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

Abstract

Methods for treating anatomic tissue defects such as a patent foramen ovale 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 Serial 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 plac...

AI Technical Summary

Benefits of technology

The present invention provides apparatus, systems, and methods for treating anatomical defects in human tissues, particularly involving layered tissue structures such as the patent foramen ovale (PFO). The apparatus includes an elongate catheter with a housing for engaging the tissue surface and an energy transmission member for applying energy to the tissue to effect welding and closure of the defect. The methods involve positioning the closure device using a guiding member that indicates the size and orientation of the defect, and then using the guiding member to bring the closure device into apposition with the defect to achieve an effective seal. The invention can be used for treating other tissue defects such as atrial septal defects, ventricular septal defects, patent ductus arteriosus, blood vessel wall defects, and patent text describes various features and improvements of the guiding member and the treatment apparatus.

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 and other defects impractical.

None of these disclosures, however, show methods or apparatus suitable for positioning the tissues of an anatomic defect for welding or for delivering the energy to an anatomic defect to be welded.

These disclosures do not teach methods that would be particularly useful for welding layered tissue structures such as PFOs, nor do they teach bringing together tissues of a defect such that a tissue overlap is created that can then be welded together.

Frequently, scar tissue may fail to form or may form incompletely, resulting in a still patent PFO.

In addition to PFO, a number of other anatomic tissue defects, such as other ASDs, ventricular septal defects (VSDs), patent ductus arteriosis (PDA), aneurysms and other blood vessel wall defects, atrial appendages and other naturally occurring cavities within which blood clots can form, and the like cause a number of different health problems (note that the term “defect” may include a naturally occurring structure that results a potential health risk such as the clot forming in the atrial appendage).

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