Methods and apparatus to achieve a closure of a layered tissue defect

Abstract

Methods for treating anatomic tissue defects such as a patent foramen ovate generally involve positioning a distal end of a catheter device at the site of the defect, exposing a housing and energy transmission member from the distal end of the catheter, engaging the housing with tissues at the site of the defect, applying suction or other approximating tool to the tissue via the housing to bring the tissue together, and applying energy to the tissue with the energy transmission member or to deliver a clip or fixation device to substantially close the defect. Apparatus generally include a catheter body, a housing extending from a distal end of the catheter body for engaging tissue at the site of the defect, and further adapted to house a fusing or fixation device such as an energy transmission member adjacent a distal end of the housing, or a clip or fixation delivery element.

Description

CROSS-REFERENCES TO RELATED APPLICATIONS [0001] The present application is a non-provisional of U.S. patent application Ser. No. 60 / 670,535 (Attorney Docket No. 022128-000700US), filed Apr. 11, 2005, the full disclosure of which is incorporated herein by reference.BACKGROUND OF THE INVENTION [0002] The invention generally relates to medical devices and methods. More specifically, the invention relates to positioning closure devices, including energy based devices and methods for treatment of anatomic defects in human tissue, such as a patent foramen ovale (PFO), atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosis (PDA), left atrial appendages (LAA), blood vessel wall defects and other defects having layered and apposed tissue structures. [0003] The following is an example of how one particular type of anatomical defect, a PFO, is formed. Fetal blood circulation is very different from adult circulation. Because fetal blood is oxygenated by the placen...

AI Technical Summary

Benefits of technology

[0015] The present invention provides apparatus, systems and methods for treating anatomic defects in human tissues, particularly defects involving tissue layers where it is desired to weld or fuse the layers together, such as a patent foramen ovale (PFO). The methods will also find use with closing a variety of other defects which may or may not display layered tissue structures, such as atrial septal defects, ventricular septal defects, patent ductus arteriosis, left atrial appendages, blood vessel wall defects, and the like. For the treatment of PFOs, the apparatus will usually comprise endovascular/intravascular catheters having an elongate catheter body with a proximal end and a distal end. A housing may be positioned at or near a distal end of the catheter body, where the housing has an opening for engaging a tissue surface where the tissue defect may be present. Usually, the housing will be connectable to a vacuum source to enhance engagement of the housing against the tissue, and an energy tran

Problems solved by technology

It has been estimated that patients with PFOs who have already had cryptogenic strokes may have a risk of having another stroke.

The cost and potential side-effects and complications of such a procedure must be low, however, since the event rate due to PFOs is relatively low.

Currently available interventional therapies for defect closure are generally fairly invasive and/or have potential drawbacks.

Performing open heart surgery purely to close an asymptomatic PFO or even a very small ASD, however, would be very hard to justify.

Although available devices may work well in some cases, they also face a number of challenges.

Relatively frequent causes of complications include, for example, improper deployment, device embolization into the circulation and device breakage.

In some instances, a deployed device does not heal into the septal wall completely, leaving an exposed tissue which may itself be a nidus for thrombus formation.

Furthermore, currently available devices are generally complex and expensive to manufacture, making their use for prophylactic treatment of PFO an

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