WO2000049952A1 - Method of using focused pressure fronts in myocardial revascularization - Google Patents

Method of using focused pressure fronts in myocardial revascularization Download PDF

Info

Publication number
WO2000049952A1
WO2000049952A1 PCT/US2000/004484 US0004484W WO0049952A1 WO 2000049952 A1 WO2000049952 A1 WO 2000049952A1 US 0004484 W US0004484 W US 0004484W WO 0049952 A1 WO0049952 A1 WO 0049952A1
Authority
WO
WIPO (PCT)
Prior art keywords
heart
cardiac tissue
focusing
providing
lithotriptor
Prior art date
Application number
PCT/US2000/004484
Other languages
French (fr)
Inventor
Dnyanesh Talpade
Thomas R. Hektner
Original Assignee
Scimed Life Systems, Inc.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Scimed Life Systems, Inc. filed Critical Scimed Life Systems, Inc.
Publication of WO2000049952A1 publication Critical patent/WO2000049952A1/en

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/225—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • 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
    • A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00681—Aspects not otherwise provided for
    • A61B2017/00694—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body
    • A61B2017/00703—Aspects not otherwise provided for with means correcting for movement of or for synchronisation with the body correcting for movement of heart, e.g. ECG-triggered
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00351—Heart
    • A61B2018/00392—Transmyocardial revascularisation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N7/00—Ultrasound therapy
    • A61N2007/0078—Ultrasound therapy with multiple treatment transducers

Definitions

  • the present invention generally relates to cardiovascular disease. More specifically, the invention relates to myocardial revascularization. Those skilled in the art will recognize the benefits of applying the present invention to similar fields not discussed herein.
  • Extra-corporeal shock-wave lithotripsy is a medical procedure that has traditionally been used to disintegrate renal (kidney) stones.
  • the term, lithotripsy is derived from a Greek work which literally means “stone crushing”.
  • This medical "stone crushing” technique has been demonstrated to be effective on kidney, upper ureteral and biliary stones (gallstones) in human patients. The technique is noninvasive and eliminates the need for the more conventional stone removal procedures, such as open surgery.
  • LMR Laser Myocardial Revascularization
  • a CO sub 2 laser is used to produce channels in the heart wall from the epicardium through the endocardium. This procedure follows a surgical cutdown. External pressure is used to stop bleeding from the interior of the heart to the outside. Dr. Mirhoseini has documented that although the channel is sealed at the epicardial layer, it remains patent in the endocardial and myocardial layers. Laser energy is transmitted from the laser to the epicardium by means of an articulated arm device that is commonly used for CO sub 2 laser surgery.
  • the present invention improves upon the prior art by providing a non-invasive method of trans-myocardial revascularization.
  • the invention further contemplates using commercially available lithotriptors to produce focused acoustic waves.
  • the waves may be directed to heart tissue and thereby induce a controlled injury sufficient to improve cardiac function.
  • Control of the focus of the lithotriptor may provide the ability to create specific patterns of injury to the heart or to provide a diffuse injury over a relatively large portion of the heart wall.
  • Figure 1 depicts an electro-hydraulic lithotriptor.
  • Figure 2 depicts a diffuse injury pattern.
  • Figure 3 depicts an array of injuries.
  • Figure 4 depicts a stereotactic lithotriptor.
  • FIG. 1 depicts a patent 10 positioned in tank 15. Tank 15 is filled with water 17.
  • Figure 1 further depicts a spark gap electrode 20 which generates shock waves 30. Shock waves 30 propagate through water 17 until shock waves 30 contact patient 10.
  • the shock wave 30 may be directed to any part of the patient's body 10 through careful positioning of the patient 10 relative to the electrode 20 and by using a parabolic reflector 25 to focus the wave 30.
  • Electro-hydraulic systems create a diverging pulse or explosion of energy which may be distributed over an area of 15-20 square mm.
  • Other systems include piezoelectric methods are available from Wolf. Inc. and electromagnetic methods from Siemens.
  • piezoelectric systems create a focused shock wave by arranging a number of piezoelectric crystals in an array. That array may be affixed to the interior surface of a concave dish and thereby create focused waves.
  • the converging wave of piezoelectric system may be focused on an area as small as 2-3 square mm.
  • this system may be used with a patient who is positioned on a cushion or bag which is filled with water or an acoustic gel.
  • any of the known lithotripsy systems available may, in the inventive method, be used to create an injury to cardiac tissue.
  • energy from the lithotriptor 35 may be diffusely focused on a relatively large portion 40 of the heart.
  • Figure 3 depicts lithotriptor 35 intensely focused on the heart in such a way as to produce an array 45 of injured tissue.
  • Careful control of the lithotripsy system may be required to take full advantage.
  • the system may be controlled by an ECG gating system to time the pulses with the patient's heart beats.
  • ECG gating system to time the pulses with the patient's heart beats.
  • Other acoustic or x-ray imaging systems could be used to control the focal point of the wave as the heart is moving.
  • Figure 4 depicts a stereotactic lithotripsy system which uses a number (3 shown) of spark gap wave generators 20 to direct and manipulate the pressure waves 30 from different angles for more precise control of the location of the injury to patient 10.
  • An advantage of this system is that each of the generators 20 can be of lower energy but the focal points sees the same effective energy. This will result in precise focusing with little collateral damage to surrounding tissue.
  • drugs or genes may also be provided to augment the procedure and thereby improve any angiogenic affect.
  • a wide variety of drugs or genes are known in the art including but not limited to thrombolytics, glycoproteins, anti-thrombotics, recombinant glycoproteins, anti-proliferatives, recombinant glycoproteins, antiarrhythmics, peptides, beta blockers, calcium channel blockers, recombinant peptide/proteins, vasodilators, recombinant peptide/proteins, genetic material, vasoconstrictors, inorganic ions or glycoproteins.
  • Drugs may delivered locally, systemically or directly to a desired area of the heart. Drugs may be delivered before, after or during the lithotripsy procedure. While the specification describes the preferred designs, materials, methods of manufacture and methods of use, those skilled in the art will appreciate the scope and spirit of the invention with reference to the appended claims.

Abstract

A method of producing an angiogenic response in heart tissue using a lithotriptor.

Description

Method of Using Focused Pressure Fronts in Myocardial Revascularization
Field of the Invention
The present invention generally relates to cardiovascular disease. More specifically, the invention relates to myocardial revascularization. Those skilled in the art will recognize the benefits of applying the present invention to similar fields not discussed herein.
Background of the Invention
Extra-corporeal shock-wave lithotripsy (lithotripsy) is a medical procedure that has traditionally been used to disintegrate renal (kidney) stones. The term, lithotripsy is derived from a Greek work which literally means "stone crushing". This medical "stone crushing" technique has been demonstrated to be effective on kidney, upper ureteral and biliary stones (gallstones) in human patients. The technique is noninvasive and eliminates the need for the more conventional stone removal procedures, such as open surgery.
The number and variety of medical methods available to repair the effects of cardiovascular disease has increased rapidly over the last several years. More particularly, alternatives to open heart surgery and cardiovascular by-pass surgery have been extensively investigated, resulting in non-surgical procedures such as percutaneous transluminal coronary angioplasty, laser angioplasty, and atherectomy. These procedures are primarily directed toward the reduction of stenosis within the vasculature of a patient by either expanding the lumen through the use of a balloon, or ablating or otherwise removing the material making up the stenosis.
While these procedures have shown considerable promise, many patients still require bypass surgery due to such conditions as the presence of extremely diffuse stenotic lesions, the presence of total occlusions and the presence of stenotic lesions in extremely tortuous vessels. Also, some patients are too sick to successfully undergo bypass surgery, and because the above treatments require surgical backup in the case of complications, they are untreatable. Some patients requiring repeat bypass surgeries are also untreatable.
One alternative to these procedures is known as Laser Myocardial Revascularization (LMR). In LMR, channels are formed in the heart wall with a laser. These channels provide blood flow to ischemic heart muscle. A history and description of this method is presented by Dr. M. Mirhoseini and M. Cayton in "Lasers in Cardiothoracic Surgery" in Lasers in General Surgery (Williams & Wilkins; 1989) pp. 216-223.
In the procedure described therein, a CO sub 2 laser is used to produce channels in the heart wall from the epicardium through the endocardium. This procedure follows a surgical cutdown. External pressure is used to stop bleeding from the interior of the heart to the outside. Dr. Mirhoseini has documented that although the channel is sealed at the epicardial layer, it remains patent in the endocardial and myocardial layers. Laser energy is transmitted from the laser to the epicardium by means of an articulated arm device that is commonly used for CO sub 2 laser surgery.
Further research in this general field indicated that the therapeutic benefits of the LMR procedure might not have been caused by increased perfusion but, instead, were an angiogenic affect stimulated by an injury to the heart wall. Typically, the heart does not re-grow muscle tissue which is dead. Angiogenises is the growth of vibrant muscle tissue in areas that have necrossed. Other methods of causing a heart wall injury include spark-ablation, mechanical injury, and direct injection of fluid. At a minimum, all know procedures currently are invasive or minimally invasive. Certainly, a non-invasive method of creating an angiogenic affect would be advantageous.
Summary of the Invention
The present invention improves upon the prior art by providing a non-invasive method of trans-myocardial revascularization. The invention further contemplates using commercially available lithotriptors to produce focused acoustic waves. The waves may be directed to heart tissue and thereby induce a controlled injury sufficient to improve cardiac function. Control of the focus of the lithotriptor may provide the ability to create specific patterns of injury to the heart or to provide a diffuse injury over a relatively large portion of the heart wall.
Brief Description of the Drawings
Figure 1 depicts an electro-hydraulic lithotriptor. Figure 2 depicts a diffuse injury pattern. Figure 3 depicts an array of injuries. Figure 4 depicts a stereotactic lithotriptor.
Detailed Description of the Invention
The following detailed description should be read with reference to the drawings in which like elements in different drawing are numbered identically. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention.
Examples of constructions, materials, dimensions, and manufacturing processes are provided for selected elements. All other elements employ that which is known to those skilled in the field of the invention. Those skilled in the art will recognize that many of the examples provided have suitable alternatives that may also be used.
Lithotripsy requires a patient to be immersed in a large tank of water. Figure 1 depicts a patent 10 positioned in tank 15. Tank 15 is filled with water 17. Figure 1 further depicts a spark gap electrode 20 which generates shock waves 30. Shock waves 30 propagate through water 17 until shock waves 30 contact patient 10. The shock wave 30 may be directed to any part of the patient's body 10 through careful positioning of the patient 10 relative to the electrode 20 and by using a parabolic reflector 25 to focus the wave 30.
In general, the system depicted is an electro-hydraulic spark gap lithotriptor, which is commercially available from Dornier Medical Systems. Electro-hydraulic systems create a diverging pulse or explosion of energy which may be distributed over an area of 15-20 square mm. Other systems include piezoelectric methods are available from Wolf. Inc. and electromagnetic methods from Siemens.
These other systems do not necessarily incorporate a tank of water. For example, piezoelectric systems create a focused shock wave by arranging a number of piezoelectric crystals in an array. That array may be affixed to the interior surface of a concave dish and thereby create focused waves. Advantageously, the converging wave of piezoelectric system may be focused on an area as small as 2-3 square mm. Furthermore, this system may be used with a patient who is positioned on a cushion or bag which is filled with water or an acoustic gel.
Any of the known lithotripsy systems available may, in the inventive method, be used to create an injury to cardiac tissue. As depicted in Figure 2, energy from the lithotriptor 35 may be diffusely focused on a relatively large portion 40 of the heart. Alternatively, Figure 3 depicts lithotriptor 35 intensely focused on the heart in such a way as to produce an array 45 of injured tissue.
Careful control of the lithotripsy system may be required to take full advantage. For instance, the system may be controlled by an ECG gating system to time the pulses with the patient's heart beats. Other acoustic or x-ray imaging systems could be used to control the focal point of the wave as the heart is moving.
Figure 4 depicts a stereotactic lithotripsy system which uses a number (3 shown) of spark gap wave generators 20 to direct and manipulate the pressure waves 30 from different angles for more precise control of the location of the injury to patient 10. An advantage of this system is that each of the generators 20 can be of lower energy but the focal points sees the same effective energy. This will result in precise focusing with little collateral damage to surrounding tissue.
It may be appreciated that drugs or genes may also be provided to augment the procedure and thereby improve any angiogenic affect. A wide variety of drugs or genes are known in the art including but not limited to thrombolytics, glycoproteins, anti-thrombotics, recombinant glycoproteins, anti-proliferatives, recombinant glycoproteins, antiarrhythmics, peptides, beta blockers, calcium channel blockers, recombinant peptide/proteins, vasodilators, recombinant peptide/proteins, genetic material, vasoconstrictors, inorganic ions or glycoproteins. Drugs may delivered locally, systemically or directly to a desired area of the heart. Drugs may be delivered before, after or during the lithotripsy procedure. While the specification describes the preferred designs, materials, methods of manufacture and methods of use, those skilled in the art will appreciate the scope and spirit of the invention with reference to the appended claims.

Claims

We claim:
1. A method for producing a controlled injury response in heart tissue comprising: focusing Shockwave energy on the heart tissue.
2. The method of claim 1 further comprising: providing a lithotriptor; and controlling the lithotriptor such that the Shockwave energy is focused on the cardiac tissue.
3. The method of claim 1 further comprising: focusing the Shockwave energy relatively diffusely about the cardiac tissue such that the energy is distributed over a relatively large amount of cardiac tissue.
4. The method of claim 1 further comprising: focusing the Shockwave energy on a relatively small amount of cardiac tissue.
5. The method of claim 4 further comprising: focusing the Shockwave energy on several different portions of the cardiac tissue such that an array of injuries is created.
6. The method of claim 2 further comprising: providing controls which may time a pulse of Shockwave energy with a beat of the heart.
7. The method of claim 2 further comprising: providing a stereotactic lithotripsy system.
8. The method of claim 1 further comprising: providing a drug or gene to the cardiac tissue before, after or during focusing of Shockwave energy upon the cardiac tissue.
9. A method for inducing angiogenesis in a human heart comprising: focusing a shock wave on the heart.
10. The method of claim 9 further comprising: providing a lithotriptor as a source of the shock wave.
1 1. The method of claim 10 further comprising: providing at least two lithotriptors aligned such that the shock waves produced by the lithotriptors impact the heart from different directions.
12. The method of claim 9 further comprising: controlling the timing of the shock waves to coincide with the beating of the heart.
13. The method of claim 9 further comprising: producing a diffuse injury to the heart.
14. The method of claim 9 further comprising: producing an array of injured areas on the heart.
15. The method of claim 9 further comprising: introducing a drug or gene into the heart.
16. A system for producing an angiogenic injury in a human heart comprising: an array of lithotriptors focused on the heart.
17. The system of claim 16 further comprising controls which time pressure waves generated by the lithotriptor to coincide with beating of the heart.
PCT/US2000/004484 1999-02-23 2000-02-22 Method of using focused pressure fronts in myocardial revascularization WO2000049952A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13717199P 1999-02-23 1999-02-23
US60/137,171 1999-02-23

Publications (1)

Publication Number Publication Date
WO2000049952A1 true WO2000049952A1 (en) 2000-08-31

Family

ID=22476121

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2000/004484 WO2000049952A1 (en) 1999-02-23 2000-02-22 Method of using focused pressure fronts in myocardial revascularization

Country Status (1)

Country Link
WO (1) WO2000049952A1 (en)

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7704222B2 (en) 1998-09-10 2010-04-27 Jenavalve Technology, Inc. Methods and conduits for flowing blood from a heart chamber to a blood vessel
US10993805B2 (en) 2008-02-26 2021-05-04 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US11065138B2 (en) 2016-05-13 2021-07-20 Jenavalve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US11185405B2 (en) 2013-08-30 2021-11-30 Jenavalve Technology, Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US11197754B2 (en) 2017-01-27 2021-12-14 Jenavalve Technology, Inc. Heart valve mimicry
US11337800B2 (en) 2015-05-01 2022-05-24 Jenavalve Technology, Inc. Device and method with reduced pacemaker rate in heart valve replacement
US11357624B2 (en) 2007-04-13 2022-06-14 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
US11517431B2 (en) 2005-01-20 2022-12-06 Jenavalve Technology, Inc. Catheter system for implantation of prosthetic heart valves
US11564794B2 (en) 2008-02-26 2023-01-31 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US11589981B2 (en) 2010-05-25 2023-02-28 Jenavalve Technology, Inc. Prosthetic heart valve and transcatheter delivered endoprosthesis comprising a prosthetic heart valve and a stent

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3146628A1 (en) * 1981-11-25 1983-06-01 Dornier System Gmbh, 7990 Friedrichshafen "RELEASE DEVICE FOR SHOCK WAVES FOR THERAPEUTIC PURPOSES"
US4693247A (en) * 1986-09-29 1987-09-15 Trutek Research, Inc. Triggering circuit
DE3812838A1 (en) * 1987-03-21 1989-11-02 Schubert Werner Small unit for the shock wave treatment of disorders
US4957099A (en) * 1988-02-10 1990-09-18 Siemens Aktiengesellschaft Shock wave source for extracorporeal lithotripsy
DE4312264A1 (en) * 1993-04-15 1994-10-20 Siemens Ag Pulsed ultrasonic source for therapeutic treatment of heart tissue
DE19543741C1 (en) * 1995-11-24 1997-05-22 Wolf Gmbh Richard Electroacoustic transducer generating focussed sound waves for lithotripsy
WO1998007469A1 (en) * 1996-08-22 1998-02-26 Storz Medical Ag Therapeutic method of treating the heart, etc. and device for carrying out said method

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE3146628A1 (en) * 1981-11-25 1983-06-01 Dornier System Gmbh, 7990 Friedrichshafen "RELEASE DEVICE FOR SHOCK WAVES FOR THERAPEUTIC PURPOSES"
US4693247A (en) * 1986-09-29 1987-09-15 Trutek Research, Inc. Triggering circuit
DE3812838A1 (en) * 1987-03-21 1989-11-02 Schubert Werner Small unit for the shock wave treatment of disorders
US4957099A (en) * 1988-02-10 1990-09-18 Siemens Aktiengesellschaft Shock wave source for extracorporeal lithotripsy
DE4312264A1 (en) * 1993-04-15 1994-10-20 Siemens Ag Pulsed ultrasonic source for therapeutic treatment of heart tissue
DE19543741C1 (en) * 1995-11-24 1997-05-22 Wolf Gmbh Richard Electroacoustic transducer generating focussed sound waves for lithotripsy
WO1998007469A1 (en) * 1996-08-22 1998-02-26 Storz Medical Ag Therapeutic method of treating the heart, etc. and device for carrying out said method

Cited By (14)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7704222B2 (en) 1998-09-10 2010-04-27 Jenavalve Technology, Inc. Methods and conduits for flowing blood from a heart chamber to a blood vessel
US7736327B2 (en) 1998-09-10 2010-06-15 Jenavalve Technology, Inc. Methods and conduits for flowing blood from a heart chamber to a blood vessel
US8216174B2 (en) 1998-09-10 2012-07-10 Jenavalve Technology, Inc. Methods and conduits for flowing blood from a heart chamber to a blood vessel
US8597226B2 (en) 1998-09-10 2013-12-03 Jenavalve Technology, Inc. Methods and conduits for flowing blood from a heart chamber to a blood vessel
US11517431B2 (en) 2005-01-20 2022-12-06 Jenavalve Technology, Inc. Catheter system for implantation of prosthetic heart valves
US11357624B2 (en) 2007-04-13 2022-06-14 Jenavalve Technology, Inc. Medical device for treating a heart valve insufficiency
US11154398B2 (en) 2008-02-26 2021-10-26 JenaValve Technology. Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US10993805B2 (en) 2008-02-26 2021-05-04 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US11564794B2 (en) 2008-02-26 2023-01-31 Jenavalve Technology, Inc. Stent for the positioning and anchoring of a valvular prosthesis in an implantation site in the heart of a patient
US11589981B2 (en) 2010-05-25 2023-02-28 Jenavalve Technology, Inc. Prosthetic heart valve and transcatheter delivered endoprosthesis comprising a prosthetic heart valve and a stent
US11185405B2 (en) 2013-08-30 2021-11-30 Jenavalve Technology, Inc. Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame
US11337800B2 (en) 2015-05-01 2022-05-24 Jenavalve Technology, Inc. Device and method with reduced pacemaker rate in heart valve replacement
US11065138B2 (en) 2016-05-13 2021-07-20 Jenavalve Technology, Inc. Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system
US11197754B2 (en) 2017-01-27 2021-12-14 Jenavalve Technology, Inc. Heart valve mimicry

Similar Documents

Publication Publication Date Title
US6755821B1 (en) System and method for stimulation and/or enhancement of myocardial angiogenesis
US6685640B1 (en) Ablation system
EP1633266B1 (en) Apparatus for treating atrial fibrillation using high intensity focused ultrasound
US5389096A (en) System and method for percutaneous myocardial revascularization
US7001336B2 (en) Method for treating ischemia
US5925033A (en) Method for intra-operative myocardial revascularization
US6719770B2 (en) Ultrasonic device for providing reversible tissue damage to heart muscle
EP1595576B1 (en) Non-contact tissue ablation device
US20050165298A1 (en) Treatment of cardiac tissue following myocardial infarction utilizing high intensity focused ultrasound
US20050080469A1 (en) Treatment of cardiac arrhythmia utilizing ultrasound
KR101640424B1 (en) Image Guided Plaque Ablation
WO1999049788A9 (en) Ablation system
JP4125130B2 (en) Ultrasound methods for revascularization and drug delivery
EP1602339A1 (en) Devices, systems, and methods for treating atrial fibrillation
EP0901399A4 (en)
EP1545314B1 (en) Cardiac ablation using microbubbles
WO2000049952A1 (en) Method of using focused pressure fronts in myocardial revascularization
US20050149008A1 (en) Treatment of cardiac arrhythmia utilizing ultrasound
US20130211436A1 (en) Treatment of cardiac arrhythmia utilizing ultrasound
WO2000033913A2 (en) System and method for stimulation and/or enhancement of myocardial angiogenesis
WO2022023968A1 (en) A medical device with ultrasonic waves emission
US6149649A (en) Radio frequency transmyocardial revascularization channel formation
RU2200042C2 (en) Surgical method for treating cardiac ischemia disease
Verdaasdonck et al. Ultrasonic needle system for transmyocardial revascularization: mechanism of action and efficacy compared with laser modalities

Legal Events

Date Code Title Description
AK Designated states

Kind code of ref document: A1

Designated state(s): CA JP

AL Designated countries for regional patents

Kind code of ref document: A1

Designated state(s): AT BE CH CY DE DK ES FI FR GB GR IE IT LU MC NL PT SE

121 Ep: the epo has been informed by wipo that ep was designated in this application
DFPE Request for preliminary examination filed prior to expiration of 19th month from priority date (pct application filed before 20040101)
122 Ep: pct application non-entry in european phase