US20010016675A1 - Stress reduction apparatus and method - Google Patents
Stress reduction apparatus and method Download PDFInfo
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- US20010016675A1 US20010016675A1 US09/843,078 US84307801A US2001016675A1 US 20010016675 A1 US20010016675 A1 US 20010016675A1 US 84307801 A US84307801 A US 84307801A US 2001016675 A1 US2001016675 A1 US 2001016675A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2487—Devices within the heart chamber, e.g. splints
-
- 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
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0404—Buttons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/048—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery for reducing heart wall tension, e.g. sutures with a pad on each extremity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
Definitions
- the present invention pertains to the field of apparatus for treatment of a failing heart.
- the apparatus of the present invention is directed toward reducing the wall stress in the failing heart.
- Heart failure is a common course for the progression of many forms of heart disease.
- Heart failure may be considered to be the condition in which an abnormality of cardiac function is responsible for the inability of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissues, or can do so only at an abnormally elevated filling pressure.
- Etiologies that can lead to this form of failure include idiopathic cardiomyopathy, viral cardiomyopathy, and ischemic cardiomyopathy.
- the process of ventricular dilatation is generally the result of chronic volume overload or specific damage to the myocardium.
- a normal heart that is exposed to long term increased cardiac output requirements, for example, that of an athlete, there is an adaptive process of ventricular dilation and myocyte hypertrophy. In this way, the heart fully compensates for the increased cardiac output requirements.
- damage to the myocardium or chronic volume overload however, there are increased requirements put on the contracting myocardium to such a level that this compensated state is never achieved and the heart continues to dilate.
- Prior art treatments for heart failure fall into three generally categories. The first being pharmacological, for example, diuretics. The second being assist systems, for example, pumps. Finally, surgical treatments have been experimented with, which are described in more detail below.
- diuretics have been used to reduce the workload of the heart by reducing blood volume and preload.
- preload is defined in several ways including left ventricular end diastolic pressure (LVEDP), or left ventricular end diastolic volume (LVEDV).
- LEDP left ventricular end diastolic pressure
- LVEDV left ventricular end diastolic volume
- the preferred definition is the length of stretch of the sarcomere at end diastole.
- Diuretics reduce extra cellular fluid which builds in congestive heart failure patients increasing preload conditions.
- Nitrates, arteriolar vasodilators, angiotensin converting enzyme inhibitors have been used to treat heart failure through the reduction of cardiac workload through the reduction of afterload.
- Afterload may be defined as the tension or stress required in the wall of the ventricle during ejection.
- Inotropes such as digoxin are cardiac glycosides and function to increase cardiac output by increasing the force and speed of cardiac muscle contraction.
- Assist devices include, for example, mechanical pumps.
- Mechanical pumps reduce the load on the heart by performing all or part of the pumping function normally done by the heart.
- mechanical pumps are used to sustain the patient while a donor heart for transplantation becomes available for the patient.
- Heart transplantation has serious limitations including restricted availability of organs and adverse effects of immunosuppressive therapies required following heart transplantation.
- Cardiomyoplasty includes wrapping the heart with skeletal muscle and electrically stimulating the muscle to contract synchronously with the heart in order to help the pumping function of the heart.
- the Batista partial left ventriculectomy includes surgically remodeling the left ventricle by removing a segment of the muscular wall. This procedure reduces the diameter of the dilated heart, which in turn reduces the loading of the heart. However, this extremely invasive procedure reduces muscle mass of the heart.
- the present invention pertains to a device and method for reducing mechanical heart wall muscle stress.
- Heart muscle stress is a stimulus for the initiation and progressive enlargement of the left ventricle in heart failure.
- Reduction of heart wall stress with the devices and methods disclosed herein is anticipated to substantially slow, stop or reverse the heart failure disease process.
- the primary focus of the discussion of the devices and methods of the present invention herein relates to heart failure and the left ventricle, these devices and method could be used to reduce stress in the heart's other chambers.
- the devices and methods of the present invention can reduce heart wall stress throughout the cardiac cycle including end diastole and end systole. Alternatively, they can be used to reduce wall stress during the portions of the cardiac cycle not including end systole. Those devices which operate throughout the cardiac cycle are referred to herein as “full cycle splints”. Those devices which do not operate to reduce wall stress during end stage systole are referred to as “restrictive devices”. Restrictive devices include both “restrictive splints” which alter the geometric shape of the left ventricle, and “wraps” which merely limit the magnitude of the expansion of the left ventricle during diastolic filling without a substantial shape change.
- restrictive devices and methods acting during diastole will reduce the maximum wall stress experience during end diastole and early systole. It should be understood that restrictive devices and methods can be used in combination with full cycle splinting to more precisely control or manipulate stress reduction throughout the cardiac cycle.
- FIG. 1 is a vertical side view of a heart including a transventricular splint and band splint;
- FIG. 2 is a horizontal cross section of the heart, splint and band splint of FIG. 1;
- FIG. 3 is a graph showing the relationship between stress and strain for the sarcomeres of the left ventricle for a normal and failing heart throughout the cardiac cycle;
- FIG. 4 is an idealized horizontal cross section of a left ventricle splinted to form two lobes
- FIG. 5 is an idealized horizontal cross sectional left ventricle splinted to form three lobes
- FIG. 6 is a vertical view of a heart including two transventricular splints and two band splints;
- FIG. 7 is a cross sectional view of the heart, a band splint and a splint of FIG. 6;
- FIG. 8 is a vertical view of a heart including a transventricular splint and a partial band splint;
- FIG. 9 is a horizontal cross sectional view of the heart, splint and band splint of FIG. 8;
- FIG. 10 is a horizontal cross section of a heart including a splint having full cycle and restrictive elements at the beginning of diastolic filling;
- FIG. 11 is a view of the splint of FIG. 10 at end diastole;
- FIG. 12 is a horizontal cross section of the left ventricle including a full cycle transventricular splint and a restrictive transventricular splint at the beginning of diastolic filling;
- FIG. 13 is a view of the splints of FIG. 12 at end diastole;
- FIG. 14 is a horizontal cross sectional view of the left ventricle including a restrictive splint at the beginning of diastolic filling;
- FIG. 15 is a view of the splint of FIG. 14 at end diastole;
- FIG. 16 is a vertical view of the heart in phantom line including a band splint
- FIG. 17 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 18 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 19 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 20 is a vertical view of a heart including a partial circumferential strap
- FIG. 21 is a horizontal cross sectional view of the heart and strap of FIG. 20;
- FIG. 22 is a vertical view of a heart including a vertical partial strap
- FIG. 23 is a horizontal cross sectional view of a heart including a transventricular splint passing through the papillary muscles;
- FIG. 24 is a horizontal cross sectional view of a heart including a transventricular splint passing through the left ventricle to lateral the papillary muscles;
- FIG. 25 is a horizontal cross sectional view of the left ventricle including a plurality of transventricular splints
- FIG. 26 is a vertical view of a heart in phantom line including a single element wrap including longitudinal axis securing points;
- FIG. 27 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 28 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 29 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 30 is a vertical view of the heart including a mesh wrap
- FIG. 31 is a cross sectional view of a patient's torso and heart showing a band splint anchored to the patient's ribs;
- FIG. 32 is a partial vertical view of the heart and band splint of FIG. 31;
- FIG. 33 is a partial vertical view of a failing heart
- FIG. 34 is a cross sectional view of the heart of FIG. 33;
- FIG. 35 is a vertical view of the heart for decreasing the horizontal radius of the ventricles and increasing their vertical length;
- FIG. 36 is an exaggerated vertical view of the heart of FIG. 33 elongated by the device of FIG. 35;
- FIG. 37 is a view of the cross section of FIG. 34 showing the decrease in radius of the ventricles
- FIG. 38 is a horizontal cross sectional view of the heart showing the left and right ventricles and a splint disposed within the myocardium;
- FIG. 39 is a vertical cross section of the left ventricle showing a splint within the myocardium
- FIG. 40 is a partial cross section of the left ventricle showing a splint extending through a portion of the myocardium;
- FIG. 41 is a partial vertical view of a heart showing the splint of FIG. 40 extending horizontally through the myocardium;
- FIG. 42 is a horizontal cross sectional view of the left and right ventricles including reinforcement loops
- FIG. 43 is an alternate embodiment of the reinforcing loops of FIG. 43;
- FIG. 44 shows a vertical view of the heart including the reinforcement loops of FIG. 43 and a rigid shape changing member
- FIG. 45 is a vertical cross sectional view of a heart showing a ring around the chordae.
- the present invention is directed at reducing wall stress in a failing heart.
- Diastolic wall stress is considered to be an initiator of muscle damage and chamber enlargement. For this reason, it is desirable to reduce diastolic wall stress to prevent the progression of the disease.
- the significant impact of stress occurs at all stages and functional levels of heart failure, however, independent of the original causes.
- mechanical stress can lead to symptomatic heart failure marked by an enlarged heart with decreased left ventricle function.
- mechanical stress on the heart wall increases proportionally to the increasing radius of the heart in accordance with LaPlace's Law. It can thus be appreciated that as stress increases in symptomatic heart failure, those factors that contributed to increasing stress also increase. Thus, the progression of the disease accelerates to late stage heart failure, end stage heart failure and death unless the disease is treated.
- the present invention pertains to devices and methods for directly and passively changing chamber geometry to lower wall stress.
- the devices and methods of the present invention also lend themselves to application in the case of a decrease in cardiac function caused by, for example, acute myocardial infarction.
- splints The device's disclosed herein for changing chamber geometry are referred to as “splints”.
- wraps which can be placed around the heart can limit muscle stress without the chamber shape change. When a wrap is used, wall stress is merely transferred to the wrap, while the generally globular shape of the heart is maintained.
- a wrap could be used in conjunction with a splint to modulate heart wall stress reduction at various stages of the cardiac cycle.
- the present invention includes a number of splint embodiments.
- Splints and wraps can be classified by where in the cardiac cycle they engage the heart wall, i.e., mechanically limit the size of the left ventricle in the case of wraps and change the geometry of the ventricle in the case of splints. If a splint or wrap only begins to engage during diastolic filling, the splint can be termed a “restrictive splint”. If the splint or wrap is engaged throughout the cardiac cycle, both during diastolic filling and systolic contraction and ejection, the splint can be termed a “full cycle splint”.
- the wrap will generally be a restrictive device which begins to engage during diastolic filling to increase the elastance (reduces compliance) of the chamber. If a wrap is made from elastic material it may engage full cycle, but the force required to elongate the wrap will increase as diastolic filling progresses, preload strain will be reduced without an improvement in systolic contraction.
- FIG. 1 is a view of a heart A in a normal, generally vertical orientation.
- a wrap 11 surrounds heart A and a transventricular splint 12 extends through the heart and includes an anchor or anchor pad 13 disposed on opposite sides of the heart.
- FIG. 2 is a horizontal cross sectional view of heart A taken through wrap 11 and splint 12 .
- Splint 12 includes a tension member 15 extending through left ventricle B. Anchor pads 13 are disposed at each end of tension member 15 .
- Right ventricle C is to the left of left ventricle B.
- wrap 11 and splint 12 are shown engaged with heart A.
- heart A is shown spaced from wrap 11 except at anchor pads 13 .
- heart A is thus at a point in the cardiac cycle where the muscles are shortening during systole, or have yet to stretch sufficiently during diastolic expansion to reach wrap 11 .
- wrap 11 can be considered a restrictive device as it does not engage the heart full cycle.
- wrap 11 is in contact with heart A at pads 13 , only the splint is providing a compressive force to change the shape of the heart and limiting the stress of the heart in FIG. 2.
- transventricular splint 12 is a full cycle device as the cross section of left ventricle B does not have the generally circular unsplinted shape. It can be appreciated that transventricular splint 12 can be used without wrap 11 . Alternately, wrap 11 could be secured to heart A by sutures or other means than splint 12 , in which case wrap 11 would be merely a restrictive device. It should be noted that unless wrap 11 extends vertically along heart A a sufficient amount, as heart A expands and engages wrap 11 , the portion of left ventricle B disposed above or below wrap 11 could expand substantially further than that portion of the left ventricle wall restrained by wrap 11 .
- left ventricle B could have a bi-lobed shape in a vertical cross section.
- the wrap 11 would not be merely limiting the size of the left ventricle, but rather inducing a shape change in the left ventricle.
- the element 11 would not be a wrap, but rather a splint which could be referred to as a “band splint”.
- Each of the splints, wraps and other devices disclosed in this application preferably do not substantially deform during the cardiac cycle such that the magnitude of the resistance to the expansion or contraction of the heart provided by these devices is reduced by substantial deflection. It is, however, contemplated that devices which deflect or elongate elastically under load are within the scope of the present invention, though not preferred.
- the materials from which each device are formed must be biocompatible and are preferably configured to be substantially atraumatic.
- FIG. 3 is a plot of sarcomere, i.e., heart wall muscle, stress in (g/cm 2 ) versus strain throughout a normal cardiac cycle N, and a failing heart cardiac cycle F.
- the cardiac cycles or loops shown on FIG. 3 are bounded by the normal contractility curve N c and failing heart contractility curve F c above and to the left, and the diastolic filling curve 12 toward the bottom and right.
- Contractility is a measure of muscle stress at an attainable systolic stress at a given elongation or strain.
- the diastolic filling curve 12 is a plot of the stress in the muscle tissue at a given elongation or strain when the muscle is at rest.
- An arbitrary beginning of the normal cardiac cycle N can be chosen at end diastole 14 , where the left ventricle is full, the aortic valve is closed. Just after end diastole 14 , systole begins, the sarcomere muscles become active and the mitral valve closes, increasing muscle stress without substantially shortening (sometimes referred to as “isovolumic contraction”). Stress increases until the aortic valve opens at 16 . Isotonic shortening begins and stress decreases and the muscles shorten until end systole 18 , where the blood has been ejected from the left ventricle and the aortic valve closes.
- N The total muscle shortening and lengthening during the normal cycle N is N s .
- An analogous cycle F also occurs in a failing heart.
- the larger radius of a dilated left ventricle causes stress to increase at a given blood pressure. Consequently, a failing heart must compensate to maintain the blood pressure.
- the compensation for the increased stress is reflected in the shift to the right of failing heart cardiac cycle F relative to the normal cycle N.
- the stress at end diastole 22 is elevated over the stress at end diastole 14 of the normal heart.
- Muscle shortening and elongation F s throughout the cycle is also reduced in view of the relative steepening of the diastolic curve 12 to the right and the flatter contractility curve F c relative to the normal contractility N c .
- the cardiac cycle will still operate between the failing heart contractility curve F c and the diastolic filling curve 12 . If chronic muscle contractility increases such that the muscle contractility curve F c shifts back toward the normal heart contractility curve N c as a consequence of the stress reduction, the stress/strain curve F of the cardiac cycle will shift to the left reducing mechanical stress still further.
- FIG. 4 shows an idealized horizontal cross section of a left ventricle 30 subdivided into two symmetrical lobes 32 and 34 having an arc passing through an angle ⁇ > ⁇ , and a radius R.
- Lobes 32 and 34 can be formed using a splint, such as transventricular splint 12 shown in FIGS. 1 and 2.
- Lobes 32 and 34 are joined at points 36 and 38 . Points 36 and 38 are separated by a distance l.
- FIG. 5 is an idealized horizontal cross section of a left ventricle 40 subdivided into three generally equal sized lobes 42 , 44 and 46 .
- Each lobe has an equal radius and has an arc passing through an angle less than ⁇ .
- Adjacent ends of the lobes 48 , 50 and 52 are separated by a distance l.
- a plurality of transventricular splints such as splint 12 as shown in FIGS. 1 and 2 could be extended between adjacent ends 48 , 50 and 52 to form lobes 42 , 44 and 46 .
- the horizontal cross sections 30 and 40 will have a generally circular shape, i.e., a non-splinted shape at end systole.
- the radius of the circular shape will continue to increase until the splint engages.
- the lobed shape will begin to form.
- the radius will continue to increase as diastolic filling proceeds.
- the three or more lobed shape such as the three lobed configuration of FIG. 5
- radius R will decrease as diastolic filling proceeds. The radius will continue to decrease unless or until the pressure in the heart causes the heart to expand such that the arc of the lobe passes through an angle ⁇ greater than ⁇ .
- wrap is substantially inelastic, as pressure increases in the chamber during diastolic filling, stress in the heart wall muscle will increase until the wrap fully engages and substantially all additional muscle elongating load created by increased chamber pressure will be shifted to the wrap. No further elongation of the chamber muscles disposed in a horizontal cross section through the wrap and the chamber will occur. Thus, inelastic wraps will halt additional preload muscle strain (end diastolic muscle stretch).
- the type of shape change illustrated in FIGS. 4 and 5 is of substantial significance for restrictive splints. It is undesirable in the case of restrictive splints, to excessively limit preload muscle strain.
- the Frank-Starling Curve demonstrates the dependence and need for variable preload muscle strain on overall heart pumping performance. During a person's normal activities, their body may need increased blood perfusion, for example, during exertion. In response to increased blood perfusion through a person's tissue, the heart will compensate for the additional demand by increasing stroke volume and/or heart rate. When stroke volume is increased, the patient's normal preload strain is also increased. That is, the lines 14 - 16 and 22 - 24 of the normal and failing hearts, respectively, will shift to the right.
- An inelastic wrap will, at engagement, substantially stop this shift.
- significant stress reduction can be achieved while allowing for variable preload strain. If the number of lobes is increased substantially, however, variable preload will decrease as the multi-lobed configuration approaches the performance of an inelastic wrap.
- the magnitude of shape change in the case of full cycle splinting becomes very important as full cycle splinting generally reduces chamber volume more than restrictive splinting.
- the type of shape change is also important to allow for variable preload strain.
- Both restrictive device and full cycle splints reduce chamber volume as they reduce the cross sectional area of the chamber during the cardiac cycle.
- the magnitude of the shape change can vary from very slight at end diastole, such that chamber volume is only slightly reduced from the unsplinted end diastolic volume, to an extreme reduction in volume, for example, complete bifurcation by transventricular splint.
- the magnitude of the shape change is preferably modulated to reduce muscle stress while not overly reducing chamber volume.
- the reduction of chamber volume is compensated for by increased contractile shortening, which in turn leads to an increased ejection fraction, i.e., the ratio of the stroke volume to chamber volume.
- ejection fraction i.e., the ratio of the stroke volume to chamber volume.
- FIG. 6 is a vertical view of a heart A similar to that shown in FIG. 1. Rather than having a single band splints surrounding heart A, there are two band splints 51 affixed to the heart by two transventricular splints 52 . Splints 52 include oppositely disposed anchors or anchor pads 53 . FIG. 7 is a horizontal cross sectional view of heart A of FIG. 6, wraps 51 and splint 52 . Splints 52 include a tension member 54 disposed through left ventricle B. Pads 53 are disposed on the opposite ends of tension members 54 . Right ventricle C is shown to the left of left ventricle B.
- Splints 52 can be restrictive or full cycle splints.
- Band Splints 51 are shown as restrictive band splints as in FIG. 6, heart A is shown engaged with the band splints 51 , where as in FIG. 7, heart A has contracted to move away from band splints 51 .
- Wraps 51 and splints 52 should be made from biocompatible materials.
- Band Splints 51 are preferably made from a pliable fabric or other material which resists elongation under normal operating loads.
- Band splints 51 can, however, be made from an elastic material which elongates during the cardiac cycle.
- Tension members 54 also preferably resist elongation under normal operating loads. Tension members 54 can, however, be made from an elastic material which elongates during the cardiac cycle.
- FIG. 8 is a vertical view of heart A, partial wrap 61 and transventricular splint 62 .
- Transventricular splint 62 includes anchor pads 63 .
- FIG. 9 is a horizontal cross sectional view of heart A, partial band splint 61 and splint 62 .
- Splint 62 is essentially similar to wrap or band splint 12 shown in FIGS. 1 and 2.
- Partial band splint 61 is also essentially similar to wrap or band splint 11 shown in FIGS. 1 and 2 except that band splint 61 only surrounds a portion of heart A. This portion is shown in FIGS. 8 and 9 to the left including a portion of left ventricle B.
- FIG. 10 is a horizontal cross sectional view of left ventricle B and right ventricle C of heart A taken at a similar elevation as that shown in FIG. 2.
- a splint 70 is shown disposed on heart A.
- Splint 70 includes a frame having two heart engaging anchors or pads 72 disposed at its opposite ends.
- a third heart engaging pad 73 is disposed along frame 70 approximately midway between pads 72 .
- Pads 72 are shown engaged with heart A to change the shape of ventricle B in FIG. 10.
- Pads 73 are not engaged with heart A in FIG. 10.
- FIG. 11 is the same horizontal cross sectional view as FIG. 10 except that heart A has to contact pad 73 to create a further shape change of left ventricle B.
- Frame 70 is preferably rigid enough that pads 72 could be disposed on the heart for full cycle splinting and sufficiently adjustable that pads 72 could be spaced further apart for restrictive splinting.
- Pad 73 accomplishes restrictive splinting.
- Frame 71 , pads 72 and 73 of splint 70 are made of a biocompatible material.
- Pads 72 and 73 are preferably substantially atraumatic.
- FIG. 12 is a horizontal cross sectional view of the left ventricle B of heart A.
- a transventricular splint 80 having a tension member 81 and oppositely disposed anchor pads 82 is shown extending across left ventricle B.
- Another transventricular splint 83 having a tension member 84 and oppositely disposed anchor pads 85 extends generally perpendicularly to splint 80 , across left ventricle B.
- splint 83 is engaging heart A to deform left ventricle B.
- Splint 80 includes a tension member 81 made of a flexible filament, line or the like which is shown in a relaxed state in FIG. 12.
- tension member 81 is shown in an elongated, taunt configuration as heart A has expanded into engagement with pads 82 .
- Transventricular splints 80 and 83 can be made as described above with respect to the transventricular splint of FIGS. 1 and 2.
- Tension member 81 may be elastic or inelastic.
- FIG. 14 is a horizontal cross section of left ventricle B of heart A including a transventricular splint 90 .
- Splint 90 includes a tension member 91 including three branches extending to atraumatic anchors or anchor pads 92 . Similarly to tension member 81 of FIG. 12, tension member 90 is shown in a relaxed state. Splint 90 can be made in a similar way as splint 80 of FIGS. 12 and 13.
- FIG. 15 is the same horizontal cross section of heart A as shown in FIG. 14 except that heart A has expanded to engage atraumatic pads 92 of splint 90 .
- Tension member 91 is now drawn taunt to form a three lobed cross sectional configuration of left ventricle B.
- FIG. 16 is a vertical view of heart A shown in phantom line. Shown disposed about the ventricles of heart A is a basket-like band splint 100 .
- Band splint 100 includes a horizontal encircling band 101 around an upper region of the ventricles and four bands 102 which extend downward toward the apex of heart A. It can be appreciated that bands 102 can act as splints to form four lobes in heart A in a horizontal plane. Depending on the placement of bands 102 around heart A, lobes could be created only in the left ventricle or in the left ventricle and/or other chambers of the heart.
- Band 102 is joined at the apex Band 101 and band 102 can be made from a webbing, fabric or other biocompatible material.
- band splint 100 substantially elongated elastically under normal operating loads, it could be friction fit to heart A and act full cycle, limiting muscle stress at end diastole as well end systole. Band splint 100 could be sutured into place or otherwise held on heart A and act as a restrictive device. If band 101 were securely fastened to heart A, bands 102 could limit the vertical elongation of heart A during diastolic filling.
- FIG. 17 is an alternate embodiment 110 of the band splint of FIG. 16.
- Band splint 110 includes a horizontally heart encircling band 111 and four bands 113 extending downward from band 111 .
- Bands 113 unlike bands 102 of band splint 100 do not extend to the apex of heart A, but rather to a second horizontally heart encircling band 112 .
- Band splint 110 could be made of the same materials as band splint 100 .
- Band splint 110 can also be used in a manner similar to band splint 100 except that band splint 110 would limit the vertical elongation of the ventricles less than band splint 100 .
- FIG. 18 is yet another alternate embodiment 120 of the wrap of FIG. 16.
- Band splint 120 closely resembles alternate embodiment 110 of FIG. 17, except that rather than having four vertically extending web members, band splint 120 includes two substantially rigid members 123 interconnecting two horizontally encircling web members 121 and 122 .
- FIG. 19 is yet another alternate embodiment 130 of the band splint of FIG. 16.
- band splint 130 includes a horizontally encircling member 131 and four downwardly extending members 132 .
- members 132 are joined by a ring 133 .
- Members 132 extend through ring 133 .
- Ring 133 can be used to adjust the length of members 132 between band 131 and ring 133 .
- Ring 133 can be formed from metallic material and crimped inwardly to fix its position along members 132 . Other means of holding ring 133 in position would be readily apparent to those skilled in the art.
- FIG. 20 is a vertical view of heart A including a partial band splint 140 secured around a substantial portion of left ventricle B.
- Band splint 140 includes a vertically elongating anchor member 141 which sutures 142 can encircle to anchor member 141 to heart A.
- a band 143 extends generally horizontally from anchor member 141 to an opposite anchor 141 .
- band 143 can be seen in its entirety in FIG. 21 which is a horizontal cross sectional view of heart A through band 143 , left ventricle B and right ventricle C.
- FIG. 20 is a horizontal cross sectional view of heart A through band 143 , left ventricle B and right ventricle C.
- FIG. 20 heart A is shown engaged with band 143
- band 143 is shown spaced from heart A.
- wrap 140 would be acting as a restrictive device.
- band splint 140 were made from a material that substantially deforms elastically under normal loads, band splint 140 could also be secured sufficiently snuggly to heart A to act as a full cycle device.
- band 143 of band splint 140 is formed from a webbing or substantially inelastic fabric.
- FIG. 22 is a vertical view of heart A including band splint 140 disposed vertically on left ventricle B. In this position, band splint 140 can limit the vertical elongation of left ventricle B during diastolic filling.
- FIG. 23 is a horizontal cross section of heart A through left ventricle B, right ventricle C and the papillary muscles D of left ventricle B.
- a transventricular splint 150 including an elongate tension member 151 and oppositely disposed anchor pads 152 extends through left ventricle B and papillary muscles D. Splint 150 could be similar to splint 12 of FIGS. 1 and 2.
- FIG. 24 is a horizontal cross section similar to that of FIG. 23. In FIG. 24, however, transventricular splint 150 is shown avoiding papillary muscles D.
- FIG. 25 is a horizontal cross section of left ventricle B of heart A.
- three splints 150 have been placed to form six lobes.
- Three of the lobes 153 have an arc length which passes through an angle greater than ⁇ .
- Disposed between each lobe 153 are three lobes 154 which have an arc length which passes through an angle less than ⁇ . Consequently, during diastolic filling, the effective radius of lobes 153 will be increasing while the radius of lobes 154 will be decreasing.
- FIG. 26 is a vertical view of heart A including a wrap 160 .
- Wrap 160 can include a single thread or line 161 encircling the heart several times. After line 161 encircles heart A, line 161 can be threaded through a bar 162 , including a plurality of eyelets 163 spaced along its length in pairs. Bar 162 is preferably rigid enough to substantially maintain the distance between eyelets 163 under normal operating loads.
- line 161 When line 161 is placed in heart A, one end of line 161 can be tied to bar 162 at 164 . Line 161 can then encircle the heart and be drawn through eyelet 162 adjacent the beginning of line 161 at 164 . Line 161 can then be drawn through one eyelet 163 of a lower pair of eyelets to encircle the heart again. This process continues until line 161 is tied to an eyelet 163 at 165 . It can be appreciated that wrap 160 could be used as a restrictive or full cycle device depending on the diameter of loop formed by line 161 .
- FIG. 27 is an alternate embodiment 170 of the wrap of FIG. 26.
- Wrap 170 includes two vertically extending bars 172 having eyelets 173 through which line 171 is threaded. Line 171 can be tied to one of the bars 172 at 174 and 175 .
- FIG. 28 is a vertical view of heart A including yet another embodiment 180 of the wrap of FIG. 26.
- Wrap 180 includes a line 181 encircling heart A a plurality of times. Rather than having a single vertically extending bar 162 to position line 180 on heart A, wrap 180 includes a plurality of horizontal bars 182 including a pair of eyelets 183 .
- One end of line 181 is tied to an upper bar 182 at 184 and the opposite end of line 181 is tied to a lower bar 182 at 185 .
- line 181 is threaded through eyelets 182 to form the heart encircling pattern shown in FIG. 28.
- FIG. 29 is a vertical view of heart A including yet another alternate embodiment 190 of the wrap of FIG. 26. Wrap 190 closely resembles 180 of FIG. 28. Line 181 has, however, been threaded through eyelets 183 of bars 182 in a pattern which, unlike that of FIG. 28, bars 182 are disposed at various selected locations around the circumference of heart A.
- FIG. 30 is a vertical view of heart A including a wrap 200 .
- Wrap 200 is substantially similar to wrap 11 of FIGS. 1 and 2, except that wrap 200 extends vertically a greater distance than wrap 11 .
- Wrap 200 is not shown with a transventricular splint. It can be appreciated that wrap 200 could be used as restrictive or full cycle device.
- FIG. 31 is a horizontal cross section of a human torso including heart A, left ventricle B, right ventricle C, lungs E and ribs G.
- a wrap 210 is shown partially encircling heart A. Opposite ends of wrap 210 are anchored at 211 to ribs G. At 211 , wrap 210 can be anchored to ribs G by bone screw, knot or other means of fastening. It can be appreciated that band splint 210 could be used as a restrictive or full cycle device.
- FIG. 33 is a vertical view of heart A having a W 1 .
- FIG. 34 is an idealized horizontal cross sectional view of heart A of FIG. 33.
- Heart A includes left ventricle B and right ventricle C.
- Left ventricle B has a radius R 1 .
- FIG. 35 is a view of a device 220 .
- Device 220 includes a horizontally encircling band 222 which can be affixed to heart A by sutures, other attachment means or friction fit. Extending from band 222 is a substantially rigid elongate member 224 .
- Member 224 extends to the apex of heart A.
- Pin 226 extends into left ventricle B of the apex.
- An anchor or pad 228 is disposed within left ventricle B to anchor the apex of heart A to elongate member 224 .
- Elongate member 224 can be made of sufficient length such that heart A is vertically elongate full cycle, or alternately not at end diastole.
- FIG. 36 is a vertical view of an elongate heart A having a horizontal width W 2 less than W 1 .
- FIG. 37 is a horizontal cross section of the heart A of FIG. 36 including left ventricle B and right ventricle C. In FIG. 37, the radius R 2 of left ventricle B is less than R 1 of FIG. 34. Assuming that the hearts of FIGS. 33 and 36 are at the same point in the cardiac cycle, it can be appreciated that the wall stress in heart A is less in FIG. 37 as R 2 is shorter R.
- elongate bar 224 is sized such that device 220 does not engage at end diastole, but rather anchor pad 228 first engages during systolic contraction, device 220 can fall into a third class of device neither full cycle nor restrictive. Such a device would reduce wall stress during a portion of systolic contraction including end systole, but not reduce wall stress during end diastole, thus maintaining maximum preload.
- Band 222 of device 220 is preferably formed from a web material or other fabric.
- Band 220 is preferably does not elongate substantially during diastolic filling.
- Members 224 , 226 and 228 are formed from materials which remain substantially rigid under the influences of the forces encountered during the cardiac cycle.
- FIG. 38 is a horizontal cross section of heart A including left ventricle B and right ventricle C.
- Advanced through the myocardium of heart A is a device including a tubular member 231 and thread or line 232 disposed within tubular member 231 .
- the free ends of thread 232 are disposed outside of heart A.
- the free ends of thread 232 could be drawn toward each other to reduce the diameter of device 230 in heart A. After a desired reduction in diameter, the free ends could be tied together.
- Tube 231 is preferably highly flexible, yet durable enough to prevent thread 232 from “cheese cutting” through the myocardium of heart A.
- Tube 231 and line 232 are preferably formed from biocompatible atraumatic materials which do not substantially elongate under the influence of forces encountered during expansion and contraction of heart A.
- tube 231 and line 232 could be made from materials which readily elongate under the influence of the forces encountered during the cardiac cycle. It can be appreciated that device 230 could be used as a full cycle device or restrictive device.
- FIG. 39 is a vertical cross sectional view of heart A including left ventricle B.
- a substantially V-shaped or U-shaped member having arms 241 is shown substantially advanced into the myocardium of heart A.
- Device 240 includes an apex 242 disposed adjacent the apex of heart A. The spacing of arms 241 from each other is preferably such that device 240 can form lobes in horizontal cross sections of left ventricle B.
- Device 240 is preferably formed from biocompatible materials which preferably do not deform substantially under the influence of the forces encountered during the cardiac cycle. It can be appreciated that device 240 could be used as a restrictive or full cycle device.
- FIG. 40 is a partial cross section of heart A and left ventricle B.
- a device 250 extends through a portion of the myocardium of heart A.
- Device 250 can be configured similarly to splint 12 of FIGS. 1 and 2.
- Device 250 accordingly includes two tension members 251 and oppositely disposed anchors pad 252 .
- Tension members 251 do not extend transventricularly.
- FIG. 41 is a vertical view of heart A including device 250 .
- Splint 250 can act as a full cycle device or a restrictive device, to shorten a portion of the left ventricle heart wall.
- FIG. 42 is a horizontal cross sectional view of heart A including left ventricle B and C.
- a device 260 including a thread or line 261 is disposed transventricularly and transmyocardially through heart A.
- a portion of line 261 is disposed outside of heart A.
- Opposite ends of line 261 are connected at 262 .
- Those portions of line 261 outside heart A form loops 263 .
- the size of loops 263 are exaggerated for purposes of illustration. It is assumed that heart A in the process of diastolic filling in FIG. 42, and loops 263 are sufficiently small, eventually heart A will engage loops 263 . In such a configuration, device 260 is used as a restrictive device. Loops 263 could be sized, however, such that they engage full cycle.
- Line 261 is preferably made from atraumatic biocompatible material.
- the diameter of line 261 is preferably sufficiently great that cutting of heart A does not occur during diastolic filling.
- FIG. 43 is a horizontal cross sectional view of heart A including left ventricle B and right ventricle C and an alternate embodiment 270 of the device of FIG. 42.
- Device 270 includes a line 271 which does not extend transventricularly but extends through the myocardium of heart A to form four loops 273 .
- Device 270 can be formed from material similar to that used to form device 260 . Additionally, device 270 can be made to function as a restrictive device or full cycle device in a manner similar to that of device 260 .
- Line 261 and line 267 could be disposed within a tube such as tube 231 of FIG. 38 to avoid cheese cutting of the myocardium.
- Devices 260 and 270 could extend through the septum or right ventricle to avoid forming lobes in right ventricle C.
- FIG. 44 is a vertical view of heart A including three devices 270 disposed at three spaced elevations.
- An elongate generally rigid bar 274 is disposed through loops 273 to distribute the load on heart A from loops 273 across a larger area than lines 271 can alone.
- FIG. 45 is a vertical cross section of heart A showing left ventricle B including papillary muscles D and chordae H. Joining chordae H is a ring 290 . Ring 290 is preferably strong and rigid enough to hold chordae H, papillary muscles D and consequently the wall of left ventricle B inward during diastolic expansion. It can be appreciated that loop 290 could be configured to operate as a full cycle or a restrictive device. Preferably loop 229 is formed from an atraumatic biocompatible material.
Abstract
Description
- This application is related to U.S. application Ser. No. ______, filed on date even herewith and entitled “Transventricular Implant Tools and Devices” and U.S. application Serial No. ______, filed on date even herewith and entitled “Heart Wall Tension Reduction Apparatus and Method”, both of which are incorporated herein by reference
- The present invention pertains to the field of apparatus for treatment of a failing heart. In particular, the apparatus of the present invention is directed toward reducing the wall stress in the failing heart.
- The syndrome of heart failure is a common course for the progression of many forms of heart disease. Heart failure may be considered to be the condition in which an abnormality of cardiac function is responsible for the inability of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissues, or can do so only at an abnormally elevated filling pressure. There are many specific disease processes that can lead to heart failure with a resulting difference in pathophysiology of the failing heart, such as the dilatation of the left ventricular chamber. Etiologies that can lead to this form of failure include idiopathic cardiomyopathy, viral cardiomyopathy, and ischemic cardiomyopathy.
- The process of ventricular dilatation is generally the result of chronic volume overload or specific damage to the myocardium. In a normal heart that is exposed to long term increased cardiac output requirements, for example, that of an athlete, there is an adaptive process of ventricular dilation and myocyte hypertrophy. In this way, the heart fully compensates for the increased cardiac output requirements. With damage to the myocardium or chronic volume overload, however, there are increased requirements put on the contracting myocardium to such a level that this compensated state is never achieved and the heart continues to dilate.
- The basic problem with a large dilated left ventricle is that there is a significant increase in wall tension and/or stress both during diastolic filling and during systolic contraction. In a normal heart, the adaptation of muscle hypertrophy (thickening) and ventricular dilatation maintain a fairly constant wall tension for systolic contraction. However, in a failing heart, the ongoing dilatation is greater than the hypertrophy and the result is a rising wall tension requirement for systolic contraction. This is felt to be an ongoing insult to the muscle myocyte resulting in further muscle damage. The increase in wall stress is also true for diastolic filling. Additionally, because of the lack of cardiac output, there is generally a rise in ventricular filling pressure from several physiologic mechanisms. Moreover, in diastole there is both a diameter increase and a pressure increase over normal, both contributing to higher wall stress levels. The increase in diastolic wall stress is felt to be the primary contributor to ongoing dilatation of the chamber.
- Prior art treatments for heart failure fall into three generally categories. The first being pharmacological, for example, diuretics. The second being assist systems, for example, pumps. Finally, surgical treatments have been experimented with, which are described in more detail below.
- With respect to pharmacological treatments, diuretics have been used to reduce the workload of the heart by reducing blood volume and preload. Clinically, preload is defined in several ways including left ventricular end diastolic pressure (LVEDP), or left ventricular end diastolic volume (LVEDV). Physiologically, the preferred definition is the length of stretch of the sarcomere at end diastole. Diuretics reduce extra cellular fluid which builds in congestive heart failure patients increasing preload conditions. Nitrates, arteriolar vasodilators, angiotensin converting enzyme inhibitors have been used to treat heart failure through the reduction of cardiac workload through the reduction of afterload. Afterload may be defined as the tension or stress required in the wall of the ventricle during ejection. Inotropes such as digoxin are cardiac glycosides and function to increase cardiac output by increasing the force and speed of cardiac muscle contraction. These drug therapies offer some beneficial effects but do not stop the progression of the disease.
- Assist devices include, for example, mechanical pumps. Mechanical pumps reduce the load on the heart by performing all or part of the pumping function normally done by the heart. Currently, mechanical pumps are used to sustain the patient while a donor heart for transplantation becomes available for the patient.
- There are at least three surgical procedures for treatment of heart failure: 1) heart transplant; 2) dynamic cardiomyoplasty; and 3) the Batista partial left ventriculectomy. Heart transplantation has serious limitations including restricted availability of organs and adverse effects of immunosuppressive therapies required following heart transplantation. Cardiomyoplasty includes wrapping the heart with skeletal muscle and electrically stimulating the muscle to contract synchronously with the heart in order to help the pumping function of the heart. The Batista partial left ventriculectomy includes surgically remodeling the left ventricle by removing a segment of the muscular wall. This procedure reduces the diameter of the dilated heart, which in turn reduces the loading of the heart. However, this extremely invasive procedure reduces muscle mass of the heart.
- The present invention pertains to a device and method for reducing mechanical heart wall muscle stress. Heart muscle stress is a stimulus for the initiation and progressive enlargement of the left ventricle in heart failure. Reduction of heart wall stress with the devices and methods disclosed herein is anticipated to substantially slow, stop or reverse the heart failure disease process. Although the primary focus of the discussion of the devices and methods of the present invention herein relates to heart failure and the left ventricle, these devices and method could be used to reduce stress in the heart's other chambers.
- The devices and methods of the present invention can reduce heart wall stress throughout the cardiac cycle including end diastole and end systole. Alternatively, they can be used to reduce wall stress during the portions of the cardiac cycle not including end systole. Those devices which operate throughout the cardiac cycle are referred to herein as “full cycle splints”. Those devices which do not operate to reduce wall stress during end stage systole are referred to as “restrictive devices”. Restrictive devices include both “restrictive splints” which alter the geometric shape of the left ventricle, and “wraps” which merely limit the magnitude of the expansion of the left ventricle during diastolic filling without a substantial shape change.
- While it is desirable to reduce wall stress for the treatment of heart failure, to slow or reverse the disease process and to increase heart wall muscle shortening and pumping efficiency, it is also desirable to maintain or improve stroke volume and allow for variable preload.
- Improving muscle shortening both total length change and extent at end systole, is particularly important in symptomatic heart failure wherein the heart has decreased left ventricle function and has enlarged. Full cycle splinting can be used to obtain a substantial increase in muscle shortening. Improved shortening will lead to an increase in pump function, and chronically may result in muscle strengthening and reversal of the disease because of increased pumping efficiency. The increase in shortening should be balanced against a reduction in chamber volume.
- In asymtomatic, early stage heart failure, it may be possible to use only a restrictive device or method as elevated wall stress is considered to be an initiator of muscle damage and chamber enlargement. Restrictive devices and methods acting during diastole will reduce the maximum wall stress experience during end diastole and early systole. It should be understood that restrictive devices and methods can be used in combination with full cycle splinting to more precisely control or manipulate stress reduction throughout the cardiac cycle.
- FIG. 1 is a vertical side view of a heart including a transventricular splint and band splint;
- FIG. 2 is a horizontal cross section of the heart, splint and band splint of FIG. 1;
- FIG. 3 is a graph showing the relationship between stress and strain for the sarcomeres of the left ventricle for a normal and failing heart throughout the cardiac cycle;
- FIG. 4 is an idealized horizontal cross section of a left ventricle splinted to form two lobes;
- FIG. 5 is an idealized horizontal cross sectional left ventricle splinted to form three lobes;
- FIG. 6 is a vertical view of a heart including two transventricular splints and two band splints;
- FIG. 7 is a cross sectional view of the heart, a band splint and a splint of FIG. 6;
- FIG. 8 is a vertical view of a heart including a transventricular splint and a partial band splint;
- FIG. 9 is a horizontal cross sectional view of the heart, splint and band splint of FIG. 8;
- FIG. 10 is a horizontal cross section of a heart including a splint having full cycle and restrictive elements at the beginning of diastolic filling;
- FIG. 11 is a view of the splint of FIG. 10 at end diastole;
- FIG. 12 is a horizontal cross section of the left ventricle including a full cycle transventricular splint and a restrictive transventricular splint at the beginning of diastolic filling;
- FIG. 13 is a view of the splints of FIG. 12 at end diastole;
- FIG. 14 is a horizontal cross sectional view of the left ventricle including a restrictive splint at the beginning of diastolic filling;
- FIG. 15 is a view of the splint of FIG. 14 at end diastole;
- FIG. 16 is a vertical view of the heart in phantom line including a band splint;
- FIG. 17 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 18 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 19 is an alternate embodiment of the band splint of FIG. 16;
- FIG. 20 is a vertical view of a heart including a partial circumferential strap;
- FIG. 21 is a horizontal cross sectional view of the heart and strap of FIG. 20;
- FIG. 22 is a vertical view of a heart including a vertical partial strap;
- FIG. 23 is a horizontal cross sectional view of a heart including a transventricular splint passing through the papillary muscles;
- FIG. 24 is a horizontal cross sectional view of a heart including a transventricular splint passing through the left ventricle to lateral the papillary muscles;
- FIG. 25 is a horizontal cross sectional view of the left ventricle including a plurality of transventricular splints;
- FIG. 26 is a vertical view of a heart in phantom line including a single element wrap including longitudinal axis securing points;
- FIG. 27 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 28 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 29 is an alternate embodiment of the wrap of FIG. 26;
- FIG. 30 is a vertical view of the heart including a mesh wrap;
- FIG. 31 is a cross sectional view of a patient's torso and heart showing a band splint anchored to the patient's ribs;
- FIG. 32 is a partial vertical view of the heart and band splint of FIG. 31;
- FIG. 33 is a partial vertical view of a failing heart;
- FIG. 34 is a cross sectional view of the heart of FIG. 33;
- FIG. 35 is a vertical view of the heart for decreasing the horizontal radius of the ventricles and increasing their vertical length;
- FIG. 36 is an exaggerated vertical view of the heart of FIG. 33 elongated by the device of FIG. 35;
- FIG. 37 is a view of the cross section of FIG. 34 showing the decrease in radius of the ventricles;
- FIG. 38 is a horizontal cross sectional view of the heart showing the left and right ventricles and a splint disposed within the myocardium;
- FIG. 39 is a vertical cross section of the left ventricle showing a splint within the myocardium;
- FIG. 40 is a partial cross section of the left ventricle showing a splint extending through a portion of the myocardium;
- FIG. 41 is a partial vertical view of a heart showing the splint of FIG. 40 extending horizontally through the myocardium;
- FIG. 42 is a horizontal cross sectional view of the left and right ventricles including reinforcement loops;
- FIG. 43 is an alternate embodiment of the reinforcing loops of FIG. 43;
- FIG. 44 shows a vertical view of the heart including the reinforcement loops of FIG. 43 and a rigid shape changing member; and
- FIG. 45 is a vertical cross sectional view of a heart showing a ring around the chordae.
- The present invention is directed at reducing wall stress in a failing heart. Diastolic wall stress is considered to be an initiator of muscle damage and chamber enlargement. For this reason, it is desirable to reduce diastolic wall stress to prevent the progression of the disease. The significant impact of stress occurs at all stages and functional levels of heart failure, however, independent of the original causes. For example, in asymtomatic early stages of heart failure mechanical stress can lead to symptomatic heart failure marked by an enlarged heart with decreased left ventricle function. As the heart enlarges, mechanical stress on the heart wall increases proportionally to the increasing radius of the heart in accordance with LaPlace's Law. It can thus be appreciated that as stress increases in symptomatic heart failure, those factors that contributed to increasing stress also increase. Thus, the progression of the disease accelerates to late stage heart failure, end stage heart failure and death unless the disease is treated.
- Three parameters influence mechanical stress on the muscle. These are: (1) muscle mass, i.e., as reflected by the thickness of the muscle; (2) pressure in the chamber which is a function of the resistance to blood flow of the patient's vasculature and the volume of blood within the patient; and (3) chamber of geometry. The present invention pertains to devices and methods for directly and passively changing chamber geometry to lower wall stress. In addition to treatment of heart failure, the devices and methods of the present invention also lend themselves to application in the case of a decrease in cardiac function caused by, for example, acute myocardial infarction.
- The device's disclosed herein for changing chamber geometry are referred to as “splints”. In addition to splints, wraps which can be placed around the heart can limit muscle stress without the chamber shape change. When a wrap is used, wall stress is merely transferred to the wrap, while the generally globular shape of the heart is maintained. A wrap could be used in conjunction with a splint to modulate heart wall stress reduction at various stages of the cardiac cycle.
- The present invention includes a number of splint embodiments. Splints and wraps can be classified by where in the cardiac cycle they engage the heart wall, i.e., mechanically limit the size of the left ventricle in the case of wraps and change the geometry of the ventricle in the case of splints. If a splint or wrap only begins to engage during diastolic filling, the splint can be termed a “restrictive splint”. If the splint or wrap is engaged throughout the cardiac cycle, both during diastolic filling and systolic contraction and ejection, the splint can be termed a “full cycle splint”. The wrap will generally be a restrictive device which begins to engage during diastolic filling to increase the elastance (reduces compliance) of the chamber. If a wrap is made from elastic material it may engage full cycle, but the force required to elongate the wrap will increase as diastolic filling progresses, preload strain will be reduced without an improvement in systolic contraction.
- FIG. 1 is a view of a heart A in a normal, generally vertical orientation. A
wrap 11 surrounds heart A and atransventricular splint 12 extends through the heart and includes an anchor oranchor pad 13 disposed on opposite sides of the heart. FIG. 2 is a horizontal cross sectional view of heart A taken throughwrap 11 andsplint 12.Splint 12 includes atension member 15 extending through left ventricleB. Anchor pads 13 are disposed at each end oftension member 15. Right ventricle C is to the left of left ventricle B. - In FIG. 1, wrap11 and
splint 12 are shown engaged with heart A. In FIG. 2, heart A is shown spaced fromwrap 11 except atanchor pads 13. In FIG. 2, heart A is thus at a point in the cardiac cycle where the muscles are shortening during systole, or have yet to stretch sufficiently during diastolic expansion to reachwrap 11. Accordingly, wrap 11 can be considered a restrictive device as it does not engage the heart full cycle. Althoughwrap 11 is in contact with heart A atpads 13, only the splint is providing a compressive force to change the shape of the heart and limiting the stress of the heart in FIG. 2. - If heart A, as shown in FIG. 2 is at end systole,
transventricular splint 12 is a full cycle device as the cross section of left ventricle B does not have the generally circular unsplinted shape. It can be appreciated thattransventricular splint 12 can be used withoutwrap 11. Alternately, wrap 11 could be secured to heart A by sutures or other means thansplint 12, in which case wrap 11 would be merely a restrictive device. It should be noted that unlesswrap 11 extends vertically along heart A a sufficient amount, as heart A expands and engages wrap 11, the portion of left ventricle B disposed above or belowwrap 11 could expand substantially further than that portion of the left ventricle wall restrained bywrap 11. In such a case, left ventricle B could have a bi-lobed shape in a vertical cross section. As such, thewrap 11 would not be merely limiting the size of the left ventricle, but rather inducing a shape change in the left ventricle. In such a case, theelement 11 would not be a wrap, but rather a splint which could be referred to as a “band splint”. - Each of the splints, wraps and other devices disclosed in this application preferably do not substantially deform during the cardiac cycle such that the magnitude of the resistance to the expansion or contraction of the heart provided by these devices is reduced by substantial deflection. It is, however, contemplated that devices which deflect or elongate elastically under load are within the scope of the present invention, though not preferred. The materials from which each device are formed must be biocompatible and are preferably configured to be substantially atraumatic.
- The distinction between restrictive devices, such as restrictive splints and wraps, and full cycle splints and wraps, can be better understood by reference to FIG. 3. FIG. 3 is a plot of sarcomere, i.e., heart wall muscle, stress in (g/cm2) versus strain throughout a normal cardiac cycle N, and a failing heart cardiac cycle F. The cardiac cycles or loops shown on FIG. 3 are bounded by the normal contractility curve Nc and failing heart contractility curve Fc above and to the left, and the
diastolic filling curve 12 toward the bottom and right. Contractility is a measure of muscle stress at an attainable systolic stress at a given elongation or strain. It can be appreciated that the muscle contractility Nc of normal muscle tissue is greater than the contractility Fc of the muscle tissue of a failing heart. Thediastolic filling curve 12 is a plot of the stress in the muscle tissue at a given elongation or strain when the muscle is at rest. - An arbitrary beginning of the normal cardiac cycle N can be chosen at
end diastole 14, where the left ventricle is full, the aortic valve is closed. Just afterend diastole 14, systole begins, the sarcomere muscles become active and the mitral valve closes, increasing muscle stress without substantially shortening (sometimes referred to as “isovolumic contraction”). Stress increases until the aortic valve opens at 16. Isotonic shortening begins and stress decreases and the muscles shorten untilend systole 18, where the blood has been ejected from the left ventricle and the aortic valve closes. Afterend systole 18, diastole begins, the muscles relax without elongating until diastolic filling begins when the mitral valve opens at 20. The muscles then elongate while the mitral valve remains open during diastolic filling untilend diastole 14. The total muscle shortening and lengthening during the normal cycle N is Ns. - An analogous cycle F also occurs in a failing heart. As the left ventricle has dilated, in accordance with LaPlace's Law, the larger radius of a dilated left ventricle causes stress to increase at a given blood pressure. Consequently, a failing heart must compensate to maintain the blood pressure. The compensation for the increased stress is reflected in the shift to the right of failing heart cardiac cycle F relative to the normal cycle N. The stress at
end diastole 22 is elevated over the stress atend diastole 14 of the normal heart. A similar increase can be seen for the point at which the aortic valve opens 24,end systole 26 and the beginning of diastolic filling 28 relative to the analogous points for the normal cycle N. Muscle shortening and elongation Fs throughout the cycle is also reduced in view of the relative steepening of thediastolic curve 12 to the right and the flatter contractility curve Fc relative to the normal contractility Nc. - By reference to the heart cycle stress strain graph of FIG. 3, the effect on mechanical muscle stress and strain caused by the use of the devices and methods of the present invention can be illustrated. Restrictive devices begin to engage during diastolic filling, which in the case of a failing heart occurs along
diastolic filling curve 12 betweenpoint end systole 26. Thus, the acute effect of placement of a restrictive device is to reduce muscle stress at end diastole relative to the stress atpoint 22, and shift the line 22-24 to the left reducing muscle shortening and elongation Fs. Acutely, the cardiac cycle will still operate between the failing heart contractility curve Fc and thediastolic filling curve 12. If chronic muscle contractility increases such that the muscle contractility curve Fc shifts back toward the normal heart contractility curve Nc as a consequence of the stress reduction, the stress/strain curve F of the cardiac cycle will shift to the left reducing mechanical stress still further. - The effect on the stress/strain relationship of a full cycle splint will acutely shift the entire stress/strain curve F for the cycle to the left. That is, stress is reduced at both
end diastole 22 andend systole 26. Muscle shortening and elongation Fs will increase acutely. If, as in the case of a restrictive splint, muscle contractility Fc improves, the entire cardiac cycle curve F will shift further to the left reducing mechanical stress still further. - The type and magnitude of shape change are important factors in determining the effectiveness of splinting. There are several types of lower stress cardiac geometries that can be created from an enlarged globular left ventricular chamber typically associate with heart failure. They include lobed, disc-like, narrowed elongate, and multiple vertically stacked bulbs.
- FIG. 4 shows an idealized horizontal cross section of a
left ventricle 30 subdivided into twosymmetrical lobes radius R. Lobes transventricular splint 12 shown in FIGS. 1 and 2.Lobes points Points - FIG. 5 is an idealized horizontal cross section of a
left ventricle 40 subdivided into three generally equalsized lobes lobes splint 12 as shown in FIGS. 1 and 2 could be extended between adjacent ends 48, 50 and 52 to formlobes - For a restrictive splint, the
horizontal cross sections - In the case of a full cycle splint, at end systole, the splint will already be engaged. Thus, for a full cycle splint at end systole, the horizontal cross section of the chamber will not have the normal generally circular shape. Rather, at end systole, the
horizontal cross sections - In view of LaPlace's Law which states that stress is directly proportional to radius of curvature, it can be appreciated that whether the radius is increasing or decreasing during diastolic filling, will have an impact on heart pumping performance. Where R is increasing during diastolic filling, wall stress will increase more rapidly than where R is decreasing. The number of lobes that are created can significantly influence the level of end diastolic muscle stress reduction achieved through splinting. Eventually adding additional lobes forms a configuration which approaches a behavior similar to a wrap. If a wrap is substantially inelastic, or of sufficient size, a wrap will only engage the heart wall at some stage of diastolic filling. If the wrap is substantially inelastic, as pressure increases in the chamber during diastolic filling, stress in the heart wall muscle will increase until the wrap fully engages and substantially all additional muscle elongating load created by increased chamber pressure will be shifted to the wrap. No further elongation of the chamber muscles disposed in a horizontal cross section through the wrap and the chamber will occur. Thus, inelastic wraps will halt additional preload muscle strain (end diastolic muscle stretch).
- The type of shape change illustrated in FIGS. 4 and 5 is of substantial significance for restrictive splints. It is undesirable in the case of restrictive splints, to excessively limit preload muscle strain. The Frank-Starling Curve demonstrates the dependence and need for variable preload muscle strain on overall heart pumping performance. During a person's normal activities, their body may need increased blood perfusion, for example, during exertion. In response to increased blood perfusion through a person's tissue, the heart will compensate for the additional demand by increasing stroke volume and/or heart rate. When stroke volume is increased, the patient's normal preload strain is also increased. That is, the lines14-16 and 22-24 of the normal and failing hearts, respectively, will shift to the right. An inelastic wrap will, at engagement, substantially stop this shift. In the case of the bi-load shape change of FIG. 4 or a multiple lobed change having a small number of lobes of FIG. 5, significant stress reduction can be achieved while allowing for variable preload strain. If the number of lobes is increased substantially, however, variable preload will decrease as the multi-lobed configuration approaches the performance of an inelastic wrap.
- The magnitude of shape change in the case of full cycle splinting becomes very important as full cycle splinting generally reduces chamber volume more than restrictive splinting. Although as with restrictive devices, the type of shape change is also important to allow for variable preload strain. Both restrictive device and full cycle splints reduce chamber volume as they reduce the cross sectional area of the chamber during the cardiac cycle. The magnitude of the shape change can vary from very slight at end diastole, such that chamber volume is only slightly reduced from the unsplinted end diastolic volume, to an extreme reduction in volume, for example, complete bifurcation by transventricular splint. The magnitude of the shape change, for example, as measured by the ratio of splint length to non-splinted ventricular diameter, is preferably modulated to reduce muscle stress while not overly reducing chamber volume. For full cycle splint, the reduction of chamber volume is compensated for by increased contractile shortening, which in turn leads to an increased ejection fraction, i.e., the ratio of the stroke volume to chamber volume. For given stress/volume and stress/shortening relationships, there will be a theoretical optimum maximal stroke volume. Clinically, 20% to 30% stress reduction is expected to be attainable through full cycle bi-lobe splinting. See U.S. patent application Ser. No. 08/933,456, filed Sep. 18, 1997 for calculation of stress reduction for idealized bi-lobe splinting.
- When using the full cycle and restrictive devices described herein, caution should be exercised to limit the pressure on the coronary vasculature. In the case of transventricular splints, valve structure, electrical pathways and coronary vasculature should be avoided.
- FIG. 6 is a vertical view of a heart A similar to that shown in FIG. 1. Rather than having a single band splints surrounding heart A, there are two
band splints 51 affixed to the heart by two transventricular splints 52.Splints 52 include oppositely disposed anchors oranchor pads 53. FIG. 7 is a horizontal cross sectional view of heart A of FIG. 6, wraps 51 andsplint 52.Splints 52 include atension member 54 disposed through leftventricle B. Pads 53 are disposed on the opposite ends oftension members 54. Right ventricle C is shown to the left of left ventricle B. -
Splints 52 can be restrictive or full cycle splints.Band Splints 51 are shown as restrictive band splints as in FIG. 6, heart A is shown engaged with the band splints 51, where as in FIG. 7, heart A has contracted to move away from band splints 51.Wraps 51 andsplints 52 should be made from biocompatible materials.Band Splints 51 are preferably made from a pliable fabric or other material which resists elongation under normal operating loads. Band splints 51 can, however, be made from an elastic material which elongates during the cardiac cycle.Tension members 54 also preferably resist elongation under normal operating loads.Tension members 54 can, however, be made from an elastic material which elongates during the cardiac cycle. - FIG. 8 is a vertical view of heart A,
partial wrap 61 andtransventricular splint 62.Transventricular splint 62 includesanchor pads 63. FIG. 9 is a horizontal cross sectional view of heart A,partial band splint 61 andsplint 62.Splint 62 is essentially similar to wrap orband splint 12 shown in FIGS. 1 and 2.Partial band splint 61 is also essentially similar to wrap orband splint 11 shown in FIGS. 1 and 2 except thatband splint 61 only surrounds a portion of heart A. This portion is shown in FIGS. 8 and 9 to the left including a portion of left ventricle B. - FIG. 10 is a horizontal cross sectional view of left ventricle B and right ventricle C of heart A taken at a similar elevation as that shown in FIG. 2. A
splint 70 is shown disposed onheart A. Splint 70 includes a frame having two heart engaging anchors orpads 72 disposed at its opposite ends. A thirdheart engaging pad 73 is disposed alongframe 70 approximately midway betweenpads 72. -
Pads 72 are shown engaged with heart A to change the shape of ventricle B in FIG. 10.Pads 73 are not engaged with heart A in FIG. 10. FIG. 11 is the same horizontal cross sectional view as FIG. 10 except that heart A has to contactpad 73 to create a further shape change of left ventricle B. -
Frame 70 is preferably rigid enough thatpads 72 could be disposed on the heart for full cycle splinting and sufficiently adjustable thatpads 72 could be spaced further apart for restrictive splinting.Pad 73 accomplishes restrictive splinting. Frame 71,pads splint 70 are made of a biocompatible material.Pads - FIG. 12 is a horizontal cross sectional view of the left ventricle B of heart A. A
transventricular splint 80 having atension member 81 and oppositely disposedanchor pads 82 is shown extending across left ventricle B.Another transventricular splint 83 having atension member 84 and oppositely disposedanchor pads 85 extends generally perpendicularly to splint 80, across left ventricle B. - It can be appreciated that in FIG. 12
splint 83 is engaging heart A to deform leftventricle B. Splint 80, however, includes atension member 81 made of a flexible filament, line or the like which is shown in a relaxed state in FIG. 12. In FIG. 13,tension member 81 is shown in an elongated, taunt configuration as heart A has expanded into engagement withpads 82. - Transventricular splints80 and 83 can be made as described above with respect to the transventricular splint of FIGS. 1 and 2.
Tension member 81 may be elastic or inelastic. - FIG. 14 is a horizontal cross section of left ventricle B of heart A including a
transventricular splint 90.Splint 90 includes atension member 91 including three branches extending to atraumatic anchors oranchor pads 92. Similarly totension member 81 of FIG. 12,tension member 90 is shown in a relaxed state.Splint 90 can be made in a similar way assplint 80 of FIGS. 12 and 13. - FIG. 15 is the same horizontal cross section of heart A as shown in FIG. 14 except that heart A has expanded to engage
atraumatic pads 92 ofsplint 90.Tension member 91 is now drawn taunt to form a three lobed cross sectional configuration of left ventricle B. - FIG. 16 is a vertical view of heart A shown in phantom line. Shown disposed about the ventricles of heart A is a basket-
like band splint 100.Band splint 100 includes a horizontalencircling band 101 around an upper region of the ventricles and fourbands 102 which extend downward toward the apex of heart A. It can be appreciated thatbands 102 can act as splints to form four lobes in heart A in a horizontal plane. Depending on the placement ofbands 102 around heart A, lobes could be created only in the left ventricle or in the left ventricle and/or other chambers of the heart.Band 102 is joined at theapex Band 101 andband 102 can be made from a webbing, fabric or other biocompatible material. - If
band splint 100 substantially elongated elastically under normal operating loads, it could be friction fit to heart A and act full cycle, limiting muscle stress at end diastole as well end systole.Band splint 100 could be sutured into place or otherwise held on heart A and act as a restrictive device. Ifband 101 were securely fastened to heart A,bands 102 could limit the vertical elongation of heart A during diastolic filling. - FIG. 17 is an
alternate embodiment 110 of the band splint of FIG. 16.Band splint 110 includes a horizontallyheart encircling band 111 and fourbands 113 extending downward fromband 111.Bands 113, however, unlikebands 102 ofband splint 100 do not extend to the apex of heart A, but rather to a second horizontallyheart encircling band 112. -
Band splint 110 could be made of the same materials asband splint 100.Band splint 110 can also be used in a manner similar toband splint 100 except thatband splint 110 would limit the vertical elongation of the ventricles less thanband splint 100. - FIG. 18 is yet another
alternate embodiment 120 of the wrap of FIG. 16.Band splint 120 closely resemblesalternate embodiment 110 of FIG. 17, except that rather than having four vertically extending web members,band splint 120 includes two substantiallyrigid members 123 interconnecting two horizontally encirclingweb members - FIG. 19 is yet another
alternate embodiment 130 of the band splint of FIG. 16. Like the wrap of FIG. 16,band splint 130 includes a horizontally encirclingmember 131 and four downwardly extendingmembers 132. At a location proximate of the apex of heart A,members 132 are joined by aring 133.Members 132 extend throughring 133.Ring 133 can be used to adjust the length ofmembers 132 betweenband 131 andring 133.Ring 133 can be formed from metallic material and crimped inwardly to fix its position alongmembers 132. Other means of holdingring 133 in position would be readily apparent to those skilled in the art. - FIG. 20 is a vertical view of heart A including a
partial band splint 140 secured around a substantial portion of left ventricleB. Band splint 140 includes a vertically elongatinganchor member 141 which sutures 142 can encircle to anchormember 141 to heart A. Aband 143 extends generally horizontally fromanchor member 141 to anopposite anchor 141. - The length of
band 143 can be seen in its entirety in FIG. 21 which is a horizontal cross sectional view of heart A throughband 143, left ventricle B and right ventricle C. In FIG. 20, heart A is shown engaged withband 143, however, in FIG. 21,band 143 is shown spaced from heart A. Thus, in this configuration, wrap 140 would be acting as a restrictive device. Ifband splint 140 were made from a material that substantially deforms elastically under normal loads,band splint 140 could also be secured sufficiently snuggly to heart A to act as a full cycle device. Preferably, however,band 143 ofband splint 140 is formed from a webbing or substantially inelastic fabric. - FIG. 22 is a vertical view of heart A including
band splint 140 disposed vertically on left ventricle B. In this position,band splint 140 can limit the vertical elongation of left ventricle B during diastolic filling. - FIG. 23 is a horizontal cross section of heart A through left ventricle B, right ventricle C and the papillary muscles D of left ventricle B.
A transventricular splint 150 including anelongate tension member 151 and oppositely disposedanchor pads 152 extends through left ventricle B and papillarymuscles D. Splint 150 could be similar to splint 12 of FIGS. 1 and 2. FIG. 24 is a horizontal cross section similar to that of FIG. 23. In FIG. 24, however, transventricularsplint 150 is shown avoiding papillary muscles D. - FIG. 25 is a horizontal cross section of left ventricle B of heart A. Here three
splints 150 have been placed to form six lobes. Three of thelobes 153 have an arc length which passes through an angle greater than π. Disposed between eachlobe 153 are threelobes 154 which have an arc length which passes through an angle less than π. Consequently, during diastolic filling, the effective radius oflobes 153 will be increasing while the radius oflobes 154 will be decreasing. - FIG. 26 is a vertical view of heart A including a
wrap 160. Wrap 160 can include a single thread orline 161 encircling the heart several times. Afterline 161 encircles heart A,line 161 can be threaded through abar 162, including a plurality ofeyelets 163 spaced along its length in pairs.Bar 162 is preferably rigid enough to substantially maintain the distance betweeneyelets 163 under normal operating loads. - When
line 161 is placed in heart A, one end ofline 161 can be tied to bar 162 at 164.Line 161 can then encircle the heart and be drawn througheyelet 162 adjacent the beginning ofline 161 at 164.Line 161 can then be drawn through oneeyelet 163 of a lower pair of eyelets to encircle the heart again. This process continues untilline 161 is tied to aneyelet 163 at 165. It can be appreciated thatwrap 160 could be used as a restrictive or full cycle device depending on the diameter of loop formed byline 161. - FIG. 27 is an
alternate embodiment 170 of the wrap of FIG. 26.Wrap 170, however, includes two vertically extendingbars 172 havingeyelets 173 through whichline 171 is threaded.Line 171 can be tied to one of thebars 172 at 174 and 175. - FIG. 28 is a vertical view of heart A including yet another
embodiment 180 of the wrap of FIG. 26.Wrap 180 includes aline 181 encircling heart A a plurality of times. Rather than having a single vertically extendingbar 162 to positionline 180 on heart A, wrap 180 includes a plurality ofhorizontal bars 182 including a pair ofeyelets 183. One end ofline 181 is tied to anupper bar 182 at 184 and the opposite end ofline 181 is tied to alower bar 182 at 185. Between 184 and 185,line 181 is threaded througheyelets 182 to form the heart encircling pattern shown in FIG. 28. - FIG. 29 is a vertical view of heart A including yet another
alternate embodiment 190 of the wrap of FIG. 26.Wrap 190 closely resembles 180 of FIG. 28.Line 181 has, however, been threaded througheyelets 183 ofbars 182 in a pattern which, unlike that of FIG. 28,bars 182 are disposed at various selected locations around the circumference of heart A. - FIG. 30 is a vertical view of heart A including a
wrap 200.Wrap 200 is substantially similar to wrap 11 of FIGS. 1 and 2, except thatwrap 200 extends vertically a greater distance thanwrap 11.Wrap 200 is not shown with a transventricular splint. It can be appreciated thatwrap 200 could be used as restrictive or full cycle device. - FIG. 31 is a horizontal cross section of a human torso including heart A, left ventricle B, right ventricle C, lungs E and ribs G. A
wrap 210 is shown partially encircling heart A. Opposite ends ofwrap 210 are anchored at 211 to ribs G. At 211, wrap 210 can be anchored to ribs G by bone screw, knot or other means of fastening. It can be appreciated thatband splint 210 could be used as a restrictive or full cycle device. - FIG. 33 is a vertical view of heart A having a W1. FIG. 34 is an idealized horizontal cross sectional view of heart A of FIG. 33. Heart A includes left ventricle B and right ventricle C. Left ventricle B has a radius R1.
- FIG. 35 is a view of a
device 220.Device 220 includes a horizontally encirclingband 222 which can be affixed to heart A by sutures, other attachment means or friction fit. Extending fromband 222 is a substantially rigidelongate member 224.Member 224 extends to the apex ofheart A. Pin 226 extends into left ventricle B of the apex. An anchor orpad 228 is disposed within left ventricle B to anchor the apex of heart A to elongatemember 224.Elongate member 224 can be made of sufficient length such that heart A is vertically elongate full cycle, or alternately not at end diastole. - FIG. 36 is a vertical view of an elongate heart A having a horizontal width W2 less than W1. FIG. 37 is a horizontal cross section of the heart A of FIG. 36 including left ventricle B and right ventricle C. In FIG. 37, the radius R2 of left ventricle B is less than R1 of FIG. 34. Assuming that the hearts of FIGS. 33 and 36 are at the same point in the cardiac cycle, it can be appreciated that the wall stress in heart A is less in FIG. 37 as R2 is shorter R.
- If
elongate bar 224 is sized such thatdevice 220 does not engage at end diastole, but rather anchor pad 228 first engages during systolic contraction,device 220 can fall into a third class of device neither full cycle nor restrictive. Such a device would reduce wall stress during a portion of systolic contraction including end systole, but not reduce wall stress during end diastole, thus maintaining maximum preload. -
Band 222 ofdevice 220 is preferably formed from a web material or other fabric.Band 220 is preferably does not elongate substantially during diastolic filling.Members - FIG. 38 is a horizontal cross section of heart A including left ventricle B and right ventricle C. Advanced through the myocardium of heart A is a device including a
tubular member 231 and thread orline 232 disposed withintubular member 231. In FIG. 38, the free ends ofthread 232 are disposed outside of heart A. The free ends ofthread 232 could be drawn toward each other to reduce the diameter ofdevice 230 in heart A. After a desired reduction in diameter, the free ends could be tied together. -
Tube 231 is preferably highly flexible, yet durable enough to preventthread 232 from “cheese cutting” through the myocardium ofheart A. Tube 231 andline 232 are preferably formed from biocompatible atraumatic materials which do not substantially elongate under the influence of forces encountered during expansion and contraction of heart A. In an alternate embodiment,tube 231 andline 232 could be made from materials which readily elongate under the influence of the forces encountered during the cardiac cycle. It can be appreciated thatdevice 230 could be used as a full cycle device or restrictive device. - FIG. 39 is a vertical cross sectional view of heart A including left ventricle B. A substantially V-shaped or U-shaped
member having arms 241 is shown substantially advanced into the myocardium ofheart A. Device 240 includes an apex 242 disposed adjacent the apex of heart A. The spacing ofarms 241 from each other is preferably such thatdevice 240 can form lobes in horizontal cross sections of left ventricle B. -
Device 240 is preferably formed from biocompatible materials which preferably do not deform substantially under the influence of the forces encountered during the cardiac cycle. It can be appreciated thatdevice 240 could be used as a restrictive or full cycle device. - FIG. 40 is a partial cross section of heart A and left ventricle B. A
device 250 extends through a portion of the myocardium ofheart A. Device 250 can be configured similarly to splint 12 of FIGS. 1 and 2.Device 250 accordingly includes twotension members 251 and oppositely disposedanchors pad 252.Tension members 251, however, do not extend transventricularly. - FIG. 41 is a vertical view of heart
A including device 250.Splint 250 can act as a full cycle device or a restrictive device, to shorten a portion of the left ventricle heart wall. - FIG. 42 is a horizontal cross sectional view of heart A including left ventricle B and C. A
device 260 including a thread orline 261 is disposed transventricularly and transmyocardially through heart A. A portion ofline 261 is disposed outside of heart A. Opposite ends ofline 261 are connected at 262. Those portions ofline 261 outside heartA form loops 263. The size ofloops 263 are exaggerated for purposes of illustration. It is assumed that heart A in the process of diastolic filling in FIG. 42, andloops 263 are sufficiently small, eventually heart A will engageloops 263. In such a configuration,device 260 is used as a restrictive device.Loops 263 could be sized, however, such that they engage full cycle. -
Line 261 is preferably made from atraumatic biocompatible material. The diameter ofline 261 is preferably sufficiently great that cutting of heart A does not occur during diastolic filling. - FIG. 43 is a horizontal cross sectional view of heart A including left ventricle B and right ventricle C and an
alternate embodiment 270 of the device of FIG. 42.Device 270 includes aline 271 which does not extend transventricularly but extends through the myocardium of heart A to form fourloops 273. -
Device 270 can be formed from material similar to that used to formdevice 260. Additionally,device 270 can be made to function as a restrictive device or full cycle device in a manner similar to that ofdevice 260. -
Line 261 and line 267 could be disposed within a tube such astube 231 of FIG. 38 to avoid cheese cutting of the myocardium.Devices - FIG. 44 is a vertical view of heart A including three
devices 270 disposed at three spaced elevations. An elongate generallyrigid bar 274 is disposed throughloops 273 to distribute the load on heart A fromloops 273 across a larger area thanlines 271 can alone. - FIG. 45 is a vertical cross section of heart A showing left ventricle B including papillary muscles D and chordae H. Joining chordae H is a
ring 290.Ring 290 is preferably strong and rigid enough to hold chordae H, papillary muscles D and consequently the wall of left ventricle B inward during diastolic expansion. It can be appreciated thatloop 290 could be configured to operate as a full cycle or a restrictive device. Preferably loop 229 is formed from an atraumatic biocompatible material. - Numerous characteristics and advantages of the invention covered by this document have been set forth in the foregoing description. It will be understood, however, that this disclosure is, in many respects, only illustrative. Changes may be made in details, particularly in matters of shape, size and ordering of steps without exceeding the scope of the invention. The invention's scope is, of course, defined in the language in which the appended claims are expressed.
Claims (9)
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US09/843,078 US6402680B2 (en) | 1998-07-29 | 2001-04-27 | Stress reduction apparatus and method |
US10/127,731 US7883539B2 (en) | 1997-01-02 | 2002-04-23 | Heart wall tension reduction apparatus and method |
US10/138,520 US6908424B2 (en) | 1998-07-29 | 2002-05-06 | Stress reduction apparatus and method |
US10/218,914 US20030045771A1 (en) | 1997-01-02 | 2002-08-15 | Heart wall tension reduction devices and methods |
US11/048,743 US20050131277A1 (en) | 1997-01-02 | 2005-02-03 | Heart wall tension reduction apparatus and method |
US11/060,380 US8439817B2 (en) | 1998-07-29 | 2005-02-17 | Chordae capturing methods for stress reduction |
US12/832,507 US8267852B2 (en) | 1997-01-02 | 2010-07-08 | Heart wall tension reduction apparatus and method |
US13/609,585 US8460173B2 (en) | 1997-01-02 | 2012-09-11 | Heart wall tension reduction apparatus and method |
US13/914,437 US20140094647A1 (en) | 1997-01-02 | 2013-06-10 | Heart wall tension reduction apparatus and method |
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Cited By (50)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6592619B2 (en) | 1996-01-02 | 2003-07-15 | University Of Cincinnati | Heart wall actuation device for the natural heart |
US20040015039A1 (en) * | 2002-07-16 | 2004-01-22 | The University Of Cincinnati | Modular power system and method for a heart wall actuation system for the natural heart |
US20040034271A1 (en) * | 2002-08-19 | 2004-02-19 | The University Of Cincinnati | Heart wall actuation system for the natural heart with shape limiting elements |
US20040260317A1 (en) * | 2003-06-20 | 2004-12-23 | Elliot Bloom | Tensioning device, system, and method for treating mitral valve regurgitation |
US20060089711A1 (en) * | 2004-10-27 | 2006-04-27 | Medtronic Vascular, Inc. | Multifilament anchor for reducing a compass of a lumen or structure in mammalian body |
US7077862B2 (en) * | 2002-01-09 | 2006-07-18 | Myocor, Inc. | Devices and methods for heart valve treatment |
US20070025009A1 (en) * | 2005-07-29 | 2007-02-01 | Fuji Photo Film Co., Ltd. | Magnetic recorder |
US20070066863A1 (en) * | 2005-08-31 | 2007-03-22 | Medtronic Vascular, Inc. | Device for treating mitral valve regurgitation |
US20070203391A1 (en) * | 2006-02-24 | 2007-08-30 | Medtronic Vascular, Inc. | System for Treating Mitral Valve Regurgitation |
US7678135B2 (en) | 2004-06-09 | 2010-03-16 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
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US8092367B2 (en) | 2001-09-07 | 2012-01-10 | Mardil, Inc. | Method for external stabilization of the base of the heart |
US8092363B2 (en) | 2007-09-05 | 2012-01-10 | Mardil, Inc. | Heart band with fillable chambers to modify heart valve function |
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US8870916B2 (en) | 2006-07-07 | 2014-10-28 | USGI Medical, Inc | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
USD717954S1 (en) | 2013-10-14 | 2014-11-18 | Mardil, Inc. | Heart treatment device |
US8926634B2 (en) | 2004-05-07 | 2015-01-06 | Usgi Medical, Inc. | Apparatus and methods for manipulating and securing tissue |
US9044221B2 (en) | 2010-12-29 | 2015-06-02 | Neochord, Inc. | Exchangeable system for minimally invasive beating heart repair of heart valve leaflets |
US9370425B2 (en) | 2012-10-12 | 2016-06-21 | Mardil, Inc. | Cardiac treatment system and method |
US9585651B2 (en) | 2005-05-26 | 2017-03-07 | Usgi Medical, Inc. | Methods and apparatus for securing and deploying tissue anchors |
US9737403B2 (en) | 2006-03-03 | 2017-08-22 | Mardil, Inc. | Self-adjusting attachment structure for a cardiac support device |
US10588620B2 (en) | 2018-03-23 | 2020-03-17 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US10695178B2 (en) | 2011-06-01 | 2020-06-30 | Neochord, Inc. | Minimally invasive repair of heart valve leaflets |
US10765517B2 (en) | 2015-10-01 | 2020-09-08 | Neochord, Inc. | Ringless web for repair of heart valves |
US10966709B2 (en) | 2018-09-07 | 2021-04-06 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11173030B2 (en) | 2018-05-09 | 2021-11-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
US11253360B2 (en) | 2018-05-09 | 2022-02-22 | Neochord, Inc. | Low profile tissue anchor for minimally invasive heart valve repair |
US11376126B2 (en) | 2019-04-16 | 2022-07-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11589989B2 (en) | 2017-03-31 | 2023-02-28 | Neochord, Inc. | Minimally invasive heart valve repair in a beating heart |
US11957584B2 (en) | 2021-11-11 | 2024-04-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
Families Citing this family (349)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6572529B2 (en) * | 1993-06-17 | 2003-06-03 | Wilk Patent Development Corporation | Intrapericardial assist method |
US6520904B1 (en) | 1996-01-02 | 2003-02-18 | The University Of Cincinnati | Device and method for restructuring heart chamber geometry |
US5957977A (en) | 1996-01-02 | 1999-09-28 | University Of Cincinnati | Activation device for the natural heart including internal and external support structures |
US6123662A (en) * | 1998-07-13 | 2000-09-26 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
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 |
US20030045771A1 (en) * | 1997-01-02 | 2003-03-06 | Schweich Cyril J. | Heart wall tension reduction devices and methods |
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 |
US6183411B1 (en) | 1998-09-21 | 2001-02-06 | Myocor, Inc. | External stress reduction device and method |
US7883539B2 (en) * | 1997-01-02 | 2011-02-08 | Edwards Lifesciences Llc | Heart wall tension reduction apparatus and method |
EP0991373B1 (en) | 1997-06-21 | 2004-09-15 | Acorn Cardiovascular, Inc. | Bag for at least partially enveloping a heart |
WO1999000059A1 (en) * | 1997-06-27 | 1999-01-07 | The Trustees Of Columbia University In The City Of New York | Method and apparatus for circulatory valve repair |
FR2768324B1 (en) | 1997-09-12 | 1999-12-10 | Jacques Seguin | SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER |
US6332893B1 (en) | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
US6190408B1 (en) | 1998-03-05 | 2001-02-20 | The University Of Cincinnati | Device and method for restructuring the heart chamber geometry |
US7491232B2 (en) * | 1998-09-18 | 2009-02-17 | Aptus Endosystems, Inc. | Catheter-based fastener implantation apparatus and methods with implantation force resolution |
US6260552B1 (en) | 1998-07-29 | 2001-07-17 | Myocor, Inc. | Transventricular implant tools and devices |
US6685627B2 (en) | 1998-10-09 | 2004-02-03 | Swaminathan Jayaraman | Modification of properties and geometry of heart tissue to influence heart function |
US8715156B2 (en) * | 1998-10-09 | 2014-05-06 | Swaminathan Jayaraman | Modification of properties and geometry of heart tissue to influence function |
US6587734B2 (en) | 1998-11-04 | 2003-07-01 | Acorn Cardiovascular, Inc. | Cardio therapeutic heart sack |
US6169922B1 (en) | 1998-11-18 | 2001-01-02 | Acorn Cardiovascular, Inc. | Defibrillating cardiac jacket with interwoven electrode grids |
US7811296B2 (en) | 1999-04-09 | 2010-10-12 | Evalve, Inc. | Fixation devices for variation in engagement of tissue |
US7226467B2 (en) | 1999-04-09 | 2007-06-05 | Evalve, Inc. | Fixation device delivery catheter, systems and methods of use |
CA2620783C (en) | 1999-04-09 | 2011-04-05 | Evalve, Inc. | Methods and apparatus for cardiac valve repair |
US6752813B2 (en) | 1999-04-09 | 2004-06-22 | Evalve, Inc. | Methods and devices for capturing and fixing leaflets in valve repair |
US10327743B2 (en) * | 1999-04-09 | 2019-06-25 | Evalve, Inc. | Device and methods for endoscopic annuloplasty |
US20040044350A1 (en) | 1999-04-09 | 2004-03-04 | Evalve, Inc. | Steerable access sheath and methods of use |
US8216256B2 (en) | 1999-04-09 | 2012-07-10 | Evalve, Inc. | Detachment mechanism for implantable fixation devices |
US7604646B2 (en) | 1999-04-09 | 2009-10-20 | Evalve, Inc. | Locking mechanisms for fixation devices and methods of engaging tissue |
SE514718C2 (en) | 1999-06-29 | 2001-04-09 | Jan Otto Solem | Apparatus for treating defective closure of the mitral valve apparatus |
US7192442B2 (en) * | 1999-06-30 | 2007-03-20 | Edwards Lifesciences Ag | Method and device for treatment of mitral insufficiency |
US6997951B2 (en) * | 1999-06-30 | 2006-02-14 | Edwards Lifesciences Ag | Method and device for treatment of mitral insufficiency |
US6241654B1 (en) * | 1999-07-07 | 2001-06-05 | Acorn Cardiovasculr, Inc. | Cardiac reinforcement devices and methods |
US20060229491A1 (en) * | 2002-08-01 | 2006-10-12 | Cardiokinetix, Inc. | Method for treating myocardial rupture |
US7887477B2 (en) * | 1999-08-09 | 2011-02-15 | Cardiokinetix, Inc. | Method of improving cardiac function using a porous membrane |
US7279007B2 (en) * | 1999-08-09 | 2007-10-09 | Cardioklnetix, Inc. | Method for improving cardiac function |
US8388672B2 (en) * | 1999-08-09 | 2013-03-05 | Cardiokinetix, Inc. | 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 |
US7674222B2 (en) | 1999-08-09 | 2010-03-09 | Cardiokinetix, Inc. | Cardiac device and methods of use thereof |
US10307147B2 (en) | 1999-08-09 | 2019-06-04 | Edwards Lifesciences Corporation | System for improving cardiac function by sealing a partitioning membrane within a ventricle |
US9694121B2 (en) | 1999-08-09 | 2017-07-04 | Cardiokinetix, Inc. | Systems and methods for improving cardiac function |
US7582051B2 (en) * | 2005-06-10 | 2009-09-01 | Cardiokinetix, Inc. | Peripheral seal for a ventricular partitioning device |
US8257428B2 (en) * | 1999-08-09 | 2012-09-04 | Cardiokinetix, Inc. | System for improving cardiac function |
US8529430B2 (en) | 2002-08-01 | 2013-09-10 | Cardiokinetix, Inc. | Therapeutic methods and devices following myocardial infarction |
US7972337B2 (en) | 2005-12-28 | 2011-07-05 | Intrinsic Therapeutics, Inc. | Devices and methods for bone anchoring |
WO2004100841A1 (en) | 1999-08-18 | 2004-11-25 | Intrinsic Therapeutics, Inc. | Devices and method for augmenting a vertebral disc nucleus |
WO2009033100A1 (en) * | 2007-09-07 | 2009-03-12 | Intrinsic Therapeutics, Inc. | Bone anchoring systems |
US7998213B2 (en) | 1999-08-18 | 2011-08-16 | Intrinsic Therapeutics, Inc. | Intervertebral disc herniation repair |
JP4247519B2 (en) * | 1999-08-18 | 2009-04-02 | イントリンジック セラピューティックス インコーポレイテッド | Apparatus and method for nucleus augmentation and retention |
US7717961B2 (en) * | 1999-08-18 | 2010-05-18 | Intrinsic Therapeutics, Inc. | Apparatus delivery in an intervertebral disc |
US8323341B2 (en) | 2007-09-07 | 2012-12-04 | Intrinsic Therapeutics, Inc. | Impaction grafting for vertebral fusion |
US6328689B1 (en) | 2000-03-23 | 2001-12-11 | Spiration, Inc., | Lung constriction apparatus and method |
US6174279B1 (en) * | 1999-09-21 | 2001-01-16 | Acorn Cardiovascular, Inc. | Cardiac constraint with tension indicator |
US6702732B1 (en) * | 1999-12-22 | 2004-03-09 | Paracor Surgical, Inc. | Expandable cardiac harness for treating congestive heart failure |
EP1113497A3 (en) * | 1999-12-29 | 2006-01-25 | Texas Instruments Incorporated | Semiconductor package with conductor impedance selected during assembly |
US6402781B1 (en) * | 2000-01-31 | 2002-06-11 | Mitralife | Percutaneous mitral annuloplasty and cardiac reinforcement |
US6989028B2 (en) | 2000-01-31 | 2006-01-24 | Edwards Lifesciences Ag | Medical system and method for remodeling an extravascular tissue structure |
US7507252B2 (en) * | 2000-01-31 | 2009-03-24 | Edwards Lifesciences Ag | Adjustable transluminal annuloplasty system |
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 |
ITPC20000013A1 (en) * | 2000-04-13 | 2000-07-13 | Paolo Ferrazzi | INTROVENTRICULAR DEVICE AND RELATED METHOD FOR THE TREATMENT AND CORRECTION OF MYOCARDIOPATHIES. |
US6425856B1 (en) | 2000-05-10 | 2002-07-30 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
AU2001265264A1 (en) * | 2000-05-31 | 2001-12-11 | Cardioclasp, Inc. | Devices and methods for assisting natural heart function |
US6730016B1 (en) | 2000-06-12 | 2004-05-04 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US7618364B2 (en) * | 2000-06-12 | 2009-11-17 | Acorn Cardiovascular, Inc. | Cardiac wall tension relief device and method |
US6902522B1 (en) | 2000-06-12 | 2005-06-07 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US6951534B2 (en) | 2000-06-13 | 2005-10-04 | Acorn Cardiovascular, Inc. | Cardiac support device |
US6482146B1 (en) * | 2000-06-13 | 2002-11-19 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US10064696B2 (en) | 2000-08-09 | 2018-09-04 | Edwards Lifesciences Corporation | Devices and methods for delivering an endocardial device |
US20060030881A1 (en) | 2004-08-05 | 2006-02-09 | Cardiokinetix, Inc. | Ventricular partitioning device |
US9078660B2 (en) | 2000-08-09 | 2015-07-14 | Cardiokinetix, Inc. | Devices and methods for delivering an endocardial device |
US9332992B2 (en) | 2004-08-05 | 2016-05-10 | Cardiokinetix, Inc. | Method for making a laminar ventricular partitioning 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 |
US7862500B2 (en) * | 2002-08-01 | 2011-01-04 | Cardiokinetix, Inc. | Multiple partitioning devices for heart treatment |
US7399271B2 (en) * | 2004-01-09 | 2008-07-15 | Cardiokinetix, Inc. | Ventricular partitioning device |
US9332993B2 (en) | 2004-08-05 | 2016-05-10 | Cardiokinetix, Inc. | Devices and methods for delivering an endocardial device |
US6572533B1 (en) * | 2000-08-17 | 2003-06-03 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US6887192B1 (en) | 2000-09-08 | 2005-05-03 | Converge Medical, Inc. | Heart support to prevent ventricular remodeling |
US20050228422A1 (en) * | 2002-11-26 | 2005-10-13 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US20060106279A1 (en) | 2004-05-14 | 2006-05-18 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of a bridge implant having an adjustable bridge stop |
US7527646B2 (en) * | 2000-09-20 | 2009-05-05 | Ample Medical, Inc. | Devices, systems, and methods for retaining a native heart valve leaflet |
US6893459B1 (en) * | 2000-09-20 | 2005-05-17 | Ample Medical, Inc. | Heart valve annulus device and method of using same |
US7381220B2 (en) | 2000-09-20 | 2008-06-03 | Ample Medical, Inc. | Devices, systems, and methods for supplementing, repairing, or replacing a native heart valve leaflet |
US20090287179A1 (en) | 2003-10-01 | 2009-11-19 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US8784482B2 (en) * | 2000-09-20 | 2014-07-22 | Mvrx, Inc. | Method of reshaping a heart valve annulus using an intravascular device |
US20050222489A1 (en) * | 2003-10-01 | 2005-10-06 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of a bridge implant |
US20060106278A1 (en) * | 2004-05-14 | 2006-05-18 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of an adjustable bridge implant system |
US20080091264A1 (en) | 2002-11-26 | 2008-04-17 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US8956407B2 (en) * | 2000-09-20 | 2015-02-17 | Mvrx, Inc. | Methods for reshaping a heart valve annulus using a tensioning implant |
US6808483B1 (en) | 2000-10-03 | 2004-10-26 | Paul A. Spence | Implantable heart assist devices and methods |
US6723038B1 (en) | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US6616684B1 (en) * | 2000-10-06 | 2003-09-09 | Myocor, Inc. | Endovascular splinting devices and methods |
US6564094B2 (en) | 2000-12-22 | 2003-05-13 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US7510576B2 (en) * | 2001-01-30 | 2009-03-31 | Edwards Lifesciences Ag | Transluminal mitral annuloplasty |
US6810882B2 (en) | 2001-01-30 | 2004-11-02 | Ev3 Santa Rosa, Inc. | Transluminal mitral annuloplasty |
US20030181940A1 (en) * | 2001-02-28 | 2003-09-25 | Gregory Murphy | Ventricular restoration shaping apparatus and method of use |
US6622730B2 (en) | 2001-03-30 | 2003-09-23 | Myocor, Inc. | Device for marking and aligning positions on the heart |
US6923646B2 (en) * | 2001-04-18 | 2005-08-02 | Air Techniques, Inc. | Process and apparatus for treating an exhaust stream from a dental operatory |
US8202315B2 (en) | 2001-04-24 | 2012-06-19 | Mitralign, Inc. | Catheter-based annuloplasty using ventricularly positioned catheter |
US20020188170A1 (en) * | 2001-04-27 | 2002-12-12 | Santamore William P. | Prevention of myocardial infarction induced ventricular expansion and remodeling |
US7311731B2 (en) * | 2001-04-27 | 2007-12-25 | Richard C. Satterfield | Prevention of myocardial infarction induced ventricular expansion and remodeling |
AU2011213723B2 (en) * | 2001-04-27 | 2015-02-05 | Satterfield, Richard | Prevention of myocardial infarction induced ventricular expansion and remodeling |
IL159816A0 (en) * | 2001-07-16 | 2004-06-20 | Corassist Cardiovascular Ltd | In-vivo method and device for improving diastolic function of the left ventricle |
US7485088B2 (en) * | 2001-09-05 | 2009-02-03 | Chase Medical L.P. | Method and device for percutaneous surgical ventricular repair |
US20060025800A1 (en) * | 2001-09-05 | 2006-02-02 | Mitta Suresh | Method and device for surgical ventricular repair |
US20040243170A1 (en) * | 2001-09-05 | 2004-12-02 | Mitta Suresh | Method and device for percutaneous surgical ventricular repair |
US6723041B2 (en) | 2001-09-10 | 2004-04-20 | Lilip Lau | Device for treating heart failure |
US20030050648A1 (en) | 2001-09-11 | 2003-03-13 | Spiration, Inc. | Removable lung reduction devices, systems, and methods |
US6695769B2 (en) * | 2001-09-25 | 2004-02-24 | The Foundry, Inc. | Passive ventricular support devices and methods of using them |
US7060023B2 (en) | 2001-09-25 | 2006-06-13 | The Foundry Inc. | Pericardium reinforcing devices and methods of using them |
US6685620B2 (en) | 2001-09-25 | 2004-02-03 | The Foundry Inc. | Ventricular infarct assist device and methods for using it |
JP4458845B2 (en) * | 2001-10-01 | 2010-04-28 | アンプル メディカル,インコーポレイテッド | Medical device |
US6632239B2 (en) * | 2001-10-02 | 2003-10-14 | Spiration, Inc. | Constriction device including reinforced suture holes |
US6589161B2 (en) * | 2001-10-18 | 2003-07-08 | Spiration, Inc. | Constriction device including tear resistant structures |
US6592594B2 (en) | 2001-10-25 | 2003-07-15 | Spiration, Inc. | Bronchial obstruction device deployment system and method |
US6575971B2 (en) | 2001-11-15 | 2003-06-10 | Quantum Cor, Inc. | Cardiac valve leaflet stapler device and methods thereof |
US8231639B2 (en) | 2001-11-28 | 2012-07-31 | Aptus Endosystems, Inc. | Systems and methods for attaching a prosthesis within a body lumen or hollow organ |
US20110087320A1 (en) * | 2001-11-28 | 2011-04-14 | Aptus Endosystems, Inc. | Devices, Systems, and Methods for Prosthesis Delivery and Implantation, Including a Prosthesis Assembly |
US20090099650A1 (en) * | 2001-11-28 | 2009-04-16 | Lee Bolduc | Devices, systems, and methods for endovascular staple and/or prosthesis delivery and implantation |
US20070073389A1 (en) | 2001-11-28 | 2007-03-29 | Aptus Endosystems, Inc. | Endovascular aneurysm devices, systems, and methods |
CN100479786C (en) | 2001-11-28 | 2009-04-22 | 阿普特斯内系统公司 | Endovascular aneurysm repair system |
US9320503B2 (en) | 2001-11-28 | 2016-04-26 | Medtronic Vascular, Inc. | Devices, system, and methods for guiding an operative tool into an interior body region |
US20050177180A1 (en) * | 2001-11-28 | 2005-08-11 | Aptus Endosystems, Inc. | Devices, systems, and methods for supporting tissue and/or structures within a hollow body organ |
ATE462378T1 (en) * | 2001-12-28 | 2010-04-15 | Edwards Lifesciences Ag | DELAYED MEMORY DEVICE |
SE524709C2 (en) * | 2002-01-11 | 2004-09-21 | Edwards Lifesciences Ag | Device for delayed reshaping of a heart vessel and a heart valve |
US7174896B1 (en) | 2002-01-07 | 2007-02-13 | Paracor Medical, Inc. | Method and apparatus for supporting a heart |
US7022063B2 (en) | 2002-01-07 | 2006-04-04 | Paracor Medical, Inc. | Cardiac harness |
US20030216769A1 (en) | 2002-05-17 | 2003-11-20 | Dillard David H. | Removable anchored lung volume reduction devices and methods |
US20030181922A1 (en) | 2002-03-20 | 2003-09-25 | Spiration, Inc. | Removable anchored lung volume reduction devices and methods |
US7181272B2 (en) | 2002-04-22 | 2007-02-20 | Medtronic, Inc. | Cardiac restraint with electrode attachment sites |
AU2003229003B2 (en) * | 2002-05-09 | 2008-09-18 | Covidien Lp | Organ retractor and method of using the same |
CA2483905C (en) * | 2002-05-09 | 2011-01-25 | Tyco Healthcare Group Lp | Endoscopic organ retractor and method of using the same |
EP1530441B1 (en) * | 2002-06-13 | 2017-08-02 | Ancora Heart, Inc. | Devices and methods for heart valve repair |
US7753922B2 (en) | 2003-09-04 | 2010-07-13 | Guided Delivery Systems, Inc. | Devices and methods for cardiac annulus stabilization and treatment |
US8641727B2 (en) | 2002-06-13 | 2014-02-04 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US8287555B2 (en) | 2003-02-06 | 2012-10-16 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US9949829B2 (en) | 2002-06-13 | 2018-04-24 | Ancora Heart, Inc. | Delivery devices and methods for heart valve repair |
US20060122633A1 (en) | 2002-06-13 | 2006-06-08 | John To | Methods and devices for termination |
US7883538B2 (en) | 2002-06-13 | 2011-02-08 | Guided Delivery Systems Inc. | Methods and devices for termination |
US9226825B2 (en) | 2002-06-13 | 2016-01-05 | Guided Delivery Systems, Inc. | Delivery devices and methods for heart valve repair |
US7850729B2 (en) | 2002-07-18 | 2010-12-14 | The University Of Cincinnati | Deforming jacket for a heart actuation device |
US20040059180A1 (en) * | 2002-09-23 | 2004-03-25 | The University Of Cincinnati | Basal mounting cushion frame component to facilitate extrinsic heart wall actuation |
AU2003277116A1 (en) * | 2002-10-01 | 2004-04-23 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
DE60336497D1 (en) * | 2002-10-04 | 2011-05-05 | Tyco Healthcare | ENDOSCOPIC RETRACTOR |
US7087064B1 (en) | 2002-10-15 | 2006-08-08 | Advanced Cardiovascular Systems, Inc. | Apparatuses and methods for heart valve repair |
US20050119735A1 (en) | 2002-10-21 | 2005-06-02 | Spence Paul A. | Tissue fastening systems and methods utilizing magnetic guidance |
NZ539136A (en) | 2002-10-21 | 2008-04-30 | Mitralign Inc | Method and apparatus for performing catheter-based annuloplasty using local plications |
US7247134B2 (en) * | 2002-11-12 | 2007-07-24 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7112219B2 (en) | 2002-11-12 | 2006-09-26 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7981152B1 (en) | 2004-12-10 | 2011-07-19 | Advanced Cardiovascular Systems, Inc. | Vascular delivery system for accessing and delivering devices into coronary sinus and other vascular sites |
US7335213B1 (en) | 2002-11-15 | 2008-02-26 | Abbott Cardiovascular Systems Inc. | Apparatus and methods for heart valve repair |
US7404824B1 (en) | 2002-11-15 | 2008-07-29 | Advanced Cardiovascular Systems, Inc. | Valve aptation assist device |
US7331972B1 (en) | 2002-11-15 | 2008-02-19 | Abbott Cardiovascular Systems Inc. | Heart valve chord cutter |
US6945978B1 (en) | 2002-11-15 | 2005-09-20 | Advanced Cardiovascular Systems, Inc. | Heart valve catheter |
US7736299B2 (en) | 2002-11-15 | 2010-06-15 | Paracor Medical, Inc. | Introducer for a cardiac harness delivery |
US20040098116A1 (en) | 2002-11-15 | 2004-05-20 | Callas Peter L. | Valve annulus constriction apparatus and method |
US8187324B2 (en) | 2002-11-15 | 2012-05-29 | Advanced Cardiovascular Systems, Inc. | Telescoping apparatus for delivering and adjusting a medical device in a vessel |
US7485143B2 (en) * | 2002-11-15 | 2009-02-03 | Abbott Cardiovascular Systems Inc. | Apparatuses and methods for heart valve repair |
US9149602B2 (en) | 2005-04-22 | 2015-10-06 | Advanced Cardiovascular Systems, Inc. | Dual needle delivery system |
US20060241334A1 (en) * | 2003-01-27 | 2006-10-26 | Corassist Cardiovascular Ltd. | In vivo device for improving diastolic ventricular function |
US20040254600A1 (en) * | 2003-02-26 | 2004-12-16 | David Zarbatany | Methods and devices for endovascular mitral valve correction from the left coronary sinus |
US7883500B2 (en) * | 2003-03-26 | 2011-02-08 | G&L Consulting, Llc | Method and system to treat and prevent myocardial infarct expansion |
US7100616B2 (en) | 2003-04-08 | 2006-09-05 | Spiration, Inc. | Bronchoscopic lung volume reduction method |
US10646229B2 (en) | 2003-05-19 | 2020-05-12 | Evalve, Inc. | Fixation devices, systems and methods for engaging tissue |
US7341584B1 (en) | 2003-05-30 | 2008-03-11 | Thomas David Starkey | Device and method to limit filling of the heart |
WO2004110257A2 (en) | 2003-06-09 | 2004-12-23 | The University Of Cincinnati | Power system for a heart actuation device |
US20060178551A1 (en) * | 2003-06-09 | 2006-08-10 | Melvin David B | Securement system for a heart actuation device |
WO2004110553A1 (en) | 2003-06-09 | 2004-12-23 | The University Of Cincinnati | Actuation mechanisms for a heart actuation device |
US7513867B2 (en) * | 2003-07-16 | 2009-04-07 | Kardium, Inc. | Methods and devices for altering blood flow through the left ventricle |
EP1646332B1 (en) | 2003-07-18 | 2015-06-17 | Edwards Lifesciences AG | Remotely activated mitral annuloplasty system |
US7533671B2 (en) | 2003-08-08 | 2009-05-19 | Spiration, Inc. | Bronchoscopic repair of air leaks in a lung |
US7998112B2 (en) | 2003-09-30 | 2011-08-16 | Abbott Cardiovascular Systems Inc. | Deflectable catheter assembly and method of making same |
US7004176B2 (en) * | 2003-10-17 | 2006-02-28 | Edwards Lifesciences Ag | Heart valve leaflet locator |
US7158839B2 (en) * | 2003-11-07 | 2007-01-02 | Paracor Medical, Inc. | Cardiac harness for treating heart disease |
US20060276684A1 (en) | 2003-11-07 | 2006-12-07 | Giovanni Speziali | Device and method for treating congestive heart failure |
US7155295B2 (en) * | 2003-11-07 | 2006-12-26 | Paracor Medical, Inc. | Cardiac harness for treating congestive heart failure and for defibrillating and/or pacing/sensing |
US20050187620A1 (en) * | 2003-11-14 | 2005-08-25 | Suresh Pai | Systems for heart treatment |
US20050273138A1 (en) * | 2003-12-19 | 2005-12-08 | Guided Delivery Systems, Inc. | Devices and methods for anchoring tissue |
US8864822B2 (en) | 2003-12-23 | 2014-10-21 | Mitralign, Inc. | Devices and methods for introducing elements into tissue |
US7166127B2 (en) * | 2003-12-23 | 2007-01-23 | Mitralign, Inc. | Tissue fastening systems and methods utilizing magnetic guidance |
US20050148814A1 (en) * | 2004-01-05 | 2005-07-07 | Fischi Michael C. | Muscle function augmentation |
EP1703854A1 (en) * | 2004-01-12 | 2006-09-27 | Paracor Medical, Inc. | Cardiac harness having interconnected strands |
US7758491B2 (en) * | 2004-04-05 | 2010-07-20 | Genesee Biomedical, Inc. | Method and apparatus for the surgical treatment of congestive heart failure |
US7993397B2 (en) * | 2004-04-05 | 2011-08-09 | Edwards Lifesciences Ag | Remotely adjustable coronary sinus implant |
US7601117B2 (en) * | 2004-06-30 | 2009-10-13 | Ethicon, Inc. | Systems and methods for assisting cardiac valve coaptation |
DE102004040135B3 (en) * | 2004-08-19 | 2005-12-15 | Abg Allgemeine Baumaschinen-Gesellschaft Mbh | Self-propelled device for milling traffic areas |
AU2005286101A1 (en) * | 2004-09-22 | 2006-03-30 | Corassist Cardiovascular Ltd. | In vivo device for assisting and improving diastolic ventricular function |
US8052592B2 (en) | 2005-09-27 | 2011-11-08 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
CA2748617C (en) | 2004-09-27 | 2014-09-23 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
US20060079736A1 (en) | 2004-10-13 | 2006-04-13 | Sing-Fatt Chin | Method and device for percutaneous left ventricular reconstruction |
US20060135966A1 (en) * | 2004-11-15 | 2006-06-22 | Laurent Schaller | Catheter-based tissue remodeling devices and methods |
WO2006055820A2 (en) * | 2004-11-19 | 2006-05-26 | G & L Consulting Llc | Biodegradable pericardial constraint system and method |
US7211110B2 (en) * | 2004-12-09 | 2007-05-01 | Edwards Lifesciences Corporation | Diagnostic kit to assist with heart valve annulus adjustment |
EP3967269A3 (en) | 2005-02-07 | 2022-07-13 | Evalve, Inc. | Systems and devices for cardiac valve repair |
US20100298929A1 (en) * | 2005-02-07 | 2010-11-25 | Thornton Troy L | Methods, systems and devices for cardiac valve repair |
US8470028B2 (en) | 2005-02-07 | 2013-06-25 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
US7320665B2 (en) * | 2005-03-02 | 2008-01-22 | Venkataramana Vijay | Cardiac Ventricular Geometry Restoration Device and Treatment for Heart Failure |
US20060199995A1 (en) * | 2005-03-02 | 2006-09-07 | Venkataramana Vijay | Percutaneous cardiac ventricular geometry restoration device and treatment for heart failure |
US10219902B2 (en) | 2005-03-25 | 2019-03-05 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve anulus, including the use of a bridge implant having an adjustable bridge stop |
US8333777B2 (en) * | 2005-04-22 | 2012-12-18 | Benvenue Medical, Inc. | Catheter-based tissue remodeling devices and methods |
US7621866B2 (en) * | 2005-05-31 | 2009-11-24 | Ethicon, Inc. | Method and device for deployment of a sub-pericardial sack |
US7766816B2 (en) | 2005-06-09 | 2010-08-03 | Chf Technologies, Inc. | Method and apparatus for closing off a portion of a heart ventricle |
US8951285B2 (en) | 2005-07-05 | 2015-02-10 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
US20070055206A1 (en) * | 2005-08-10 | 2007-03-08 | Guided Delivery Systems, Inc. | Methods and devices for deployment of tissue anchors |
WO2007022519A2 (en) | 2005-08-19 | 2007-02-22 | Chf Technologies, Inc. | Steerable heart implants for congestive heart failure |
US8506474B2 (en) | 2005-08-19 | 2013-08-13 | Bioventrix, Inc. | Method and device for treating dysfunctional cardiac tissue |
US7715918B2 (en) | 2005-10-18 | 2010-05-11 | University Of Cincinnati | Muscle energy converter with smooth continuous tissue interface |
CN101466316B (en) | 2005-10-20 | 2012-06-27 | 阿普特斯内系统公司 | Devices systems and methods for prosthesis delivery and implantation including the use of a fastener tool |
US7749249B2 (en) | 2006-02-21 | 2010-07-06 | Kardium Inc. | Method and device for closing holes in tissue |
US7691151B2 (en) | 2006-03-31 | 2010-04-06 | Spiration, Inc. | Articulable Anchor |
US20070265658A1 (en) * | 2006-05-12 | 2007-11-15 | Aga Medical Corporation | Anchoring and tethering system |
US20070270882A1 (en) * | 2006-05-19 | 2007-11-22 | Acorn Cardiovascular, Inc. | Pericardium management method for intra-pericardial surgical procedures |
US8449605B2 (en) | 2006-06-28 | 2013-05-28 | Kardium Inc. | Method for anchoring a mitral valve |
US20080004488A1 (en) * | 2006-06-29 | 2008-01-03 | Acorn Cardiovascular, Inc. | Low friction delivery tool for a cardiac support device |
US7651462B2 (en) | 2006-07-17 | 2010-01-26 | Acorn Cardiovascular, Inc. | Cardiac support device delivery tool with release mechanism |
US7837610B2 (en) * | 2006-08-02 | 2010-11-23 | Kardium Inc. | System for improving diastolic dysfunction |
US7875017B2 (en) * | 2007-04-11 | 2011-01-25 | Henry Ford Health System | Cardiac repair, resizing and reshaping using the venous system of the heart |
US9782258B2 (en) * | 2006-09-08 | 2017-10-10 | The Regents Of The University Of California | Intramyocardial patterning for global cardiac resizing and reshaping |
US20080071365A1 (en) * | 2006-09-19 | 2008-03-20 | Astudillo Medical Aktiebolag | Transpericardial mitral annuloplasty system for the treatment of ischemic mitral regurgitation |
US7641608B1 (en) | 2006-09-26 | 2010-01-05 | Acorn Cardiovascular, Inc. | Sectional cardiac support device and method of delivery |
US8123668B2 (en) | 2006-09-28 | 2012-02-28 | Bioventrix (A Chf Technologies' Company) | Signal transmitting and lesion excluding heart implants for pacing defibrillating and/or sensing of heart beat |
US9211115B2 (en) | 2006-09-28 | 2015-12-15 | Bioventrix, Inc. | Location, time, and/or pressure determining devices, systems, and methods for deployment of lesion-excluding heart implants for treatment of cardiac heart failure and other disease states |
US20080082170A1 (en) * | 2006-09-29 | 2008-04-03 | Peterman Marc M | Apparatus and methods for surgical repair |
US20080091057A1 (en) * | 2006-10-11 | 2008-04-17 | Cardiac Pacemakers, Inc. | Method and apparatus for passive left atrial support |
US8388680B2 (en) | 2006-10-18 | 2013-03-05 | Guided Delivery Systems, Inc. | Methods and devices for catheter advancement and delivery of substances therethrough |
US11660190B2 (en) | 2007-03-13 | 2023-05-30 | Edwards Lifesciences Corporation | Tissue anchors, systems and methods, and devices |
US8911461B2 (en) | 2007-03-13 | 2014-12-16 | Mitralign, Inc. | Suture cutter and method of cutting suture |
US8845723B2 (en) | 2007-03-13 | 2014-09-30 | Mitralign, Inc. | Systems and methods for introducing elements into tissue |
WO2008154033A2 (en) * | 2007-06-11 | 2008-12-18 | Symphony Medical, Inc. | Cardiac patterning for improving diastolic function |
US20080082168A1 (en) * | 2007-07-31 | 2008-04-03 | Marc Peterman | Surgical scaffold to enhance fibrous tissue response |
US8192351B2 (en) | 2007-08-13 | 2012-06-05 | Paracor Medical, Inc. | Medical device delivery system having integrated introducer |
DE102007043830A1 (en) | 2007-09-13 | 2009-04-02 | Lozonschi, Lucian, Madison | Heart valve stent |
US8491455B2 (en) | 2007-10-03 | 2013-07-23 | Bioventrix, Inc. | Treating dysfunctional cardiac tissue |
CA2702615C (en) * | 2007-10-19 | 2017-06-06 | Guided Delivery Systems, Inc. | Systems and methods for cardiac remodeling |
US9131928B2 (en) | 2007-12-20 | 2015-09-15 | Mor Research Applications Ltd. | Elongated body for deployment in a heart |
WO2009100242A2 (en) | 2008-02-06 | 2009-08-13 | Guided Delivery Systems, Inc. | Multi-window guide tunnel |
CA2723810C (en) * | 2008-05-07 | 2015-06-30 | Guided Delivery Systems, Inc. | Deflectable guide |
US20090287304A1 (en) | 2008-05-13 | 2009-11-19 | Kardium Inc. | Medical Device for Constricting Tissue or a Bodily Orifice, for example a mitral valve |
US8337390B2 (en) * | 2008-07-30 | 2012-12-25 | Cube S.R.L. | Intracardiac device for restoring the functional elasticity of the cardiac structures, holding tool for the intracardiac device, and method for implantation of the intracardiac device in the heart |
US20100121349A1 (en) * | 2008-10-10 | 2010-05-13 | Meier Stephen C | Termination devices and related methods |
EP2349020B1 (en) * | 2008-10-10 | 2020-06-03 | Ancora Heart, Inc. | Tether tensioning device |
EP2349086B1 (en) | 2008-10-16 | 2017-03-22 | Medtronic Vascular, Inc. | Devices and systems for endovascular staple and/or prosthesis delivery and implantation |
WO2010085456A1 (en) | 2009-01-20 | 2010-07-29 | Guided Delivery Systems Inc. | Anchor deployment devices and related methods |
US20100210899A1 (en) * | 2009-01-21 | 2010-08-19 | Tendyne Medical, Inc. | Method for percutaneous lateral access to the left ventricle for treatment of mitral insufficiency by papillary muscle alignment |
US20100274227A1 (en) * | 2009-02-13 | 2010-10-28 | Alexander Khairkhahan | Delivery catheter handle cover |
US20110015476A1 (en) * | 2009-03-04 | 2011-01-20 | Jeff Franco | Devices and Methods for Treating Cardiomyopathy |
US8449466B2 (en) | 2009-05-28 | 2013-05-28 | Edwards Lifesciences Corporation | System and method for locating medical devices in vivo using ultrasound Doppler mode |
EP3042615A1 (en) | 2009-09-15 | 2016-07-13 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
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 |
WO2011072084A2 (en) | 2009-12-08 | 2011-06-16 | Avalon Medical Ltd. | Device and system for transcatheter mitral valve replacement |
US9307980B2 (en) | 2010-01-22 | 2016-04-12 | 4Tech Inc. | Tricuspid valve repair using tension |
US10058323B2 (en) | 2010-01-22 | 2018-08-28 | 4 Tech Inc. | Tricuspid valve repair using tension |
US8475525B2 (en) | 2010-01-22 | 2013-07-02 | 4Tech Inc. | Tricuspid valve repair using tension |
WO2011109813A2 (en) * | 2010-03-05 | 2011-09-09 | Edwards Lifesciences Corporation | Retaining mechanisms for prosthetic valves |
US9050066B2 (en) | 2010-06-07 | 2015-06-09 | Kardium Inc. | Closing openings in anatomical tissue |
US9861350B2 (en) | 2010-09-03 | 2018-01-09 | Ancora Heart, Inc. | Devices and methods for anchoring tissue |
US8940002B2 (en) | 2010-09-30 | 2015-01-27 | Kardium Inc. | Tissue anchor system |
US8888843B2 (en) | 2011-01-28 | 2014-11-18 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valve regurgitation |
US8845717B2 (en) | 2011-01-28 | 2014-09-30 | Middle Park Medical, Inc. | Coaptation enhancement implant, system, and method |
US10709449B2 (en) | 2011-02-18 | 2020-07-14 | Ancora Heart, Inc. | Systems and methods for variable stiffness tethers |
US10111663B2 (en) | 2011-02-18 | 2018-10-30 | Ancora Heart, Inc. | Implant retrieval device |
US9072511B2 (en) | 2011-03-25 | 2015-07-07 | Kardium Inc. | Medical kit for constricting tissue or a bodily orifice, for example, a mitral valve |
US8795241B2 (en) | 2011-05-13 | 2014-08-05 | Spiration, Inc. | Deployment catheter |
EP4289398A3 (en) | 2011-08-11 | 2024-03-13 | Tendyne Holdings, Inc. | Improvements for prosthetic valves and related inventions |
US8945177B2 (en) | 2011-09-13 | 2015-02-03 | Abbott Cardiovascular Systems Inc. | Gripper pusher mechanism for tissue apposition systems |
EP3175797B1 (en) | 2011-09-30 | 2020-02-12 | Bioventrix, Inc. | Trans-catheter ventricular reconstruction structures and systems for treatment of congestive heart failure and other conditions |
US9827092B2 (en) | 2011-12-16 | 2017-11-28 | Tendyne Holdings, Inc. | Tethers for prosthetic mitral valve |
JP6084775B2 (en) * | 2012-03-09 | 2017-02-22 | 学校法人金沢医科大学 | Heart correction net |
US9265514B2 (en) | 2012-04-17 | 2016-02-23 | Miteas Ltd. | Manipulator for grasping tissue |
WO2014022124A1 (en) | 2012-07-28 | 2014-02-06 | Tendyne Holdings, Inc. | Improved multi-component designs for heart valve retrieval device, sealing structures and stent assembly |
US9675454B2 (en) | 2012-07-30 | 2017-06-13 | Tendyne Holdings, Inc. | Delivery systems and methods for transcatheter prosthetic valves |
EP2943132B1 (en) | 2013-01-09 | 2018-03-28 | 4Tech Inc. | Soft tissue anchors |
WO2014141239A1 (en) | 2013-03-14 | 2014-09-18 | 4Tech Inc. | Stent with tether interface |
US11224510B2 (en) | 2013-04-02 | 2022-01-18 | Tendyne Holdings, Inc. | Prosthetic heart valve and systems and methods for delivering the same |
US10463489B2 (en) | 2013-04-02 | 2019-11-05 | Tendyne Holdings, Inc. | Prosthetic heart valve and systems and methods for delivering the same |
US9486306B2 (en) | 2013-04-02 | 2016-11-08 | Tendyne Holdings, Inc. | Inflatable annular sealing device for prosthetic mitral valve |
US10478293B2 (en) | 2013-04-04 | 2019-11-19 | Tendyne Holdings, Inc. | Retrieval and repositioning system for prosthetic heart valve |
AU2014268717A1 (en) | 2013-05-24 | 2015-12-03 | Bioventrix, Inc. | Cardiac tissue penetrating devices, methods, and systems for treatment of congestive heart failure and other conditions |
US9610159B2 (en) | 2013-05-30 | 2017-04-04 | Tendyne Holdings, Inc. | Structural members for prosthetic mitral valves |
JP6461122B2 (en) | 2013-06-25 | 2019-01-30 | テンダイン ホールディングス,インコーポレイテッド | Thrombus management and structural compliance features of prosthetic heart valves |
EP3027144B1 (en) | 2013-08-01 | 2017-11-08 | Tendyne Holdings, Inc. | Epicardial anchor devices |
CA2922132A1 (en) | 2013-08-30 | 2015-03-05 | Bioventrix, Inc. | Heart anchor positioning devices, methods, and systems for treatment of congestive heart failure and other conditions |
CA2922126A1 (en) | 2013-08-30 | 2015-03-05 | Bioventrix, Inc. | Cardiac tissue anchoring devices, methods, and systems for treatment of congestive heart failure and other conditions |
US10070857B2 (en) | 2013-08-31 | 2018-09-11 | Mitralign, Inc. | Devices and methods for locating and implanting tissue anchors at mitral valve commissure |
WO2015058039A1 (en) | 2013-10-17 | 2015-04-23 | Robert Vidlund | Apparatus and methods for alignment and deployment of intracardiac devices |
US10166098B2 (en) | 2013-10-25 | 2019-01-01 | Middle Peak Medical, Inc. | Systems and methods for transcatheter treatment of valve regurgitation |
EP3656353A1 (en) | 2013-10-28 | 2020-05-27 | Tendyne Holdings, Inc. | Prosthetic heart valve and systems for delivering the same |
US9526611B2 (en) | 2013-10-29 | 2016-12-27 | Tendyne Holdings, Inc. | Apparatus and methods for delivery of transcatheter prosthetic valves |
US10052095B2 (en) | 2013-10-30 | 2018-08-21 | 4Tech Inc. | Multiple anchoring-point tension system |
US10022114B2 (en) | 2013-10-30 | 2018-07-17 | 4Tech Inc. | Percutaneous tether locking |
WO2015120122A2 (en) | 2014-02-05 | 2015-08-13 | Robert Vidlund | Apparatus and methods for transfemoral delivery of prosthetic mitral valve |
US9986993B2 (en) | 2014-02-11 | 2018-06-05 | Tendyne Holdings, Inc. | Adjustable tether and epicardial pad system for prosthetic heart valve |
AU2015229708B2 (en) | 2014-03-10 | 2019-08-15 | Tendyne Holdings, Inc. | Devices and methods for positioning and monitoring tether load for prosthetic mitral valve |
US10390943B2 (en) | 2014-03-17 | 2019-08-27 | Evalve, Inc. | Double orifice device for transcatheter mitral valve replacement |
CA2951413C (en) | 2014-06-12 | 2019-07-02 | The Cleveland Clinic Foundation | Device, system, and method for treating a regurgitant heart valve |
CA2958061A1 (en) | 2014-06-18 | 2015-12-23 | Middle Peak Medical, Inc. | Mitral valve implants for the treatment of valvular regurgitation |
CN106573129B (en) * | 2014-06-19 | 2019-09-24 | 4科技有限公司 | Heart tissue is tightened |
EP3160396B1 (en) | 2014-06-24 | 2022-03-23 | Polares Medical Inc. | Systems for anchoring an implant |
WO2016048802A1 (en) | 2014-09-28 | 2016-03-31 | Cardiokinetix, Inc. | Apparatuses for treating cardiac dysfunction |
US9907547B2 (en) | 2014-12-02 | 2018-03-06 | 4Tech Inc. | Off-center tissue anchors |
US10188392B2 (en) | 2014-12-19 | 2019-01-29 | Abbott Cardiovascular Systems, Inc. | Grasping for tissue repair |
EP3242630A2 (en) | 2015-01-07 | 2017-11-15 | Tendyne Holdings, Inc. | Prosthetic mitral valves and apparatus and methods for delivery of same |
CA2975294A1 (en) | 2015-02-05 | 2016-08-11 | Tendyne Holdings, Inc. | Expandable epicardial pads and devices and methods for delivery of same |
CA2978599C (en) | 2015-03-05 | 2022-09-06 | Ancora Heart, Inc. | Devices and methods of visualizing and determining depth of penetration in cardiac tissue |
US10201423B2 (en) | 2015-03-11 | 2019-02-12 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
US10524912B2 (en) | 2015-04-02 | 2020-01-07 | Abbott Cardiovascular Systems, Inc. | Tissue fixation devices and methods |
CA2983002C (en) | 2015-04-16 | 2023-07-04 | Tendyne Holdings, Inc. | Apparatus and methods for delivery, repositioning, and retrieval of transcatheter prosthetic valves |
US10980973B2 (en) | 2015-05-12 | 2021-04-20 | Ancora Heart, Inc. | Device and method for releasing catheters from cardiac structures |
US10376673B2 (en) | 2015-06-19 | 2019-08-13 | Evalve, Inc. | Catheter guiding system and methods |
US10238494B2 (en) | 2015-06-29 | 2019-03-26 | Evalve, Inc. | Self-aligning radiopaque ring |
US10667815B2 (en) | 2015-07-21 | 2020-06-02 | Evalve, Inc. | Tissue grasping devices and related methods |
US10413408B2 (en) | 2015-08-06 | 2019-09-17 | Evalve, Inc. | Delivery catheter systems, methods, and devices |
US10206779B2 (en) | 2015-09-10 | 2019-02-19 | Bioventrix, Inc. | Systems and methods for deploying a cardiac anchor |
US10327894B2 (en) | 2015-09-18 | 2019-06-25 | Tendyne Holdings, Inc. | Methods for delivery of prosthetic mitral valves |
US10238495B2 (en) | 2015-10-09 | 2019-03-26 | Evalve, Inc. | Delivery catheter handle and methods of use |
US9592121B1 (en) | 2015-11-06 | 2017-03-14 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
ES2777609T3 (en) | 2015-12-03 | 2020-08-05 | Tendyne Holdings Inc | Framework Features for Prosthetic Mitral Valves |
AU2016366840B2 (en) | 2015-12-10 | 2021-09-23 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
CN108366859B (en) | 2015-12-28 | 2021-02-05 | 坦迪尼控股股份有限公司 | Atrial capsular bag closure for prosthetic heart valves |
US11478353B2 (en) | 2016-01-29 | 2022-10-25 | Bioventrix, Inc. | Percutaneous arterial access to position trans-myocardial implant devices and methods |
US10470877B2 (en) | 2016-05-03 | 2019-11-12 | Tendyne Holdings, Inc. | Apparatus and methods for anterior valve leaflet management |
EP3468480B1 (en) | 2016-06-13 | 2023-01-11 | Tendyne Holdings, Inc. | Sequential delivery of two-part prosthetic mitral valve |
WO2018005779A1 (en) | 2016-06-30 | 2018-01-04 | Tegels Zachary J | Prosthetic heart valves and apparatus and methods for delivery of same |
US10736632B2 (en) | 2016-07-06 | 2020-08-11 | Evalve, Inc. | Methods and devices for valve clip excision |
US11065116B2 (en) | 2016-07-12 | 2021-07-20 | Tendyne Holdings, Inc. | Apparatus and methods for trans-septal retrieval of prosthetic heart valves |
US11071564B2 (en) | 2016-10-05 | 2021-07-27 | Evalve, Inc. | Cardiac valve cutting device |
US10363138B2 (en) | 2016-11-09 | 2019-07-30 | Evalve, Inc. | Devices for adjusting the curvature of cardiac valve structures |
US10398553B2 (en) | 2016-11-11 | 2019-09-03 | Evalve, Inc. | Opposing disk device for grasping cardiac valve tissue |
US10426616B2 (en) | 2016-11-17 | 2019-10-01 | Evalve, Inc. | Cardiac implant delivery system |
US10667914B2 (en) | 2016-11-18 | 2020-06-02 | Ancora Heart, Inc. | Myocardial implant load sharing device and methods to promote LV function |
US10779837B2 (en) | 2016-12-08 | 2020-09-22 | Evalve, Inc. | Adjustable arm device for grasping tissues |
US10314586B2 (en) | 2016-12-13 | 2019-06-11 | Evalve, Inc. | Rotatable device and method for fixing tricuspid valve tissue |
US10653524B2 (en) | 2017-03-13 | 2020-05-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
CN110913801B (en) | 2017-03-13 | 2022-04-15 | 宝来瑞斯医疗有限公司 | Coaptation assistance element for treating an adverse coaptation of a heart valve of a heart and system for delivering the same |
US10478303B2 (en) | 2017-03-13 | 2019-11-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
DE102018107407A1 (en) | 2017-03-28 | 2018-10-04 | Edwards Lifesciences Corporation | POSITIONING, INSERTING AND RETRIEVING IMPLANTABLE DEVICES |
WO2018209313A1 (en) | 2017-05-12 | 2018-11-15 | Evalve, Inc. | Long arm valve repair clip |
WO2019014473A1 (en) | 2017-07-13 | 2019-01-17 | Tendyne Holdings, Inc. | Prosthetic heart valves and apparatus and methods for delivery of same |
JP7291124B2 (en) | 2017-08-28 | 2023-06-14 | テンダイン ホールディングス,インコーポレイテッド | Heart valve prosthesis with tethered connections |
WO2021011659A1 (en) | 2019-07-15 | 2021-01-21 | Ancora Heart, Inc. | Devices and methods for tether cutting |
EP3831343B1 (en) | 2019-12-05 | 2024-01-31 | Tendyne Holdings, Inc. | Braided anchor for mitral valve |
US11648114B2 (en) | 2019-12-20 | 2023-05-16 | Tendyne Holdings, Inc. | Distally loaded sheath and loading funnel |
US11951002B2 (en) | 2020-03-30 | 2024-04-09 | Tendyne Holdings, Inc. | Apparatus and methods for valve and tether fixation |
WO2022039853A1 (en) | 2020-08-19 | 2022-02-24 | Tendyne Holdings, Inc. | Fully-transseptal apical pad with pulley for tensioning |
US11464634B2 (en) | 2020-12-16 | 2022-10-11 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation with secondary anchors |
US11759321B2 (en) | 2021-06-25 | 2023-09-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
Family Cites Families (150)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US34021A (en) * | 1861-12-24 | Ufacture of fibrous water | ||
US3019790A (en) | 1960-07-15 | 1962-02-06 | Robert J Militana | Combination hemostat and intravenous needle |
US3980086A (en) | 1974-02-28 | 1976-09-14 | Bio-Medicus, Inc. | Fluid conveying surgical instrument |
US4192293A (en) * | 1978-09-05 | 1980-03-11 | Manfred Asrican | Cardiac assist device |
ES474582A1 (en) * | 1978-10-26 | 1979-11-01 | Aranguren Duo Iker | Process for installing mitral valves in their anatomical space by attaching cords to an artificial stent |
JPS5563638A (en) | 1978-11-09 | 1980-05-13 | Olympus Optical Co | Renal pelvis forceps |
US4372293A (en) | 1980-12-24 | 1983-02-08 | Vijil Rosales Cesar A | Apparatus and method for surgical correction of ptotic breasts |
US4409974A (en) * | 1981-06-29 | 1983-10-18 | Freedland Jeffrey A | Bone-fixating surgical implant device |
IT1155105B (en) * | 1982-03-03 | 1987-01-21 | Roberto Parravicini | PLANT DEVICE TO SUPPORT THE MYOCARDIUM ACTIVITY |
US5104392A (en) * | 1985-03-22 | 1992-04-14 | Massachusetts Institute Of Technology | Laser spectro-optic imaging for diagnosis and treatment of diseased tissue |
US4690134A (en) | 1985-07-01 | 1987-09-01 | Snyders Robert V | Ventricular assist device |
US4705040A (en) | 1985-11-18 | 1987-11-10 | Medi-Tech, Incorporated | Percutaneous fixation of hollow organs |
USRE34021E (en) | 1985-11-18 | 1992-08-04 | Abbott Laboratories | Percutaneous fixation of hollow organs |
DE3614292C1 (en) | 1986-04-26 | 1987-11-19 | Alexander Prof Dr Bernhard | Holder for unframed biological mitral valve implant |
SU1604377A1 (en) * | 1987-02-23 | 1990-11-07 | Благовещенский государственный медицинский институт | Artificial pericardium |
US4925443A (en) | 1987-02-27 | 1990-05-15 | Heilman Marlin S | Biocompatible ventricular assist and arrhythmia control device |
US4960424A (en) * | 1988-06-30 | 1990-10-02 | Grooters Ronald K | Method of replacing a defective atrio-ventricular valve with a total atrio-ventricular valve bioprosthesis |
US4944753A (en) * | 1988-09-26 | 1990-07-31 | Burgess Frank M | Method for producing retro-sternal space |
US5290300A (en) | 1989-07-31 | 1994-03-01 | Baxter International Inc. | Flexible suture guide and holder |
US4997431A (en) * | 1989-08-30 | 1991-03-05 | Angeion Corporation | Catheter |
GB9012716D0 (en) * | 1990-06-07 | 1990-08-01 | Frater Robert W M | Mitral heart valve replacements |
US5131905A (en) * | 1990-07-16 | 1992-07-21 | Grooters Ronald K | External cardiac assist device |
JPH05184611A (en) | 1991-03-19 | 1993-07-27 | Kenji Kusuhara | Valvular annulation retaining member and its attaching method |
US5300087A (en) | 1991-03-22 | 1994-04-05 | Knoepfler Dennis J | Multiple purpose forceps |
US5169381A (en) * | 1991-03-29 | 1992-12-08 | Snyders Robert V | Ventricular assist device |
US5584803A (en) * | 1991-07-16 | 1996-12-17 | Heartport, Inc. | System for cardiac procedures |
US5571215A (en) * | 1993-02-22 | 1996-11-05 | Heartport, Inc. | Devices and methods for intracardiac procedures |
US5452733A (en) * | 1993-02-22 | 1995-09-26 | Stanford Surgical Technologies, Inc. | Methods for performing thoracoscopic coronary artery bypass |
US5458574A (en) * | 1994-03-16 | 1995-10-17 | Heartport, Inc. | System for performing a cardiac procedure |
US5344385A (en) | 1991-09-30 | 1994-09-06 | Thoratec Laboratories Corporation | Step-down skeletal muscle energy conversion system |
US5192314A (en) * | 1991-12-12 | 1993-03-09 | Daskalakis Michael K | Synthetic intraventricular implants and method of inserting |
US5250049A (en) * | 1992-01-10 | 1993-10-05 | Michael Roger H | Bone and tissue connectors |
US5758663A (en) | 1992-04-10 | 1998-06-02 | Wilk; Peter J. | Coronary artery by-pass method |
US5733331A (en) * | 1992-07-28 | 1998-03-31 | Newcor Industrial S.A. | Total mitral heterologous bioprosthesis to be used in mitral or tricuspid heat replacement |
DE4234127C2 (en) * | 1992-10-09 | 1996-02-22 | Herbert Dr Vetter | Heart valve prosthesis |
US5718725A (en) * | 1992-12-03 | 1998-02-17 | Heartport, Inc. | Devices and methods for intracardiac procedures |
US5814097A (en) * | 1992-12-03 | 1998-09-29 | Heartport, Inc. | Devices and methods for intracardiac procedures |
US5284488A (en) * | 1992-12-23 | 1994-02-08 | Sideris Eleftherios B | Adjustable devices for the occlusion of cardiac defects |
US6125852A (en) | 1993-02-22 | 2000-10-03 | Heartport, Inc. | Minimally-invasive devices and methods for treatment of congestive heart failure |
US20020029783A1 (en) | 1993-02-22 | 2002-03-14 | Stevens John H. | Minimally-invasive devices and methods for treatment of congestive heart failure |
US5972030A (en) | 1993-02-22 | 1999-10-26 | Heartport, Inc. | Less-invasive devices and methods for treatment of cardiac valves |
US5797960A (en) | 1993-02-22 | 1998-08-25 | Stevens; John H. | Method and apparatus for thoracoscopic intracardiac procedures |
US5682906A (en) * | 1993-02-22 | 1997-11-04 | Heartport, Inc. | Methods of performing intracardiac procedures on an arrested heart |
US6010531A (en) | 1993-02-22 | 2000-01-04 | Heartport, Inc. | Less-invasive devices and methods for cardiac valve surgery |
DE4306277C2 (en) | 1993-03-01 | 2000-11-02 | Leibinger Gmbh | Operation marking tool |
US6155968A (en) | 1998-07-23 | 2000-12-05 | Wilk; Peter J. | Method and device for improving cardiac function |
US5800334A (en) | 1993-06-17 | 1998-09-01 | Wilk; Peter J. | Intrapericardial assist device and associated method |
US6258021B1 (en) | 1993-06-17 | 2001-07-10 | Peter J. Wilk | Intrapericardial assist method |
US5971911A (en) | 1993-06-17 | 1999-10-26 | Wilk; Peter J. | Intrapericardial assist device and associated method |
US6572529B2 (en) * | 1993-06-17 | 2003-06-03 | Wilk Patent Development Corporation | Intrapericardial assist method |
US5385528A (en) * | 1993-06-17 | 1995-01-31 | Wilk; Peter J. | Intrapericardial assist device and associated method |
US5533958A (en) * | 1993-06-17 | 1996-07-09 | Wilk; Peter J. | Intrapericardial assist device and associated method |
US5389006A (en) | 1993-08-13 | 1995-02-14 | Burndy Corporation | Lightweight entertainment connector |
US5450860A (en) | 1993-08-31 | 1995-09-19 | W. L. Gore & Associates, Inc. | Device for tissue repair and method for employing same |
AU699189B2 (en) * | 1993-12-17 | 1998-11-26 | Heartport, Inc. | System for cardiac procedures |
US5417709A (en) | 1994-04-12 | 1995-05-23 | Symbiosis Corporation | Endoscopic instrument with end effectors forming suction and/or irrigation lumens |
US5509428A (en) * | 1994-05-31 | 1996-04-23 | Dunlop; Richard W. | Method and apparatus for the creation of tricuspid regurgitation |
US6217610B1 (en) * | 1994-07-29 | 2001-04-17 | Edwards Lifesciences Corporation | Expandable annuloplasty ring |
US5593424A (en) | 1994-08-10 | 1997-01-14 | Segmed, Inc. | Apparatus and method for reducing and stabilizing the circumference of a vascular structure |
US5433727A (en) * | 1994-08-16 | 1995-07-18 | Sideris; Eleftherios B. | Centering buttoned device for the occlusion of large defects for occluding |
JPH08196538A (en) | 1994-09-26 | 1996-08-06 | Ethicon Inc | Tissue sticking apparatus for surgery with elastomer component and method of attaching mesh for surgery to said tissue |
US5849005A (en) * | 1995-06-07 | 1998-12-15 | Heartport, Inc. | Method and apparatus for minimizing the risk of air embolism when performing a procedure in a patient's thoracic cavity |
US6132438A (en) * | 1995-06-07 | 2000-10-17 | Ep Technologies, Inc. | Devices for installing stasis reducing means in body tissue |
US5840059A (en) | 1995-06-07 | 1998-11-24 | Cardiogenesis Corporation | Therapeutic and diagnostic agent delivery |
US5713954A (en) | 1995-06-13 | 1998-02-03 | Abiomed R&D, Inc. | Extra cardiac ventricular assist device |
US5800528A (en) * | 1995-06-13 | 1998-09-01 | Abiomed R & D, Inc. | Passive girdle for heart ventricle for therapeutic aid to patients having ventricular dilatation |
DE19538796C2 (en) * | 1995-10-18 | 1999-09-23 | Fraunhofer Ges Forschung | Device for supporting the heart function with elastic filling chambers |
US5662704A (en) * | 1995-12-01 | 1997-09-02 | Medtronic, Inc. | Physiologic mitral valve bioprosthesis |
US6592619B2 (en) * | 1996-01-02 | 2003-07-15 | University Of Cincinnati | Heart wall actuation device for the natural heart |
US6520904B1 (en) * | 1996-01-02 | 2003-02-18 | The University Of Cincinnati | Device and method for restructuring heart chamber geometry |
US5957977A (en) | 1996-01-02 | 1999-09-28 | University Of Cincinnati | Activation device for the natural heart including internal and external support structures |
US6182664B1 (en) | 1996-02-19 | 2001-02-06 | Edwards Lifesciences Corporation | Minimally invasive cardiac valve surgery procedure |
US5853422A (en) | 1996-03-22 | 1998-12-29 | Scimed Life Systems, Inc. | Apparatus and method for closing a septal defect |
US5855601A (en) | 1996-06-21 | 1999-01-05 | The Trustees Of Columbia University In The City Of New York | Artificial heart valve and method and device for implanting the same |
US5972019A (en) | 1996-07-25 | 1999-10-26 | Target Therapeutics, Inc. | Mechanical clot treatment device |
US5755783A (en) | 1996-07-29 | 1998-05-26 | Stobie; Robert | Suture rings for rotatable artificial heart valves |
US5800531A (en) | 1996-09-30 | 1998-09-01 | Baxter International Inc. | Bioprosthetic heart valve implantation device |
US5702343A (en) * | 1996-10-02 | 1997-12-30 | Acorn Medical, Inc. | Cardiac reinforcement device |
US6123662A (en) | 1998-07-13 | 2000-09-26 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
BR9712239A (en) | 1996-10-18 | 2000-01-25 | Cardio Tech Inc | Method and apparatus to assist a heart to pump blood by applying substantially uniform pressure to at least a portion of the ventricles. |
US5827268A (en) | 1996-10-30 | 1998-10-27 | Hearten Medical, Inc. | Device for the treatment of patent ductus arteriosus and method of using the device |
EP0839497A1 (en) * | 1996-11-01 | 1998-05-06 | EndoSonics Corporation | A method for measuring volumetric fluid flow and its velocity profile in a lumen or other body cavity |
US5865749A (en) * | 1996-11-07 | 1999-02-02 | Data Sciences International, Inc. | Blood flow meter apparatus and method of use |
DE29619294U1 (en) | 1996-11-07 | 1997-07-17 | Caic Pero | Heart cuff |
US6120520A (en) | 1997-05-27 | 2000-09-19 | Angiotrax, Inc. | Apparatus and methods for stimulating revascularization and/or tissue growth |
US6206004B1 (en) * | 1996-12-06 | 2001-03-27 | Comedicus Incorporated | Treatment method via the pericardial space |
US6071303A (en) | 1996-12-08 | 2000-06-06 | Hearten Medical, Inc. | Device for the treatment of infarcted tissue and method of treating infarcted tissue |
US5807384A (en) | 1996-12-20 | 1998-09-15 | Eclipse Surgical Technologies, Inc. | Transmyocardial revascularization (TMR) enhanced treatment for coronary artery disease |
US5999678A (en) | 1996-12-27 | 1999-12-07 | Eclipse Surgical Technologies, Inc. | Laser delivery means adapted for drug delivery |
US6077214A (en) | 1998-07-29 | 2000-06-20 | Myocor, Inc. | Stress reduction apparatus and method |
US20030045771A1 (en) * | 1997-01-02 | 2003-03-06 | Schweich Cyril J. | Heart wall tension reduction devices and methods |
US6406420B1 (en) | 1997-01-02 | 2002-06-18 | Myocor, Inc. | Methods and devices for improving cardiac function in hearts |
US6050936A (en) | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US5961440A (en) | 1997-01-02 | 1999-10-05 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US6183411B1 (en) | 1998-09-21 | 2001-02-06 | Myocor, Inc. | External stress reduction device and method |
US6045497A (en) * | 1997-01-02 | 2000-04-04 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US5928224A (en) | 1997-01-24 | 1999-07-27 | Hearten Medical, Inc. | Device for the treatment of damaged heart valve leaflets and methods of using the device |
US6443949B2 (en) * | 1997-03-13 | 2002-09-03 | Biocardia, Inc. | Method of drug delivery to interstitial regions of the myocardium |
US5928281A (en) | 1997-03-27 | 1999-07-27 | Baxter International Inc. | Tissue heart valves |
US5961549A (en) | 1997-04-03 | 1999-10-05 | Baxter International Inc. | Multi-leaflet bioprosthetic heart valve |
US6245102B1 (en) * | 1997-05-07 | 2001-06-12 | Iowa-India Investments Company Ltd. | Stent, stent graft and stent valve |
EP0991373B1 (en) * | 1997-06-21 | 2004-09-15 | Acorn Cardiovascular, Inc. | Bag for at least partially enveloping a heart |
WO1999000059A1 (en) * | 1997-06-27 | 1999-01-07 | The Trustees Of Columbia University In The City Of New York | Method and apparatus for circulatory valve repair |
AU9225598A (en) | 1997-09-04 | 1999-03-22 | Endocore, Inc. | Artificial chordae replacement |
FR2768324B1 (en) | 1997-09-12 | 1999-12-10 | Jacques Seguin | SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER |
US6338712B2 (en) * | 1997-09-17 | 2002-01-15 | Origin Medsystems, Inc. | Device to permit offpump beating heart coronary bypass surgery |
US6019722A (en) | 1997-09-17 | 2000-02-01 | Guidant Corporation | Device to permit offpump beating heart coronary bypass surgery |
US6086532A (en) * | 1997-09-26 | 2000-07-11 | Ep Technologies, Inc. | Systems for recording use of structures deployed in association with heart tissue |
WO1999022784A1 (en) | 1997-11-03 | 1999-05-14 | Cardio Technologies, Inc. | Method and apparatus for assisting a heart to pump blood |
US6332893B1 (en) | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
US6001126A (en) | 1997-12-24 | 1999-12-14 | Baxter International Inc. | Stentless bioprosthetic heart valve with coronary protuberances and related methods for surgical repair of defective heart valves |
DE69838526T2 (en) | 1998-02-05 | 2008-07-03 | Biosense Webster, Inc., Diamond Bar | Device for releasing a drug in the heart |
US5944738A (en) | 1998-02-06 | 1999-08-31 | Aga Medical Corporation | Percutaneous catheter directed constricting occlusion device |
US6314322B1 (en) | 1998-03-02 | 2001-11-06 | Abiomed, Inc. | System and method for treating dilated cardiomyopathy using end diastolic volume (EDV) sensing |
US6190408B1 (en) * | 1998-03-05 | 2001-02-20 | The University Of Cincinnati | Device and method for restructuring the heart chamber geometry |
US5902229A (en) | 1998-03-30 | 1999-05-11 | Cardio Technologies, Inc. | Drive system for controlling cardiac compression |
US6095968A (en) | 1998-04-10 | 2000-08-01 | Cardio Technologies, Inc. | Reinforcement device |
US6110100A (en) | 1998-04-22 | 2000-08-29 | Scimed Life Systems, Inc. | System for stress relieving the heart muscle and for controlling heart function |
US6221104B1 (en) * | 1998-05-01 | 2001-04-24 | Cor Restore, Inc. | Anterior and interior segment cardiac restoration apparatus and method |
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 |
US6511426B1 (en) * | 1998-06-02 | 2003-01-28 | Acuson Corporation | Medical diagnostic ultrasound system and method for versatile processing |
US6250308B1 (en) | 1998-06-16 | 2001-06-26 | Cardiac Concepts, Inc. | Mitral valve annuloplasty ring and method of implanting |
EP1102567B1 (en) | 1998-07-13 | 2004-11-10 | Acorn Cardiovascular, Inc. | Cardiac disease treatment device |
US6085754A (en) | 1998-07-13 | 2000-07-11 | Acorn Cardiovascular, Inc. | Cardiac disease treatment method |
US6165183A (en) * | 1998-07-15 | 2000-12-26 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
US6547821B1 (en) * | 1998-07-16 | 2003-04-15 | Cardiothoracic Systems, Inc. | Surgical procedures and devices for increasing cardiac output of the heart |
US6260552B1 (en) * | 1998-07-29 | 2001-07-17 | Myocor, Inc. | Transventricular implant tools and devices |
US6251061B1 (en) | 1998-09-09 | 2001-06-26 | Scimed Life Systems, Inc. | Cardiac assist device using field controlled fluid |
US6080532A (en) * | 1998-09-17 | 2000-06-27 | Eastman Kodak Company | Clear duplitized display materials |
DE19947885B4 (en) | 1998-10-05 | 2009-04-09 | Cardiothoracic Systems, Inc., Cupertino | Device for positioning the heart during cardiac surgery while maintaining cardiac output |
US6169922B1 (en) | 1998-11-18 | 2001-01-02 | Acorn Cardiovascular, Inc. | Defibrillating cardiac jacket with interwoven electrode grids |
US6230714B1 (en) | 1998-11-18 | 2001-05-15 | Acorn Cardiovascular, Inc. | Cardiac constraint with prior venus occlusion methods |
US6155972A (en) | 1999-02-02 | 2000-12-05 | Acorn Cardiovascular, Inc. | Cardiac constraint jacket construction |
US6231602B1 (en) | 1999-04-16 | 2001-05-15 | Edwards Lifesciences Corporation | Aortic annuloplasty ring |
US6577902B1 (en) | 1999-04-16 | 2003-06-10 | Tony R. Brown | Device for shaping infarcted heart tissue and method of using the device |
US6260820B1 (en) | 1999-05-21 | 2001-07-17 | Nordstrom Valves, Inc. | Valve with rotatable valve member and method for forming same |
US6241654B1 (en) | 1999-07-07 | 2001-06-05 | Acorn Cardiovasculr, Inc. | Cardiac reinforcement devices and methods |
US6179791B1 (en) | 1999-09-21 | 2001-01-30 | Acorn Cardiovascular, Inc. | Device for heart measurement |
US6193648B1 (en) | 1999-09-21 | 2001-02-27 | Acorn Cardiovascular, Inc. | Cardiac constraint with draw string tensioning |
US6174279B1 (en) | 1999-09-21 | 2001-01-16 | Acorn Cardiovascular, Inc. | Cardiac constraint with tension indicator |
US6797002B2 (en) | 2000-02-02 | 2004-09-28 | Paul A. Spence | Heart valve repair apparatus and methods |
JP2001317938A (en) * | 2000-05-01 | 2001-11-16 | Asahi Optical Co Ltd | Surveying machine with light wave range finder |
US6723038B1 (en) | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US7297150B2 (en) | 2002-08-29 | 2007-11-20 | Mitralsolutions, Inc. | Implantable devices for controlling the internal circumference of an anatomic orifice or lumen |
US7404824B1 (en) | 2002-11-15 | 2008-07-29 | Advanced Cardiovascular Systems, Inc. | Valve aptation assist device |
EP1943982A1 (en) | 2004-02-23 | 2008-07-16 | International Heart Institute of Montana Foundation | Papilloplasty band and sizing device |
US8206439B2 (en) | 2004-02-23 | 2012-06-26 | International Heart Institute Of Montana Foundation | Internal prosthesis for reconstruction of cardiac geometry |
WO2007100408A2 (en) | 2005-12-15 | 2007-09-07 | Georgia Tech Research Corporation | Papillary muscle position control devices, systems & methods |
DE602007012691D1 (en) | 2006-05-15 | 2011-04-07 | Edwards Lifesciences Ag | SYSTEM FOR CHANGING THE GEOMETRY OF THE HEART |
-
1998
- 1998-07-29 US US09/124,321 patent/US6077214A/en not_active Expired - Lifetime
-
1999
- 1999-07-27 AU AU52309/99A patent/AU5230999A/en not_active Abandoned
- 1999-07-27 EP EP99937484A patent/EP1143859A2/en not_active Withdrawn
- 1999-07-27 WO PCT/US1999/016875 patent/WO2000006027A2/en active Application Filing
-
2000
- 2000-03-09 US US09/522,068 patent/US6264602B1/en not_active Expired - Lifetime
-
2001
- 2001-04-27 US US09/843,078 patent/US6402680B2/en not_active Expired - Lifetime
-
2002
- 2002-05-06 US US10/138,520 patent/US6908424B2/en not_active Expired - Lifetime
-
2005
- 2005-02-17 US US11/060,380 patent/US8439817B2/en not_active Expired - Lifetime
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US6592619B2 (en) | 1996-01-02 | 2003-07-15 | University Of Cincinnati | Heart wall actuation device for the natural heart |
US7361191B2 (en) | 1996-01-02 | 2008-04-22 | The University Of Cincinnati | Heart wall actuation device for the natural heart |
US7704264B2 (en) | 1999-06-25 | 2010-04-27 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US8574243B2 (en) | 1999-06-25 | 2013-11-05 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US8343175B2 (en) | 1999-06-25 | 2013-01-01 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US7744613B2 (en) | 1999-06-25 | 2010-06-29 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US7955340B2 (en) | 1999-06-25 | 2011-06-07 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US10292821B2 (en) | 2001-09-07 | 2019-05-21 | Phoenix Cardiac Devices, Inc. | Method and apparatus for external stabilization of the heart |
US8092367B2 (en) | 2001-09-07 | 2012-01-10 | Mardil, Inc. | Method for external stabilization of the base of the heart |
US8128553B2 (en) | 2001-09-07 | 2012-03-06 | Mardil, Inc. | Method and apparatus for external stabilization of the heart |
US7077862B2 (en) * | 2002-01-09 | 2006-07-18 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7081084B2 (en) | 2002-07-16 | 2006-07-25 | University Of Cincinnati | Modular power system and method for a heart wall actuation system for the natural heart |
US20040015039A1 (en) * | 2002-07-16 | 2004-01-22 | The University Of Cincinnati | Modular power system and method for a heart wall actuation system for the natural heart |
US6988982B2 (en) | 2002-08-19 | 2006-01-24 | Cardioenergetics | Heart wall actuation system for the natural heart with shape limiting elements |
US20040034271A1 (en) * | 2002-08-19 | 2004-02-19 | The University Of Cincinnati | Heart wall actuation system for the natural heart with shape limiting elements |
US8066719B2 (en) | 2002-12-11 | 2011-11-29 | Ewers Richard C | Apparatus and methods for forming gastrointestinal tissue approximations |
US8262676B2 (en) | 2002-12-11 | 2012-09-11 | Usgi Medical, Inc. | Apparatus and methods for forming gastrointestinal tissue approximations |
US8216260B2 (en) | 2002-12-11 | 2012-07-10 | Usgi Medical, Inc. | Apparatus and methods for forming and securing gastrointestinal tissue folds |
US7942884B2 (en) | 2002-12-11 | 2011-05-17 | Usgi Medical, Inc. | Methods for reduction of a gastric lumen |
US7942898B2 (en) | 2002-12-11 | 2011-05-17 | Usgi Medical, Inc. | Delivery systems and methods for gastric reduction |
US7918845B2 (en) | 2003-01-15 | 2011-04-05 | Usgi Medical, Inc. | Endoluminal tool deployment system |
US20040260317A1 (en) * | 2003-06-20 | 2004-12-23 | Elliot Bloom | Tensioning device, system, and method for treating mitral valve regurgitation |
US7316706B2 (en) | 2003-06-20 | 2008-01-08 | Medtronic Vascular, Inc. | Tensioning device, system, and method for treating mitral valve regurgitation |
US9510817B2 (en) | 2003-12-12 | 2016-12-06 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
US10045871B2 (en) | 2003-12-12 | 2018-08-14 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
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US8308765B2 (en) | 2004-05-07 | 2012-11-13 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
US8828027B2 (en) | 2004-05-07 | 2014-09-09 | U.S.G.I. Medical, Inc. | Tissue manipulation and securement system |
US11045341B2 (en) | 2004-05-07 | 2021-06-29 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
US8926634B2 (en) | 2004-05-07 | 2015-01-06 | Usgi Medical, Inc. | Apparatus and methods for manipulating and securing tissue |
US8444657B2 (en) | 2004-05-07 | 2013-05-21 | Usgi Medical, Inc. | Apparatus and methods for rapid deployment of tissue anchors |
US7918869B2 (en) | 2004-05-07 | 2011-04-05 | Usgi Medical, Inc. | Methods and apparatus for performing endoluminal gastroplasty |
US8216253B2 (en) | 2004-05-07 | 2012-07-10 | Usgi Medical, Inc. | Apparatus for manipulating and securing tissue |
US8216252B2 (en) | 2004-05-07 | 2012-07-10 | Usgi Medical, Inc. | Tissue manipulation and securement system |
US8236009B2 (en) | 2004-05-07 | 2012-08-07 | Usgi Medical, Inc. | Needle assembly for tissue manipulation |
US8257394B2 (en) | 2004-05-07 | 2012-09-04 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
US7736374B2 (en) | 2004-05-07 | 2010-06-15 | Usgi Medical, Inc. | Tissue manipulation and securement system |
US7736378B2 (en) | 2004-05-07 | 2010-06-15 | Usgi Medical, Inc. | Apparatus and methods for positioning and securing anchors |
US7678135B2 (en) | 2004-06-09 | 2010-03-16 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US8740940B2 (en) | 2004-06-09 | 2014-06-03 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US8382800B2 (en) | 2004-06-09 | 2013-02-26 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US8206417B2 (en) | 2004-06-09 | 2012-06-26 | Usgi Medical Inc. | Apparatus and methods for optimizing anchoring force |
US7736379B2 (en) | 2004-06-09 | 2010-06-15 | Usgi Medical, Inc. | Compressible tissue anchor assemblies |
US7695493B2 (en) | 2004-06-09 | 2010-04-13 | Usgi Medical, Inc. | System for optimizing anchoring force |
US20060089711A1 (en) * | 2004-10-27 | 2006-04-27 | Medtronic Vascular, Inc. | Multifilament anchor for reducing a compass of a lumen or structure in mammalian body |
US11534156B2 (en) | 2005-01-21 | 2022-12-27 | Mayo Foundation For Medical Education And Research | Thorascopic heart valve repair method and apparatus |
US10582924B2 (en) | 2005-01-21 | 2020-03-10 | Mayo Foundation For Medical Education And Research | Thorascopic heart valve repair method |
US8465500B2 (en) | 2005-01-21 | 2013-06-18 | Mayo Foundation For Medical Education And Research | Thorascopic heart valve repair method and apparatus |
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US9364213B2 (en) | 2005-01-21 | 2016-06-14 | Mayo Foundation For Medical Education And Research | Thorascopic heart valve repair method |
US8298291B2 (en) | 2005-05-26 | 2012-10-30 | Usgi Medical, Inc. | Methods and apparatus for securing and deploying tissue anchors |
US9585651B2 (en) | 2005-05-26 | 2017-03-07 | Usgi Medical, Inc. | Methods and apparatus for securing and deploying tissue anchors |
US20070025009A1 (en) * | 2005-07-29 | 2007-02-01 | Fuji Photo Film Co., Ltd. | Magnetic recorder |
US20070066863A1 (en) * | 2005-08-31 | 2007-03-22 | Medtronic Vascular, Inc. | Device for treating mitral valve regurgitation |
US8726909B2 (en) | 2006-01-27 | 2014-05-20 | Usgi Medical, Inc. | Methods and apparatus for revision of obesity procedures |
US20070203391A1 (en) * | 2006-02-24 | 2007-08-30 | Medtronic Vascular, Inc. | System for Treating Mitral Valve Regurgitation |
US10806580B2 (en) | 2006-03-03 | 2020-10-20 | Mardil, Inc. | Self-adjusting attachment structure for a cardiac support device |
US9737403B2 (en) | 2006-03-03 | 2017-08-22 | Mardil, Inc. | Self-adjusting attachment structure for a cardiac support device |
US8870916B2 (en) | 2006-07-07 | 2014-10-28 | USGI Medical, Inc | Low profile tissue anchors, tissue anchor systems, and methods for their delivery and use |
USRE46927E1 (en) | 2007-09-05 | 2018-07-03 | Mardil, Inc. | Heart band with fillable chambers to modify heart valve function |
US8092363B2 (en) | 2007-09-05 | 2012-01-10 | Mardil, Inc. | Heart band with fillable chambers to modify heart valve function |
US10507018B2 (en) | 2007-10-18 | 2019-12-17 | Neochord, Inc. | Minimally invasive repair of a valve leaflet in a beating heart |
US8758393B2 (en) | 2007-10-18 | 2014-06-24 | Neochord, Inc. | Minimally invasive repair of a valve leaflet in a beating heart |
US11419602B2 (en) | 2007-10-18 | 2022-08-23 | Neochord, Inc. | Minimally invasive repair of a valve leaflet in a beating heart |
US9192374B2 (en) | 2007-10-18 | 2015-11-24 | Neochord, Inc. | Minimally invasive repair of a valve leaflet in a beating heart |
US10080659B1 (en) | 2010-12-29 | 2018-09-25 | Neochord, Inc. | Devices and methods for minimally invasive repair of heart valves |
US10130474B2 (en) | 2010-12-29 | 2018-11-20 | Neochord, Inc. | Exchangeable system for minimally invasive beating heart repair of heart valve leaflets |
US9044221B2 (en) | 2010-12-29 | 2015-06-02 | Neochord, Inc. | Exchangeable system for minimally invasive beating heart repair of heart valve leaflets |
US10695178B2 (en) | 2011-06-01 | 2020-06-30 | Neochord, Inc. | Minimally invasive repair of heart valve leaflets |
US11406500B2 (en) | 2012-10-12 | 2022-08-09 | Diaxamed, Llc | Cardiac treatment system and method |
US9844437B2 (en) | 2012-10-12 | 2017-12-19 | Mardil, Inc. | Cardiac treatment system and method |
US10420644B2 (en) | 2012-10-12 | 2019-09-24 | Mardil, Inc. | Cardiac treatment system and method |
US10405981B2 (en) | 2012-10-12 | 2019-09-10 | Mardil, Inc. | Cardiac treatment system |
US10064723B2 (en) | 2012-10-12 | 2018-09-04 | Mardil, Inc. | Cardiac treatment system and method |
US11517437B2 (en) | 2012-10-12 | 2022-12-06 | Diaxamed, Llc | Cardiac treatment system |
US9370425B2 (en) | 2012-10-12 | 2016-06-21 | Mardil, Inc. | Cardiac treatment system and method |
US9421101B2 (en) | 2012-10-12 | 2016-08-23 | Mardil, Inc. | Cardiac treatment system |
US9421102B2 (en) | 2012-10-12 | 2016-08-23 | Mardil, Inc. | Cardiac treatment system and method |
USD717954S1 (en) | 2013-10-14 | 2014-11-18 | Mardil, Inc. | Heart treatment device |
US11484409B2 (en) | 2015-10-01 | 2022-11-01 | Neochord, Inc. | Ringless web for repair of heart valves |
US10765517B2 (en) | 2015-10-01 | 2020-09-08 | Neochord, Inc. | Ringless web for repair of heart valves |
US11589989B2 (en) | 2017-03-31 | 2023-02-28 | Neochord, Inc. | Minimally invasive heart valve repair in a beating heart |
US10588620B2 (en) | 2018-03-23 | 2020-03-17 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11612389B2 (en) | 2018-03-23 | 2023-03-28 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11253360B2 (en) | 2018-05-09 | 2022-02-22 | Neochord, Inc. | Low profile tissue anchor for minimally invasive heart valve repair |
US11173030B2 (en) | 2018-05-09 | 2021-11-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
US10966709B2 (en) | 2018-09-07 | 2021-04-06 | Neochord, Inc. | Device for suture attachment for minimally invasive heart valve repair |
US11376126B2 (en) | 2019-04-16 | 2022-07-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11918468B2 (en) | 2019-04-16 | 2024-03-05 | Neochord, Inc. | Transverse helical cardiac anchor for minimally invasive heart valve repair |
US11957584B2 (en) | 2021-11-11 | 2024-04-16 | Neochord, Inc. | Suture length adjustment for minimally invasive heart valve repair |
Also Published As
Publication number | Publication date |
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EP1143859A2 (en) | 2001-10-17 |
US6264602B1 (en) | 2001-07-24 |
US20050143620A1 (en) | 2005-06-30 |
US20020173694A1 (en) | 2002-11-21 |
US6402680B2 (en) | 2002-06-11 |
US8439817B2 (en) | 2013-05-14 |
US6908424B2 (en) | 2005-06-21 |
WO2000006027A2 (en) | 2000-02-10 |
WO2000006027A9 (en) | 2000-08-03 |
WO2000006027A3 (en) | 2001-11-08 |
AU5230999A (en) | 2000-02-21 |
US6077214A (en) | 2000-06-20 |
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