293 results about "Pericardium" patented technology

Devices formed of or including biocompatible polyhydroxyalkanoates are provided with controlled degradation rates, preferably less than one year under physiological conditions. Preferred devices include sutures, suture fasteners, meniscus repair devices, rivets, tacks, staples, screws (including interference screws), bone plates and bone plating systems, surgical mesh, repair patches, slings, cardiovascular patches, orthopedic pins (including bone filling augmentation material), adhesion barriers, stents, guided tissue repair / regeneration devices, articular cartilage repair devices, nerve guides, tendon repair devices, atrial septal defect repair devices, pericardial patches, bulking and filling agents, vein valves, bone marrow scaffolds, meniscus regeneration devices, ligament and tendon grafts, ocular cell implants, spinal fusion cages, skin substitutes, dural substitutes, bone graft substitutes, bone dowels, wound dressings, and hemostats. The polyhydroxyalkanoates can contain additives, be formed of mixtures of monomers or include pendant groups or modifications in their backbones, or can be chemically modified, all to alter the degradation rates. The polyhydroxyalkanoate compositions also provide favorable mechanical properties, biocompatibility, and degradation times within desirable time frames under physiological conditions.

A prosthetic valve for replacing a cardiac valve includes an expandable support member and at least two valve leaflets made of a first layer of biological material selected from peritoneal tissue, pleural tissue or pericardial tissue. A second layer of biological material is attached to the support member. The second layer is also made from peritoneal tissue, pleural tissue or pericardial tissue. The second layer includes a radially inwardly facing surface that defines a conduit for directing blood flow. The valve leaflets extend across the conduit to permit unidirectional flow of blood through the conduit. Methods for making and implanting the prosthetic valve are also provided.

Devices and methods for establishing pericardial access to facilitate therapeutic and / or diagnostic applications. Pericardial access is facilitated, in part, by a tissue grasping device that reliably holds pericardial tissue, even in the presence of fatty deposits. The tissue grasping portion may include a tissue penetrating tip, a tissue dilating distal section, a tissue retention neck, and a tissue stop. When advanced into the pericardium, the tip may serve to create an opening (e.g., pierce, cut, etc.) in the pericardium, the distal section may serve to dilate the opening, the neck may serve to hold the tissue upon recoil of the dilated opening, and the stop may serve to limit further penetration once tissue is retained in the neck.

A peritoneal ultrasound imager includes an elongated body less than about 20 inches in length that is adapted to be inserted through a cannula into or near the pericardium space, and an ultrasound transducer array at one end of the body that is suitable for ultrasound echocardiography. The cannula and ultrasound imager may be of a single piece construction. A method for imaging the heart includes introducing a cannula into the wall of a patient's chest, inserting the elongated body into the cannula, moving the inserted elongated body to a position near the heart, and imaging the heart with ultrasound echo.

The methods and apparatus for lead placement on a surface of the heart are employed using an elongated body having proximal and distal end portions. The body defines a lead receiving passageway extending between a proximal inlet and a distal outlet for receiving a lead therethrough for contact with the heart surface. The elongated body is adapted for insertion between a pericardium and an epicardial surface. At least a portion of the body may have a non-circular cross-sectional shape adapted to retain the body orientation between the pericardium and the epicardial surface.

Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Rather than trying to immobilize a living, moving organ to place the organ in the fixed frame of reference of a table-mounted robotic device, the present disclosure teaches mounting a robot in the moving frame of reference of the organ. That task can be accomplished with a wide variety of robots including a miniature crawling robotic device designed to be introduced, in the case of the heart, into the pericardium through a port, attach itself to the epicardial surface, and then, under the direct control of the surgeon, travel to the desired location for treatment. The problem of beating-heart motion is largely avoided by attaching the device directly to the epicardium. The problem of access is resolved by incorporating the capability for locomotion. The device and technique can be used on other organs and on other living bodies such as pets, farm animals, etc. Because of the rules governing abstracts, this abstract should not be used in construing the claims.

An implantable lead having an elongated lead body that includes an electrical conductor extending between a distal end of the lead body and a proximal end of the lead body is disclosed. The lead further includes an electrode formed at the distal end of the lead body, the electrode being coupled to the electrical conductor and one or more passive fixation mesh sections coupled to the distal end of the lead body that promotes tissue over growth.

Apparatus and methods are provided for excluding and reducing the volume of the left atrial appendage (“LAA”) by deploying a first tissue capture element in contact with the pericardium and a second tissue capture element in engagement with the endocardial surface adjacent to the ostium of the LAA, such that the LAA tissue is retained in a collapsed, reduced volume state therebetween. Methods of using the apparatus of the present invention to reduce or occlude the LAA also are provided.

Endoscopic subxiphoid surgical procedures and instruments facilitate translumination of tissue through the pericardium, and promote encircling an intrapericardial region with one or more tissue-ablating probes for ablating cardiac tissue substantially encircling the left and right pulmonary veins as a treatment for chronic atrial fibrillation. Such endoscopic subxiphoid surgical procedures and instruments also facilitate placement of epicardial tacks about the annulus of the mitral valve for supporting a tensioned suture or band that decreases the size of the mitral annulus to repair a regurgitant valve. Suction-oriented instruments facilitate temporary attachment to an organ to establish precise positioning on the organ during a surgical procedure.

An intraventricular blood pump is retained in position by an expandable stent placed in the aorta that anchors to the aortic wall. The pump ejects blood across the aortic valve either through a conduit or as a free stream of blood without a mechanical conduit passing between the valve leaflets. The ejection of blood causes a reactive force pushing the pump towards the ventricular apex and away from the valve. Thus, the pump may be held by three filaments connecting it to the anchoring stent. Other flexible members such as a tube made of pericardium, sutures, or a rigid rod may be used to hold the pump in place. The preferred embodiment includes an apically introduced stent anchored aortic valve having two flexible tissue leaflets and a conduit channeling blood from the pump in the ventricle into the aortic root and passing through the non-coronary sinus in the position usually occupied by the non-coronary cusp of the aortic valve. This device can be surgically implanted through a small incision without the need for cardiopulmonary bypass in elderly or severely ill patients who cannot safely undergo more invasive surgery. Pumps using durable bearings and hermetically sealed motors are combined with tissue valves such that the entire device is durable for many years.

In a method for improving cardiac function, a compressive device is inserted into an intrapericardial space about a lower end portion of a heart. Thereafter the compressive device is operated to compress and close off lower portions of both ventricles of the heart.

An apparatus for delivering a medical device onto a heart includes a housing within which is releasably disposed the medical device. The housing in one embodiment comprises inner and outer deflectors between which is delivered the medical device. Both deflectors are self-expanding. A deflector compression sheath is slidable longitudinally over the housing to a delivery position at which it moves the deflectors to a collapsed configuration. The compression sheath is retracted to a deployment position to permit the deflectors to deploy by self-expanding to their larger diameters. The outer deflector has an expanded diameter sufficient to engage the inner surface of the pericardium to hold it away from the delivery site while the second deflector guides the medical device into position over the heart while protecting the heart. In another embodiment, the housing includes only an outer deflector. The apparatus also functions as an introducer when the compression sheath is moved to the delivery or “introducer” position at which configuration, the apparatus functions as an introducer.

Embodiments of the present disclosure are directed to stents, valved-stents, and associated methods and systems for their delivery via minimally-invasive surgery.

The present invention provides one medicine composition for treating coronary heat disease ventricular premature beat based on the Chinese medicine theory of benefiting vital energy, nourishing Yin, promoting blood circulation, dredging meridian, clearing away heat-evil in the pericardium and tranquilizing. The medicine composition has 12 kinds of Chinese medicinal materials including ginseng, ophiopogon root, dogwood, red sage, common jujube seed, etc. The pharmacological test shows that the composite medicine capsule has obvious effect of preventing mouse's arrhythmia caused by CaCl2 and decreasing the sustained time of rat's arrhythmia caused by aconitine.

Apparatus and method for performing surgical procedures within the mediastinum and within the pericardium include an endoscopic cannula having a transparent tip, and an endoscope for introduction into the mediastinum and optionally into the pericardium via a single subxiphoid incision. A cavity may be initially dilated for advancing the endoscopic cannula using a dilating tool that exerts a lateral-expansive force against surrounding tissue for evaluating the endoscopic cannula to be introduced into the mediastinum. Other surgical instruments are positioned through the endoscopic cannula to cut a flap of the pericardium as an opening through which other surgical apparatus may be introduced. The endoscopic cannula may be swept around selected regions of the heart through an aperture near the apex of the heart to facilitate placement of epicardial tacks about regions of the heart.

A method of cutting tissue material of biology origin employs a plotted water-jet or RF cutting system. The cutting system is computer controlled and includes a water-jet or RF cutting means combined with a motion system. The cutting energy is selected so that communication of thermal energy into the segment beyond the edge is minimized to avoid damaging the segment adjacent the edge.

Methods, devices, and systems for accessing and penetrating an anatomical structure using suction force and energy ablation or mechanical penetration. In one aspect, a catheter is stabilized on the occlusion, a longitudinal member is advanced to penetrate the occlusion and recanalize the body vessel. In another aspect, a catheter is stabilized on the pericardium, ablation energy is delivered through a longitudinal member to create an opening on the pericardium.

A new cardiac risk factors are disclosed along with method for deriving the components of the factors, for developing the factors and for using the factors. Methods for computing pericardial fat and abdominal fat are also disclosed as well as methods for motion compensation.

An apparatus for automatically retroperfusing a coronary vein includes an intraluminal cannula having a main body portion extending between a proximal end portion and a distal end portion. The proximal end portion is for connecting to an artery outside of the pericardium to automatically supply oxygenated blood from the artery for retroperfusion. The main body portion and the distal end portion are insertable through a vein that is fluidly connected with the coronary vein and into the coronary vein. An expandable stent is attached to the distal end portion for expanding radially into engagement with the interior wall of the coronary vein to secure the distal end portion at a desired location within the coronary vein. Occluding structure for at least partially occluding the coronary vein is provided at the distal end to decrease the back-flow of blood into the right atrium during retroperfusion.

A heart valve prosthesis and a method of fabricating the same. The heart valve prosthesis uses a leaflet of pig pericardium or a leaflet of cattle pericardium, which has a suitable thickness according to the size of the valve, and a stent. The heart valve prosthesis is fabricated by placing a valve body over a Dacron body, binding the valve body to the Dacron body using stitching fiber, rolling the Dacron body into a cylindrical form such that the valve body is located inside, binding opposite edges of the Dacron body to each other using stitching fiber, and inserting the resultant structure into a stent, which is knitted using a shape memory alloy wire. The heart valve prosthesis is friendly to and is not rejected by human tissue, is free from deformation, and can be implanted using a non-invasive manner without incising the chest wall of a patient.

A product for implantation within a soft tissue site of the human or animal body comprises a pulverized or morselized matrix of a substantially non-mineralized native soft tissue (NSTM) of the human or animal body, provided in a therapeutic amount to induce growth of native tissue or organs and healing at the tissue site. The NSTM is composed of at least one soft tissue selected from the group consisting of cartilage, meniscus, intervertebral disc, ligament, tendon, muscle, fascia, periosteum, pericardium, perichondrium, skin, nerve, blood vessels, and heart valves or from organs such as bladder, lung, kidney, liver, pancreas, thyroid, or thymus. Preferably, the NSTM is composed of a soft tissue of the same type of tissue native to the repair site. In another embodiment, the NSTM includes soft tissue of a different type than the tissue repair site.

An apparatus for delivering a medical device onto a heart includes a housing within which is releasably disposed the medical device. The housing in one embodiment comprises inner and outer deflectors between which is delivered the medical device. Both deflectors are self-expanding. A deflector compression sheath is slidable longitudinally over the housing to a delivery position at which it moves the deflectors to a collapsed configuration. The compression sheath is retracted to a deployment position to permit the deflectors to deploy by self-expanding to their larger diameters. The outer deflector has an expanded diameter sufficient to engage the inner surface of the pericardium to hold it away from the delivery site while the second deflector guides the medical device into position over the heart while protecting the heart. In another embodiment, the housing includes only an outer deflector. The apparatus also functions as an introducer when the compression sheath is moved to the delivery or “introducer” position at which configuration, the apparatus functions as an introducer.

A system for creating a passage through the pericardium of a patient to permit access of a cardiac harness delivery device, including a tubular introducer sleeve and a tubular dilator sleeve insertable into the introducer sleeve. The introducer sleeve has a slot and a distal portion biased in a reduced opening. The distal end being positioned within an incision through the pericardium. Insertion of the dilator sleeve into the introducer sleeve causes it to push outwardly against the reduced opening, thereby expanding the reduced opening of the introducer sleeve sufficiently to permit a cardiac harness delivery device to access the epicardium. The introducer sleeve is releasably locked to the dilator sleeve by operation of a slot on the introducer sleeve and a protrusion on the dilator sleeve, which slides within the slot. The slot has detents that releasably lock the dilator sleeve at alternative positions within the introducer sleeve, thereby maintaining the reduced opening or, alternatively, the expanded opening to facilitate operation of a cardiac harness delivery device.

Embodiments described herein provide devices, systems, and methods that reduce the distance between two locations in tissue, often for treatment of congestive heart failure. For example, an anchor of an implant system may, when the implant system is fully deployed, reside within the right ventricle in engagement with the ventricular septum. The anchor may be deployed into the heart through a working lumen of a minimally invasive access tool. The minimally invasive access tool may have a plurality of grippers near a distal end of the working lumen. The grippers may engage epicardial tissue of the heart and may be moved radially inwardly relative so as to provide stabilization of the epicardial tissue and / or hemostasis near an access site where the anchor is inserted through the epicardium. The minimally invasive access tool may minimize blood loss from the access site and improve anchor implant processes.

Devices, systems and methods are provided which are capable of applying pressure and constraint to the heart and use the pericardium to assist in the application of the pressure and force to the heart.

A valved conduit including a bioprosthetic valve, such as a heart valve, and a tubular conduit sealed with a bioresorbable material. The bioprosthetic heart valve includes prosthetic tissue that has been treated such that the tissue may be stored dry for extended periods without degradation of functionality of the valve. The bioprosthetic heart valve may have separate bovine pericardial leaflets or a whole porcine valve. The sealed conduit includes a tubular matrix impregnated with a bioresorbable medium such as gelatin or collagen. The valved conduit is stored dry in packaging in which a desiccant pouch is supplied having a capacity for absorbing moisture within the packaging limited to avoid drying the bioprosthetic tissue out beyond a point where its ability to function in the bioprosthetic heart valve is compromised. The heart valve may be sewn within the sealed conduit or coupled thereto with a snap-fit connection.