Devices and methods for coronary sinus pressure relief

a technology of coronary sinus and device, applied in the field of devices, can solve the problems of few, if any, proven effective treatments, increased end-diastolic pressure, symptom, morbidity and/or mortality, etc., and achieve the effects of reducing possible pressure necrosis, increasing flexibility without decreasing strength, and increasing radiopacity

Inactive Publication Date: 2011-10-20
DC DEVICES
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0021]Yet other needs are met by providing within the opening a venting device, a prosthesis, such as an interatrial pressure vent, which in some embodiments comprises a controlled opening or an extended tubular opening, between the left atrium and right atrium that allows an amount of blood to vent from the left heart to the right heart, thereby reducing left atrial pressure and the symptoms associated with diastolic heart failure.
[0104]In embodiments, the flange segments are formed so the radius of curvature at the end is greater than about 0.03 inches. In embodiments, there is a radiopaque marker, preferably tantalum or platinum alloy, formed around, or integral with, the flange segment end to increase radiopacity and increase the area of contact between the flange segment and septum. In embodiments, the flange on the left atrium side of the septum is bent at a shorter radius of curvature than the right atrium side.

Problems solved by technology

Heart failure is a common and potentially lethal condition affecting humans, with sub-optimal clinical outcomes often resulting in symptoms, morbidity and / or mortality, despite maximal medical treatment.
This condition is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end-diastolic pressure.
Approximately one third of patients with heart failure have diastolic heart failure and there are very few, if any, proven effective treatments.
In addition to diastolic heart failure, a number of other medical conditions, including systolic dysfunction of the left ventricle and valve disease, can lead to elevated pressures in the left atrium.
Increased left atrial pressure often causes acute or chronic breathlessness amongst other problems.
In addition, a variety of heart conditions can lead to “right heart failure”, which can result in enlargement of the liver (hepatomegaly), fluid accumulation in the abdomen (ascites) and / or swelling of the lower limbs.
As blood backs up into the pulmonary system, fluid leaks into the lungs and causes pulmonary edema.
Blood volume going to the atrium reduces volume of blood going forward into the aorta causing low cardiac output.
Excess blood in the atrium over-fills the ventricle during each cardiac cycle and causes volume overload in the left ventricle.
Heart failure with such symptoms is a common and potentially lethal condition affecting humans, with sub-optimal clinical outcomes often resulting in symptoms, morbidity and / or mortality, despite maximal medical treatment.
This condition is characterized by a stiff left ventricle with decreased compliance and impaired relaxation, which leads to increased end-diastolic pressure.
Approximately one third of patients with heart failure have diastolic heart failure and there are very few, if any, proven effective treatments.
In addition to diastolic heart failure, a number of other medical conditions, including systolic dysfunction of the left ventricle and valve disease, can lead to elevated pressures in the left atrium.
Increased left atrial pressure often causes acute or chronic breathlessness amongst other problems.
In addition, a variety of heart conditions can lead to “right heart failure”, which can result in enlargement of the liver (hepatomegaly), fluid accumulation in the abdomen (ascites) and / or swelling of the lower limbs.

Method used

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  • Devices and methods for coronary sinus pressure relief
  • Devices and methods for coronary sinus pressure relief
  • Devices and methods for coronary sinus pressure relief

Examples

Experimental program
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Effect test

embodiment 200

[0211]Referring now to FIG. 8, an interatrial pressure vent 100 is shown in its stowed configuration. In embodiments, the interatrial pressure vent can be collapsed to a substantially cylindrical shape for stowing in a delivery catheter during placement. Flange segments 102a-102h and 103a-103h can be fabricated to be substantially equal in length. The “stowed position” is not meant to apply only to devices having flange segments of equal length but rather to all embodiments of the venting device disclosed herein. Devices having flange segments of varying length and orientation such as those described herein are also designed to stow in substantially the same manner as shown in FIG. 8. In an embodiment 200 seen in FIG. 20, flange segments 202a-202h and 203a-203h are formed on a slanted angle so that, when marker elements are secured to the ends of the flange segments, the flange segments can be stowed into a smaller volume. In embodiments 300 seen in FIG. 21, flange segments 302a-302...

first embodiment

[0260]FIG. 31 depicts a mounting and loading tool useful for placing the prosthesis onto a catheter or other delivery device for delivery in vivo to a patient. In this embodiment, mounting tool 2001 includes a base plate 2002 with orifices 2003 for securing other components as shown with fasteners 2004 and pin 2009. The principal component is a loader body 2014, mounted via the outer two fasteners and orifices as shown. A mounting platform 2023 is mounted in the center of the loader body via the third orifice and pin 2009. Mounting platform 2023 includes a lower orifice 2026 for mounting to the loader body via the middle loader body orifice with pin 2009. Mounting platform 2023 also includes a slotted cam surface 2024. Pivot 2029 mounts to the loader body 2014 via pivot pin 2028 through pivot orifice 2030 and loader body orifice 2016. Pivot 2029 and lever 2031 mount on the left side of loader body 2014 below the side doors 2020, as seen in FIG. 31. Movement of pivot 2029 and lever 2...

third embodiment

[0350]a design for retrieval is depicted in FIGS. 48A and 48B. In this embodiment, prosthesis 151 is very similar to prosthesis 141 above, including retrieval sutures or wires 153 from bores 109 of the right atrium flange apices 102a-h, to a central annular retrieval suture or wire 157. Each retrieval suture or wire 153 is joined to the central retrieval thread 157 at a juncture 155. The junctures may simply be suture tie-offs; alternatively, the junctures could be orifices in central wire 157 for joining retrieval sutures or wires 153. In some embodiments, an additional retrieval suture or wire 147, suitable for non-invasive imaging, may be tied to the central thread at least at one point for grasping by a retrieval device.

[0351]A fourth embodiment of a prosthesis 161 designed for retrieval and redeployment is depicted in FIG. 49. Prosthesis 161 is similar to prosthesis 100a, described above. In the fourth embodiment, there is a retrieval wire or suture 163 secured to each apex 102...

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Abstract

A method and devices for relieving pressure in the left atrium of a patient's heart is disclosed. The method includes using an ablative catheter in a minimally invasive procedure to prepare an opening from the coronary sinus into a left atrium of the patient's heart. Once the opening is prepared, the opening may be enlarged by a technique such as expanding a balloon within the opening. A stent is then placed within the coronary sinus of the patient, with a transverse portion expanding within the opening, allowing blood to flow from the left atrium to the coronary sinus and then to the right atrium. Pressure within the left atrium is thus relieved.

Description

CROSS REFERENCE TO RELATED APPLICATIONS[0001]This application is a non-provisional of U.S. Provisional Appl. 61 / 449,566, filed Mar. 4, 2011 entitled DEVICES AND METHODS FOR CORONARY SINUS PRESSURE RELIEF. This application is also a continuation-in-part of copending U.S. Nonprovisional patent application Ser. No. 12 / 954,468, filed on Nov. 24, 2010, entitled MOUNTING TOOL FOR LOADING A PROSTHESIS, which is incorporated herein by reference in its entirety. U.S. Nonprovisional patent application Ser. No. 12 / 954,468 application claims the benefit of U.S. Provisional Patent Application having Ser. No. 61 / 240,085 entitled DEVICES AND METHODS TO TREAT HEART FAILURE filed Sep. 4, 2009, the entirety of which is incorporated herein by reference. U.S. Nonprovisional patent application Ser. No. 12 / 954,468 is also a continuation-in-part of copending U.S. Nonprovisional patent application Ser. No. 12 / 719,843, filed on Mar. 8, 2010, entitled DEVICES, SYSTEMS AND METHODS TO TREAT HEART FAILURE, and ...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61F2/82A61F2/84A61F2/06
CPCA61B17/0057A61F2230/0067A61B18/1492A61B2017/00575A61B2017/00592A61B2017/00597A61B2017/00606A61B2017/00623A61B2017/22035A61B2017/2215A61B2018/00023A61B2018/00351A61B2018/144A61F2/2403A61F2/2412A61F2/2418A61F2/2493A61F2/91A61F2002/061A61F2002/821A61L31/022A61F2/82A61M29/02A61F2250/0098A61F2220/0008A61F2220/0041A61F2220/005A61F2220/0058A61F2230/0017A61F2230/005A61F2230/0054A61B17/221A61F2/2478A61B2017/00252A61F2/954A61F2250/0069A61F2250/0067A61F2210/0014A61B2017/00247A61F2/2451A61M1/3613A61F2/844A61F2/90
Inventor MCNAMARA, EDWARD
Owner DC DEVICES
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