Transventricular implant tools and devices

a technology of transventricular implant and tool, which is applied in the field of applicative treatment of a failing heart, can solve the problems of increasing the requirement of systolic contraction of the wall tension, increasing the radius of curvature, and increasing the tension within the ventricle wall

Inactive Publication Date: 2005-07-07
EDWARDS LIFESCIENCES LLC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0011] The transventricular splints placed by the tools and methods of the present invention can reduce heart wall stress throughout the cardiac cycle including end diastole and end systole. Alternately, they can be used to reduce wall stress during the portions of the cardiac cycle not including end systole. The splints which operate throughout the cardiac cycle are referred to herein as “full cycle splints”. Those splints which do not operate to reduce wall stress during end systole are referred to as “restrictive devices” or, more specifically, “restrictive splints”. Splints reduce left ventricle wall stress by altering the geometric shape of the left ventricle.
[0013] In this manner, portions of the walls of the ventricle are fixed in a drawn position reducing the radius of curvature of the majority of the ventricle and thereby reducing the tension within the ventricle wall.

Problems solved by technology

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.
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.
Additionally, because of the lack of cardiac output, there is generally a rise in ventricular filling pressure from several physiologic mechanisms.
These drug therapies offer some beneficial effects but do not stop the progression of the disease.
Heart transplantation has serious limitations including restricted availability of organs and adverse effects of immunosuppressive therapies required following heart transplantation.
However, this extremely invasive procedure reduces muscle mass of the heart.

Method used

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Examples

Experimental program
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embodiment 141

[0124]FIG. 19 is a perspective view of an alternate embodiment of an alignment device pad 141. Alternate embodiment 141 is disposed at the end of an alignment device arm 140. Pad 141 includes a funnel shape aperture 142. Aperture 142 includes a large diameter end 144 and a small diameter end 143. Large diameter end 144 is preferably disposed adjacent the heart and tension member exit point during use. A guide tube 145 can lead out from smaller diameter end 143 of aperture 142. Guide tube 145 preferably includes a bend passing through an arc of preferably between about 45° to about 135° and more preferably about 90°. The radius of the bend is preferably long enough that devices advanced through guide tube 145 are not permanently bent as a consequence of being advanced through the arc of guide tube 145. The radius of the arc is preferably about 0.05 inches to about 2 inches, and more preferably between about 0.75 inches and, most preferably about 1 inch as measured to the central axis...

embodiment 151

[0125]FIG. 20 is a perspective view of yet another alternate pad embodiment 151. Pad 151 has a similar shape to that of FIG. 18 and is disposed at the end of an alignment device arm 156. Pad 151 has an aperture 152 therethrough and a side notch 153 for transverse removal of a tension member guide and / or tension member. Extending from arm 156 is a stop arm 155 having a tension member guide stop 154 aligned with aperture 156 and spaced from pad 151. In use, stop 154 is disposed on the opposite side of pad 151 from the heart. As a tension member guide 157 is advanced from the heart through aperture 152, advancement of the tip of guide 157 is limited by needle stop 154. Stop 154 thus can limit additional advancement of guide 157 which might injure tissue adjacent to the heart.

[0126]FIG. 21 is a perspective view of an alignment device guide tube 165. Alignment device guide tube 165 preferably includes a luer lock or similar coupling 166 releasably connectable to a corresponding coupling ...

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Abstract

A method and implantation tools for placing a transventricular splint including a tension member. The method includes gaining access to the patient's hearts and identifying entry or exit points for the tension member, marking those locations and delivering the tension member. Anchors for the tension member are also delivered. The length of the tensions member is measured and the walls of the heart drawn together. The pads are secured to the tension member and the tension member is trimmed to length. The pads are secured to the heart surface.

Description

RELATED APPLICATIONS [0001] This application is related to U.S. application Ser. No. ______, filed on date even herewith and entitled “Stress Apparatus and Method” and U.S. application Ser. No. ______, filed on date even herewith and entitled “Heart Wall Tension Reduction Apparatus and Method”, both of which are incorporated herein by reference.FIELD OF THE INVENTION [0002] 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 implanting a device for reducing wall stress in the failing heart. BACKGROUND OF THE INVENTION [0003] 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...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61B17/00A61B17/04A61B17/122A61B19/00
CPCA61B17/00234A61B17/1227A61B19/54A61B2017/00243A61B2017/0404A61F2250/0003A61B2017/048A61B2017/0496A61B2019/464A61F2/2487A61B2017/0441A61B90/39A61B2090/064
Inventor MORTIER, TODD J.SCHWEICH, CYRIL J. JR.VIDLUND, ROBERT M.KEITH, PETER T.PAULSON, THOMAS M.KUSZ, DAVID A.
Owner EDWARDS LIFESCIENCES LLC
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