US20140142689A1 - Device and method of treating heart valve malfunction - Google Patents

Device and method of treating heart valve malfunction Download PDF

Info

Publication number
US20140142689A1
US20140142689A1 US13/691,087 US201213691087A US2014142689A1 US 20140142689 A1 US20140142689 A1 US 20140142689A1 US 201213691087 A US201213691087 A US 201213691087A US 2014142689 A1 US2014142689 A1 US 2014142689A1
Authority
US
United States
Prior art keywords
chord
valve leaflet
heart
recited
anchor
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US13/691,087
Inventor
Didier De Canniere
Christophe Moureaux
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Corquest Medical Inc
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to US13/691,087 priority Critical patent/US20140142689A1/en
Assigned to CORQUEST MEDICAL, INC. reassignment CORQUEST MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: DE CANNIERE, Didier, MOUREAUX, CHRISTOPHE
Priority to US13/967,647 priority patent/US10159571B2/en
Priority to EP13856513.0A priority patent/EP2922502B1/en
Priority to PCT/US2013/070972 priority patent/WO2014081809A2/en
Priority to AU2013348100A priority patent/AU2013348100C1/en
Priority to CA2891356A priority patent/CA2891356A1/en
Priority to JP2015544111A priority patent/JP2015535465A/en
Publication of US20140142689A1 publication Critical patent/US20140142689A1/en
Priority to IL238933A priority patent/IL238933A0/en
Priority to JP2018005752A priority patent/JP2018061855A/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2466Delivery devices therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064Surgical staples, i.e. penetrating the tissue
    • A61B17/0643Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068Surgical staplers, e.g. containing multiple staples or clamps
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2454Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
    • A61F2/2457Chordae tendineae prostheses
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482Needle or suture guides
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409Instruments for applying suture anchors
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0427Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
    • A61B2017/0437Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being resilient or spring-like
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0446Means for attaching and blocking the suture in the suture anchor
    • A61B2017/0448Additional elements on or within the anchor
    • A61B2017/045Additional elements on or within the anchor snug fit within the anchor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0464Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue

Definitions

  • the present invention is directed to an instrument assembly and method of use and application in the treatment of heart valve malfunction.
  • the instrument assembly is specifically adapted to treat mitral regurgitation by means of a direct entry of the instrument through the atrial wall rather than through the vascular system, in order to apply sufficient tension to a prolapsing leaflet, including the anterior leaflet and/or the posterior leaflet of the mitral valve, in order to overcome mitral regurgitation.
  • the human heart is a four chambered pump that moves blood efficiently through the vascular system.
  • blood enters the heart through the vena cava and flows into the right atrium. Thereafter, blood flows from the right atrium through the tricuspid valve and into the right ventricle.
  • blood is forced through the pulmonic valve and into the lungs for oxygenation.
  • the oxygenated blood returns from the lungs and enters the heart through the left atrium and passes through the mitral valve into the left ventricle.
  • the blood therein flows through the aortic valve and into the aorta and throughout the vascular system.
  • the mitral valve is disposed in flow regulating communication between the left atrium and the left ventricle. It is composed of two valve leaflets, the mitral valve annulus, which forms a ring that supports the valve leaflets; papillary muscles, which tether the valve leaflets to the left ventricle wall, by preventing them from prolapsing back into the left atrium. Chordae tendineae serve to connect the mitral valve leaflets to the papillary muscles thereby further preventing the leaflets from prolapsing back into the left atrium. A dysfunction of any of these components of the mitral valve can cause “mitral regurgitation”. Mitral regurgitation is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood.
  • mitral regurgitation is the second most common form of valvular heart disease.
  • the anterior and posterior valve leaflets of the mitral valve overlap during contraction of the left ventricle and prevent blood from flowing back into the left atrium.
  • This overlap of the 2 leaflets leaning upon each other is called the coaptation and absorbs most of the strain on the mitral apparatus during the ventricular contraction.
  • the mitral valve malfunctions, due to various cardiac diseases, the leaflets are no longer coapting resulting in the mitral valve remaining partially open during ventricular contraction. In turn this allows the “regurgitation” of the blood back into the left atrium, as generally set forth above.
  • Methods of treating conditions relating to the malfunctioning of the heart valve specifically including valve incompetencies, mitral valve leakage and other heart failure conditions may be in various stages of development such as the extending of an elongate member transverse across a corresponding or affected heart chamber.
  • Each end of the elongate member extends through a wall of the heart such as the septum wall and an oppositely disposed wall portion, wherein first and second anchoring members are connected to corresponding ends of the elongate member but are disposed external of the heart chamber.
  • Connecting clips or the like are applied to the corresponding exterior ends of the elongate member, resulting in the papillary muscles within the chamber to be effectively repositioned.
  • a predetermined force is applied to the heart itself and/or the affected portions of the heart chamber.
  • mitral regurgitation sometimes may include the replacement of the mitral valve, resulting in traumatic and frequently dangerous surgical procedures being performed on a patient.
  • the present invention is directed to an instrument assembly and attendant method for treating heart valve malfunction.
  • the instrumentation and method are specifically, but not exclusively, adapted for the treatment of mitral regurgitation.
  • the subject instrument assembly and method will be described generically regarding treatment of a predetermined heart valve.
  • the present invention will be more specifically described in regard to a procedure involving correction of a prolapsing mitral valve leaflet, which may include the anterior mitral valve leaflet and/or the posterior valve leaflet correcting of mitral regurgitation.
  • the instrument assembly of the present invention includes an introductory sheath formed of a material of sufficient rigidity to facilitate the penetration and passage through various portions of the heart and mitral valve.
  • the introductory sheath may be said to be formed of at least a “semi-rigid” material.
  • this term is to be understood to include material having sufficient flexibility to be manipulated or “steered” through and/or along a predetermined path during the delivery of the sheath and associated components of the instrument assembly to predetermined portions of the heart.
  • the sheath will be sufficiently maneuverable to pass through the atrial wall into interior portions of the heart such as the left atrium and left ventricle.
  • an introduction assembly and a delivery catheter will be used to facilitate the positioning the introductory sheath into the thoracic cavity and through the atrial wall or other preferred exterior locations of the heart wall.
  • Additional structural operative features of the instrument assembly include the provision and utilization of at least one, or under required circumstances, more than one elongated chord formed of a biocompatible material and being at least partially flexible.
  • the material from which the chord is formed should have sufficient and/or predetermined tensile strength to exert a predetermined tension on the predetermined, prolapsing valve leaflet as the chord extends between a corresponding portion of the heart wall, such as the ventricular wall, as also more fully described hereinafter.
  • the chord is initially housed concentrically within the interior of the introductory sheath, wherein the sheath and the chord are concurrently movable relative to the heart as well as throughout a portion of the interior thereof.
  • the introductory sheath is formed of a material having physical characteristics that allow it to be accurately manipulated so as to be steerable in such a manner that its tip can aim towards the different designated portions of the anterior or posterior mitral valve leaflets that are in the siege of the prolapse.
  • the exteriorly concentric introductory sheath is movable relative to and along the length of the chord so as to accommodate proper and intended placement and anchoring of the chord within the heart chamber. Therefore, the sheath is movable with the chord into and through predetermined portions of the heart chamber and movable relative to the chord after proper anchoring, securing and/or intended placement of the chord within the heart chamber.
  • the instrument assembly of the present invention also includes an anchor secured to an outer or distal end of the chord.
  • the anchor may also be sufficiently sharpened, pointed or otherwise configured to penetrate an intended heart valve leaflet, such as a prolapsing leaflet of the mitral valve. Further, the penetration and passage of the anchor, the chord, and the introductory sheath substantially through the predetermined valve leaflet may thereby be facilitated.
  • the anchor When properly positioned, the anchor is structured to be secured to a substantially opposing portion of the heart wall, such as the ventricular wall associated with the left ventricle and/or the papillary muscles associated therewith.
  • a gripping structure may be operatively attached to a remainder of the anchor and disposable into an outwardly and/or radially extending orientation. When so disposed, the gripping structure, in combination with the remainder of the anchor, eliminates or significantly restricts the inadvertent detachment of the anchor, and the distal end of the chord attached thereto, from the corresponding ventricular wall portion.
  • the anchor and the gripping structure are disposed and applied so as to penetrate the corresponding portion of the ventricular wall but not extend there through. Therefore, the anchored relation of the gripping structure, anchor and the connected distal end of the chord may be defined by a penetration into the interior of the ventricular wall rather than a passage completely there through. Complications associated with sealing and exterior attachment of the chord to the exterior of the ventricular wall are thereby eliminated.
  • the present invention further comprises a method of treating heart and valve malfunction utilizing the instrument as generally set forth above.
  • the attendant method comprises, at least in more generic terms, the passing of a portion of the instrument assembly into an intended heart chamber and into penetrating relation to a predetermined valve leaflet, such as a prolapsing leaflet.
  • a predetermined valve leaflet such as a prolapsing leaflet.
  • the sheath, with the chord concentrically disposed on the interior thereof, is passed through the predetermined valve leaflet. Therefore, by virtue of the enclosed disposition of the chord, the chord and sheath will concurrently enter and extend through the predetermined valve leaflet.
  • the sheath and the chord will extend across a corresponding heart chamber and into an anchored relation with a substantially opposing portion of the heart wall.
  • the sheath is withdrawn from heart chamber in which the chord is anchored. More specifically, the sheath is withdrawn by moving relative to and back along the length of the anchored chord in a direction away from the anchor and connected distal end of the chord. The introductory sheath is further withdrawn back through the predetermined valve leaflet while the proximal portion of the chord remains within the valve leaflet.
  • a securing assembly is operatively disposed within the heart chamber in interconnecting relation between a proximal extremity of the chord and the predetermined valve leaflet.
  • the securing assembly may include a securing member, which will be mounted on or connected to a proximal portion of the chord and moved along the length thereof into a predetermined, interconnecting position relative to the prolapsing valve leaflet.
  • the position of the securing member will be tailored to and disposed at the exact position needed to achieve correction of the mitral regurgitation, which may be determined by preoperative transoesopageal echography or other preoperative manner, to quantify the occurring mitral regurgitation preoperatively.
  • the securing member then securely interconnects the proximal extremity of the chord to the predetermined valve leaflet and any excess length of the chord will be severed or detached from the proximal extremity of the chord, which is secured to the surface of the leaflet associated with the atrium.
  • the chord is thereby properly tensioned between the opposing, interior corresponding wall portion of the heart and the predetermined valve leaflet so as to overcome the malfunction of the predetermined valve leaflet as explained in more specific details hereinafter.
  • the instrument assembly and attendant method of the present invention is specifically adapted for the treatment of mitral regurgitation.
  • the introductory sheath and the chord substantially concurrently enter the atrial wall of the left atrium and pass into the interior thereof. Further, the sheath and the chord penetrate and are passed, substantially concurrently, through a prolapsing (flail) anterior or posterior leaflet of the mitral valve into the left ventricle of the heart chamber. Thereafter the sheath and chord are concurrently extended transversely across the left ventricle, wherein the anchor penetrates and is thereby secured in an anchored relation with a substantially opposing portion of the ventricular wall and/or corresponding papillary muscles. The distal end of the chord is connected to the anchor and is thereby secured in an anchored relation to the ventricular wall, by virtue of the penetrating anchor.
  • the sheath is withdrawn back along the length of the chord, away from the anchor and the ventricular wall to which the distal portion of the chord is secured. Moreover, the introductory sheath continues to travel back along the length of the chord through the prolapsing anterior or posterior mitral valve leaflet to a location at least exterior to the leaflet, such as within the left atrium and possibly exteriorly of the heart itself.
  • a securing assembly is then operatively associated with the instrument and is movably disposed along the length of a proximal portion of the chord.
  • the movement of the securing assembly and its associated securing member are disposed into an interconnecting position between a proximal extremity of the chord and the mitral valve leaflet penetrated by the chord.
  • proper tensioning is thereby placed on the prolapsing mitral valve leaflet in order to restore a sufficient surface of coaptation between its counterpart, opposing leaflet and maintain the suppressed leaflet in an operative position sufficient to overcome the mitral regurgitation.
  • FIG. 1 is a perspective view of one preferred embodiment of the instrument assembly of the present invention used in the treatment of heart valve malfunction.
  • FIG. 1A is a perspective view of the instrument assembly of the embodiment of FIG. 1 in an initially introductory position.
  • FIGS. 2 through 9 are schematic representations of successive steps in the attendant method of utilizing and applying the instrument assembly of the embodiment of FIGS. 1 and 1A specifically for the treatment and correction of mitral regurgitation.
  • the instrument assembly of the present invention is schematically and generally indicated as 10 and is used for the treatment of heart valve malfunction generally and more specifically for the treatment of mitral regurgitation.
  • the instrument assembly 10 includes an elongated delivery catheter or tube 12 having a hollow interior and structured to deliver operative portions of the instrument assembly 10 to the treatment site within the heart of a patient.
  • the elongated delivery catheter or tube 12 is dimensioned and configured to enter the chest cavity through appropriate introduction instrumentation.
  • the delivery tube 12 is formed of a material and/or includes positioning structure or linkage incorporated therein which facilitates the maneuvering or steering thereof to a point at least generally exterior the heart and more specifically the atrial wall of the left atrium.
  • the at least semi-rigid material of the delivery tube 12 should be sufficient to also facilitate proper manipulation so as to position or “steer” the remainder of the instrument assembly 10 to the intended location within the interior thereof, as well as facilitate penetration of and anchoring to intended tissue portions.
  • the instrument assembly 10 also includes an introductory sheath 14 movable within the delivery tube 12 and an elongated flexible material chord 16 .
  • the introductory sheath 14 is concentrically and movably enclosed within the delivery tube 12 and the sheath 14 is movably disposed concentrically about the chord 16 .
  • FIG. 1 represents a completely assembled instrument assembly 10 .
  • the various portions of the instrument assembly 10 are used in successive steps to accomplish installation relative to the affected portions of the heart valve being treated.
  • the instrument assembly 10 further includes the elongated flexible material chord 16 which may be formed of a synthetic, biocompatible material.
  • An anchor 18 is fixedly secured to the outer or distal end of the chord 16 and is movable therewith relative to the introductory sheath 14 .
  • chord 16 is at least initially enclosed concentrically within the interior of the introductory sheath 14 , wherein the sheath 14 is movable along the length of the chord 16 .
  • the sheath includes an open distal end 14 ′ serving to at least partially encloses or be registered alignment with the anchor 18 . Therefore, FIG. 1A represents cooperative portions of the instrument assembly 10 at least upon initial entry of the introductory sheath 14 and anchor 18 into the interior of the heart 30 , as specifically described in detail in FIGS. 2 through 9 , hereinafter described.
  • the positioning of the anchor 18 , the introductory sheath 14 and the chord 16 is such that the chord 16 is disposed within the interior of the introductory sheath 14 .
  • the anchor 18 is disposed at least partially within and/or in an exposed relation to the open distal end 14 ′ of the sheath 14 .
  • the anchor 18 has a sharpened, pointed or other appropriate configuration for penetrating portions of the heart.
  • the anchor 18 may also include a gripping structure 20 which may be initially disposed in a collapsed position when the anchor 18 is in registry with the distal opening 14 ′ of the sheath 14 .
  • the gripping structure 20 may include an inherent bias causing it to expand outwardly and/or radially from the remainder of the anchor 18 .
  • This gripping structure 20 is provided to facilitate a secure engagement of the anchor 18 with predetermined heart wall portions, when the instrument assembly 10 is properly applied in the treatment of the heart valve malfunction.
  • the assembled representation of the instrument assembly 10 further includes the provision of a securing member 22 which may travel along the length of the chord 16 .
  • the securing member may be forcibly positioned into an intended interconnecting location relative to a heart valve leaflet in order to accomplish a secure attachment of the chord 16 to the leaflet as will be explained in greater detail hereinafter.
  • Such an interconnecting placement of the securing member 22 relative to both the chord 16 and the affected valve leaflet serves to establish and maintain a sufficient tension and/or positioning force on the predetermined valve leaflet to suppress movement thereof, as explained hereinafter with regard to FIGS. 2 through 9 .
  • the heart is generally indicated as 30 and includes the representative portions including the left atrium 32 , the left ventricle 34 and the mitral valve 36 , including the anterior and posterior mitral valve leaflets 38 and 38 ′, respectively.
  • the left ventricle 34 is at least partially bordered or surrounded by ventricular wall 40 which may be directly associated with corresponding papillary muscles (not shown) facilitating the proper positioning of the mitral valve leaflets 38 and 38 ′ through organic tissue tethering, as generally outlined above.
  • FIGS. 2-9 schematically represent the instrument assembly 10 used on the anterior leaflet 38 of the mitral valve 30 in order to treat and correct mitral regurgitation.
  • the instrument assembly 10 and the attendant method of the present invention may be applied to an anterior and/or the posterior prolapsing leaflet in the manner described herein, in correcting a mitral regurgitation condition of the heart.
  • the various embodiments of the present invention are described using a single chord 16 , a plurality of chords 16 may be used with the cooperative instrument components of the instrument assembly 10 .
  • the instrument assembly 10 is introduced into the interior of the heart 30 and more specifically into the left atrium 32 , through the atrium wall 33 , using an appropriate introduction assembly 42 . Therefore, the introductory sheath 14 and the chord 16 located concentrically within the sheath 14 will concurrently pass through the atrial wall 33 of the heart into the left atrium 32 , as it is directed towards the anterior leaflet 38 of the mitral valve 36 .
  • the anchor 18 is at least initially in the position generally represented in FIG. 1A . Due to its predetermined configuration the anchor 18 will serve to approach and penetrate the anterior leaflet 38 of the mitral valve 36 as clearly represented in FIG. 3 .
  • the penetration of the anterior leaflet 38 initially by the anchor 18 will facilitate the penetration and passage, substantially concurrently, of the chord 16 and the introductory sheath 14 through the anterior leaflet 38 as schematically represented.
  • a continued force will be applied to the introductory sheath 14 causing the sheath 14 and interiorly disposed chord 16 , as well as the anchor 18 to continue concurrent passage through the anterior valve leaflet 38 until the anchor 18 reaches, penetrates and is secured to the ventricular wall 40 and/or correspondingly disposed papillary muscles associated therewith.
  • the distal end of the chord 16 will be affixed to the ventricular wall 40 and remain in place as the introductory sheath 14 is withdrawn back along the length of the chord 16 , as indicated by the directional arrows.
  • the aforementioned gripping structure 20 will have been expanded into a gripping orientation.
  • the anchor 18 and the distal end of the chord 16 connected thereto will be reliably anchored or connected to the ventricular wall 40 .
  • the securing assembly including securing member 22 , will move along the length of the chord 16 as it is introduced into the left atrium 32 such as through the atrium wall via, the introduction assembly 42 .
  • the securing member 22 will be forced, moved, positioned, etc. along the proximal portion or length 16 ′ of the chord 16 by any appropriate technique and/or appropriate positioning instrument/device, which may be incorporated or operatively associated with the chord 16 .
  • Positioning of the securing member 22 will continue until it is disposed in engaging, interconnecting and at least partially protective or sealing engagement with an exterior surface portion of the suppressed anterior mitral valve leaflet 38 located within the left atrium 32 .
  • the position of the securing member 22 will be disposed in the exact position, on and along the length of the chord 16 needed to position and or suppress movement of the leaflet 38 to achieve correction of the mitral regurgitation.
  • exact positioning may be determined by preoperative transoesopageal echography or other preoperative manner to quantify online mitral regurgitation preoperatively.
  • One embodiment may also include a guiding element or sleeve 25 , as represented in FIG. 1 .
  • the element 25 When utilized, the element 25 will be disposed at a predetermined position along the length on the artificial chord 16 and be mounted concentrically about and/or along a portion of the chord 16 .
  • the guiding element 25 may assume and or be at least partially defined by a variety of different structures, devices and/or mechanisms other than, but possibly including, the schematically represented sleeve.
  • the guiding element is operative to accurately center or otherwise dispose the securing member 22 in sealing and/or covering relation to the aperture or area where the chord 16 remains in its extended position through the anterior leaflet 38 .
  • the securing member 22 securely connects the proximal extremity 16 ′′ of the chord 16 to the valve leaflet 38 and any excess length of the proximal portion 16 ′ of the chord 16 will be severed or detached from the extremity 16 ′′ of the chord 16 and the securing member 22 , which interconnects the proximal extremity 16 ′′ to the “exterior” surface of the leaflet 38 exposed to the left atrium 32 .
  • manipulation of the instrument of the assembly 10 causes a severing of the proximal extremity from a remainder of the chord 16 .
  • the securing member 22 serves to securely connect and fasten the chord 16 to the exterior of the anterior leaflet 38 , disposed within the left atrium 32 .
  • the introductory sheath 14 passes back through the introduction assembly 42 so as to exit the left atrium 32 and the remainder of the heart. Thereafter, the introduction assembly 42 is also removed from its initial operative position.
  • the heart 30 is represented with the synthetic chord 16 properly anchored between the ventricular wall 40 and the penetrated anterior leaflet 38 .
  • proper tensioning or positioning forces are applied to the anterior leaflet 38 causing it to be positioned in a manner which effectively overcomes mitral regurgitation, as set forth above.

Abstract

An assembly and method for treating heart valve malfunction typically including treating of mitral regurgitation wherein an instrument assembly includes an elongated chord movably disposed within an introductory sheath and including an anchor secured to a distal end thereof. An attendant method includes concurrently introducing the sheath and the chord into the heart chamber through an exterior wall and penetrating and passing the sheath and the chord through the anterior mitral valve leaflet. The sheath and the chord are then extended transversely across the heart chamber and the distal end of the chord is anchored to an opposing portion of the heart wall. The sheath is then withdrawn back along the length of the anchored chord and through the anterior mitral valve leaflet and a securing member connects the proximal end of the chord to the valve leaflet. The chord is secured between the valve leaflet and the opposing heart wall under sufficient tension to maintain an intended positioning of the valve leaflet to overcome mitral regurgitation.

Description

    CLAIM OF PRIORITY
  • The present application is based on and a claim of priority is made under 35 U.S.C. Section 119(e) to a provisional patent application that is currently pending in the U.S. Patent and Trademark Office, namely, that having Ser. No. 61/729,152 and a filing date of Nov. 21, 2012, and which is incorporated herein by reference in its entirety.
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The present invention is directed to an instrument assembly and method of use and application in the treatment of heart valve malfunction. In more specific terms the instrument assembly is specifically adapted to treat mitral regurgitation by means of a direct entry of the instrument through the atrial wall rather than through the vascular system, in order to apply sufficient tension to a prolapsing leaflet, including the anterior leaflet and/or the posterior leaflet of the mitral valve, in order to overcome mitral regurgitation.
  • 2. Description of the Related Art
  • The human heart is a four chambered pump that moves blood efficiently through the vascular system. During normal operation, blood enters the heart through the vena cava and flows into the right atrium. Thereafter, blood flows from the right atrium through the tricuspid valve and into the right ventricle. Upon contraction of the right ventricle, blood is forced through the pulmonic valve and into the lungs for oxygenation. The oxygenated blood returns from the lungs and enters the heart through the left atrium and passes through the mitral valve into the left ventricle. Upon contraction of the left ventricle the blood therein flows through the aortic valve and into the aorta and throughout the vascular system.
  • The mitral valve is disposed in flow regulating communication between the left atrium and the left ventricle. It is composed of two valve leaflets, the mitral valve annulus, which forms a ring that supports the valve leaflets; papillary muscles, which tether the valve leaflets to the left ventricle wall, by preventing them from prolapsing back into the left atrium. Chordae tendineae serve to connect the mitral valve leaflets to the papillary muscles thereby further preventing the leaflets from prolapsing back into the left atrium. A dysfunction of any of these components of the mitral valve can cause “mitral regurgitation”. Mitral regurgitation is a disorder of the heart in which the mitral valve does not close properly when the heart pumps out blood. This abnormal leaking of blood from the left ventricle, through the mitral valve and, into the left atrium when the left ventricle contracts, results in the “regurgitation” of blood back into the left atrium. It is generally recognized in the medical profession that mitral regurgitation is the second most common form of valvular heart disease.
  • As generally set forth above, when properly functioning, the anterior and posterior valve leaflets of the mitral valve overlap during contraction of the left ventricle and prevent blood from flowing back into the left atrium. This overlap of the 2 leaflets leaning upon each other is called the coaptation and absorbs most of the strain on the mitral apparatus during the ventricular contraction. However, when the mitral valve malfunctions, due to various cardiac diseases, the leaflets are no longer coapting resulting in the mitral valve remaining partially open during ventricular contraction. In turn this allows the “regurgitation” of the blood back into the left atrium, as generally set forth above. When the mitral valve does not close hermetically during the ventricular contraction, the aforementioned back flow of blood to the atrium and the pulmonary vasculature, results in a deleterious condition. More specifically, this condition increases the work load to the heart and may lead to heart failure.
  • Methods of treating conditions relating to the malfunctioning of the heart valve specifically including valve incompetencies, mitral valve leakage and other heart failure conditions may be in various stages of development such as the extending of an elongate member transverse across a corresponding or affected heart chamber. Each end of the elongate member extends through a wall of the heart such as the septum wall and an oppositely disposed wall portion, wherein first and second anchoring members are connected to corresponding ends of the elongate member but are disposed external of the heart chamber. Connecting clips or the like are applied to the corresponding exterior ends of the elongate member, resulting in the papillary muscles within the chamber to be effectively repositioned. A predetermined force is applied to the heart itself and/or the affected portions of the heart chamber.
  • Other specific treatments associated with mitral regurgitation sometimes may include the replacement of the mitral valve, resulting in traumatic and frequently dangerous surgical procedures being performed on a patient.
  • Accordingly, there is a need in the medical arts for appropriate instrumentation and attendant methods of overcoming heart valve malfunctions, specifically including mitral regurgitation.
  • SUMMARY OF THE INVENTION
  • The present invention is directed to an instrument assembly and attendant method for treating heart valve malfunction. In more specific terms, the instrumentation and method are specifically, but not exclusively, adapted for the treatment of mitral regurgitation. However, for purposes of clarity and in order to emphasize the versatility of the various embodiments of the present invention, the subject instrument assembly and method will be described generically regarding treatment of a predetermined heart valve. In addition, the present invention will be more specifically described in regard to a procedure involving correction of a prolapsing mitral valve leaflet, which may include the anterior mitral valve leaflet and/or the posterior valve leaflet correcting of mitral regurgitation.
  • Accordingly, the instrument assembly of the present invention includes an introductory sheath formed of a material of sufficient rigidity to facilitate the penetration and passage through various portions of the heart and mitral valve. As such, the introductory sheath may be said to be formed of at least a “semi-rigid” material. However, this term is to be understood to include material having sufficient flexibility to be manipulated or “steered” through and/or along a predetermined path during the delivery of the sheath and associated components of the instrument assembly to predetermined portions of the heart. Moreover, in one preferred embodiment the sheath will be sufficiently maneuverable to pass through the atrial wall into interior portions of the heart such as the left atrium and left ventricle. In addition and as described in greater detail hereinafter, an introduction assembly and a delivery catheter will be used to facilitate the positioning the introductory sheath into the thoracic cavity and through the atrial wall or other preferred exterior locations of the heart wall.
  • Additional structural operative features of the instrument assembly include the provision and utilization of at least one, or under required circumstances, more than one elongated chord formed of a biocompatible material and being at least partially flexible. The material from which the chord is formed should have sufficient and/or predetermined tensile strength to exert a predetermined tension on the predetermined, prolapsing valve leaflet as the chord extends between a corresponding portion of the heart wall, such as the ventricular wall, as also more fully described hereinafter. The chord is initially housed concentrically within the interior of the introductory sheath, wherein the sheath and the chord are concurrently movable relative to the heart as well as throughout a portion of the interior thereof. As set forth above, the introductory sheath is formed of a material having physical characteristics that allow it to be accurately manipulated so as to be steerable in such a manner that its tip can aim towards the different designated portions of the anterior or posterior mitral valve leaflets that are in the siege of the prolapse.
  • Also, the exteriorly concentric introductory sheath is movable relative to and along the length of the chord so as to accommodate proper and intended placement and anchoring of the chord within the heart chamber. Therefore, the sheath is movable with the chord into and through predetermined portions of the heart chamber and movable relative to the chord after proper anchoring, securing and/or intended placement of the chord within the heart chamber. Accordingly, the instrument assembly of the present invention also includes an anchor secured to an outer or distal end of the chord. The anchor may also be sufficiently sharpened, pointed or otherwise configured to penetrate an intended heart valve leaflet, such as a prolapsing leaflet of the mitral valve. Further, the penetration and passage of the anchor, the chord, and the introductory sheath substantially through the predetermined valve leaflet may thereby be facilitated.
  • When properly positioned, the anchor is structured to be secured to a substantially opposing portion of the heart wall, such as the ventricular wall associated with the left ventricle and/or the papillary muscles associated therewith. In order to assure secure anchoring of the distal end of the chord with the corresponding ventricular wall, a gripping structure may be operatively attached to a remainder of the anchor and disposable into an outwardly and/or radially extending orientation. When so disposed, the gripping structure, in combination with the remainder of the anchor, eliminates or significantly restricts the inadvertent detachment of the anchor, and the distal end of the chord attached thereto, from the corresponding ventricular wall portion. In at least one preferred embodiment of the present invention, the anchor and the gripping structure are disposed and applied so as to penetrate the corresponding portion of the ventricular wall but not extend there through. Therefore, the anchored relation of the gripping structure, anchor and the connected distal end of the chord may be defined by a penetration into the interior of the ventricular wall rather than a passage completely there through. Complications associated with sealing and exterior attachment of the chord to the exterior of the ventricular wall are thereby eliminated.
  • As provided, the present invention further comprises a method of treating heart and valve malfunction utilizing the instrument as generally set forth above. Accordingly, the attendant method comprises, at least in more generic terms, the passing of a portion of the instrument assembly into an intended heart chamber and into penetrating relation to a predetermined valve leaflet, such as a prolapsing leaflet. The sheath, with the chord concentrically disposed on the interior thereof, is passed through the predetermined valve leaflet. Therefore, by virtue of the enclosed disposition of the chord, the chord and sheath will concurrently enter and extend through the predetermined valve leaflet. By manipulation and the application of a positioning force on the sheath, the sheath and the chord will extend across a corresponding heart chamber and into an anchored relation with a substantially opposing portion of the heart wall.
  • Once the anchor and the connected distal end of the chord are secured to the opposing heart wall portion, the sheath, still concentrically mounted exteriorly of and in enclosing relation to the chord, is withdrawn from heart chamber in which the chord is anchored. More specifically, the sheath is withdrawn by moving relative to and back along the length of the anchored chord in a direction away from the anchor and connected distal end of the chord. The introductory sheath is further withdrawn back through the predetermined valve leaflet while the proximal portion of the chord remains within the valve leaflet. Once the sheath is disposed exteriorly of the valve leaflet and possibly on the exterior of the heart itself, a securing assembly is operatively disposed within the heart chamber in interconnecting relation between a proximal extremity of the chord and the predetermined valve leaflet.
  • In more specific terms, the securing assembly may include a securing member, which will be mounted on or connected to a proximal portion of the chord and moved along the length thereof into a predetermined, interconnecting position relative to the prolapsing valve leaflet. The position of the securing member will be tailored to and disposed at the exact position needed to achieve correction of the mitral regurgitation, which may be determined by preoperative transoesopageal echography or other preoperative manner, to quantify the occurring mitral regurgitation preoperatively. The securing member then securely interconnects the proximal extremity of the chord to the predetermined valve leaflet and any excess length of the chord will be severed or detached from the proximal extremity of the chord, which is secured to the surface of the leaflet associated with the atrium. The chord is thereby properly tensioned between the opposing, interior corresponding wall portion of the heart and the predetermined valve leaflet so as to overcome the malfunction of the predetermined valve leaflet as explained in more specific details hereinafter.
  • As emphasized throughout this description, the instrument assembly and attendant method of the present invention is specifically adapted for the treatment of mitral regurgitation. As such, the introductory sheath and the chord, substantially concurrently enter the atrial wall of the left atrium and pass into the interior thereof. Further, the sheath and the chord penetrate and are passed, substantially concurrently, through a prolapsing (flail) anterior or posterior leaflet of the mitral valve into the left ventricle of the heart chamber. Thereafter the sheath and chord are concurrently extended transversely across the left ventricle, wherein the anchor penetrates and is thereby secured in an anchored relation with a substantially opposing portion of the ventricular wall and/or corresponding papillary muscles. The distal end of the chord is connected to the anchor and is thereby secured in an anchored relation to the ventricular wall, by virtue of the penetrating anchor.
  • Once the distal end of the chord and anchor are in the anchored relation to the ventricular wall, the sheath is withdrawn back along the length of the chord, away from the anchor and the ventricular wall to which the distal portion of the chord is secured. Moreover, the introductory sheath continues to travel back along the length of the chord through the prolapsing anterior or posterior mitral valve leaflet to a location at least exterior to the leaflet, such as within the left atrium and possibly exteriorly of the heart itself.
  • A securing assembly is then operatively associated with the instrument and is movably disposed along the length of a proximal portion of the chord. In even more specific terms, the movement of the securing assembly and its associated securing member are disposed into an interconnecting position between a proximal extremity of the chord and the mitral valve leaflet penetrated by the chord. As indicated above, proper tensioning is thereby placed on the prolapsing mitral valve leaflet in order to restore a sufficient surface of coaptation between its counterpart, opposing leaflet and maintain the suppressed leaflet in an operative position sufficient to overcome the mitral regurgitation.
  • These and other objects, features and advantages of the present invention will become clearer when the drawings as well as the detailed description are taken into consideration.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • For a fuller understanding of the nature of the present invention, reference should be had to the following detailed description taken in connection with the accompanying drawings in which:
  • FIG. 1 is a perspective view of one preferred embodiment of the instrument assembly of the present invention used in the treatment of heart valve malfunction.
  • FIG. 1A is a perspective view of the instrument assembly of the embodiment of FIG. 1 in an initially introductory position.
  • FIGS. 2 through 9 are schematic representations of successive steps in the attendant method of utilizing and applying the instrument assembly of the embodiment of FIGS. 1 and 1A specifically for the treatment and correction of mitral regurgitation.
  • Like reference numerals refer to like parts throughout the several views of the drawings.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • As represented in the accompanying drawings and with specific reference to FIGS. 1 and 1A, the instrument assembly of the present invention is schematically and generally indicated as 10 and is used for the treatment of heart valve malfunction generally and more specifically for the treatment of mitral regurgitation. As such, the instrument assembly 10 includes an elongated delivery catheter or tube 12 having a hollow interior and structured to deliver operative portions of the instrument assembly 10 to the treatment site within the heart of a patient. As such, the elongated delivery catheter or tube 12 is dimensioned and configured to enter the chest cavity through appropriate introduction instrumentation. The delivery tube 12 is formed of a material and/or includes positioning structure or linkage incorporated therein which facilitates the maneuvering or steering thereof to a point at least generally exterior the heart and more specifically the atrial wall of the left atrium. However, the at least semi-rigid material of the delivery tube 12 should be sufficient to also facilitate proper manipulation so as to position or “steer” the remainder of the instrument assembly 10 to the intended location within the interior thereof, as well as facilitate penetration of and anchoring to intended tissue portions.
  • The instrument assembly 10 also includes an introductory sheath 14 movable within the delivery tube 12 and an elongated flexible material chord 16. The introductory sheath 14 is concentrically and movably enclosed within the delivery tube 12 and the sheath 14 is movably disposed concentrically about the chord 16. It is emphasized that FIG. 1 represents a completely assembled instrument assembly 10. However, as will be described in detail with the schematic representations of FIGS. 1 through 9, the various portions of the instrument assembly 10 are used in successive steps to accomplish installation relative to the affected portions of the heart valve being treated.
  • Accordingly, the instrument assembly 10 further includes the elongated flexible material chord 16 which may be formed of a synthetic, biocompatible material. An anchor 18 is fixedly secured to the outer or distal end of the chord 16 and is movable therewith relative to the introductory sheath 14. As clearly represented in FIG. 1A chord 16 is at least initially enclosed concentrically within the interior of the introductory sheath 14, wherein the sheath 14 is movable along the length of the chord 16. Further, the sheath includes an open distal end 14′ serving to at least partially encloses or be registered alignment with the anchor 18. Therefore, FIG. 1A represents cooperative portions of the instrument assembly 10 at least upon initial entry of the introductory sheath 14 and anchor 18 into the interior of the heart 30, as specifically described in detail in FIGS. 2 through 9, hereinafter described.
  • Therefore, with further regard to FIG. 1A, the positioning of the anchor 18, the introductory sheath 14 and the chord 16 is such that the chord 16 is disposed within the interior of the introductory sheath 14. Further, the anchor 18 is disposed at least partially within and/or in an exposed relation to the open distal end 14′ of the sheath 14. In addition, the anchor 18 has a sharpened, pointed or other appropriate configuration for penetrating portions of the heart. The anchor 18 may also include a gripping structure 20 which may be initially disposed in a collapsed position when the anchor 18 is in registry with the distal opening 14′ of the sheath 14. However, upon removal or exposure of the anchor 18 and a length of the chord 16 from an interior of the sheath 14, the gripping structure 20 may include an inherent bias causing it to expand outwardly and/or radially from the remainder of the anchor 18. This gripping structure 20 is provided to facilitate a secure engagement of the anchor 18 with predetermined heart wall portions, when the instrument assembly 10 is properly applied in the treatment of the heart valve malfunction.
  • With further reference to FIG. 1 the assembled representation of the instrument assembly 10 further includes the provision of a securing member 22 which may travel along the length of the chord 16. The securing member may be forcibly positioned into an intended interconnecting location relative to a heart valve leaflet in order to accomplish a secure attachment of the chord 16 to the leaflet as will be explained in greater detail hereinafter. Such an interconnecting placement of the securing member 22 relative to both the chord 16 and the affected valve leaflet serves to establish and maintain a sufficient tension and/or positioning force on the predetermined valve leaflet to suppress movement thereof, as explained hereinafter with regard to FIGS. 2 through 9.
  • As schematically represented in FIGS. 2 through 9, the heart is generally indicated as 30 and includes the representative portions including the left atrium 32, the left ventricle 34 and the mitral valve 36, including the anterior and posterior mitral valve leaflets 38 and 38′, respectively. As additionally represented, the left ventricle 34 is at least partially bordered or surrounded by ventricular wall 40 which may be directly associated with corresponding papillary muscles (not shown) facilitating the proper positioning of the mitral valve leaflets 38 and 38′ through organic tissue tethering, as generally outlined above.
  • For purposes of clarity, FIGS. 2-9 schematically represent the instrument assembly 10 used on the anterior leaflet 38 of the mitral valve 30 in order to treat and correct mitral regurgitation. However, it is emphasized the instrument assembly 10 and the attendant method of the present invention may be applied to an anterior and/or the posterior prolapsing leaflet in the manner described herein, in correcting a mitral regurgitation condition of the heart. Moreover, while the various embodiments of the present invention are described using a single chord 16, a plurality of chords 16 may be used with the cooperative instrument components of the instrument assembly 10.
  • With initial reference to FIGS. 2 and 3, the instrument assembly 10 is introduced into the interior of the heart 30 and more specifically into the left atrium 32, through the atrium wall 33, using an appropriate introduction assembly 42. Therefore, the introductory sheath 14 and the chord 16 located concentrically within the sheath 14 will concurrently pass through the atrial wall 33 of the heart into the left atrium 32, as it is directed towards the anterior leaflet 38 of the mitral valve 36. It should be further noted that the anchor 18 is at least initially in the position generally represented in FIG. 1A. Due to its predetermined configuration the anchor 18 will serve to approach and penetrate the anterior leaflet 38 of the mitral valve 36 as clearly represented in FIG. 3.
  • In addition, the penetration of the anterior leaflet 38 initially by the anchor 18 will facilitate the penetration and passage, substantially concurrently, of the chord 16 and the introductory sheath 14 through the anterior leaflet 38 as schematically represented. As further represented in FIG. 3, a continued force will be applied to the introductory sheath 14 causing the sheath 14 and interiorly disposed chord 16, as well as the anchor 18 to continue concurrent passage through the anterior valve leaflet 38 until the anchor 18 reaches, penetrates and is secured to the ventricular wall 40 and/or correspondingly disposed papillary muscles associated therewith.
  • As best represented in FIGS. 4 and 5, once the anchor 18 is secured to the ventricular wall 40 and/or the corresponding papillary muscles, the distal end of the chord 16 will be affixed to the ventricular wall 40 and remain in place as the introductory sheath 14 is withdrawn back along the length of the chord 16, as indicated by the directional arrows. As the introductory sheath 14 is withdrawn back along the length of the chord 16, the aforementioned gripping structure 20 will have been expanded into a gripping orientation. When the gripping structure 20 is so oriented, the anchor 18 and the distal end of the chord 16 connected thereto will be reliably anchored or connected to the ventricular wall 40. Continued withdrawal of the introductory sheath 14 will result in its passage back through the initially penetrated and suppressed mitral valve leaflet 38, as clearly represented in FIG. 5. As such, the majority of the length of the chord 16 will thereby be exposed and maintained in the represented position within the left ventricle and between the ventricular wall 40 and the penetrated (suppressed) leaflet 38, while the introductory sheath 14 passes back through the introduction assembly 42 and out of the interior of the left atrium 32, through the atrium wall 33. Therefore, the proximal portion 16′ of the chord 16 remains in place, within the left atrium 32, and may serve effectively as a guide or otherwise facilitate the placement of the securing member 22, as represented in FIGS. 6 through 9.
  • More specifically, once the introductory sheath 14 is removed from the left atrium 32, through the introduction assembly 42, the securing assembly, including securing member 22, will move along the length of the chord 16 as it is introduced into the left atrium 32 such as through the atrium wall via, the introduction assembly 42. As schematically represented, the securing member 22 will be forced, moved, positioned, etc. along the proximal portion or length 16′ of the chord 16 by any appropriate technique and/or appropriate positioning instrument/device, which may be incorporated or operatively associated with the chord 16. Positioning of the securing member 22 will continue until it is disposed in engaging, interconnecting and at least partially protective or sealing engagement with an exterior surface portion of the suppressed anterior mitral valve leaflet 38 located within the left atrium 32. The position of the securing member 22 will be disposed in the exact position, on and along the length of the chord 16 needed to position and or suppress movement of the leaflet 38 to achieve correction of the mitral regurgitation. Such exact positioning may be determined by preoperative transoesopageal echography or other preoperative manner to quantify online mitral regurgitation preoperatively.
  • With further regard to the positioning of the securing member 22 into the interconnecting relation between the proximal extremity of chord 16 and the anterior leaflet 38. One embodiment may also include a guiding element or sleeve 25, as represented in FIG. 1. When utilized, the element 25 will be disposed at a predetermined position along the length on the artificial chord 16 and be mounted concentrically about and/or along a portion of the chord 16. As applied, the guiding element 25 may assume and or be at least partially defined by a variety of different structures, devices and/or mechanisms other than, but possibly including, the schematically represented sleeve. Accordingly, the guiding element is operative to accurately center or otherwise dispose the securing member 22 in sealing and/or covering relation to the aperture or area where the chord 16 remains in its extended position through the anterior leaflet 38. Further, the securing member 22 securely connects the proximal extremity 16″ of the chord 16 to the valve leaflet 38 and any excess length of the proximal portion 16′ of the chord 16 will be severed or detached from the extremity 16″ of the chord 16 and the securing member 22, which interconnects the proximal extremity 16″ to the “exterior” surface of the leaflet 38 exposed to the left atrium 32.
  • With continued reference to FIGS. 5 through 8, manipulation of the instrument of the assembly 10, such as by medical personnel manipulating the delivery catheter 12 causes a severing of the proximal extremity from a remainder of the chord 16. As a result, the securing member 22 serves to securely connect and fasten the chord 16 to the exterior of the anterior leaflet 38, disposed within the left atrium 32. Upon a secure connection of the securing member 22 to the exterior side or surface of the anterior leaflet 38, the introductory sheath 14 passes back through the introduction assembly 42 so as to exit the left atrium 32 and the remainder of the heart. Thereafter, the introduction assembly 42 is also removed from its initial operative position.
  • Therefore, as represented in FIG. 9 the heart 30 is represented with the synthetic chord 16 properly anchored between the ventricular wall 40 and the penetrated anterior leaflet 38. In this position, proper tensioning or positioning forces are applied to the anterior leaflet 38 causing it to be positioned in a manner which effectively overcomes mitral regurgitation, as set forth above.
  • Since many modifications, variations and changes in detail can be made to the described preferred embodiment of the invention, it is intended that all matters in the foregoing description and shown in the accompanying drawings be interpreted as illustrative and not in a limiting sense. Thus, the scope of the invention should be determined by the appended claims and their legal equivalents.
  • Now that the invention has been described,

Claims (28)

1. An instrument assembly for treating heart valve malfunction, said instrument assembly comprising:
at least one elongated chord and an introductory sheath, said sheath at least initially disposed in enclosing relation to said one chord and movable with said chord and along the length thereof,
said sheath and said one chord cooperatively structured to concurrently enter the heart chamber through the heart wall and penetrate and pass through a predetermined heart valve leaflet,
an anchor connected to a distal end of said one chord and disposable into an anchored relation with the heart wall substantially oppositely disposed to the predetermined valve leaflet,
a securing assembly connectable to a proximal extremity of said one chord in an interconnecting position between said one chord and the predetermined valve leaflet, and
said anchored relation of said anchor and said interconnecting position of said securing assembly collectively defining an operative length of one said chord within the heart chamber and a tensioning of the predetermined valve leaflet sufficient to restrict prolapsing of the predetermined valve leaflet, by said one chord.
2. An instrument assembly as recited in claim 1 wherein said interconnecting position comprises said securing assembly disposed in securing relation between said proximal extremity of said one chord and an exterior surface exposed to the left atrium of the predetermined valve leaflet.
3. An instrument assembly as recited in claim 1 wherein the predetermined valve leaflet comprises a prolapsing one of the anterior mitral valve leaflet and posterior mitral valve leaflet.
4. An instrument assembly as recited in claim 1 wherein said securing assembly comprises a securing member movably mounted on and extendable along the length of said one chord into said interconnecting position.
5. An instrument assembly as recited in claim 4 wherein said securing assembly further comprises a sleeve connected to said securing member, said sleeve concentrically mounted on and positionable along the length of said one chord with said securing member into said interconnecting position.
6. An instrument assembly as recited in claim 5 wherein said interconnecting position further comprises said sleeve disposed through the predetermined valve leaflet concurrently to said securing member being disposed in securing relation between said proximal extremity of said one chord and the predetermined valve leaflet.
7. An instrument assembly as recited in claim 1 wherein said anchor comprises an outer extremity comprising a configuration sufficient to penetrate the opposing heart wall portion.
8. An instrument assembly as recited in claim 7 wherein said outer extremity is disposable in penetrating relation to the predetermined valve leaflet prior to a chord securing relation with the opposing heart wall portion.
9. An instrument assembly as recited in claim 7 wherein said sheath comprises an open distal end dimensioned to facilitate disposition of said anchor into a penetrating orientation to the predetermined valve leaflet and subsequently, the opposing heart wall portion.
10. An instrument assembly as recited in claim wherein said anchor comprises a gripping structure disposed laterally outward from said outer extremity of said anchor; said gripping structure structured to define a secure connection of said anchor with the opposing heart wall portion.
11. An instrument assembly as recited in claim 10 wherein said gripping structure is expandable radially outward from said outer extremity of said anchor.
12. An instrument assembly as recited in claim wherein said anchor comprises a gripping structure disposed laterally outward from said outer extremity of said anchor; said gripping structure structured to define a secure connection of said anchor with the opposing heart wall.
13. A method of treating mitral valve regurgitation using the instrument assembly as recited in claim 1, the method comprising:
introducing the sheath and at least one chord into the chamber of the heart through the atrium wall thereof;
passing the sheath and one chord substantially concurrently through at least one mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber,
extending the sheath and one chord transversely across the left ventricle and securing the anchor into an anchored relation with a substantially opposing portion of the ventricular wall of the heart,
withdrawing the sheath back along the length of the anchored one chord from the ventricular wall and back through the one mitral valve leaflet, and
securing the securing assembly along the length of the one chord into an interconnecting position between a proximal extremity of the one chord and the one mitral valve leaflet.
14. A method as recited in claim 13 disposing the securing assembly along the length of the one chord into the interconnecting position with an exterior of the one mitral valve leaflet which is exposed to the left atrium.
15. A method as recited in claim 13 comprising passing the sheath and one chord substantially concurrently through the anterior mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber.
16. A method as recited in claim 13 comprising passing the sheath and one chord substantially concurrently through the posterior mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber.
17. A method as recited in claim 13 comprising disconnecting a remaining distal portion of the one chord, extending between the securing assembly and the atrium wall, subsequently to securing the securing assembly in the interconnecting position.
18. A method of treating heart valve malfunction comprising:
passing an instrument into the heart chamber and into penetrating relation to a predetermined valve leaflet under the siege of prolapse,
passing the instrument through the predetermined valve leaflet,
extending at least one chord of the instrument from the predetermined valve leaflet across the heart chamber into anchored relation with a portion of the heart wall substantially opposing the predetermined valve leaflet,
withdrawing a sheath of the instrument back along a length of the anchored one chord from the opposing portion of the heart wall and back through the predetermined valve leaflet, and
securing a corresponding proximal extremity of the one chord to the predetermined valve leaflet.
19. A method as recited in claim 18 comprising disposing an anchor of the instrument into a griping orientation when in the anchored relation with the opposing portion of the heart wall.
20. A method as recited in claim 19 further comprising expanding the anchor into the gripping orientation with the opposing portion of the heart wall.
21. A method as recited in claim 19 further comprising defining the gripping orientation of the anchor portion as a penetrating engagement with an interior portion of the ventricular wall.
22. A method as recited in claim 21 further comprising tensioning the one chord between the ventricular wall and the predetermined valve leaflet by securing the corresponding proximal extremity of the one chord to an exterior of the predetermined valve leaflet.
23. A method as recited in claim 18 further comprising establishing an operative length of said one chord between the predetermined valve leaflet and the opposing portion of the heart wall to define a tensioning of the predetermined valve leaflet sufficient to restrict prolapsing of the predetermined valve leaflet, by the one chord.
24. A method as recited in claim 18 comprising treating mitral valve regurgitation by entering the heart through the atrial wall into the left atrium and penetrating the predetermined mitral valve leaflet under the siege of prolapse with a distal portion of the one chord and passing the one chord through the mitral valve leaflet and transversely across the left ventricle and disposing an anchor, secured to the distal end of the one chord, into anchored relation with an oppositely disposed portion of the ventricular wall.
25. A method as recited in claim 24 comprising positioning the anchor into a gripping orientation on the interior of the heart chamber by penetrating interior portions of the ventricular wall.
26. A method as recited in claim 25 further defining the gripping orientation by expanding the anchor into penetrating engagement with the interior portions of the papillary muscle of the ventricular wall.
27. A method as recited in claim 24 further comprising tensioning the one chord between the penetrated portion of the ventricular wall and the one mitral valve leaflet by securing a proximal extremity of the one chord to the one mitral valve leaflet.
28. A method as recited in claim 27 further comprising establishing an operative length of said one chord between the predetermined mitral valve leaflet and penetrated portion of the ventricular wall to define a tensioning of the predetermine valve leaflet sufficient to restrict prolapsing of the predetermined mitral valve leaflet, by the one chord.
US13/691,087 2012-11-21 2012-11-30 Device and method of treating heart valve malfunction Abandoned US20140142689A1 (en)

Priority Applications (9)

Application Number Priority Date Filing Date Title
US13/691,087 US20140142689A1 (en) 2012-11-21 2012-11-30 Device and method of treating heart valve malfunction
US13/967,647 US10159571B2 (en) 2012-11-21 2013-08-15 Device and method of treating heart valve malfunction
JP2015544111A JP2015535465A (en) 2012-11-21 2013-11-20 Apparatus and method for treating heart valve failure
AU2013348100A AU2013348100C1 (en) 2012-11-21 2013-11-20 Device and method of treating heart valve malfunction
PCT/US2013/070972 WO2014081809A2 (en) 2012-11-21 2013-11-20 Device and method of treating heart valve malfunction
EP13856513.0A EP2922502B1 (en) 2012-11-21 2013-11-20 Device for treating heart valve malfunction
CA2891356A CA2891356A1 (en) 2012-11-21 2013-11-20 Device and method of treating heart valve malfunction
IL238933A IL238933A0 (en) 2012-11-21 2015-05-20 Device and method of treating heart valve malfunction
JP2018005752A JP2018061855A (en) 2012-11-21 2018-01-17 Device and method of treating heart valve malfunction

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201261729152P 2012-11-21 2012-11-21
US13/691,087 US20140142689A1 (en) 2012-11-21 2012-11-30 Device and method of treating heart valve malfunction

Related Child Applications (1)

Application Number Title Priority Date Filing Date
US13/967,647 Continuation-In-Part US10159571B2 (en) 2012-11-21 2013-08-15 Device and method of treating heart valve malfunction

Publications (1)

Publication Number Publication Date
US20140142689A1 true US20140142689A1 (en) 2014-05-22

Family

ID=50728681

Family Applications (2)

Application Number Title Priority Date Filing Date
US13/691,087 Abandoned US20140142689A1 (en) 2012-11-21 2012-11-30 Device and method of treating heart valve malfunction
US13/967,647 Active 2033-06-14 US10159571B2 (en) 2012-11-21 2013-08-15 Device and method of treating heart valve malfunction

Family Applications After (1)

Application Number Title Priority Date Filing Date
US13/967,647 Active 2033-06-14 US10159571B2 (en) 2012-11-21 2013-08-15 Device and method of treating heart valve malfunction

Country Status (7)

Country Link
US (2) US20140142689A1 (en)
EP (1) EP2922502B1 (en)
JP (2) JP2015535465A (en)
AU (1) AU2013348100C1 (en)
CA (1) CA2891356A1 (en)
IL (1) IL238933A0 (en)
WO (1) WO2014081809A2 (en)

Cited By (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20140114390A1 (en) * 2010-01-22 2014-04-24 4Tech Inc. Tricuspid valve repair using tension
US20150025312A1 (en) * 2011-08-09 2015-01-22 Didier De Canniere Introductory assembly and method for inserting intracardiac instruments
US20150045878A1 (en) * 2006-10-04 2015-02-12 Edwards Lifesciences Corporation Method and apparatus for reshaping a ventricle
US20150148692A1 (en) * 2013-11-22 2015-05-28 On-X Life Technologies, Inc. Chordal Sizer
US20160120535A1 (en) * 2014-10-29 2016-05-05 Smith & Nephew, Inc. Modular tissue repair kit and devices and method related thereto
WO2016126699A1 (en) * 2015-02-02 2016-08-11 On-X Life Technologies, Inc. Rapid deployment artificial chordae tendinae system
US9693865B2 (en) 2013-01-09 2017-07-04 4 Tech Inc. Soft tissue depth-finding tool
US9801720B2 (en) 2014-06-19 2017-10-31 4Tech Inc. Cardiac tissue cinching
WO2017210434A1 (en) * 2016-06-01 2017-12-07 On-X Life Technologies, Inc. Pull-through chordae tendineae system
US9877833B1 (en) 2016-12-30 2018-01-30 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US9907547B2 (en) 2014-12-02 2018-03-06 4Tech Inc. Off-center tissue anchors
US9907681B2 (en) 2013-03-14 2018-03-06 4Tech Inc. Stent with tether interface
US10022114B2 (en) 2013-10-30 2018-07-17 4Tech Inc. Percutaneous tether locking
US10039643B2 (en) 2013-10-30 2018-08-07 4Tech Inc. Multiple anchoring-point tension system
US10052095B2 (en) 2013-10-30 2018-08-21 4Tech Inc. Multiple anchoring-point tension system
US10058323B2 (en) 2010-01-22 2018-08-28 4 Tech Inc. Tricuspid valve repair using tension
CN108697418A (en) * 2015-11-02 2018-10-23 马里兰大学巴尔的摩分校 Distal side anchoring device and method for mitral valve reparation
US10206673B2 (en) 2012-05-31 2019-02-19 4Tech, Inc. Suture-securing for cardiac valve repair
US10307167B2 (en) 2012-12-14 2019-06-04 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
US10314594B2 (en) 2012-12-14 2019-06-11 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
USD853561S1 (en) * 2018-02-16 2019-07-09 Chengjun Guo Implantation device
US20190254816A1 (en) * 2018-02-22 2019-08-22 Medtronic Vascular, Inc. Prosthetic heart valve delivery systems and methods
US10405978B2 (en) 2010-01-22 2019-09-10 4Tech Inc. Tricuspid valve repair using tension
US10543090B2 (en) 2016-12-30 2020-01-28 Pipeline Medical Technologies, Inc. Neo chordae tendinae deployment system
US20200222186A1 (en) * 2019-01-16 2020-07-16 Neochord, Inc. Transcatheter methods for heart valve repair
US10799356B2 (en) 2017-09-12 2020-10-13 Boston Scientific Scimed, Inc. Percutaneous papillary muscle relocation
US10813630B2 (en) 2011-08-09 2020-10-27 Corquest Medical, Inc. Closure system for atrial wall
US10925731B2 (en) 2016-12-30 2021-02-23 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US20220142778A1 (en) * 2019-01-28 2022-05-12 Vesalius Cardiovascular Inc. Apparatus for use in repairing mitral valves and method of use thereof
US11696828B2 (en) 2016-12-30 2023-07-11 Pipeline Medical Technologies, Inc. Method and apparatus for mitral valve chord repair

Families Citing this family (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8579964B2 (en) 2010-05-05 2013-11-12 Neovasc Inc. Transcatheter mitral valve prosthesis
US9554897B2 (en) 2011-04-28 2017-01-31 Neovasc Tiara Inc. Methods and apparatus for engaging a valve prosthesis with tissue
US9308087B2 (en) 2011-04-28 2016-04-12 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US9345573B2 (en) 2012-05-30 2016-05-24 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US9572665B2 (en) 2013-04-04 2017-02-21 Neovasc Tiara Inc. Methods and apparatus for delivering a prosthetic valve to a beating heart
GB2536538B (en) 2014-09-17 2018-07-18 Cardiomech As Anchor for implantation in body tissue
JP7006940B2 (en) 2016-01-29 2022-01-24 ニオバスク ティアラ インコーポレイテッド Artificial valve to avoid blockage of outflow
WO2018090148A1 (en) 2016-11-21 2018-05-24 Neovasc Tiara Inc. Methods and systems for rapid retraction of a transcatheter heart valve delivery system
EP3672530A4 (en) 2017-08-25 2021-04-14 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
JP7260930B2 (en) 2018-11-08 2023-04-19 ニオバスク ティアラ インコーポレイテッド Ventricular deployment of a transcatheter mitral valve prosthesis
EP3946163A4 (en) 2019-04-01 2022-12-21 Neovasc Tiara Inc. Controllably deployable prosthetic valve
WO2020210652A1 (en) 2019-04-10 2020-10-15 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
CA3140925A1 (en) 2019-05-20 2020-11-26 Neovasc Tiara Inc. Introducer with hemostasis mechanism
WO2020257643A1 (en) 2019-06-20 2020-12-24 Neovasc Tiara Inc. Low profile prosthetic mitral valve
CN113662714A (en) * 2021-08-30 2021-11-19 上海汇禾医疗器械有限公司 Clamping device

Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100042147A1 (en) * 2008-08-14 2010-02-18 Edwards Lifesciences Corporation Method and apparatus for repairing or replacing chordae tendinae
US20100179574A1 (en) * 2009-01-14 2010-07-15 James Longoria Synthetic chord
US20110029071A1 (en) * 2007-12-20 2011-02-03 Amnon Zlotnick Elongated body for deployment in a coronary sinus
US8147542B2 (en) * 2008-12-22 2012-04-03 Valtech Cardio, Ltd. Adjustable repair chords and spool mechanism therefor
WO2013036742A1 (en) * 2011-09-09 2013-03-14 Emory University Systems, devices and methods for repair of heart valve lesions
US8408214B2 (en) * 2010-07-08 2013-04-02 Benjamin Spenser Method for implanting prosthetic valve
US8758393B2 (en) * 2007-10-18 2014-06-24 Neochord, Inc. Minimally invasive repair of a valve leaflet in a beating heart
US8790394B2 (en) * 2010-05-24 2014-07-29 Valtech Cardio, Ltd. Adjustable artificial chordeae tendineae with suture loops

Family Cites Families (465)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3587567A (en) 1968-12-20 1971-06-28 Peter Paul Schiff Mechanical ventricular assistance assembly
IT1155105B (en) 1982-03-03 1987-01-21 Roberto Parravicini PLANT DEVICE TO SUPPORT THE MYOCARDIUM ACTIVITY
US4690134A (en) 1985-07-01 1987-09-01 Snyders Robert V Ventricular assist device
US5201742A (en) 1991-04-16 1993-04-13 Hasson Harrith M Support jig for a surgical instrument
GR930100244A (en) 1992-06-30 1994-02-28 Ethicon Inc Flexible endoscopic surgical port
US20020095164A1 (en) * 1997-06-26 2002-07-18 Andreas Bernard H. Device and method for suturing tissue
US5797960A (en) 1993-02-22 1998-08-25 Stevens; John H. Method and apparatus for thoracoscopic intracardiac procedures
US5591170A (en) 1994-10-14 1997-01-07 Genesis Orthopedics Intramedullary bone cutting saw
US5702421A (en) 1995-01-11 1997-12-30 Schneidt; Bernhard Closure device for closing a vascular opening, such as patent ductus arteriosus
US6063070A (en) 1997-08-05 2000-05-16 Target Therapeutics, Inc. Detachable aneurysm neck bridge (II)
US6540693B2 (en) 1998-03-03 2003-04-01 Senorx, Inc. Methods and apparatus for securing medical instruments to desired locations in a patients body
US6405491B1 (en) 1999-04-22 2002-06-18 Hill-Rom Services, Inc. Modular patient room
US6328757B1 (en) 1999-04-23 2001-12-11 Robert G. Matheny Device and method for performing surgery without impeding organ function
US6206907B1 (en) 1999-05-07 2001-03-27 Cardia, Inc. Occlusion device with stranded wire support arms
US6692916B2 (en) 1999-06-28 2004-02-17 Source Precision Medicine, Inc. Systems and methods for characterizing a biological condition or agent using precision gene expression profiles
US8062675B2 (en) 1999-07-07 2011-11-22 Angioblast Systems, Inc. Mesenchymal precursor cell
US6592609B1 (en) * 1999-08-09 2003-07-15 Bonutti 2003 Trust-A Method and apparatus for securing tissue
US20040102804A1 (en) 1999-08-10 2004-05-27 Chin Albert K. Apparatus and methods for endoscopic surgical procedures
US6551303B1 (en) 1999-10-27 2003-04-22 Atritech, Inc. Barrier device for ostium of left atrial appendage
US6641592B1 (en) * 1999-11-19 2003-11-04 Lsi Solutions, Inc. System for wound closure
US6462169B1 (en) 1999-11-30 2002-10-08 Poly-Med, Inc. Amorphous polymeric polyaxial initiators and compliant crystalline copolymers therefrom
US8217304B2 (en) 2001-03-29 2012-07-10 Gsi Group Corporation Methods and systems for thermal-based laser processing a multi-material device
US7145191B1 (en) 2000-03-31 2006-12-05 National Semiconductor Corporation P-channel field-effect transistor with reduced junction capacitance
DE60022475T2 (en) 2000-04-19 2006-06-14 Radi Medical Systems Ab Uppsal Intra-arterial occlusion device
JP3844661B2 (en) 2000-04-19 2006-11-15 ラディ・メディカル・システムズ・アクチェボラーグ Intra-arterial embolus
US6902522B1 (en) 2000-06-12 2005-06-07 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
US6482146B1 (en) 2000-06-13 2002-11-19 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
DE10029834A1 (en) 2000-06-16 2002-01-03 Infineon Technologies Ag Method for transferring data between devices connected via a bus, and device connectable via a bus to other devices
US6840246B2 (en) 2000-06-20 2005-01-11 University Of Maryland, Baltimore Apparatuses and methods for performing minimally invasive diagnostic and surgical procedures inside of a beating heart
WO2002004064A1 (en) 2000-07-12 2002-01-17 Oma Medical Technologies, Inc. Minimally invasive bypass system and related methods
WO2002022687A2 (en) 2000-09-15 2002-03-21 The Government Of The United States Of America, As Represented By The Secretary, Department Of Health And Human Services Viral chemokine-tumur antigen fusion proteins
US6508828B1 (en) 2000-11-03 2003-01-21 Radi Medical Systems Ab Sealing device and wound closure device
ES2173073T3 (en) 2000-11-03 2002-10-16 Radi Medical Systems DEVICE OF SUTURE AND CLOSURE OF WOUNDS.
US6616596B1 (en) 2000-11-28 2003-09-09 Abiomed, Inc. Cardiac assistance systems having multiple layers of inflatable elements
ATE303100T1 (en) 2001-01-12 2005-09-15 Radi Medical Systems ARTERY WALL CLOSURE DEVICE PROVIDED WITH A POSITION INDICATOR
US6890295B2 (en) 2002-10-31 2005-05-10 Medtronic, Inc. Anatomical space access tools and methods
US6786898B2 (en) 2003-01-15 2004-09-07 Medtronic, Inc. Methods and tools for accessing an anatomic space
AU2002240269B2 (en) 2001-02-07 2007-06-21 The United States Government As Represented By The Department Of Veteran's Affairs Pro-apoptotic bacterial vaccines to enhance cellular immune responses
US6537290B2 (en) 2001-03-05 2003-03-25 Edwards Lifesciences Corporation Sealing access cannula system
US6699240B2 (en) 2001-04-26 2004-03-02 Medtronic, Inc. Method and apparatus for tissue ablation
ES2202269T3 (en) 2001-05-03 2004-04-01 Radi Medical Systems Ab GUIDE TOOL FOR WOUND CLOSURE.
JP4267867B2 (en) 2001-05-03 2009-05-27 ラディ・メディカル・システムズ・アクチェボラーグ Wound occlusion element guide device
ES2223679T3 (en) 2001-05-09 2005-03-01 Radi Medical Systems Ab SHUTTER OF AN ARTERIAL PERFORATION.
JP4159805B2 (en) 2001-06-15 2008-10-01 ラディ・メディカル・システムズ・アクチェボラーグ Pushing mechanism for closing method
ES2236170T3 (en) 2001-06-15 2005-07-16 Radi Medical Systems Ab MACHINING MECHANISM. 3.
US6893460B2 (en) 2001-10-11 2005-05-17 Percutaneous Valve Technologies Inc. Implantable prosthetic valve
US8175680B2 (en) 2001-11-09 2012-05-08 Boston Scientific Scimed, Inc. Systems and methods for guiding catheters using registered images
US6978176B2 (en) 2001-12-08 2005-12-20 Lattouf Omar M Treatment for patient with congestive heart failure
US6764510B2 (en) 2002-01-09 2004-07-20 Myocor, Inc. Devices and methods for heart valve treatment
PL401638A1 (en) 2002-03-13 2013-05-27 Array Biopharma Inc. N3 alkylated benzimidazole derivatives as MEK inhibitors
US7691461B1 (en) 2002-04-01 2010-04-06 Advanced Cardiovascular Systems, Inc. Hybrid stent and method of making
JP2006500910A (en) 2002-04-18 2006-01-12 アキュイティ ファーマシューティカルズ、インク. Means and method for specifically regulating CNS and eye target gene and identification method thereof
DK1507554T3 (en) 2002-05-10 2011-11-21 Agennix Inc Lactoferrin in the treatment of malignant neoplasms and other hyperproliferative diseases
US8246753B2 (en) 2002-05-13 2012-08-21 Aero Jet Wash Llc Gaspath cleaning system
US6790214B2 (en) 2002-05-17 2004-09-14 Esophyx, Inc. Transoral endoscopic gastroesophageal flap valve restoration device, assembly, system and method
US7041309B2 (en) 2002-06-13 2006-05-09 Neuropro Technologies, Inc. Spinal fusion using an HMG-CoA reductase inhibitor
US7919497B2 (en) 2002-08-02 2011-04-05 Nereus Pharmaceuticals, Inc. Analogs of dehydrophenylahistins and their therapeutic use
US20040034386A1 (en) 2002-08-19 2004-02-19 Michael Fulton Aneurysm stent
EP2380900A1 (en) 2002-09-23 2011-10-26 E. I. du Pont de Nemours and Company Isolation and use of ryanodine receptors
EP1565844A4 (en) 2002-11-11 2007-03-07 Transparensee Systems Inc Search method and system and systems using the same
US20050008676A1 (en) 2002-12-19 2005-01-13 Yongxing Qiu Medical devices having antimicrobial coatings thereon
US8924049B2 (en) 2003-01-06 2014-12-30 General Electric Company System and method for controlling movement of vehicles
US6960220B2 (en) 2003-01-22 2005-11-01 Cardia, Inc. Hoop design for occlusion device
US20120276021A1 (en) 2003-03-12 2012-11-01 Danisco Us Inc. Use of repeat sequence protein polymers in personal care compositions
CA2519461C (en) * 2003-03-26 2012-05-29 Tyco Healthcare Group Lp Energy stored in spring with controlled release
WO2004091419A2 (en) 2003-04-08 2004-10-28 Wasielewski Ray C Use of micro-and miniature position sensing devices for use in tka and tha
US7330440B1 (en) 2003-05-20 2008-02-12 Cisco Technology, Inc. Method and apparatus for constructing a transition route in a data communications network
CA2528299A1 (en) 2003-06-11 2005-01-06 Furry Brothers, Llc Systems and methods for performing inspections and detecting chemical leaks using an infrared camera system
US8725246B2 (en) 2003-07-23 2014-05-13 Eleanor Schuler Method and system for modulating eating behavior by means of neuro-electrical coded signals
US8066973B2 (en) 2003-09-05 2011-11-29 The Ohio State University Research Foundation Nanoparticulate probe for in vivo monitoring of tissue oxygenation
US8133500B2 (en) 2003-12-04 2012-03-13 Kensey Nash Bvf Technology, Llc Compressed high density fibrous polymers suitable for implant
CN1917876A (en) 2003-12-16 2007-02-21 Cns生物有限公司 Methods and compositions
US20050149108A1 (en) 2003-12-17 2005-07-07 Microvention, Inc. Implant delivery and detachment system and method
US8223632B2 (en) 2003-12-23 2012-07-17 At&T Intellectual Property I, L.P. Method and system for prioritized rerouting of logical circuit data in a data network
US7431726B2 (en) * 2003-12-23 2008-10-07 Mitralign, Inc. Tissue fastening systems and methods utilizing magnetic guidance
US8048067B2 (en) 2003-12-24 2011-11-01 The Regents Of The University Of California Tissue ablation with irreversible electroporation
US7923109B2 (en) 2004-01-05 2011-04-12 Board Of Regents, The University Of Texas System Inorganic nanowires
DE102004002831B4 (en) 2004-01-13 2010-06-17 SSI Schäfer PEEM GmbH Picking station and method for picking with a light grid
US7445596B2 (en) 2004-01-29 2008-11-04 Cannuflow, Inc. Atraumatic arthroscopic instrument sheath
BRPI0508049B8 (en) 2004-02-26 2016-10-11 Cameron Systems Ireland Ltd submerged flow interface equipment connection system
US8152810B2 (en) 2004-11-23 2012-04-10 Jackson Roger P Spinal fixation tool set and method
US20070265643A1 (en) 2004-03-23 2007-11-15 Beane Richard M Apparatus and method for suturelessly connecting a conduit to a hollow organ
JP4960220B2 (en) 2004-04-19 2012-06-27 ボストン サイエンティフィック サイムド,インコーポレイテッド Ablation device having sensor structure
US7641686B2 (en) 2004-04-23 2010-01-05 Direct Flow Medical, Inc. Percutaneous heart valve with stentless support
WO2005111241A2 (en) 2004-05-07 2005-11-24 Applera Corporation Genetic polymorphisms associated with liver fibrosis methods of detection and uses thereof
US20060049234A1 (en) 2004-05-21 2006-03-09 Flak Richard A Friction stirring and its application to drill bits, oil field and mining tools, and components in other industrial applications
US8258198B2 (en) 2004-05-28 2012-09-04 Air Products And Chemicals, Inc. Fast demold/extended cream time polyurethane formulations
EP1773239B1 (en) 2004-07-15 2010-03-31 Micardia Corporation Shape memory devices for reshaping heart anatomy
JP2008511672A (en) 2004-08-30 2008-04-17 セレゲン,インコーポレーテッド Cultured three-dimensional tissue and use thereof
WO2006027567A2 (en) 2004-09-07 2006-03-16 Biocompatibles Uk Limited Drug delivery from embolic agents
US20060135962A1 (en) 2004-09-09 2006-06-22 Kick George F Expandable trans-septal sheath
ES2529451T3 (en) 2004-09-23 2015-02-20 Vasgene Therapeutics, Inc. Polypeptide compounds to inhibit angiogenesis and tumor growth
JP2008514345A (en) 2004-10-02 2008-05-08 クリストフ・ハンス・フーバー Device for treating or replacing a heart valve or surrounding tissue without requiring full cardiopulmonary support
US7682335B2 (en) 2004-10-15 2010-03-23 Futurematrix Interventional, Inc. Non-compliant medical balloon having an integral non-woven fabric layer
US20100294147A1 (en) 2004-12-20 2010-11-25 Nanoink, Inc. Apparatus and methods for preparing identification features including pharmaceutical applications
AU2006204045B2 (en) 2005-01-05 2010-10-14 Board Of Regents, The University Of Texas System Conjugates for dual imaging and radiochemotherapy: composition, manufacturing, and applications
BRPI0609143A2 (en) 2005-03-17 2011-09-13 Ind Origami Llc sheet material for forming a three-dimensional structural structure, hollow beam and exoskeleton frame
US20060247672A1 (en) 2005-04-27 2006-11-02 Vidlund Robert M Devices and methods for pericardial access
EP1883371B1 (en) 2005-05-25 2015-10-07 Covidien LP System and method for delivering and deploying and occluding device within a vessel
US7767710B2 (en) 2005-05-25 2010-08-03 Calosyn Pharma, Inc. Method for treating osteoarthritis
US8252905B2 (en) 2005-06-03 2012-08-28 Mochida Pharmaceutical Co., Ltd. Anti-CD14 antibody fusion protein
US8202835B2 (en) 2005-06-17 2012-06-19 Yitzchak Hillman Disease treatment via antimicrobial peptides or their inhibitors
ES2437865T3 (en) 2005-07-25 2014-01-14 Foundation For Biomedical Research And Innovation Composition in sheet form
FR2889525A1 (en) 2005-08-04 2007-02-09 Palumed Sa NOVEL POLYQUINOLINE DERIVATIVES AND THEIR THERAPEUTIC USE.
US20070055206A1 (en) * 2005-08-10 2007-03-08 Guided Delivery Systems, Inc. Methods and devices for deployment of tissue anchors
NZ566001A (en) 2005-08-17 2011-03-31 Rochal Ind Llp Conformable solvent-based bandage and coating material
CN103637840A (en) 2005-08-23 2014-03-19 史密夫和内修有限公司 Telemetric orthopaedic implant
GT200600381A (en) 2005-08-25 2007-03-28 ORGANIC COMPOUNDS
US8980246B2 (en) 2005-09-07 2015-03-17 Sillajen Biotherapeutics, Inc. Oncolytic vaccinia virus cancer therapy
US8518069B2 (en) 2005-09-07 2013-08-27 Cabochon Aesthetics, Inc. Dissection handpiece and method for reducing the appearance of cellulite
US8133168B2 (en) 2005-09-16 2012-03-13 Colorado State University Research Foundation Remediation of functional cardiac mitral valve regurgitation
US20070072599A1 (en) 2005-09-27 2007-03-29 Romine Christopher M Device manufacturing using the device's embedded wireless technology
US8721597B2 (en) 2006-11-09 2014-05-13 Ncontact Surgical, Inc. Diaphragm entry for posterior surgical access
EP2907519A1 (en) 2005-10-17 2015-08-19 University of the Witwatersrand, Johannesburg Osteogenic Device for Inducing Bone Formation in Clinical Contexts
US20070135826A1 (en) 2005-12-01 2007-06-14 Steve Zaver Method and apparatus for delivering an implant without bias to a left atrial appendage
EP1959866B1 (en) * 2005-12-15 2019-03-06 Georgia Tech Research Corporation Papillary muscle position control devices and systems
US20070162066A1 (en) 2006-01-10 2007-07-12 Lyon Thomas R Clear view cannula
US8147453B2 (en) 2006-03-13 2012-04-03 Applied Medical Resources Corporation Balloon trocar
US9009291B2 (en) 2006-05-12 2015-04-14 W.W. Grainger, Inc. System and method for directing attention to web site functionality
GB0611587D0 (en) 2006-06-12 2006-07-19 Glaxo Group Ltd Novel compounds
US20120277766A1 (en) 2010-11-16 2012-11-01 Anova Corporation Apparatus and methods for closure of fissures in the anulus fibrosis
NZ573919A (en) 2006-06-30 2012-08-31 Cvdevices Llc A system for engaging heart tisue utilising a vacuum for percutaneous intravascular access to cardiac tissue
US20080033241A1 (en) 2006-08-01 2008-02-07 Ruey-Feng Peh Left atrial appendage closure
US7877564B2 (en) 2006-08-05 2011-01-25 Benhov Gmbh, Llc Memory configuration and method for calibrating read/write data based on performance characteristics of the memory configuration
EP2069479A1 (en) 2006-09-18 2009-06-17 Medizinische Universität Graz Plasma-free platelet lysate for use as a supplement in cell cultures and for the preparation of cell therapeutics
US8220334B2 (en) 2006-11-10 2012-07-17 Penrith Corporation Transducer array imaging system
US9114229B2 (en) 2006-12-29 2015-08-25 St. Jude Medical, Af Division, Inc. Dual braid reinforcement deflectable device
US8239215B2 (en) 2007-01-17 2012-08-07 Mitochon Systems, Inc. Apparatus and method for revenue distribution generated from delivering healthcare advertisements via EMR systems, RHIN, and electronic advertising servers
US7722568B2 (en) 2007-01-29 2010-05-25 Onset Medical Corporation Expandable intra-aortic balloon pump sheath
EP2129332B1 (en) 2007-02-16 2019-01-23 Medtronic, Inc. Replacement prosthetic heart valves
US8156675B2 (en) 2007-03-08 2012-04-17 Browning Firearm magazine
US7820207B2 (en) 2007-03-15 2010-10-26 Omnica Gmbh Stabilized anthocyanin compositions
US8851709B2 (en) 2007-03-30 2014-10-07 Designs For Vision, Inc. Remote control of illuminating headlamp
US9050064B2 (en) 2007-04-27 2015-06-09 Cvdevices, Llc Systems for engaging a bodily tissue and methods of using the same
US20080275295A1 (en) 2007-05-01 2008-11-06 Michael Gertner Methods of using pericardial inserts
US8597353B2 (en) 2007-06-06 2013-12-03 Spinesmith Partners, L.P. Interbody fusion device and associated methods
US9186375B2 (en) 2007-06-21 2015-11-17 Arthrodynamic Technologies, Animal Health Division, Inc. Glycosaminoglycan compositions in combination with stem cells
US8240367B2 (en) 2007-06-28 2012-08-14 Exxonmobil Research And Engineering Company Plate heat exchanger port insert and method for alleviating vibrations in a heat exchanger
US8992569B2 (en) 2007-06-29 2015-03-31 Ethicon Endo-Surgery, Inc. Insertion device and method of use
US8230412B2 (en) 2007-08-31 2012-07-24 Apple Inc. Compatible trust in a computing device
CN101842111A (en) 2007-08-31 2010-09-22 密执安州立大学董事会 Selective cytopheresis devices and related methods thereof
US8092363B2 (en) 2007-09-05 2012-01-10 Mardil, Inc. Heart band with fillable chambers to modify heart valve function
US20090068250A1 (en) 2007-09-07 2009-03-12 Philippe Gravagna Bioresorbable and biocompatible compounds for surgical use
AR068767A1 (en) 2007-10-12 2009-12-02 Novartis Ag ANTIBODIES AGAINST SCLEROSTIN, COMPOSITIONS AND METHODS OF USE OF THESE ANTIBODIES TO TREAT A PATHOLOGICAL DISORDER MEDIATIONED BY SCLEROSTIN
MX2010004124A (en) 2007-10-15 2010-09-28 Hurricanefabric Com Llc Weather protection system.
US20120276189A1 (en) 2007-10-23 2012-11-01 Benjamin Johnson Therapeutic Treatment of Dermatologic Skin Disorders
US20090114228A1 (en) 2007-11-01 2009-05-07 Garry William Kirschner Disposable outdoors mask and method of use
US20090170770A1 (en) 2007-11-06 2009-07-02 Ali Hafezi-Moghadam Methods and compositions for treating conditions associated with angiogenesis using a vascular adhesion protein-1 (vap 1) inhibitor
WO2009060437A2 (en) 2007-11-08 2009-05-14 Svip 3 Llc Fecal incontinence device, system and method
US9273100B2 (en) 2007-11-09 2016-03-01 Board Of Trustees Of Michigan State University Use of Galerina marginata genes and proteins for peptide production
US8167809B2 (en) 2007-12-20 2012-05-01 Silicon Valley Medical Instruments, Inc. Imaging probe housing with fluid flushing
US20120276286A1 (en) 2008-01-17 2012-11-01 Vijayakumar R Method and Sealant for Sealing Air Filter Leaks
US8126408B2 (en) 2008-01-22 2012-02-28 Provigent Ltd Multi-mode wireless communication link
US8220091B2 (en) 2008-01-25 2012-07-17 Squire Sleep Systems LLC Sleep system
CN105400735A (en) 2008-01-30 2016-03-16 阿斯特利亚斯生物治疗股份公司 Synthetic Surfaces For Culturing Stem Cell Derived Cardiomyocytes
ITTO20080120A1 (en) 2008-02-18 2009-08-19 Tek Global Srl SEALANT COMPOSITION FOR REPAIRING TIRES
EP2242527A4 (en) 2008-02-19 2011-07-13 Portaero Inc Devices and methods for delivery of a therapeutic agent through a pneumostoma
WO2009105699A1 (en) 2008-02-22 2009-08-27 Endologix, Inc. Design and method of placement of a graft or graft system
US8968393B2 (en) 2008-02-28 2015-03-03 Medtronic, Inc. System and method for percutaneous mitral valve repair
US8252834B2 (en) 2008-03-12 2012-08-28 The Regents Of The University Of Michigan Dendrimer conjugates
JP2011515162A (en) 2008-03-21 2011-05-19 バイオミメディカ インコーポレイテッド Methods, devices and compositions for adhering hydrated polymer implants to bone
US8538509B2 (en) 2008-04-02 2013-09-17 Rhythmia Medical, Inc. Intracardiac tracking system
FR2929502B1 (en) 2008-04-04 2011-04-08 Clariance NUCLEIC IMPLANT.
US8226965B2 (en) 2008-04-25 2012-07-24 Nanobio Corporation Methods of treating fungal, yeast and mold infections
US8757629B2 (en) 2008-04-29 2014-06-24 Thermal Structures, Inc. Thermal seal and methods therefor
WO2009134768A1 (en) 2008-05-01 2009-11-05 Massachusetts Institute Of Technology (Mit) Devices and processes for analyzing nucleic acid damage and repair using electrophoresis
US8041175B2 (en) 2008-05-05 2011-10-18 Adc Telecommunications, Inc. Front-access locking arrangement for sliding drawer
CN102017065B (en) 2008-05-09 2012-07-18 Fsi国际公司 Tools and methods for processing microelectronic workpices using process chamber designs that easily transition between open and closed modes of operation
WO2009143409A2 (en) 2008-05-23 2009-11-26 Martin Scientific, Llc Reliable downhole data transmission system
US8986728B2 (en) 2008-05-30 2015-03-24 Abbott Cardiovascular Systems Inc. Soluble implantable device comprising polyelectrolyte with hydrophobic counterions
US9049879B2 (en) 2008-06-13 2015-06-09 International Ip Holdings Llc Edible energy composition
US8210090B2 (en) 2008-07-01 2012-07-03 Adcor Industries, Inc. Firearm having an expulsion device
US9662045B2 (en) 2008-07-11 2017-05-30 Medtronic, Inc. Generation of sleep quality information based on posture state data
US8291594B2 (en) 2008-08-01 2012-10-23 The Boeing Company Attachment system and method for thermal protection system
US8237206B2 (en) 2008-08-12 2012-08-07 United Microelectronics Corp. CMOS image sensor, method of making the same, and method of suppressing dark leakage and crosstalk for CMOS image sensor
US20100041506A1 (en) 2008-08-15 2010-02-18 Kenneth Cooper Axle shaft disconnect assembly
US20120273470A1 (en) 2011-02-24 2012-11-01 Zediker Mark S Method of protecting high power laser drilling, workover and completion systems from carbon gettering deposits
US8153391B2 (en) 2008-08-29 2012-04-10 Bunge Oils, Inc. Hydrolases, nucleic acids encoding them and methods for making and using them
WO2010062435A1 (en) 2008-09-04 2010-06-03 Telcordia Technologies, Inc. Computing diagnostic explanations of network faults from monitoring data
US8271153B2 (en) 2008-09-11 2012-09-18 General Electric Company System, method and computer readable memory medium for verifying track database information
AU2009291536B2 (en) 2008-09-12 2012-08-16 Xbiotech Inc. Targeting pathogenic monocytes
EA201100755A1 (en) 2008-11-11 2011-12-30 Бёрингер Ингельхайм Интернациональ Гмбх METHOD OF TREATMENT OR PREVENTION OF THROMBOSIS BY USING DABIGATRANE ETHSYLATE OR ITS SALT WITH IMPROVED EFFICIENCY IN COMPARISON WITH STANDARD TREATMENT WARFARIN
US8226601B2 (en) 2008-11-12 2012-07-24 Sanovas, Inc. Resector balloon system
ES2583639T3 (en) 2008-11-28 2016-09-21 Terravia Holdings, Inc. Production of specific oils in heterotrophic microorganisms
US8808368B2 (en) * 2008-12-22 2014-08-19 Valtech Cardio, Ltd. Implantation of repair chords in the heart
JP5659166B2 (en) 2009-02-05 2015-01-28 武田薬品工業株式会社 Pyridazinone compounds
US20120277161A1 (en) 2009-02-23 2012-11-01 Inter-K Pty Limited Inhibition of multiple cell activation pathways
US8772339B2 (en) 2009-02-24 2014-07-08 Steven N. Mink Ethylgallate and related compounds as a treatment for sepsis and septic shock
US8217303B2 (en) 2009-03-16 2012-07-10 Abbott Cardiovascular Systems Inc. Dual gas laser cutting of medical devices
US8242248B2 (en) 2009-03-23 2012-08-14 Nodality, Inc. Kits for multiparametric phospho analysis
US8239629B2 (en) 2009-03-31 2012-08-07 Micron Technology, Inc. Hierarchical memory architecture to connect mass storage devices
US8033750B2 (en) 2009-03-31 2011-10-11 Midwest Industrial Supply, Inc. Method and composition for modifying soil and dust control
US8395191B2 (en) 2009-10-12 2013-03-12 Monolithic 3D Inc. Semiconductor device and structure
US8810796B2 (en) 2009-04-21 2014-08-19 Michigan Aerospace Corporation Light processing system and method
US9050129B2 (en) 2009-04-24 2015-06-09 Medtronic, Inc. Auto-closure apical access positioner device and method
EP2422045A2 (en) 2009-04-24 2012-02-29 Completion Technology Ltd. Processes and systems for treating oil and gas wells
WO2010138580A2 (en) 2009-05-26 2010-12-02 Tissue Solutions, Llc Filamentous tissue implant
US9040238B2 (en) 2009-06-22 2015-05-26 Max-Delbrück-Centrum Für Molekulare Medizin Berlin-Buch Polynucleotides for use in medicine
US8920369B2 (en) 2009-06-24 2014-12-30 Shifamed Holdings, Llc Steerable delivery sheaths
US9474900B2 (en) 2009-06-30 2016-10-25 Bjarne Geiges Polarization device and implantation device
WO2011006249A1 (en) 2009-07-13 2011-01-20 Université de Montréal Mutated sumo isoforms and uses thereof
US8287896B2 (en) 2010-01-06 2012-10-16 The Curators Of The University Of Missouri Scaffolds with trace element for tissue regeneration in mammals
WO2011011513A1 (en) 2009-07-21 2011-01-27 University Of Washington Through Its Center For Commercialization Inhibition of pathological bone formation
US20120277110A1 (en) 2009-07-24 2012-11-01 Fabrice Andre Parp and adjuvant cisplatin-based chemotherapy in non-small-cell lung cancer
CA2769456A1 (en) 2009-07-31 2011-02-03 Chromocell Corporation Methods and compositions for identifying and validating modulators of cell fate
US8465471B2 (en) 2009-08-05 2013-06-18 Rocin Laboratories, Inc. Endoscopically-guided electro-cauterizing power-assisted fat aspiration system for aspirating visceral fat tissue within the abdomen of a patient
AU2010280768B2 (en) 2009-08-06 2015-01-22 Dsm Ip Assets B.V. Surgical repair article based on HPPE material
BR112012002336A2 (en) 2009-08-07 2016-05-31 Merck Patent Gmbh azaheterocyclic compounds
US8210085B2 (en) 2009-08-27 2012-07-03 Ethicon, Inc. Automated systems and methods for making braided barbed sutures
MX2012002755A (en) 2009-09-04 2013-12-02 William J Kitchen Stationary track with gimbaled rider carriages amusement ride.
GB2473265A (en) 2009-09-07 2011-03-09 Sonovia Ltd Flexible PCB mounting for ultrasonic transducers
EP2475379B1 (en) 2009-09-07 2017-05-10 The Regents of the University of Colorado, A Body Corporate Cd117+cells for use in islet cell transplantation
WO2011037565A1 (en) 2009-09-23 2011-03-31 Hewlett-Packard Development Company, L.P. Providing in rush current tolerance to an electronic device
EP2790132A3 (en) 2009-09-24 2014-10-29 Terrara Code Research Institute, Inc. RFID tag
US20120273439A1 (en) 2009-09-25 2012-11-01 Production Plus Corporation Electrically conductive attachment system and rack
GB0917054D0 (en) 2009-09-29 2009-11-11 Cytoguide As Agents, uses and methods
US8261444B2 (en) 2009-10-07 2012-09-11 General Electric Company Turbine rotor fabrication using cold spraying
US20120278865A1 (en) 2009-10-09 2012-11-01 Kip Sawdy Method, system and apparatus for identification
WO2011041874A1 (en) 2009-10-09 2011-04-14 Uview Ultraviolet Systems Inc. Air conditioning lubricant delivery vessel, method and system
US8979820B2 (en) 2009-10-09 2015-03-17 Cynthia S. Bailey Method and apparatus for improving the appearance of nails affected by onychomycosis through the topical application of an aqueous solution containing boric acid and camphor or other terpenes
US8295912B2 (en) 2009-10-12 2012-10-23 Kona Medical, Inc. Method and system to inhibit a function of a nerve traveling with an artery
EP2488187A4 (en) 2009-10-13 2014-03-26 Allocure Inc Assay for the prediction of therapeutic effectiveness of mesenchymal stromal cells, and methods of using same
WO2011046616A2 (en) 2009-10-15 2011-04-21 New York University Methods for modulating bacterial infection
US8281951B2 (en) 2009-10-15 2012-10-09 Leviton Manufacturing Co., Inc. Electrical component enclosure
WO2011046570A1 (en) 2009-10-16 2011-04-21 The University Of Medicine And Dentistry Of New Jersey Method for treating chronic nerve tissue injury using a cell therapy strategy
EP2491140A1 (en) 2009-10-19 2012-08-29 Stichting Het Nederlands Kanker Instituut Predicting response to anti-cancer therapy via array comparative genomic hybridization
GB0918392D0 (en) 2009-10-20 2009-12-02 Novartis Ag Diagnostic and therapeutic methods
ES2556639T3 (en) 2009-10-21 2016-01-19 The Scripps Research Institute Method for using non-rare cells to detect rare cells
DK2491056T3 (en) 2009-10-22 2021-10-25 Univ Twente VHH FOR USE IN TISSUE REPAIR, ORGAN REGENERATION, ORGAN REPLACEMENT AND TISSUE CONSTRUCTION
GB0918940D0 (en) 2009-10-28 2009-12-16 Norsk Inst For Skog Og Landska Method
WO2011051390A1 (en) 2009-10-28 2011-05-05 Helmholtz Zentrum München - Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH) Homologous recombination in the oocyte
US8690939B2 (en) * 2009-10-29 2014-04-08 Valtech Cardio, Ltd. Method for guide-wire based advancement of a rotation assembly
FR2952233B1 (en) 2009-10-30 2011-12-16 Michelin Soc Tech PROCEDURE FOR DETECTING THE STATE OF A FUEL CELL.
BR112012009172A2 (en) 2009-10-30 2016-11-22 Dieffenbacher Gmbh Maschinen granulating press to produce granules
EP2327733A1 (en) 2009-10-30 2011-06-01 Sika Technology AG Non-Crystallising Bis-Oxazolidines
RU2568549C2 (en) 2009-10-30 2015-11-20 Диффенбахер Гмбх Машинен- Унд Анлагенбау Pelletizing press for production of pellets
US20120277144A1 (en) 2009-11-04 2012-11-01 Henricus Johannes Duckers Novel compounds for modulating neovascularisation and methods of treatment using these compounds
DE102009051939A1 (en) 2009-11-04 2011-05-05 Dieffenbacher Gmbh + Co. Kg Press with a directly driven crank mechanism, press line of such presses and a method for producing a press with at least one direct drive.
US8703751B2 (en) 2009-11-09 2014-04-22 The Regents Of The University Of California Androstenediol as an indicator for assessing estrogenicity
AU2010314827A1 (en) 2009-11-09 2012-05-31 Entourage Medical Technologies, Inc. System for providing access and closure to tissue
US8226657B2 (en) 2009-11-10 2012-07-24 Carefusion 207, Inc. Systems and methods for vertebral or other bone structure height restoration and stabilization
EP2498824B1 (en) 2009-11-11 2016-04-20 University of Twente, Institute for Biomedical Technology and Technical Medicine (MIRA) Hydrogels based on polymers of dextran tyramine and tyramine conjugates of natural polymers
US8264631B2 (en) 2009-11-11 2012-09-11 Au Optronics Corporation Common repair structures for close bus in a liquid crystal display
CN107574131A (en) 2009-11-11 2018-01-12 营养健康有限公司 Probiotic bifidobacterium strains
DE102009046670A1 (en) 2009-11-12 2011-05-19 Dieffenbacher Gmbh + Co. Kg Plant for the production of fiber-reinforced molded parts and method for operating a plant for the production of fiber-reinforced molded parts
EP2322134B1 (en) 2009-11-12 2012-09-12 BonAlive Biomaterials Oy Implantable paste and its use
WO2011057774A2 (en) 2009-11-12 2011-05-19 Services Petroliers Schlumberger Integrated choke manifold system for use in a well application
US8268389B2 (en) 2010-01-08 2012-09-18 International Business Machines Corporation Precast thermal interface adhesive for easy and repeated, separation and remating
WO2011060249A2 (en) 2009-11-13 2011-05-19 The Brigham And Women's Hospital, Inc. Methods and apparatus for vascular anastomosis
US20120276139A1 (en) 2009-11-16 2012-11-01 Stichting Dienst Landbouwkundig Onderzoek Use of newcastle disease virus-based vector for inducing an immune response in mammals
US20120276365A1 (en) 2009-11-23 2012-11-01 William Petuskey Refractory Porous Ceramics
EP2504472A1 (en) 2009-11-24 2012-10-03 Collplant Ltd. Method of generating collagen fibers
CA2779374A1 (en) 2009-11-25 2011-06-03 Diversey, Inc. Surface coating system and method of using surface coating system
CN102639325A (en) 2009-11-25 2012-08-15 泰华施公司 Surface coating system and method
CA2781341C (en) 2009-11-25 2015-05-12 Wlodzimierz Myslowski Method for production of granulated polymer -asphalt binder and sulfur concrete with participation of sulfur polymer obtained in waste sulfur solvent - borne modification
EP2327412A1 (en) 2009-11-30 2011-06-01 Universitätsklinikum Hamburg-Eppendorf Treatment of nerve injuries
WO2011067770A1 (en) * 2009-12-02 2011-06-09 Valtech Cardio, Ltd. Delivery tool for implantation of spool assembly coupled to a helical anchor
US20120278123A1 (en) 2009-12-02 2012-11-01 Houle Dale T Method And System For Determining The Capacity Required To Complete Work During Planned Start And Finished Times
JP6025255B2 (en) 2009-12-10 2016-11-16 ターンストーン リミテッド パートナーシップ Oncolytic rhabdovirus
US8747775B2 (en) 2009-12-11 2014-06-10 Food Technologies International, LLC Food safety indicator
FR2953747B1 (en) 2009-12-14 2012-03-23 Snecma PROCESS FOR REPAIRING TITANIUM VANE BY LASER RECHARGING AND MODERATE HIP COMPRESSION
WO2011084342A1 (en) 2009-12-17 2011-07-14 Cook Medical Technologies Llc Delivery system with retractable proximal end
FI20096351A0 (en) 2009-12-18 2009-12-18 Pekka Vallittu implant
BR112012015034A2 (en) 2009-12-18 2016-08-23 Du Pont water-based coating composition, use and process for multi-layer coating of substrates
BR112012014146B8 (en) 2009-12-18 2022-08-30 Camfil Ventures Ab INSTALLATION WITH AIR INLET
BR112012015410A2 (en) 2009-12-21 2016-11-29 Suntory Holdings Ltd diacylglycerol acyltransferase genes and their use.
JP5816192B2 (en) 2009-12-21 2015-11-18 コーニンクレッカ フィリップス エヌ ヴェKoninklijke Philips N.V. Processing method and image forming system
DE102009060437A1 (en) 2009-12-22 2011-06-30 Konstantin Dr.-Ing. 66386 Kelaiditis Device for the use of flow energy
CN102665482B (en) 2009-12-23 2015-06-17 高露洁-棕榄公司 Oral care system
WO2011078863A1 (en) 2009-12-23 2011-06-30 Colgate-Palmolive Company Oral care system
KR101414966B1 (en) 2009-12-23 2014-07-04 콜게이트-파아므올리브캄파니 Oral care system, kit and method
KR101267813B1 (en) 2009-12-30 2013-06-04 주식회사 삼양바이오팜 An injectable composition comprising polymeric nanoparticles containing rapamycin with an improved water solubility and a method for preparing the same, and an anticancer composition comprising the same for a combination therapy with radiation
EP2519792B1 (en) 2009-12-31 2017-08-16 LG Electronics Inc. Refrigerator and control method thereof
US9138441B2 (en) 2009-12-31 2015-09-22 Ira Milton Trachtman Compositions and method for treatment and prophylaxis of inflammatory bowel disease
ES2673726T3 (en) 2010-01-05 2018-06-25 Cell Constructs I, Llc Biomaterials made from human hair
US20120276552A1 (en) 2010-01-05 2012-11-01 University Of Cincinnati Serum spla2-iia as diagnosis marker for prostate and lung cancer
US20120276581A1 (en) 2010-01-07 2012-11-01 Core Dynamics Ltd. Method for preserving cancellous bone samples and preserved cancellous bone tissue
EP2523724B1 (en) 2010-01-12 2015-08-19 The Johns Hopkins University Implantable vestibular prosthesis
WO2011091019A1 (en) 2010-01-19 2011-07-28 University Of Tennessee Research Foundation Methods and compositions for treating and preventing parenteral nutrition associated liver disease
JP5578864B2 (en) 2010-01-20 2014-08-27 三菱重工業株式会社 Repair method of wall member with flow path
US8238178B2 (en) 2010-02-12 2012-08-07 Taiwan Semiconductor Manufacturing Company, Ltd. Redundancy circuits and operating methods thereof
SE535140C2 (en) * 2010-03-25 2012-04-24 Jan Otto Solem An implantable device, kit and system for improving cardiac function, including means for generating longitudinal movement of the mitral valve
US8363475B2 (en) 2010-03-30 2013-01-29 Ememory Technology Inc. Non-volatile memory unit cell with improved sensing margin and reliability
US11337707B2 (en) 2010-05-25 2022-05-24 Miracor Medical Sa Treating heart tissue
KR101484126B1 (en) 2010-05-26 2015-01-28 도요타 지도샤(주) Fuel cell stack, manufacturing method of fuel cell stack and replacement method of module as constituent of fuel cell stack
US8623285B2 (en) 2010-05-27 2014-01-07 Shawn Grannell Ammonia flame cracker system, method and apparatus
US9125657B2 (en) 2010-06-22 2015-09-08 Covidien Lp Methods and apparatus for storage and/or introduction of implant for hollow anatomical structure
EP2407487A1 (en) 2010-07-14 2012-01-18 F-Star Biotechnologische Forschungs - und Entwicklungsges. M.B.H. Multispecific modular antibody
US8571634B2 (en) 2010-07-23 2013-10-29 David R. Hubbard Method to diagnose and measure vascular drainage insufficiency in the central nervous system
CN101924469B (en) 2010-08-06 2012-10-24 东南大学 Switching power supply with fast transient response
WO2012040865A1 (en) 2010-10-01 2012-04-05 Alberto Weber Medical apparatus and method for heart valve repair
MX338421B (en) 2010-10-07 2016-04-15 Ac Immune Sa Phosphospecific antibodies recognising tau.
US20120278200A1 (en) 2010-10-21 2012-11-01 Van Coppenolle Bart P E Value Banking System And Technique Utilizing Complementary Value Currency
GB2484952B (en) 2010-10-27 2012-09-26 Cook Medical Technologies Llc Valvuloplasty balloon catheter
US20120272815A1 (en) 2010-10-29 2012-11-01 Anaren, Inc. Magnetic Instrument Pickup
US20120277999A1 (en) 2010-10-29 2012-11-01 Pbd Biodiagnostics, Llc Methods, kits and arrays for screening for, predicting and identifying donors for hematopoietic cell transplantation, and predicting risk of hematopoietic cell transplant (hct) to induce graft vs. host disease (gvhd)
US20120276509A1 (en) 2010-10-29 2012-11-01 The Cleveland Clinic Foundation System of preoperative planning and provision of patient-specific surgical aids
KR20180059560A (en) 2010-10-29 2018-06-04 애브비 인코포레이티드 Solid dispersions containing an apoptosis-inducing agent
US8394006B2 (en) 2010-11-19 2013-03-12 Kensey Nash Corporation Centrifuge
US8608738B2 (en) 2010-12-06 2013-12-17 Soulor Surgical, Inc. Apparatus for treating a portion of a reproductive system and related methods of use
KR101293635B1 (en) 2010-12-29 2013-08-05 주식회사 엘지화학 Apparatus and method for managing battery pack based on retrogression degree of secondary electric cell and battery pack using it
WO2012097086A1 (en) 2011-01-11 2012-07-19 Amsel Medical Corporation Method and apparatus for treating varicose veins
US20120191128A1 (en) 2011-01-25 2012-07-26 Wound Care 360?, Inc. Vascular wound closing apparatus and method
JP2014511365A (en) 2011-01-27 2014-05-15 バクスター・インターナショナル・インコーポレイテッド Use of (S) -esmolol to modulate venous stimulation associated with the treatment of cardiac disorders
JP2014511218A (en) * 2011-02-01 2014-05-15 セント・ジュード・メディカル,インコーポレイテッド Apparatus and method for heart valve repair
EP2670849A1 (en) 2011-02-03 2013-12-11 Mirna Therapeutics, Inc. Synthetic mimics of mir-124
US8906397B2 (en) 2011-02-07 2014-12-09 Professional Compounding Centers of America, Ltd Permeation enhancers for topical formulations
US8944338B2 (en) 2011-02-24 2015-02-03 Google Inc. Thermostat with self-configuring connections to facilitate do-it-yourself installation
US20120276084A1 (en) 2011-02-25 2012-11-01 The Brigham And Women's Hospital, Inc. Predicting Risk of Age-Related Macular Degeneration
EP2678453A4 (en) 2011-02-25 2015-07-15 Lab Corp America Holdings Methods and compositions for determining virus susceptibility to integrase inhibitors
US20120277155A1 (en) 2011-02-25 2012-11-01 Medtronic, Inc. Therapy for kidney disease and/or heart failure
ES2748430T3 (en) 2011-02-28 2020-03-16 Seattle Childrens Res Institute Coupling endonucleases with end-processing enzymes that drive high-efficiency gene disruption
US8694866B2 (en) 2011-03-15 2014-04-08 California Institute Of Technology MDS array codes with optimal building
JP5594198B2 (en) 2011-03-16 2014-09-24 富士通株式会社 Electronic component and electronic component assembling apparatus
US20120278236A1 (en) 2011-03-21 2012-11-01 Qualcomm Incorporated System and method for presentment of nonconfidential transaction token identifier
US9046342B2 (en) 2011-04-01 2015-06-02 Habsonic, Llc Coaxial cable Bragg grating sensor
US20120278242A1 (en) 2011-04-01 2012-11-01 Massachusetts Institute Of Technology System and method for providing product data collection, monitoring, and tracking
EP2694060A4 (en) 2011-04-01 2014-09-10 Univ Utah Res Found Substituted 3-(1h-benzo{d}imidazol-2-yl)-1h-indazole-analogs as inhibitors of the pdk1 kinase
WO2012141971A2 (en) 2011-04-05 2012-10-18 The Board Of Trustees Of The Leland Stanford Junior University Methods and compositions for rejuvenation and expansion of stem cells
DE102011006905A1 (en) 2011-04-06 2012-10-11 Kugler-Womako Gmbh Machine for making books, in particular photo books and / or picture books
CA2832300C (en) 2011-04-06 2021-03-30 Mary Kay Inc. Topical skin care formulation comprising an extract of jasminum stephanense
WO2013089819A2 (en) 2011-04-08 2013-06-20 The Board Of Trustees Of The Leland Stanford Junior University Microrna mediated neuronal cell induction
US20120277517A1 (en) 2011-04-08 2012-11-01 The Johns Hopkins University Formulation and Methods for Enhanced Interventional Image-Guided Therapy of Cancer
CN102252226B (en) 2011-04-14 2013-01-09 深圳市华星光电技术有限公司 Light-emitting diode (LED) component and LED light string adopting same
US9028444B2 (en) 2011-04-15 2015-05-12 W. L. Gore & Associates, Inc. Pivoting ring seal
PL2517986T3 (en) 2011-04-26 2014-03-31 Interroll Holding Ag Braking roller
US20120277576A1 (en) 2011-04-26 2012-11-01 Chun Kee Lui Echogenic infusion port catheter
US10187494B2 (en) 2011-04-26 2019-01-22 Acumera, Inc. Gateway device application development system
US20120276518A1 (en) 2011-04-26 2012-11-01 John Archie Gillis Method and Device for Perfusing Tissue by ExVivo Attachment to a Living Organism
US9364701B2 (en) 2011-04-26 2016-06-14 Upper Core Technologies, Llc Device and methods for accessory chest muscle development
KR101330615B1 (en) 2011-04-26 2013-11-18 로베르트 보쉬 게엠베하 Rechargeable battery
US20120276008A1 (en) 2011-04-26 2012-11-01 Spine Wave, Inc. Radiopaque injectable nucleus hydrogel compositions
US20120277864A1 (en) 2011-04-26 2012-11-01 Warsaw Orthopedic, Inc. Cannula assembly with non-circular profile and method of use
US9519496B2 (en) 2011-04-26 2016-12-13 Microsoft Technology Licensing, Llc Detecting and preventing virtual disk storage linkage faults
US20120278099A1 (en) 2011-04-26 2012-11-01 Cerner Innovation, Inc. Monitoring, capturing, measuring and annotating physiological waveform data
US8900767B2 (en) 2011-04-26 2014-12-02 GM Global Technology Operations LLC Algorithm for in-situ quantification of PEMFC membrane health over its life
US20120275860A1 (en) 2011-04-26 2012-11-01 Road Science, Llc Destabilized bituminous bonding layer
KR101282270B1 (en) 2011-04-26 2013-07-10 주식회사 지엔원 Apparatus for blocking the power of coilless clutch
US20120277582A1 (en) 2011-04-26 2012-11-01 Kyphon Sarl Devices and methods for osteolytic lesion assessment using a steerable catheter
US8308680B1 (en) 2011-04-26 2012-11-13 Medtronic Minimed, Inc. Selective alarms for an infusion device
US9185824B2 (en) 2011-04-26 2015-11-10 Panduit Corp. Cable pathway system for network architecture
TWI617295B (en) 2011-04-26 2018-03-11 星瑟斯有限公司 Hinged fixation devices for combined upper jaw correction
US9721754B2 (en) 2011-04-26 2017-08-01 Carl Zeiss Smt Gmbh Method and apparatus for processing a substrate with a focused particle beam
JP5351297B2 (en) 2011-04-27 2013-11-27 パナソニック株式会社 Manufacturing method of organic EL element
US8530980B2 (en) 2011-04-27 2013-09-10 United Microelectronics Corp. Gate stack structure with etch stop layer and manufacturing process thereof
US8783297B2 (en) 2011-04-27 2014-07-22 Massachusetts Institute Of Technology Robotic system for pipeline rehabilitation
WO2012148500A2 (en) 2011-04-27 2012-11-01 Spinesmith Partners L.P. Interbody fusion device with lipped anterior plate and associated methods
WO2012149492A1 (en) 2011-04-27 2012-11-01 Massachusetts Institute Of Technology Coating compositions, methods and coated devices
US20120273220A1 (en) 2011-04-27 2012-11-01 Bp Corporation North America Inc. Pressure relief valve
US9475276B2 (en) 2011-04-27 2016-10-25 Stolle Machinery Company, Llc Can decorator machine, ink station assembly therefor, and can decorating method employing same
WO2012148499A2 (en) 2011-04-27 2012-11-01 Spinesmith Partners Lp Interbody fusion device with snap on anterior plate and associated methods
US20120273389A1 (en) 2011-04-27 2012-11-01 Freescale Semiconductor, Inc. Semiconductor tray carrier
US8795368B2 (en) 2011-04-27 2014-08-05 Warsaw Orthopedic, Inc. Expandable implant system and methods of use
US9121439B2 (en) 2011-04-27 2015-09-01 Dura Global Technologies, Llc Multi-piece shifter cable system
US9810533B2 (en) 2011-04-27 2017-11-07 Trimble Inc. Railway track monitoring
CN102760697B (en) 2011-04-27 2016-08-03 株式会社半导体能源研究所 The manufacture method of semiconductor device
KR102068107B1 (en) 2011-04-27 2020-01-20 아미리스 인코퍼레이티드 Methods for genomic modification
US9014049B2 (en) 2011-04-27 2015-04-21 Cisco Technology, Inc. Selectively populating forwarding information bases in a packet switch
US8968760B2 (en) 2011-04-27 2015-03-03 Covidien Lp Attachment of a biomaterial to tissue
US8570788B2 (en) 2011-04-27 2013-10-29 Apple Inc. Method and apparatus for power domain isolation during power down
US20120272876A1 (en) 2011-04-27 2012-11-01 Bergeron Martin Maple syrup evaporator with biomass burner
WO2012148840A2 (en) 2011-04-27 2012-11-01 Bp Corporation North America Inc. Weighted pressure relief valve
US8922063B2 (en) 2011-04-27 2014-12-30 Green Charge Networks, Llc Circuit for rendering energy storage devices parallelable
US8721728B2 (en) 2011-04-27 2014-05-13 Biomet Manufacturing, Llc Modular glenoid prosthesis
US8789852B2 (en) 2011-04-27 2014-07-29 Hosebee, Llc Hose repair clamp
US20120278195A1 (en) 2011-04-27 2012-11-01 Douglas Joseph Method for locating a provider and a provider locating system
US9036173B2 (en) 2011-04-27 2015-05-19 Xerox Corporation Methods and systems to troubleshoot malfunctions in multifunction devices using a wireless handheld device
US8857520B2 (en) 2011-04-27 2014-10-14 Wild Well Control, Inc. Emergency disconnect system for riserless subsea well intervention system
US8729957B2 (en) 2011-04-28 2014-05-20 Zoll Circulation, Inc. Battery management system with MOSFET boost system
DE102011017695B4 (en) 2011-04-28 2023-11-09 Zf Friedrichshafen Ag Device for actuating a transmission device with several electrohydraulically actuated frictional and positive switching elements
US8790087B2 (en) 2011-04-28 2014-07-29 Hamilton Sundstrand Corporation Interlocking blade sheath
US8584729B2 (en) 2011-04-28 2013-11-19 Lauren H Fillmore Mechanism for raising and lowering a dual shade covering a window
WO2012149474A2 (en) 2011-04-28 2012-11-01 Zoll Circulation, Inc. Viral distribution of battery management parameters
GB2490348B (en) 2011-04-28 2013-12-25 Rolls Royce Plc A head part of an annular combustion chamber
CA2834654A1 (en) 2011-04-28 2012-11-01 Zoll Circulation, Inc. Battery management system for control of lithium power cells
US20120273141A1 (en) 2011-04-28 2012-11-01 Qualitas Manufacturing, Inc. Manual Drive Mechanism for Rolling Protective Shutters
US8689866B2 (en) 2011-04-28 2014-04-08 Canrig Drilling Technology Ltd. Automated systems and methods for make-up and break-out of tubulars
US9940440B2 (en) 2011-04-28 2018-04-10 Medtronic, Inc. Detecting and responding to software and hardware anomalies in a fluid delivery system
US9314205B2 (en) 2011-04-28 2016-04-19 Medtronic, Inc. Measurement of cardiac cycle length and pressure metrics from pulmonary arterial pressure
US8790650B2 (en) 2011-04-28 2014-07-29 Vanderbilt University Methods of using an antibody to inhibit WNT-mediated cardiac remodeling
US8427787B2 (en) 2011-04-28 2013-04-23 Entrotech, Inc. Hard disk drives with improved exiting regions for electrical connectors and related methods
US20120278760A1 (en) 2011-04-28 2012-11-01 Medtronic, Inc. Predictive background data transfer for implantable medical devices
WO2012149269A2 (en) 2011-04-28 2012-11-01 Abb Technology Ag Determination of cd and/or md variations from scanning measurements of a sheet of material
US9017711B2 (en) 2011-04-28 2015-04-28 Warsaw Orthopedic, Inc. Soft tissue wrap
US9063747B2 (en) 2011-04-28 2015-06-23 Freescale Semiconductor, Inc. Microprocessor systems and methods for a combined register file and checkpoint repair register
US9707257B2 (en) 2011-04-28 2017-07-18 The University Of Notre Dame Anti-HIV group I introns and uses thereof in treating HIV infections
US8723468B2 (en) 2011-04-28 2014-05-13 Aurora Office Equipment Co., Ltd. Cooled motor
KR102109309B1 (en) 2011-04-28 2020-05-12 라이프셀 코포레이션 Method for enzymatic treatment of tissue products
US9649341B2 (en) 2011-04-28 2017-05-16 Warsaw Orthopedic, Inc. Collagen matrix for tissue engineering
US8591543B2 (en) 2011-04-28 2013-11-26 Cardiotulip Llc Devices and methods for closure of a patent foramen ovale
US8657001B2 (en) 2011-04-28 2014-02-25 Enventure Global Technology, L.L.C. Downhole release joint
JP4910071B1 (en) 2011-04-28 2012-04-04 昭男 平根 Sheet metal repair jig
WO2012149292A2 (en) 2011-04-28 2012-11-01 Stemit Enterprises, Llc Apparatus and method for facilitating bladder removal
US20120277324A1 (en) 2011-04-28 2012-11-01 Eastman Chemical Company Betaine esters and process for making and using
AU2012249536B2 (en) 2011-04-28 2016-09-22 Amgen (Europe) GmbH Methods and compositions using PDE4 inhibitors for the treatment and management of autoimmune and inflammatory diseases
KR101357759B1 (en) 2011-04-28 2014-02-03 에스케이하이닉스 주식회사 Semiconductor integrated circuit and semiconductor memory device having fuse circuit
GB201107090D0 (en) 2011-04-28 2011-06-08 Rolls Royce Plc A head part of an annular combustion chamber
JP2014518058A (en) 2011-04-28 2014-07-24 ゾール サーキュレイション インコーポレイテッド System and method for automatically detecting battery insertion
US20120273142A1 (en) 2011-04-28 2012-11-01 Qualitas Manufacturing, Inc. Manual Drive Mechanism for Rolling Protective Shutters
JP5746553B2 (en) 2011-04-28 2015-07-08 株式会社東芝 Substrate processing system and substrate processing program
US20120277798A1 (en) 2011-04-28 2012-11-01 Warsaw Orthopedic, Inc. Spinal Rod Construct to Limit Facet Impingement
US8593760B2 (en) 2011-04-28 2013-11-26 Entrotech, Inc. Hard disk drives with electrical connectors comprising a flexible circuit extending through an opening in the base and related methods
US9358460B2 (en) 2011-04-28 2016-06-07 Numecent Holdings, Inc. Adaptive cloud-based application streaming
US20120278913A1 (en) 2011-04-28 2012-11-01 University Of Notre Dame Ribozyme Effector Gene in Dengue Fever Transmission and Disease Control
US20120277544A1 (en) 2011-04-28 2012-11-01 Medtronic, Inc. Biodegradable insertion guide for the insertion of a medical device
US8739888B2 (en) 2011-04-28 2014-06-03 Tesco Corporation Mechanically actuated casing drive system tool
US9540610B2 (en) 2011-04-28 2017-01-10 Warsaw Orthopedic, Inc. Collagen and cell implant
US8812098B2 (en) 2011-04-28 2014-08-19 Medtronic, Inc. Seizure probability metrics
US8813998B2 (en) 2011-04-28 2014-08-26 The Procter & Gamble Company Dispensers for sanitary tissue products
US9057460B2 (en) 2011-04-28 2015-06-16 Sioux Chief Mfg. Co., Inc. Plumbing supply line and drain line mounting and finish panel
KR20120122287A (en) 2011-04-28 2012-11-07 에스케이하이닉스 주식회사 Fuse circuit for semiconductor device
US9123107B2 (en) 2011-04-28 2015-09-01 Medtronic, Inc. Image-based analysis of implantable medical device positioning
DE102011018986A1 (en) 2011-04-28 2012-10-31 Heraeus Noblelight Gmbh Lamp module, in particular for spectral analysis devices
US20120272637A1 (en) 2011-04-28 2012-11-01 Brian Kenneth Holland Replacing an aperture in a laminated component
US8468477B2 (en) 2011-04-28 2013-06-18 International Business Machines Corporation Logic modification synthesis for high performance circuits
US9206983B2 (en) 2011-04-28 2015-12-08 Siemens Energy, Inc. Internal combustion engine hot gas path component with powder metallurgy structure
US20120277599A1 (en) 2011-04-28 2012-11-01 Greenhut Saul E Measurement of cardiac cycle length and pressure metrics from pulmonary arterial pressure
JP6195558B2 (en) 2011-04-28 2017-09-13 ゾール サーキュレイション インコーポレイテッドZOLL Circulation,Inc. System and method for tracking and storing battery performance data
GB201107095D0 (en) 2011-04-28 2011-06-08 Rolls Royce Plc A head part of an annular combustion chamber
KR20120122220A (en) 2011-04-28 2012-11-07 에스케이하이닉스 주식회사 Semiconductor memory device and repair method of semiconductor memory device
US9085068B2 (en) 2011-04-28 2015-07-21 Schley Products, Inc. Pitman arm removal tool and method
JP5187409B2 (en) 2011-04-28 2013-04-24 トヨタ自動車株式会社 Air-fuel ratio variation abnormality detection device
US8740558B2 (en) 2011-04-29 2014-06-03 United Technologies Corporation External threaded mount attachment for fan case
NZ592576A (en) 2011-04-29 2013-09-27 Jenkin Timber Ltd A fixing system for cladding and a cladded structure
WO2012146383A1 (en) 2011-04-29 2012-11-01 Grünenthal GmbH Tapentadol for preventing and treating depression and anxiety
US8558132B2 (en) 2011-04-29 2013-10-15 National Presort, Inc. Document sorting machine
US8474060B2 (en) 2011-04-29 2013-06-25 Bruker Nano, Inc. Scanning probe microscope with compact scanner
WO2012149328A1 (en) 2011-04-29 2012-11-01 Boston Scientific Scimed, Inc. Protective surfaces for drug-coated medical devices
KR20120122378A (en) 2011-04-29 2012-11-07 삼성전기주식회사 Image recording system for front side of vehicle
US20120273161A1 (en) 2011-04-29 2012-11-01 Ford Global Technologies, Llc Heat Exchanger
US8439326B2 (en) 2011-04-29 2013-05-14 Esco Tool Safety tether for pipe end prep tool
FR2974576B1 (en) 2011-04-29 2013-07-19 Sanofi Aventis N - [(1H-PYRAZOL-1-YL) ARYL] -1H-INDOLE OR 1H-INDAZOLE-3-CARBOXAMIDE DERIVATIVES, THEIR PREPARATION AND THEIR THERAPEUTIC APPLICATIONS
US8530772B2 (en) 2011-04-29 2013-09-10 National Presort, Inc. Document sorting machine
US9456755B2 (en) 2011-04-29 2016-10-04 Medtronic, Inc. Method and device to monitor patients with kidney disease
US9109198B2 (en) 2011-04-29 2015-08-18 General Electric Company Automated systems and methods for isolating regenerative cells from adipose tissue
US9687227B2 (en) 2011-04-29 2017-06-27 Covidien Lp Apparatus and method of forming barbs on a suture
US9623206B2 (en) 2011-04-29 2017-04-18 Cook Medical Technologies Llc Catheter having a selectively variable degree of flexibility
US8728081B2 (en) 2011-04-29 2014-05-20 Warsaw Orthopedic, Inc. Bone tamp and methods of use
US20120272495A1 (en) 2011-04-29 2012-11-01 Leroy Hildebrandt Fence Repair System And Method Of Use
US9649494B2 (en) 2011-04-29 2017-05-16 Medtronic, Inc. Electrical stimulation therapy based on head position
US20120275927A1 (en) 2011-04-29 2012-11-01 Hotaek Rhim Water-leak Damage Prevention System Utilizing A Unitized Tank Collection Flange Reservoir System
WO2012149558A1 (en) 2011-04-29 2012-11-01 Chamberlin D Eric Systems and methods for eliciting a therapeutic zone
TWI428156B (en) 2011-04-29 2014-03-01 Far Eastern New Century Corp Composite particles, a preparation method thereof and its application
US20120276152A1 (en) 2011-04-29 2012-11-01 Syed Hossainy Systems and methods of using zinc-chelator to treat myocardial infarction
HUE049207T2 (en) 2011-04-29 2020-09-28 Penn State Res Found Small molecule trail gene induction by normal and tumor cells as an anticancer therapy
US9011133B2 (en) 2011-04-29 2015-04-21 Covidien Lp Apparatus and method of forming barbs on a suture
US8543280B2 (en) 2011-04-29 2013-09-24 Toyota Motor Engineering & Manufacturing North America, Inc. Collaborative multi-agent vehicle fault diagnostic system and associated methodology
KR20120122379A (en) 2011-04-29 2012-11-07 삼성전기주식회사 Image recording system for front side of vehicle and reflection unit
CN103502269A (en) 2011-04-29 2014-01-08 先锋国际良种公司 Down-regulation of a homeodomain-leucine zipper i-class homeobox gene for improved plant performance
US9789307B2 (en) 2011-04-29 2017-10-17 Medtronic, Inc. Dual prophylactic and abortive electrical stimulation
KR20120122549A (en) 2011-04-29 2012-11-07 에스케이하이닉스 주식회사 Semiconductor memory device and repair method of the same
US20120274440A1 (en) 2011-04-29 2012-11-01 General Electric Company Method and system to disconnect a utility service based on seismic activity
US9878161B2 (en) 2011-04-29 2018-01-30 Medtronic, Inc. Entrainment of bioelectrical brain signals
US20120272660A1 (en) 2011-04-29 2012-11-01 Proenergy Services, Llc Method and assembly for retrofitting a gas turbine combustor end cover
US20120272624A1 (en) 2011-04-29 2012-11-01 Kinex Cappers Llc Semi-automated cap securing apparatus
US8801049B2 (en) 2011-04-29 2014-08-12 Springseal, Inc. Pipe coupling system and method
US9243604B2 (en) 2011-04-29 2016-01-26 James Scott MONTGOMERY In-pipe turbine
US8335524B2 (en) 2011-04-29 2012-12-18 Navteq B.V. Method and system for providing location targeted advertisements
KR20120122594A (en) 2011-04-29 2012-11-07 에스케이하이닉스 주식회사 Semiconductor Apparatus
US10448889B2 (en) 2011-04-29 2019-10-22 Medtronic, Inc. Determining nerve location relative to electrodes
US8641101B2 (en) 2011-04-29 2014-02-04 Hamilton Sundstrand Corporation Oil transfer tube and assembly
US9700717B2 (en) 2011-04-29 2017-07-11 Chalfont LLC Apparatus and method for treating and preventing formation of pressure ulcers
JP6066997B2 (en) 2011-05-01 2017-01-25 ラッカス ワイヤレス, インコーポレイテッド Remote cable access point reset
US20130041395A1 (en) 2011-08-09 2013-02-14 Didier De Canniere Introductory assembly and method for inserting intracardiac instruments
US9566443B2 (en) 2013-11-26 2017-02-14 Corquest Medical, Inc. System for treating heart valve malfunction including mitral regurgitation

Patent Citations (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8758393B2 (en) * 2007-10-18 2014-06-24 Neochord, Inc. Minimally invasive repair of a valve leaflet in a beating heart
US20110029071A1 (en) * 2007-12-20 2011-02-03 Amnon Zlotnick Elongated body for deployment in a coronary sinus
US20100042147A1 (en) * 2008-08-14 2010-02-18 Edwards Lifesciences Corporation Method and apparatus for repairing or replacing chordae tendinae
US8147542B2 (en) * 2008-12-22 2012-04-03 Valtech Cardio, Ltd. Adjustable repair chords and spool mechanism therefor
US20100179574A1 (en) * 2009-01-14 2010-07-15 James Longoria Synthetic chord
US8790394B2 (en) * 2010-05-24 2014-07-29 Valtech Cardio, Ltd. Adjustable artificial chordeae tendineae with suture loops
US8408214B2 (en) * 2010-07-08 2013-04-02 Benjamin Spenser Method for implanting prosthetic valve
WO2013036742A1 (en) * 2011-09-09 2013-03-14 Emory University Systems, devices and methods for repair of heart valve lesions

Cited By (53)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20150045878A1 (en) * 2006-10-04 2015-02-12 Edwards Lifesciences Corporation Method and apparatus for reshaping a ventricle
US9561105B2 (en) * 2006-10-04 2017-02-07 Edwards Lifesciences Corporation Method and apparatus for reshaping a ventricle
US20140114390A1 (en) * 2010-01-22 2014-04-24 4Tech Inc. Tricuspid valve repair using tension
US10433963B2 (en) 2010-01-22 2019-10-08 4Tech Inc. Tissue anchor and delivery tool
US10238491B2 (en) 2010-01-22 2019-03-26 4Tech Inc. Tricuspid valve repair using tension
US10405978B2 (en) 2010-01-22 2019-09-10 4Tech Inc. Tricuspid valve repair using tension
US10058323B2 (en) 2010-01-22 2018-08-28 4 Tech Inc. Tricuspid valve repair using tension
US9307980B2 (en) * 2010-01-22 2016-04-12 4Tech Inc. Tricuspid valve repair using tension
US10813630B2 (en) 2011-08-09 2020-10-27 Corquest Medical, Inc. Closure system for atrial wall
US20150025312A1 (en) * 2011-08-09 2015-01-22 Didier De Canniere Introductory assembly and method for inserting intracardiac instruments
US10206673B2 (en) 2012-05-31 2019-02-19 4Tech, Inc. Suture-securing for cardiac valve repair
US10307167B2 (en) 2012-12-14 2019-06-04 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
US10314594B2 (en) 2012-12-14 2019-06-11 Corquest Medical, Inc. Assembly and method for left atrial appendage occlusion
US9788948B2 (en) 2013-01-09 2017-10-17 4 Tech Inc. Soft tissue anchors and implantation techniques
US10449050B2 (en) 2013-01-09 2019-10-22 4 Tech Inc. Soft tissue depth-finding tool
US9693865B2 (en) 2013-01-09 2017-07-04 4 Tech Inc. Soft tissue depth-finding tool
US9907681B2 (en) 2013-03-14 2018-03-06 4Tech Inc. Stent with tether interface
US10052095B2 (en) 2013-10-30 2018-08-21 4Tech Inc. Multiple anchoring-point tension system
US10039643B2 (en) 2013-10-30 2018-08-07 4Tech Inc. Multiple anchoring-point tension system
US10022114B2 (en) 2013-10-30 2018-07-17 4Tech Inc. Percutaneous tether locking
US10052096B2 (en) * 2013-11-22 2018-08-21 On-X Life Technologies, Inc. Chordal sizer
US20150148692A1 (en) * 2013-11-22 2015-05-28 On-X Life Technologies, Inc. Chordal Sizer
US9801720B2 (en) 2014-06-19 2017-10-31 4Tech Inc. Cardiac tissue cinching
US10085735B2 (en) * 2014-10-29 2018-10-02 Smith & Nephew, Inc. Modular tissue repair kit and devices and method related thereto
US20160120535A1 (en) * 2014-10-29 2016-05-05 Smith & Nephew, Inc. Modular tissue repair kit and devices and method related thereto
US9907547B2 (en) 2014-12-02 2018-03-06 4Tech Inc. Off-center tissue anchors
US11389152B2 (en) 2014-12-02 2022-07-19 4Tech Inc. Off-center tissue anchors with tension members
US10213303B2 (en) 2015-02-02 2019-02-26 On-X Life Technologies, Inc. Rapid deployment artificial chordae Tendinae system
US9480565B2 (en) * 2015-02-02 2016-11-01 On-X Life Technologies, Inc. Rapid deployment artificial chordae tendinae system
WO2016126699A1 (en) * 2015-02-02 2016-08-11 On-X Life Technologies, Inc. Rapid deployment artificial chordae tendinae system
CN108697418A (en) * 2015-11-02 2018-10-23 马里兰大学巴尔的摩分校 Distal side anchoring device and method for mitral valve reparation
WO2017210434A1 (en) * 2016-06-01 2017-12-07 On-X Life Technologies, Inc. Pull-through chordae tendineae system
US11103350B2 (en) 2016-06-01 2021-08-31 On-X Life Technologies, Inc. Pull-through chordae tendineae system
US11696828B2 (en) 2016-12-30 2023-07-11 Pipeline Medical Technologies, Inc. Method and apparatus for mitral valve chord repair
US10925731B2 (en) 2016-12-30 2021-02-23 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US10617523B2 (en) 2016-12-30 2020-04-14 Pipeline Medical Technologies, Inc. Tissue anchor with dynamic depth indicator
US10660753B2 (en) 2016-12-30 2020-05-26 Pipeline Medical Techologies, Inc. Leaflet capture and anchor deployment system
US10667910B2 (en) 2016-12-30 2020-06-02 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US10675150B2 (en) 2016-12-30 2020-06-09 Pipeline Medical Technologies, Inc. Method for transvascular implantation of neo chordae tendinae
US10548733B2 (en) 2016-12-30 2020-02-04 Pipeline Medical Technologies, Inc. Method of transvascular prosthetic chordae tendinae implantation
US11666441B2 (en) 2016-12-30 2023-06-06 Pipeline Medical Technologies, Inc. Endovascular suture lock
US10682230B2 (en) 2016-12-30 2020-06-16 Pipeline Medical Technologies, Inc. Apparatus for transvascular implantation of neo chordae tendinae
US11690719B2 (en) 2016-12-30 2023-07-04 Pipeline Medical Technologies, Inc. Leaflet capture and anchor deployment system
US9877833B1 (en) 2016-12-30 2018-01-30 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US11684475B2 (en) 2016-12-30 2023-06-27 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US11083580B2 (en) 2016-12-30 2021-08-10 Pipeline Medical Technologies, Inc. Method of securing a leaflet anchor to a mitral valve leaflet
US10543090B2 (en) 2016-12-30 2020-01-28 Pipeline Medical Technologies, Inc. Neo chordae tendinae deployment system
US10799356B2 (en) 2017-09-12 2020-10-13 Boston Scientific Scimed, Inc. Percutaneous papillary muscle relocation
USD853561S1 (en) * 2018-02-16 2019-07-09 Chengjun Guo Implantation device
US10925728B2 (en) * 2018-02-22 2021-02-23 Medtronic Vascular, Inc. Prosthetic heart valve delivery systems and methods
US20190254816A1 (en) * 2018-02-22 2019-08-22 Medtronic Vascular, Inc. Prosthetic heart valve delivery systems and methods
US20200222186A1 (en) * 2019-01-16 2020-07-16 Neochord, Inc. Transcatheter methods for heart valve repair
US20220142778A1 (en) * 2019-01-28 2022-05-12 Vesalius Cardiovascular Inc. Apparatus for use in repairing mitral valves and method of use thereof

Also Published As

Publication number Publication date
JP2015535465A (en) 2015-12-14
EP2922502A4 (en) 2016-08-03
IL238933A0 (en) 2015-07-30
AU2013348100B2 (en) 2018-05-17
WO2014081809A3 (en) 2014-07-17
CA2891356A1 (en) 2014-05-30
AU2013348100C1 (en) 2018-06-07
US10159571B2 (en) 2018-12-25
EP2922502B1 (en) 2018-04-25
EP2922502A2 (en) 2015-09-30
JP2018061855A (en) 2018-04-19
WO2014081809A2 (en) 2014-05-30
AU2013348100A1 (en) 2015-05-28
US20140142687A1 (en) 2014-05-22

Similar Documents

Publication Publication Date Title
US20140142689A1 (en) Device and method of treating heart valve malfunction
JP7365392B2 (en) mitral valve shackles
US20220280149A1 (en) Suturing devices and methods for suturing an anatomic valve
US8292884B2 (en) Cardiac devices and methods for minimally invasive repair of ischemic mitral regurgitation
US20210220123A1 (en) Heart valve therapeutic device
US8454683B2 (en) Annuloplasty device having a helical anchor and methods for its use
US20070118213A1 (en) Methods, devices, and kits for treating mitral valve prolapse
US20110301701A1 (en) Method and apparatus for minimally invasive heart valve procedures
US20070265658A1 (en) Anchoring and tethering system
US10813630B2 (en) Closure system for atrial wall
US20130041395A1 (en) Introductory assembly and method for inserting intracardiac instruments
JP2014523282A (en) Minimally invasive repair of heart valve leaflets
US20210236287A1 (en) Tether Attachment Assembly For Epicardial Pads And Devices And Methods Of Delivery For Same
US9987135B2 (en) Devices and methods for treating functional tricuspid valve regurgitation
WO2020096861A1 (en) Percutaneous anchoring for treatment of heart failure with reduced ejection fraction
US20230363908A1 (en) Suture anchor for minimally invasive heart valve repair
CA2928434A1 (en) Closure system for atrial wall
AU2014342390A1 (en) Closure system for atrial wall

Legal Events

Date Code Title Description
AS Assignment

Owner name: CORQUEST MEDICAL, INC., FLORIDA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:DE CANNIERE, DIDIER;MOUREAUX, CHRISTOPHE;SIGNING DATES FROM 20130204 TO 20130211;REEL/FRAME:030130/0097

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION