and subsequent hemodynamic compromise. Figure 2C illustrates the left ventricle 12 of Figure 2B after it has been partitioned, with the use of the partitioning device 30 according to the present invention, into the main productive or operational portion 23 and the secondary, essentially non-productive portion 24.
As can be seen from Figure 1C, with fluid path to the pericardial space blocked or reduced, the normal flow of blood from the left ventricle to the rest of the body through the aortic valve is restored.
[0047] Figures 3-6 illustrate the partitioning device 30 which embodies features of the invention and which may be utilized in practicing the method of the present invention. The device 30 includes a partitioning membrane 31, a hub 32, preferably centrally located on the partitioning device, and a radially expandable reinforcing frame 33 formed of a plurality of ribs 34. Preferably, at least part of the partitioning membrane 31 is secured to a proximal or pressure receiving side 35 of the frame 33 as shown in Figure 3. The ribs 34 have distal ends 36 which are secured to the hub 32, and free proximal ends 37 which are configured to curve or flare away from a center line axis 38 at least upon expansion of the partitioning device.
Radial expansion of the free proximal ends 37 unfurls the membrane 31 secured to the frame 33 so that the membrane presents the pressure receiving surface 35 which defines in part the productive portion 23 of the patient's partitioned heart chamber, as discussed with reference to Figures 1A-1C and 2A-2C. A
peripheral edge 39 of the membrane 31 maybe serrated as shown.
[0048] A continuous expansive strand 40 extends around the periphery of the membrane 31 on the pressure receiving side 35 thereof to apply pressure to the pressure side of the flexible material of the membrane to effectively seal the periphery of the membrane against the wall of the ventricular chamber. Ends 41 and 42 of the expansive strand 40 are shown extending away fiom the partitioning device in Figures 3 and 5. The ends 41 and 42 may be left unattached or may be secured together, e.g. by a suitable adhesive, to the membrane 31 itself. While not shown in detail, the membrane 31 has a proximal layer secured to the proximal faces of the ribs 34 and a distal layer secured to the distal faces of the ribs in a manner described in co-pending application Serial No. 10/913,608, filed on August 5, 2004, assigned to the assignee of the present invention, and incorporated herein by reference in its entirety.
[0049] The hub 32 shown in Figures 6 and 7 preferably has a distally extending stem 43 with a non-traumatic support component 44. The support component 44 has a plurality of pods or feet 45 extending radially away from the center line axis 38 and the ends of the feet 45 are secured to struts 46 which extend between adjacent feet. A plane of material (not shown) may extend R,. l td.j. i~..,.t.. p I lt 11 it P ....
betvve~li ~. ac~'~ii~ "~~e~"''~ iii a"web-Yil~e fashion to provide further support in addition to or in lieu of the struts 46.
[0050] As shown in Figure 7, the distal ends 36 of the ribs 34 are secured within the hub 32 and, as shown in Figure 8, a transversely disposed connector bar 47 is secured within the hub which is configured to secure the hub 32 and thus the partitioning device 30 to a delivery system such as that shown in Figures 10-12.
[0051] Figure 9 illustrates the curved free proximal ends 37 of ribs 34 wliich are provided with sharp tip elements 48 configured to engage, and preferably penetrate into, the wall of the heart chamber and hold the partitioning device 30 in a deployed position within the patient's heart chamber so as to partition the ventricular chamber into a productive portion and a non-productive portion, as described above with reference to Figures lA-iC and 2A-2C.
[0052] The connector bar 47 of the hub 32, as will be described later, allows the partitioning device 30 to be connected to the non-traumatic component 44 which can be secured to a delivery catheter for delivery and to be released from the delivery system within the patient's heart chamber. The distal ends 36 of the reinforcing ribs 34 are secured within the hub 32 in a suitable manner or they may be secured to the surface defining the inner lumen of the hub or they may be disposed within channels or bores in the wall of the hub 32. The distal end 36 of the ribs 34 are preshaped so that when the ribs are not constrained, other than by the membrane 31 secured thereto (as shown in Figures 3 and 4), the free proximal ends 37 thereof expand to a desired angular displacement, away from the centerline axis 38, of about 20 (degree) to about 90 , preferably about 50 to about 80 . The unconstrained diameter of the partitioning device 30 is preferably greater than the diameter of the heart chamber at the deployed location of the partitioning device so that an outward force is applied to the wall of the heart chamber by the at least partially expanded ribs 34 during systole and diastole so that the resilient frame 33 augments the heart wall movement.
[0053] Figures 10-12 illustrate one suitable delivery system 50 delivering the partitioning device 30, shown in Figures 3 and 4; into a patient's heart chamber and deploying the partitioning device to partition the heart chamber as shown in Figures 13A-13E. The delivery system 50 includes a guide catheter 51 and a delivery catheter 52. For purposes of clarity, as shown in Figures 13A-13E, the heart chamber is shown without rupture or openings 20 (as shown in Figures lA-1C and Figures 2A-2C). The present invention may be practiced after the myocardial infarct has lead to the creation of rupture or openings (such as 20) in the heart chamber, or in the case of an incipient rupture, prior to the creation of the rupture or openings as a means to minimize the size and/or the effects of rupture or opening.

[0d641" 'r&er 51 lia"s1Pan inner lumen 53 extending between proximal and distal ends, 54 and 55. A flush port 57 on the proximal end 54 of guide catheter 51 is in fluid communication with the inner lumen 53 for injecting therapeutic or diagnostic fluids thereto.
[0055] The delivery catheter 52 has an outer shaft 58 with an interior 59, and an adapter 60 at a proximal end thereof with a proximal injection port 61 which is fluid communication with interior 59 for injecting therapeutic or diagnostic fluids thereto. A
hemostatic valve (not shown) may be provided at the proximal end 54 of the guide catheter 51 to seal about the outer shaft 58 of the delivery catheter 52.
[0056] As shown in more detail in Figure 11, the outer shaft 58 has an inner shaft 62 with an interior 63, and is disposed within the interior 59 of the outer shaft and is secured to an inner surface 64 of the outer shaft 58 by webs 65 which extend along a substantial length of the inner shaft 62. The webs 65 define in part passageways 66 formed between the inner and outer shafts 62 and 58. The injection port 61 is in fluid communication with passageways 66 for directing therapeutic and/or diagnostic fluids thereto.
[0057] A torque shaft 67, preferably formed from hypotubing (e.g., stainless steel or superelastic NiTi) and having an inner lumen 68, is rotatably disposed within an inner lumen 69 of the inner shaft 62, and is secured at a proximal end 70 thereof within an adapter 71 with a rotating knob 72.
[0058] A balloon inflation port 73, preferably proximal to the rotating knob 72, is in fluid cominunication with the inner lumen 68 of the torque shaft 67.
[0059] A helical coil screw 74 is secured to a distal end 75 of the torque shaft 67 and rotation of the torque knob 72 on the proximal end 70 of the torque shaft 67 rotates the screw 74 on the distal end 75 of torque shaft =67 to facilitate deployment of the partitioning device 30. An inflatable balloon 76 at its proximal end 77 is sealingly secured (e.g., by way of adhesive 78) about the torque shaft 67 proximal to the distal end 75 of the torque shaft and has an interior 79 in fluid communication with the inner lumen 68 of the torque shaft 67.
Inflation fluid may be delivered to the interior 79 of the balloon through port 73. Inflation of the balloon 76 by inflation fluid througli port 73 facilitates securing the partitioning device 30 to the heart wall.
[0060] As shown in Figures 13A through 13E, the partitioning device 30 is delivered through the delivery system 50 which includes the guide catheter 51 and the delivery catheter 52. The partitioning device 30 is collapsed to a first delivery configuration which has small enough transverse dimensions to be slidably advanced through the inner lumen 53 of the guide catheter 51. Preferably, the guide catheter 51 has been previously percutaneously introduced and advanced through the patient's vasculature, such as the femoral artery, in a conventional manner to the desired heart chamber, such as the left ventricle 12. The delivery catheter 52 with the partitibhing d6vice319'attached"is advanced through the inner lumen 53 of the guide catheter 51 until the partitioning device 30 is ready for deployment from the distal end of the guide catheter 51 into the patient's heart chamber, such as left ventricle 12, to be partitioned.
[0061] The partitioning device 30 mounted on the screw 74 is urged partially out of the inner lumen 53 of the guide catheter 51 until the support component 44 of the hub 32 engages the heart wall as shown in Figure 13B with the free proximal ends 37 of the ribs 34 in a contracted configuration within the guide catheter. The guiding catheter 51 is withdrawn while the delivery catheter 52 is held in place until the proximal ends 37 of the ribs 34 exit a distal end 55 of the guiding catheter 51. The free proximal ends 37 of ribs 34 expand outwardly to press the sharp proximal tips 48 of the ribs 34 against and preferably into the tissue lining the heart chamber.
[0062] With the partitioning device deployed within the heart chamber and preferably partially secured therein, inflation fluid is introduced through the inflation port 73 into the inner lumen 68 of the torque shaft 67 and into the balloon interior 79 to inflate the balloon 76. The inflated balloon 76 presses against the pressure receiving surface 35 of the membrane 31 of the partitioning device 30 to ensure that the sharp proximal tips 48 are pressed well into the tissue lining the heart chamber.
[0063] With the partitioning device 30 properly positioned within the heart chamber, the knob 72 on the torque shaft 67 is rotated (e.g., counter-clockwise) to disengage the helical coil screw 74 of the delivery catheter 52 from the stem 43 of the non-traumatic support component.
The counter-clockwise rotation of the torque shaft 67 rotates the helical coil screw 74 which rides in the stem 43 of non-traumatic support component secured within the hub 32. Once the helical coil screw 74 disengages, the stem 43, the delivery system 50, including the guide catheter 51 and the delivery catheter 52, may then be removed from the patient.
[0064] The partitioning device 30 partitions the patient's heart chamber, such as left ventricle 12, into the main productive or operational portion 23 and the secondary, essentially non-productive portion 24. The operational portion 23 is much smaller than the original ventricular chainber and provides for an improved ejection fraction. The partitioning increases the ejection fraction and provides an improvement in blood flow. Over time, the non-productive portion 24 may fill first with thrombus and subsequently with cellular growth. Bio-resorbable fillers such as polylactic acid, polyglycolic acid, polycaprolactone and copolymers and blends thereof may be employed to initially fill the non-productive portion 24. Fillers may be suitably supplied in a suitable solvent such as dimethylsulfoxide (DMSO). Other materials which accelerate tissue growth or thrombus may be deployed in the non-productive portion 24 as well as non-reactive fillers. It should be noted that although the present figures describe the treatment of the left ventricle, the same can be applied to other chambers of the heart.

[06691 l~ 'FiJU~1"4 i1ltistMdVanIfternative design which embodies features of a device usable in practicing methods having features of the present invention, in which the partitioning device 30' is provided with an eccentric-shaped membrane 31' which is well suited for treating VSD
lesions that may occur further up (more proximal) the ventricular septum because of the different anatomical features and physiologic action of the ventricular septum versus the anterior free wall. The septal wall primarily moves in and out only, relative to the chamber, versus the free wall that has a rotation component to its excursion. Secondly, the outflow track which comprises the upper half of the ventricular septal wall below the aortic valve has very little or no trebeculation. It is particularly well suited for placement of the device placed to address necrotic failure of the tissue of the ventricular septum. In the embodiment shown in Figure 14, the device is shown with a nubbin foot 45' (and not the extended stem foot) allowing the device to sit more distally and intimately with the apex.
[0066] The details of the partitioning device 30' are essentially the same as in the previous embodiments and elements in this alternative embodiment are given the same reference numbers but primed as similar elements in the previously discussed embodiments. The partitioning device 30' forms a conical shape as in the previously discussed embodiments but the peripheral base of the conical shape which engages the wall that has a first dimension in a first direction greater than a second dimension in a second direction. Preferably, the second direction is at a right angle with respect to the first direction. The lengths of the ribs 34' are adjusted to provide the desired shape to the periphery of the device which engages the interior of the heart chamber.
[0067] The partitioning device 30 (and 31') may be conveniently formed by the method described in co-pending application Serial No. 10/913,608 assigned to the assignee of the present invention and which is incorporated herein by reference in its entirety.
[0068] While porous ePTFE material is preferred, the membrane 31 may be formed of suitable biocompatible polymeric material which includes Nylon, PET
(polyethylene terephthalate) and polyesters such as Hytrel. The membrane 31 is preferably foraminous in nature to facilitate tissue ingrowth after deployment within the patient's heart. The delivery catheter 52 and the guiding catheter 51 may be formed of suitable high strength polymeric material such as PEEK (polyetheretherketone), polycarbonate, PET, Nylon, and the like. Braided composite shafts may also be employed.
[0069] To the extent not otherwise described herein, the various components of the partitioning device and delivery system may be formed of conventional materials and in a conventional manner as will be appreciated by those skilled in the art.
[0070] While particular forms of the invention have been illustrated and described herein, it will be apparent that various modifications and improvements can be made to the invention.

e'm~''odiments of the invention may be shown in some drawings and not in others, but those skilled in the art will recognize that individual features of one embodiinent of the invention can be combined with any or all the features of another embodiment. Accordingly, it is not intended that the invention be limited to the specific embodiments illustrated. It is intended that this invention to be defined by the scope of the appended claims as broadly as the prior art will permit.
[0071] Terms such a "element," "member," "component," "device," "section,"
"portion,"
"step," "means," and words of similar import, when used herein shall not be construed as invoking the provisions of 35 U.S.C. 112(6) unless the following claims expressly use the term "means" followed by a particular function without specific structure or the term "step" followed by a particular function without specific action. Accordingly, it is not intended that the invention be limited, except as by the appended claims. All patents and patent applications referred to herein are hereby incorporated by reference in their entirety.

Claims (24)

1. A device for treating a patient's heart comprising;
a plurality of different length radially expandable ribs coupled at their distal ends and outwardly curved at their free proximal ends, wherein said device is configured to be endovascularly delivered to a chamber of a heart.
2. The device of claim 1 further comprising a membrane coupled to said different length ribs.
3. The device of claim 1 wherein a proximal periphery of said ribs is noncircular.
4. The device of claim 1 further comprising one or more anchor elements at each of said proximal ends of said different length ribs adapted to secure said device to a selected area of a wall within said heart.
5. The device of claim 1 wherein said device once deployed adjustably fits into an irregularly shaped area of said heart.
6. The device of claim 1 wherein said device once deployed is adapted for reducing a volume of said chamber.
7. The device of claim 1 wherein said device once deployed is adapted for partitioning said chamber of said heart into a functional portion and a non-functional portion.
8. The device of claim 1 wherein said different length ribs are self expandable upon deployment.
9. The device of claim 1 wherein said radially expandable ribs expand to a proximal diameter of about 5mm to about 80 mm.
10. The device of claim 1 wherein said different length ribs of said device provide an outward force against a wall of said chamber.
11. The device of claim 1 wherein said device once deployed augments movement of a wall of said chamber.
12. The device of claim 1 wherein said device is adapted for reducing acute mitral regurgitation.
13. The device of claim 1 further comprising a stem extending distally from said distal ends of said different length ribs wherein said stem is adapted to space said device a selected distance from a wall of said chamber of said heart.
14. The device of claim 2 wherein said membrane forms a pressure receiving surface.
15. The device of claim 4 wherein said anchor element pierces tissue at an angle of not more than 45° from a center line axis of said device.
16. The device of claim 7 wherein said non-functional portion comprises a myocardial rupture.
17. The device of claim 7 wherein said device is adapted for partitioning a myocardial rupture that is not located at an apex of a ventricle.
18. The device of claim 7 wherein said non-functional portion comprises a pseudoaneurysm.
19. The device of claim 9 wherein said proximal diameter of said device is oversized compared to a diameter of said chamber of said heart.
20. The device of claim 13 wherein said stem comprises a non-traumatic support component connected at its distal end.
21. The device of claim 14 wherein said pressure receiving surface is concave at its distal end.
22. The device of claim 16 wherein said myocardial rupture is a ventricular septal defect.
23. The device of claim 16 wherein said myocardial rupture is cardiac pericardial tamponade.
24. The device of claim 20 wherein said non-traumatic support component comprises a plurality of feet adapted to distribute force of said device about a region of said wall of said chamber.
CA2617949A 2005-08-09 2006-08-07 Method for treating myocardial rupture Expired - Fee Related CA2617949C (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US11/199,633 US20060229491A1 (en) 2002-08-01 2005-08-09 Method for treating myocardial rupture
US11/199,633 2005-08-09
PCT/US2006/030745 WO2007021647A2 (en) 2005-08-09 2006-08-07 Method for treating myocradial rupture

Publications (2)

Publication Number Publication Date
CA2617949A1 true CA2617949A1 (en) 2007-02-22
CA2617949C CA2617949C (en) 2013-11-19

Family

ID=37758076

Family Applications (1)

Application Number Title Priority Date Filing Date
CA2617949A Expired - Fee Related CA2617949C (en) 2005-08-09 2006-08-07 Method for treating myocardial rupture

Country Status (7)

Country Link
US (1) US20060229491A1 (en)
EP (1) EP1922023B1 (en)
JP (1) JP2009504255A (en)
AU (1) AU2006280120B2 (en)
CA (1) CA2617949C (en)
ES (1) ES2556181T3 (en)
WO (1) WO2007021647A2 (en)

Families Citing this family (59)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7128073B1 (en) 1998-11-06 2006-10-31 Ev3 Endovascular, Inc. Method and device for left atrial appendage occlusion
US10307147B2 (en) 1999-08-09 2019-06-04 Edwards Lifesciences Corporation System for improving cardiac function by sealing a partitioning membrane within a ventricle
US8500795B2 (en) 1999-08-09 2013-08-06 Cardiokinetix, Inc. Retrievable devices for improving cardiac function
US9694121B2 (en) 1999-08-09 2017-07-04 Cardiokinetix, Inc. Systems and methods for improving cardiac function
US8529430B2 (en) 2002-08-01 2013-09-10 Cardiokinetix, Inc. Therapeutic methods and devices following myocardial infarction
US7674222B2 (en) * 1999-08-09 2010-03-09 Cardiokinetix, Inc. Cardiac device and methods of use thereof
US8388672B2 (en) 1999-08-09 2013-03-05 Cardiokinetix, Inc. System for improving cardiac function by sealing a partitioning membrane within a ventricle
US8257428B2 (en) 1999-08-09 2012-09-04 Cardiokinetix, Inc. System for improving cardiac function
US9078660B2 (en) 2000-08-09 2015-07-14 Cardiokinetix, Inc. Devices and methods for delivering an endocardial device
US20060030881A1 (en) 2004-08-05 2006-02-09 Cardiokinetix, Inc. Ventricular partitioning device
US10064696B2 (en) 2000-08-09 2018-09-04 Edwards Lifesciences Corporation Devices and methods for delivering an endocardial device
US7762943B2 (en) 2004-03-03 2010-07-27 Cardiokinetix, Inc. Inflatable ventricular partitioning device
US8398537B2 (en) 2005-06-10 2013-03-19 Cardiokinetix, Inc. Peripheral seal for a ventricular partitioning device
US9332992B2 (en) 2004-08-05 2016-05-10 Cardiokinetix, Inc. Method for making a laminar ventricular partitioning device
US9332993B2 (en) 2004-08-05 2016-05-10 Cardiokinetix, Inc. Devices and methods for delivering an endocardial device
US7513867B2 (en) * 2003-07-16 2009-04-07 Kardium, Inc. Methods and devices for altering blood flow through the left ventricle
US20060184242A1 (en) * 2003-10-20 2006-08-17 Samuel Lichtenstein Method and apparatus for percutaneous reduction of anterior-posterior diameter of mitral valve
WO2007130724A2 (en) * 2006-02-06 2007-11-15 Northwind Ventures Systems and methods for volume reduction
US7749249B2 (en) 2006-02-21 2010-07-06 Kardium Inc. Method and device for closing holes in tissue
US20070270688A1 (en) 2006-05-19 2007-11-22 Daniel Gelbart Automatic atherectomy system
US8449605B2 (en) 2006-06-28 2013-05-28 Kardium Inc. Method for anchoring a mitral valve
US11389232B2 (en) 2006-06-28 2022-07-19 Kardium Inc. Apparatus and method for intra-cardiac mapping and ablation
US10028783B2 (en) 2006-06-28 2018-07-24 Kardium Inc. Apparatus and method for intra-cardiac mapping and ablation
US8920411B2 (en) 2006-06-28 2014-12-30 Kardium Inc. Apparatus and method for intra-cardiac mapping and ablation
US9119633B2 (en) 2006-06-28 2015-09-01 Kardium Inc. Apparatus and method for intra-cardiac mapping and ablation
US7837610B2 (en) * 2006-08-02 2010-11-23 Kardium Inc. System for improving diastolic dysfunction
US8529597B2 (en) 2006-08-09 2013-09-10 Coherex Medical, Inc. Devices for reducing the size of an internal tissue opening
US9220487B2 (en) 2006-08-09 2015-12-29 Coherex Medical, Inc. Devices for reducing the size of an internal tissue opening
US8864809B2 (en) 2006-08-09 2014-10-21 Coherex Medical, Inc. Systems and devices for reducing the size of an internal tissue opening
JP5282185B2 (en) * 2007-08-31 2013-09-04 株式会社バイタル Ventricular affected part prosthesis and ventricular affected part prosthetic treatment set
US8343029B2 (en) * 2007-10-24 2013-01-01 Circulite, Inc. Transseptal cannula, tip, delivery system, and method
US8821366B2 (en) 2007-10-24 2014-09-02 Circulite, Inc. Transseptal cannula, tip, delivery system, and method
US8906011B2 (en) 2007-11-16 2014-12-09 Kardium Inc. Medical device for use in bodily lumens, for example an atrium
EP2082690B1 (en) * 2008-01-24 2012-06-20 Kardium, Inc. Medical device to assist diastolic function and prevent ventricular enlargement
US8489172B2 (en) 2008-01-25 2013-07-16 Kardium Inc. Liposuction system
US20090287304A1 (en) 2008-05-13 2009-11-19 Kardium Inc. Medical Device for Constricting Tissue or a Bodily Orifice, for example a mitral valve
US8652202B2 (en) 2008-08-22 2014-02-18 Edwards Lifesciences Corporation Prosthetic heart valve and delivery apparatus
US20100274227A1 (en) 2009-02-13 2010-10-28 Alexander Khairkhahan Delivery catheter handle cover
EP2482749B1 (en) 2009-10-01 2017-08-30 Kardium Inc. Kit for constricting tissue or a bodily orifice, for example, a mitral valve
CA2777495A1 (en) 2009-10-26 2011-05-12 Cardiokinetix, Inc. Ventricular volume reduction
US9050066B2 (en) 2010-06-07 2015-06-09 Kardium Inc. Closing openings in anatomical tissue
US8940002B2 (en) 2010-09-30 2015-01-27 Kardium Inc. Tissue anchor system
US9452016B2 (en) 2011-01-21 2016-09-27 Kardium Inc. Catheter system
US9480525B2 (en) 2011-01-21 2016-11-01 Kardium, Inc. High-density electrode-based medical device system
CA2764494A1 (en) 2011-01-21 2012-07-21 Kardium Inc. Enhanced medical device for use in bodily cavities, for example an atrium
US11259867B2 (en) 2011-01-21 2022-03-01 Kardium Inc. High-density electrode-based medical device system
US9072511B2 (en) 2011-03-25 2015-07-07 Kardium Inc. Medical kit for constricting tissue or a bodily orifice, for example, a mitral valve
USD777926S1 (en) 2012-01-20 2017-01-31 Kardium Inc. Intra-cardiac procedure device
USD777925S1 (en) 2012-01-20 2017-01-31 Kardium Inc. Intra-cardiac procedure device
US10827977B2 (en) 2012-05-21 2020-11-10 Kardium Inc. Systems and methods for activating transducers
US9198592B2 (en) 2012-05-21 2015-12-01 Kardium Inc. Systems and methods for activating transducers
US9017320B2 (en) 2012-05-21 2015-04-28 Kardium, Inc. Systems and methods for activating transducers
WO2016048802A1 (en) 2014-09-28 2016-03-31 Cardiokinetix, Inc. Apparatuses for treating cardiac dysfunction
US10722184B2 (en) 2014-11-17 2020-07-28 Kardium Inc. Systems and methods for selecting, activating, or selecting and activating transducers
US10368936B2 (en) 2014-11-17 2019-08-06 Kardium Inc. Systems and methods for selecting, activating, or selecting and activating transducers
CN104706444B (en) * 2015-03-03 2017-07-18 上海形状记忆合金材料有限公司 Left ventricle capacity-reduction device
DE102018107407A1 (en) 2017-03-28 2018-10-04 Edwards Lifesciences Corporation POSITIONING, INSERTING AND RETRIEVING IMPLANTABLE DEVICES
US10993807B2 (en) 2017-11-16 2021-05-04 Medtronic Vascular, Inc. Systems and methods for percutaneously supporting and manipulating a septal wall
CN112206073B (en) * 2020-09-29 2024-01-30 北京华医圣杰科技有限公司 Delivery system for ventricular volume reduction device

Family Cites Families (91)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3874388A (en) * 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US4007743A (en) * 1975-10-20 1977-02-15 American Hospital Supply Corporation Opening mechanism for umbrella-like intravascular shunt defect closure device
US4425908A (en) * 1981-10-22 1984-01-17 Beth Israel Hospital Blood clot filter
US5104399A (en) * 1986-12-10 1992-04-14 Endovascular Technologies, Inc. Artificial graft and implantation method
US4685446A (en) * 1984-02-21 1987-08-11 Choy Daniel S J Method for using a ventricular assist device
US5527337A (en) * 1987-06-25 1996-06-18 Duke University Bioabsorbable stent and method of making the same
US4832055A (en) * 1988-07-08 1989-05-23 Palestrant Aubrey M Mechanically locking blood clot filter
US4917089A (en) * 1988-08-29 1990-04-17 Sideris Eleftherios B Buttoned device for the transvenous occlusion of intracardiac defects
FR2641692A1 (en) * 1989-01-17 1990-07-20 Nippon Zeon Co Plug for closing an opening for a medical application, and device for the closure plug making use thereof
US5221261A (en) * 1990-04-12 1993-06-22 Schneider (Usa) Inc. Radially expandable fixation member
CA2082090C (en) * 1991-11-05 2004-04-27 Jack Fagan Improved occluder for repair of cardiac and vascular defects
US5192314A (en) * 1991-12-12 1993-03-09 Daskalakis Michael K Synthetic intraventricular implants and method of inserting
US5707362A (en) * 1992-04-15 1998-01-13 Yoon; Inbae Penetrating instrument having an expandable anchoring portion for triggering protrusion of a safety member and/or retraction of a penetrating member
US5766246A (en) * 1992-05-20 1998-06-16 C. R. Bard, Inc. Implantable prosthesis and method and apparatus for loading and delivering an implantable prothesis
US5527338A (en) * 1992-09-02 1996-06-18 Board Of Regents, The University Of Texas System Intravascular device
US5797960A (en) * 1993-02-22 1998-08-25 Stevens; John H. Method and apparatus for thoracoscopic intracardiac procedures
US5549621A (en) * 1993-05-14 1996-08-27 Byron C. Sutherland Apparatus and method for performing vertical banded gastroplasty
US5791231A (en) * 1993-05-17 1998-08-11 Endorobotics Corporation Surgical robotic system and hydraulic actuator therefor
US6258021B1 (en) * 1993-06-17 2001-07-10 Peter J. Wilk Intrapericardial assist method
US5385156A (en) * 1993-08-27 1995-01-31 Rose Health Care Systems Diagnostic and treatment method for cardiac rupture and apparatus for performing the same
US5876325A (en) * 1993-11-02 1999-03-02 Olympus Optical Co., Ltd. Surgical manipulation system
US5634942A (en) * 1994-04-21 1997-06-03 B. Braun Celsa Assembly comprising a blood filter for temporary or definitive use and a device for implanting it
US5433727A (en) * 1994-08-16 1995-07-18 Sideris; Eleftherios B. Centering buttoned device for the occlusion of large defects for occluding
US5879366A (en) * 1996-12-20 1999-03-09 W.L. Gore & Associates, Inc. Self-expanding defect closure device and method of making and using
US5634936A (en) * 1995-02-06 1997-06-03 Scimed Life Systems, Inc. Device for closing a septal defect
US5797849A (en) * 1995-03-28 1998-08-25 Sonometrics Corporation Method for carrying out a medical procedure using a three-dimensional tracking and imaging system
EP0734698B9 (en) * 1995-04-01 2006-07-05 Variomed AG Stent for transluminal implantation into hollow organs
WO1996036297A1 (en) * 1995-05-19 1996-11-21 Kanji Inoue Transplantation instrument, method of bending same and method of transplanting same
US6132438A (en) * 1995-06-07 2000-10-17 Ep Technologies, Inc. Devices for installing stasis reducing means in body tissue
DE69612507T2 (en) * 1995-10-30 2001-08-09 Childrens Medical Center SELF-CENTERING, SHIELD-LIKE DEVICE FOR CLOSING A SEPTAL DEFECT
US6168622B1 (en) * 1996-01-24 2001-01-02 Microvena Corporation Method and apparatus for occluding aneurysms
DE19604817C2 (en) * 1996-02-09 2003-06-12 Pfm Prod Fuer Die Med Ag Device for closing defect openings in the human or animal body
US5853422A (en) * 1996-03-22 1998-12-29 Scimed Life Systems, Inc. Apparatus and method for closing a septal defect
US5702343A (en) * 1996-10-02 1997-12-30 Acorn Medical, Inc. Cardiac reinforcement device
AU4980897A (en) * 1996-10-15 1998-05-11 Paul W. Mayer Relative motion canceling platform for surgery
US5861003A (en) * 1996-10-23 1999-01-19 The Cleveland Clinic Foundation Apparatus and method for occluding a defect or aperture within body surface
JP4676580B2 (en) * 1996-11-05 2011-04-27 パーデュー・リサーチ・ファウンデーション Myocardial graft composition
US5875782A (en) * 1996-11-14 1999-03-02 Cardiothoracic Systems, Inc. Methods and devices for minimally invasive coronary artery revascularization on a beating heart without cardiopulmonary bypass
US5931848A (en) * 1996-12-02 1999-08-03 Angiotrax, Inc. Methods for transluminally performing surgery
US6050936A (en) * 1997-01-02 2000-04-18 Myocor, Inc. Heart wall tension reduction apparatus
US6045497A (en) * 1997-01-02 2000-04-04 Myocor, Inc. Heart wall tension reduction apparatus and method
US6406420B1 (en) * 1997-01-02 2002-06-18 Myocor, Inc. Methods and devices for improving cardiac function in hearts
US6077214A (en) * 1998-07-29 2000-06-20 Myocor, Inc. Stress reduction apparatus and method
US6099832A (en) * 1997-05-28 2000-08-08 Genzyme Corporation Transplants for myocardial scars
US5928260A (en) * 1997-07-10 1999-07-27 Scimed Life Systems, Inc. Removable occlusion system for aneurysm neck
US5865730A (en) * 1997-10-07 1999-02-02 Ethicon Endo-Surgery, Inc. Tissue stabilization device for use during surgery having remotely actuated feet
JP3799810B2 (en) * 1998-03-30 2006-07-19 ニプロ株式会社 Transcatheter surgery closure plug and catheter assembly
US6095968A (en) * 1998-04-10 2000-08-01 Cardio Technologies, Inc. Reinforcement device
US6544167B2 (en) * 1998-05-01 2003-04-08 Correstore, Inc. Ventricular restoration patch
US6024096A (en) * 1998-05-01 2000-02-15 Correstore Inc Anterior segment ventricular restoration apparatus and method
US6093199A (en) * 1998-08-05 2000-07-25 Endovascular Technologies, Inc. Intra-luminal device for treatment of body cavities and lumens and method of use
US5916145A (en) * 1998-08-07 1999-06-29 Scimed Life Systems, Inc. Device and method of using a surgical assembly with mesh sheath
US6102887A (en) * 1998-08-11 2000-08-15 Biocardia, Inc. Catheter drug delivery system and method for use
WO2000012152A1 (en) * 1998-08-28 2000-03-09 Juan Hernandez Herrero Apparatus aiding physiologic systolic and diastolic dynamics of cardiac cavities
US6360749B1 (en) * 1998-10-09 2002-03-26 Swaminathan Jayaraman Modification of properties and geometry of heart tissue to influence heart function
US6685627B2 (en) * 1998-10-09 2004-02-03 Swaminathan Jayaraman Modification of properties and geometry of heart tissue to influence heart function
US6193731B1 (en) * 1998-10-27 2001-02-27 Fziomed, Inc. Laparoscopic insertion and deployment device
US7713282B2 (en) * 1998-11-06 2010-05-11 Atritech, Inc. Detachable atrial appendage occlusion balloon
US6152144A (en) * 1998-11-06 2000-11-28 Appriva Medical, Inc. Method and device for left atrial appendage occlusion
US7044134B2 (en) * 1999-11-08 2006-05-16 Ev3 Sunnyvale, Inc Method of implanting a device in the left atrial appendage
US6083239A (en) * 1998-11-24 2000-07-04 Embol-X, Inc. Compliant framework and methods of use
US6076013A (en) * 1999-01-14 2000-06-13 Brennan; Edward F. Apparatus and methods for treating congestive heart failure
US6558418B2 (en) * 1999-01-26 2003-05-06 Edwards Lifesciences Corporation Flexible heart valve
US6348068B1 (en) * 1999-07-23 2002-02-19 Sulzer Carbomedics Inc. Multi-filament valve stent for a cardisc valvular prosthesis
US7279007B2 (en) * 1999-08-09 2007-10-09 Cardioklnetix, Inc. Method for improving cardiac function
US8257428B2 (en) * 1999-08-09 2012-09-04 Cardiokinetix, Inc. System for improving cardiac function
US7887477B2 (en) * 1999-08-09 2011-02-15 Cardiokinetix, Inc. Method of improving cardiac function using a porous membrane
US6231561B1 (en) * 1999-09-20 2001-05-15 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US6689150B1 (en) * 1999-10-27 2004-02-10 Atritech, Inc. Filter apparatus for ostium of left atrial appendage
US6551303B1 (en) * 1999-10-27 2003-04-22 Atritech, Inc. Barrier device for ostium of left atrial appendage
US6994092B2 (en) * 1999-11-08 2006-02-07 Ev3 Sunnyvale, Inc. Device for containing embolic material in the LAA having a plurality of tissue retention structures
DE60124872T2 (en) * 2000-03-10 2007-06-14 Paracor Medical, Inc., Los Altos EXPANDABLE HEARTS BAG FOR THE TREATMENT OF CONGESTIVE HEART FAILURE
US6537198B1 (en) * 2000-03-21 2003-03-25 Myocor, Inc. Splint assembly for improving cardiac function in hearts, and method for implanting the splint assembly
US6334864B1 (en) * 2000-05-17 2002-01-01 Aga Medical Corp. Alignment member for delivering a non-symmetric device with a predefined orientation
US6343605B1 (en) * 2000-08-08 2002-02-05 Scimed Life Systems, Inc. Percutaneous transluminal myocardial implantation device and method
US7399271B2 (en) * 2004-01-09 2008-07-15 Cardiokinetix, Inc. Ventricular partitioning device
US7510572B2 (en) * 2000-09-12 2009-03-31 Shlomo Gabbay Implantation system for delivery of a heart valve prosthesis
US6511496B1 (en) * 2000-09-12 2003-01-28 Advanced Cardiovascular Systems, Inc. Embolic protection device for use in interventional procedures
EP1326672A4 (en) * 2000-10-18 2007-03-07 Nmt Medical Inc Over-the-wire interlock attachment/detachment mechanism
US6681773B2 (en) * 2001-02-28 2004-01-27 Chase Medical, Inc. Kit and method for use during ventricular restoration
US20050096498A1 (en) * 2001-04-24 2005-05-05 Houser Russell A. Sizing and shaping device for treating congestive heart failure
US20040064014A1 (en) * 2001-05-31 2004-04-01 Melvin David B. Devices and methods for assisting natural heart function
IL159816A0 (en) * 2001-07-16 2004-06-20 Corassist Cardiovascular Ltd In-vivo method and device for improving diastolic function of the left ventricle
US6592608B2 (en) * 2001-12-07 2003-07-15 Biopsy Sciences, Llc Bioabsorbable sealant
US20060025800A1 (en) * 2001-09-05 2006-02-02 Mitta Suresh Method and device for surgical ventricular repair
CA2494505C (en) * 2002-08-01 2010-11-30 Cardiokinetix, Inc. A device for improving cardiac function
US7213961B2 (en) * 2003-07-11 2007-05-08 Hubbell Incorporated Low voltage luminaire assembly
US7513867B2 (en) * 2003-07-16 2009-04-07 Kardium, Inc. Methods and devices for altering blood flow through the left ventricle
US20050085826A1 (en) * 2003-10-21 2005-04-21 Scimed Life Systems, Inc. Unfolding balloon catheter for proximal embolus protection
US7566336B2 (en) * 2003-11-25 2009-07-28 Cardia, Inc. Left atrial appendage closure device
US7320665B2 (en) * 2005-03-02 2008-01-22 Venkataramana Vijay Cardiac Ventricular Geometry Restoration Device and Treatment for Heart Failure

Also Published As

Publication number Publication date
ES2556181T3 (en) 2016-01-13
JP2009504255A (en) 2009-02-05
CA2617949C (en) 2013-11-19
WO2007021647A2 (en) 2007-02-22
EP1922023B1 (en) 2015-10-14
AU2006280120A1 (en) 2007-02-22
WO2007021647A3 (en) 2008-10-02
EP1922023A2 (en) 2008-05-21
EP1922023A4 (en) 2012-06-20
US20060229491A1 (en) 2006-10-12
AU2006280120B2 (en) 2012-06-21

Similar Documents

Publication Publication Date Title
CA2617949C (en) Method for treating myocardial rupture
CA2613196C (en) Peripheral seal for a ventricular partitioning device
US8398537B2 (en) Peripheral seal for a ventricular partitioning device
US9592123B2 (en) Therapeutic methods and devices following myocardial infarction
US10307253B2 (en) System for improving cardiac function by sealing a partitioning membrane within a ventricle
EP1781186B1 (en) Ventricular partitioning device
EP2416736B1 (en) Sealing and filling ventricular partitioning devices to improve cardiac function
US10307147B2 (en) System for improving cardiac function by sealing a partitioning membrane within a ventricle

Legal Events

Date Code Title Description
EEER Examination request
MKLA Lapsed

Effective date: 20190807