US20230255773A1 - System and method for reshaping heart - Google Patents
System and method for reshaping heart Download PDFInfo
- Publication number
- US20230255773A1 US20230255773A1 US18/303,542 US202318303542A US2023255773A1 US 20230255773 A1 US20230255773 A1 US 20230255773A1 US 202318303542 A US202318303542 A US 202318303542A US 2023255773 A1 US2023255773 A1 US 2023255773A1
- Authority
- US
- United States
- Prior art keywords
- balloon
- cavity
- injection
- heart
- catheter
- 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.)
- Pending
Links
- 210000002216 heart Anatomy 0.000 title claims abstract description 61
- 238000000034 method Methods 0.000 title claims abstract description 43
- 238000002347 injection Methods 0.000 claims abstract description 97
- 239000007924 injection Substances 0.000 claims abstract description 97
- 239000000853 adhesive Substances 0.000 claims abstract description 22
- 230000001070 adhesive effect Effects 0.000 claims abstract description 22
- 230000004888 barrier function Effects 0.000 claims description 34
- 210000005245 right atrium Anatomy 0.000 claims description 18
- 210000005241 right ventricle Anatomy 0.000 claims description 18
- 210000001562 sternum Anatomy 0.000 claims description 17
- 239000012530 fluid Substances 0.000 claims description 15
- 210000000591 tricuspid valve Anatomy 0.000 claims description 12
- 210000001519 tissue Anatomy 0.000 claims description 11
- 239000011148 porous material Substances 0.000 claims description 6
- 238000004891 communication Methods 0.000 claims description 5
- 230000008878 coupling Effects 0.000 claims description 4
- 238000010168 coupling process Methods 0.000 claims description 4
- 238000005859 coupling reaction Methods 0.000 claims description 4
- 206010067171 Regurgitation Diseases 0.000 abstract 1
- 239000000463 material Substances 0.000 description 18
- 239000007789 gas Substances 0.000 description 16
- 210000003516 pericardium Anatomy 0.000 description 14
- 238000003780 insertion Methods 0.000 description 10
- 230000037431 insertion Effects 0.000 description 10
- 201000001943 Tricuspid Valve Insufficiency Diseases 0.000 description 9
- 230000002787 reinforcement Effects 0.000 description 9
- 230000006835 compression Effects 0.000 description 7
- 238000007906 compression Methods 0.000 description 7
- 206010044640 Tricuspid valve incompetence Diseases 0.000 description 6
- 210000003484 anatomy Anatomy 0.000 description 5
- -1 polyethylene Polymers 0.000 description 5
- 208000028073 tricuspid valve disease Diseases 0.000 description 5
- 239000004698 Polyethylene Substances 0.000 description 4
- 238000013459 approach Methods 0.000 description 4
- 230000007246 mechanism Effects 0.000 description 4
- 229920002635 polyurethane Polymers 0.000 description 4
- 239000004814 polyurethane Substances 0.000 description 4
- 239000008280 blood Substances 0.000 description 3
- 210000004369 blood Anatomy 0.000 description 3
- 210000005242 cardiac chamber Anatomy 0.000 description 3
- 230000008859 change Effects 0.000 description 3
- 238000013461 design Methods 0.000 description 3
- 230000000916 dilatatory effect Effects 0.000 description 3
- 238000002513 implantation Methods 0.000 description 3
- 238000007373 indentation Methods 0.000 description 3
- 238000003475 lamination Methods 0.000 description 3
- 229920000573 polyethylene Polymers 0.000 description 3
- 238000001356 surgical procedure Methods 0.000 description 3
- 201000006660 Ebstein Anomaly Diseases 0.000 description 2
- 239000004952 Polyamide Substances 0.000 description 2
- 239000004743 Polypropylene Substances 0.000 description 2
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 2
- 206010044642 Tricuspid valve stenosis Diseases 0.000 description 2
- 230000002950 deficient Effects 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 238000001125 extrusion Methods 0.000 description 2
- 239000000835 fiber Substances 0.000 description 2
- 238000002594 fluoroscopy Methods 0.000 description 2
- 239000006260 foam Substances 0.000 description 2
- 210000003709 heart valve Anatomy 0.000 description 2
- 239000007788 liquid Substances 0.000 description 2
- 238000000465 moulding Methods 0.000 description 2
- 229920002647 polyamide Polymers 0.000 description 2
- 229920000728 polyester Polymers 0.000 description 2
- 229920001155 polypropylene Polymers 0.000 description 2
- 229920001296 polysiloxane Polymers 0.000 description 2
- 230000008569 process Effects 0.000 description 2
- 238000005086 pumping Methods 0.000 description 2
- 210000005247 right atrial appendage Anatomy 0.000 description 2
- 239000000523 sample Substances 0.000 description 2
- 239000011780 sodium chloride Substances 0.000 description 2
- 239000000126 substance Substances 0.000 description 2
- 208000024891 symptom Diseases 0.000 description 2
- 210000000115 thoracic cavity Anatomy 0.000 description 2
- 238000012546 transfer Methods 0.000 description 2
- 238000010967 transthoracic echocardiography Methods 0.000 description 2
- 208000007340 tricuspid atresia Diseases 0.000 description 2
- 238000003466 welding Methods 0.000 description 2
- 241000272525 Anas platyrhynchos Species 0.000 description 1
- IJGRMHOSHXDMSA-UHFFFAOYSA-N Atomic nitrogen Chemical compound N#N IJGRMHOSHXDMSA-UHFFFAOYSA-N 0.000 description 1
- 208000002330 Congenital Heart Defects Diseases 0.000 description 1
- 206010063045 Effusion Diseases 0.000 description 1
- 206010019280 Heart failures Diseases 0.000 description 1
- MWCLLHOVUTZFKS-UHFFFAOYSA-N Methyl cyanoacrylate Chemical compound COC(=O)C(=C)C#N MWCLLHOVUTZFKS-UHFFFAOYSA-N 0.000 description 1
- 206010027727 Mitral valve incompetence Diseases 0.000 description 1
- 239000004677 Nylon Substances 0.000 description 1
- 241000405070 Percophidae Species 0.000 description 1
- 239000005062 Polybutadiene Substances 0.000 description 1
- 229920002614 Polyether block amide Polymers 0.000 description 1
- 239000004793 Polystyrene Substances 0.000 description 1
- 229920001328 Polyvinylidene chloride Polymers 0.000 description 1
- 238000004873 anchoring Methods 0.000 description 1
- 210000001367 artery Anatomy 0.000 description 1
- 230000004323 axial length Effects 0.000 description 1
- 230000008901 benefit Effects 0.000 description 1
- 230000008275 binding mechanism Effects 0.000 description 1
- 239000000227 bioadhesive Substances 0.000 description 1
- 230000017531 blood circulation Effects 0.000 description 1
- 210000004204 blood vessel Anatomy 0.000 description 1
- IKZZIQXKLWDPCD-UHFFFAOYSA-N but-1-en-2-ol Chemical compound CCC(O)=C IKZZIQXKLWDPCD-UHFFFAOYSA-N 0.000 description 1
- 210000000038 chest Anatomy 0.000 description 1
- 239000002131 composite material Substances 0.000 description 1
- 208000028831 congenital heart disease Diseases 0.000 description 1
- 238000010276 construction Methods 0.000 description 1
- 210000004351 coronary vessel Anatomy 0.000 description 1
- 230000003205 diastolic effect Effects 0.000 description 1
- 229910001873 dinitrogen Inorganic materials 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 239000005038 ethylene vinyl acetate Substances 0.000 description 1
- 229920002313 fluoropolymer Polymers 0.000 description 1
- 239000004811 fluoropolymer Substances 0.000 description 1
- 239000000499 gel Substances 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 239000000017 hydrogel Substances 0.000 description 1
- 238000003384 imaging method Methods 0.000 description 1
- 230000003601 intercostal effect Effects 0.000 description 1
- 210000000936 intestine Anatomy 0.000 description 1
- 238000005304 joining Methods 0.000 description 1
- 238000010030 laminating Methods 0.000 description 1
- 239000000314 lubricant Substances 0.000 description 1
- 238000004519 manufacturing process Methods 0.000 description 1
- 238000005259 measurement Methods 0.000 description 1
- 238000002324 minimally invasive surgery Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 229920001778 nylon Polymers 0.000 description 1
- 206010033675 panniculitis Diseases 0.000 description 1
- 230000035699 permeability Effects 0.000 description 1
- 229920002857 polybutadiene Polymers 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
- 229920002223 polystyrene Polymers 0.000 description 1
- 239000005033 polyvinylidene chloride Substances 0.000 description 1
- 230000002685 pulmonary effect Effects 0.000 description 1
- 238000011084 recovery Methods 0.000 description 1
- 230000009467 reduction Effects 0.000 description 1
- 230000008439 repair process Effects 0.000 description 1
- 238000009256 replacement therapy Methods 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 239000007787 solid Substances 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 239000007921 spray Substances 0.000 description 1
- 210000004304 subcutaneous tissue Anatomy 0.000 description 1
- 239000003356 suture material Substances 0.000 description 1
- 238000012360 testing method Methods 0.000 description 1
- 238000013175 transesophageal echocardiography Methods 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
- 210000002417 xiphoid bone Anatomy 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart 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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12136—Balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2/00—Filters 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
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart 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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
- A61F2002/2484—Delivery devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0004—Rounded shapes, e.g. with rounded corners
- A61F2230/001—Figure-8-shaped, e.g. hourglass-shaped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having an inflatable pocket filled with fluid, e.g. liquid or gas
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1054—Balloon catheters with special features or adapted for special applications having detachable or disposable balloons
Definitions
- the present teachings generally relate to an inflatable device, and its use in reshaping the right heart, reducing tricuspid regurgitations, or/and delaying progression of heart failure due to tricuspid regurgitation.
- Tricuspid valve diseases relate to conditions in which the valve between the two right heart chambers (i.e., the right ventricle and the right atrium) doesn't function properly and these diseases often occur with other heart valve problems.
- tricuspid valve diseases include tricuspid valve regurgitation, tricuspid valve stenosis, tricuspid valve atresia, and the Ebstein's anomaly.
- the tricuspid valve In the tricuspid valve regurgitation, the tricuspid valve doesn't close properly and blood flows back into the right atrium; in the tricuspid valve stenosis, the tricuspid valve is narrowed and reduces the amount of blood flowing into the right ventricle; in the tricuspid atresia, a congenital heart disease, a solid wall of tissues blocks the blood from flowing between the two right heart chambers; and in the Ebstein's anomaly, a malformed tricuspid valve situates at a position lower than the normal position in the right ventricle and causes blood to flow back into the right atrium.
- tricuspid valve diseases generally known to a person with ordinary skill in the art and these tricuspid valve diseases are also included in the present teachings.
- a tricuspid valve disease can be corrected by an annuloplasty ring.
- this device is preferred for surgically repairing a defective tricuspid valve.
- An annuloplasty ring is an anatomically-correct three-dimensional (3D) ring and can flexibly conform to the heart valve opening. This ring is implanted into a defective tricuspid valve and reduces the valve opening. Properly implanted, an annuloplasty ring allows the valve to open and close properly.
- Tricuspid valve repair surgeries can be done in one of the following two ways: a minimally invasive surgery or an open-heart surgery.
- a minimally invasive method involves making a small incision in the upper or lower chest and inserting a valve repairing system/device percutaneously. After the valve is repaired, the incision is closed with dissolving sutures.
- advantages of a minimally invasive approach include a shorter recovery time, less post-operation pain, and earlier return to work and normal daily activities.
- One aspect of the present teachings provides a device configured to be positioned against a right heart.
- the device has a collapsed delivery profile and an inflated deployment profile.
- the flexible outer layer is configured to prevent moisture and gas from crossing the flexible outer layer.
- the device comprises a flexible outer layer encasing a cavity.
- the cavity is configured to be filled with an injection medium.
- the device further includes an injection port configured to be used to allow the injection medium enter into the cavity.
- the device has a portion of the flexible outer layer which inflates to a greater extent than the rest of the flexible outer layer.
- the flexible outer layer further comprises a first component and a second component, wherein the first component and the second component are binding together to form a waist.
- the first component is configured to be positioned against the right atrium.
- the second component is configured to be positioned against a right ventricle.
- the waist is configured to be positioned outside of the tricuspid annulus. In its deployed configuration, the waist of the flexible outer layer inflates to a less extent than the first and second components.
- the device configured to be positioned against a right heart, wherein the device has a collapsed delivery profile and an inflated deployment profile.
- the device comprises a flexible outer layer encasing a primary cavity and a secondary cavity radially outside of the primary cavity.
- the primary cavity is configured to be filled with an injection medium.
- the secondary cavity is configured to be filled with tissue binding adhesives.
- a barrier separates the primary and second cavities, preventing moisture and gas from crossing the barrier.
- a portion of the flexible outer layer outside of the secondary cavity has a plurality of pores, allowing the tissue binding adhesive to exit the secondary cavity to the outside of the flexible outer layer.
- the barrier separating the primary and second cavities expands to a greater extent than the portion of the flexible outer layer outside of the secondary cavity.
- FIG. 1 is a perspective view of an embodiment of the present teachings where an inflatable balloon is positioned against the right heart free wall according to the present teachings.
- FIG. 2 is a perspective view of an embodiment of the present teachings where a needle is used to puncture subxiphoid to access the treatment space according to the present teachings.
- FIG. 3 is an embodiment of the inflatable balloon in its delivery profile and attached to a delivery system in accordance with the present teachings.
- FIG. 4 is an embodiment of the inflatable balloon positioned against the right heart wall according to the present teachings.
- FIG. 5 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings.
- FIG. 6 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings.
- FIG. 7 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings.
- FIG. 8 is an embodiment of the inflatable balloon attached to a delivery system in accordance with the present teachings.
- FIG. 9 is an embodiment of the inflatable balloon disengaging from a delivery system in accordance with the present teachings.
- FIG. 10 is a perspective view of an embodiment of the present teachings where an inflatable balloon is delivered to the treatment location via a delivery system.
- FIG. 11 is a perspective view of an embodiment of the present teachings where an inflatable balloon is deployed at the treatment location via a delivery system.
- FIG. 12 is a perspective view of an embodiment of the present teachings where an inflatable balloon is deployed at the treatment location via a delivery system.
- the term “lumen” means a canal, a duct, or a generally tubular space or cavity in the body of a subject, including a vein, an artery, a blood vessel, a capillary, an intestine, and the like.
- the term “lumen” can also refer to a tubular space in a catheter, a sheath, a hollow needle, a tube, or the like.
- proximal shall mean close to the operator (less into the body) and “distal” shall mean away from the operator (further into the body).
- distal refers to the direction away from a catheter insertion location and “proximal” refers to the direction close to the insertion location.
- wire can be a strand, a cord, a fiber, a yarn, a filament, a cable, a thread, or the like, and these terms may be used interchangeably.
- sheath may also be described as a “catheter” and, thus, these terms can be used interchangeably.
- the present teachings relate to devices and methods for treating a tricuspid valve regurgitation percutaneously.
- a person with ordinary skill in the art would recognize that the figures and description thereto refer to various embodiments of the present teachings and, unless indicated otherwise by their contexts, do not limit the scope of the attached claims.
- An aspect of the present teachings relates to methods of reducing the size of the right heart, and subsequently reducing the tricuspid regurgitation.
- the method includes deploying a balloon ( 10 ) through a percutaneous subxiphoid approach to the outside of the pericardium ( 2 ) as illustrated in FIG. 1 .
- the balloon ( 10 ) squeezes the right side of the heart, both the right atrium (RA) and the right ventricle (RV).
- RA right atrium
- RV right ventricle
- the tricuspid annulus changes it shape, which leads to more coaptation among the leaflets of the tricuspid valve ( 5 ).
- the balloon is positioned inside or outside of the pericardium. In various embodiments, the balloon is positioned approximately to the anterior and posterior commissure with a small portion, such as 30%, against the right atrium and a relatively larger portion against the right ventricle. In various embodiments, the balloon is anchored to the sternum. In various embodiments, the balloon is shaped to be self-anchoring, self-aligning, or self-stabilizing. In some embodiments, the balloon in its deployed configuration includes an indentation. In certain embodiments, the indentation is in a shape of wedge. In certain embodiments, the indentation is configured to fit the heart into the wedge when the balloon is in its deployed configuration. In particular embodiments, the wedge pushes posteriorly on the anterior portion of the right heart. In particular embodiments, the balloon is stabilized between the heart and the sternum by the wedge cupping with the right heart.
- FIG. 2 illustrates insertion of a needle ( 8 ) to the space between the heart and the sternum.
- the access to the space is done through a subxiphoid approach.
- the procedure starts with a small vertical incision to the left of the subxiphoid.
- a puncture through the skin and subcutaneous tissue is made straight or at a 45-degree angle pointing toward the right shoulder.
- the puncture is done by using a Tuohy needle, with appropriate endocardial and/or fluoroscopy guidance. Additionally contrasts should be used to ascertain the puncture location.
- access for an insertion catheter is created through a needle and wire exchange.
- a needle is used to puncture the chest cavity starting from below the xiphoid process and angling the needle superior and left.
- a needle is used to puncture the chest cavity through the 5th or 6th intercostal space on the left side of the sternum.
- a wire is advanced through the needle into the space between the sternum and the pericardial sac.
- the wire is specially designed to help remove any adhesions between the pericardium and the sternum.
- the wire is left behind and the needle is removed.
- an insertion catheter is advanced over the wire and into the target region of the anatomy.
- the insertion catheter includes a dilating sheath or dilating tip designed to increase the diameter of the needle hole.
- a separate dilating member is used prior to insertion of the catheter.
- a fluid is injected into the target space of the anatomy in order to facilitate the subsequent inflation of the balloon.
- the fluid is saline or nitrogen gas.
- the fluid includes a biocompatible, bio-resorbable lubricant.
- access for an insertion catheter is accomplished through a novel modification of a pericardiocentesis kit.
- a needle is advanced through the sternum and through the pericardium as is commonly done to aspirate effusions from the pericardium.
- a wire is advanced through the needle and into the pericardial space and the needle is retracted out of the body.
- an access catheter is advanced over the wire.
- the access catheter is designed with a blunted tip such that it passes through the sternum but does not dilate the hole in the pericardium created by the needle.
- the access catheter is advanced through the sternum and up to but not through the pericardium.
- the wire is withdrawn and the catheter is repositioned in order to deliver the balloon.
- the delivery of the access catheter is aided by fluoroscopy, transesophageal echocardiography, or transthoracic echocardiography.
- the delivery catheter or delivery system includes piezo electric elements designed to function as a specially designed echo probe.
- the access catheter delivery system is designed to engage a separate and commercially available TTE probe for imaging assistance during the procedure.
- the access to the space between the pericardium and the heart chambers is facilitated by an indwelling catheter in the right heart.
- the right heart catheter is designed to create a small puncture in the right atrial appendage.
- the right heart catheter is used to inject a predetermined amount of saline or other fluid into the pericardial space.
- the fluid is echogenic.
- the fluid is used to create separation between the right heart and the pericardium.
- the fluid is injected into the pericardium and then aspirated back through the access catheter or through the right heart catheter.
- a space is created between the pericardium and the right heart by a right heart catheter.
- the right heart catheter is designed to grasp a portion of the right heart, for example, the right atrial appendage, or the anterior wall of the right atrium. In some embodiments, the right heart catheter is designed to grasp the anterior wall of the right heart above the plane of the right coronary artery. In certain embodiments, the right heart catheter is retracted by 2-3 cm in order to create some space between the pericardium and the right heart.
- the distal end of the insertion needle ( 8 ) is positioned outside of the pericardium. In other embodiments, the distal end of the insertion needle ( 8 ) is further advanced slightly to puncture the pericardium and reach inside the pericardial space.
- an inflatable balloon ( 10 ) that can be deployed at a treatment location, as shown in FIG. 4 .
- the inflatable balloon ( 10 ) has a cavity ( 37 ) ( FIG. 5 ) encased by at least one layer of a flexible material.
- the inflatable balloon ( 10 ) has a delivery state where it is housed and delivered through a delivery system ( 20 ) as shown in FIG. 3 .
- the delivery system ( 20 ) includes an access sheath ( 22 ), a delivery catheter ( 24 ), and an injection catheter ( 26 ).
- the inflatable balloon ( 10 ) has a deployed state, where it is filled with an injectable medium, such as a liquid, a gel, a gas, foam, or another medium.
- an injectable medium such as a liquid, a gel, a gas, foam, or another medium.
- the delivery state of the inflatable balloon ( 10 ) is referred to as a state wherein the device is completely free of injectable medium.
- the balloon ( 10 ) is partially filled with some injectable medium during delivery.
- any state that is greater in size than the delivery state is considered to be a deployed state.
- the balloon ( 10 ) is positioned against the right heart anterior free wall approximate to the outside of the tricuspid valve ( 5 ) annulus location. As shown in FIG. 4 , a portion of the balloon ( 10 ) is placed and compresses against the right atrium, and another portion of the balloon ( 10 ) is placed and compresses against the right ventricle. In some embodiments, the balloon ( 10 ) at its deployed state is configured to compress the right side of the heart, changes the profile of the tricuspid annulus, and, as a result, improves the coaptation of the tricuspid leaflets and reduces tricuspid regurgitation.
- the deployed state of the balloon ( 10 ) could vary from a patient to another patient due to the individual anatomy and the amount of compression needed to achieve a reduction in tricuspid regurgitation.
- the amount of the medium injected inside the cavity ( 37 ) of the inflatable balloon ( 10 ) is determined based on each patient's needs and controlled by a clinician.
- the medium filled inside the cavity ( 37 ) of the balloon ( 10 ) could be an injectable medium, such as a liquid, a hydrogel, a gas, or foam.
- injectable medium such as a liquid, a hydrogel, a gas, or foam.
- other materials or structures that is capable of maintaining its volume as well as changing its shape to conform to the anatomic space at the implanting location while under compression, could also be used.
- the injectable medium is capable of reducing its volume while under compression, and increasing its volume after the compression is removed, for example, a material capable of undergoing a phase change from a first volume to a second volume at the temperature and/or pressure ranges inside a body cavity ( 37 ) may also be used.
- the inflatable balloon ( 30 ) comprises a flexible wall ( 32 ) and an injection port ( 34 ).
- the flexible wall ( 32 ) is configured to transfer the pressure from the inside to the outside of the balloon ( 10 ). As a result, in some embodiments, the inflatable balloon ( 10 ) exerts a force to the heart.
- the flexible wall ( 32 ) is flexible. In some embodiments, the flexible wall ( 32 ) allows shape change of the balloon ( 30 ) while the balloon ( 30 ) is exposed to an external pressure from the anatomy. In various embodiments, the flexible wall ( 32 ) is stiff enough to hold the pressure exerted by the medium inside the balloon ( 30 ).
- the injection port ( 34 ) joins, releasably, a medium injection catheter ( 26 ) (See, FIG. 3 ).
- the injection catheter ( 26 ) is configured to push, pull, or otherwise manipulate the inflatable balloon ( 30 ).
- the injection catheter ( 26 ) is configured to deliver a medium into the cavity ( 37 ) of the balloon ( 30 ).
- the flexible wall ( 32 ) of the device comprises at least one gas barrier layer.
- the flexible wall ( 32 ) comprises at least one moisture barrier layer.
- the gas barrier layer and moisture barrier layer are laminated together.
- the gas barrier is constructed as an external layer of the flexible wall ( 32 ).
- the moisture barrier is constructed as an internal layer of the flexible wall ( 32 ).
- the moisture barrier is constructed as an external layer of the flexible wall ( 32 ).
- the gas barrier is constructed as an internal layer of the flexible wall ( 32 ).
- the gas barrier material and moisture barrier material are blended together to form a single barrier layer.
- more than one layer of the gas barrier and/or more than one layer of the moisture barrier layer are incorporated.
- the more than one layer of the gas barrier and the more than one layer of the moisture barrier layer are arranged in an alternating manner.
- any other arrangements are equally applicable as long as they are suitable for the purpose of the present teachings and their manufacturing capability.
- gas barrier materials including polyvinylidene chloride, ethyl vinyl alcohol, fluoropolymers, or etc.
- Gas barrier materials are generally relatively stiff, have high moisture vapor permeability, and low impact strength. Consequently, a layer of flexible material with high moisture barrier and high impact strength should also be incorporated into the flexible wall ( 32 ) of the device.
- moisture barrier materials including polyamide, polyethylene, polypropylene, polyurethane, polyamide/polyester copolymer, polystyrene/polybutadiene copolymer, and etc.
- the moisture barrier materials are generally flexible and have high impact strength.
- an additional reinforcement layer is incorporated into the flexible wall ( 32 ) in order to enhance the structural integrity of the device.
- the reinforcement layer has high impact strength.
- the reinforcement layer is made of a polymer, including polyurethane, EVA, PE, polypropylene, or silicone.
- the reinforcement layer is an external layer of the flexible wall ( 32 ).
- the reinforcement layer is an internal layer of the flexible wall ( 32 ).
- the reinforcement layer is a middle layer of the flexible wall ( 32 ).
- the flexible wall ( 32 ) includes more than one reinforcement layer. In certain embodiments, at least one of the more than one reinforcement layers is between a gas barrier layer and a moisture barrier layer.
- the device have three, four, five, or more layers including a gas barrier layer, a moisture barrier layer, and one or more reinforcement layers. In some embodiments, the device has multiple gas barrier layers and/or multiple moisture barrier layers, arranged in a sequential or non-sequential arrangement.
- the overall thickness of the flexible wall ( 32 ) is preferably minimized. In some embodiments, the overall thickness of the flexible wall ( 32 ) ranges between 0.003 to 0.03 inches. In some embodiments, each layer of the flexible wall ( 32 ) has a same thickness. In some embodiments, at least two layers have different thickness. In certain embodiments, each layer of the flexible wall ( 32 ) has a different thickness from the other layers.
- the layers of the flexible wall ( 32 ) can be made in any number of ways known to those skilled in the art, including, but not limited to, lamination, co-extrusion, dip molding, spray molding, or the like.
- the flexible wall ( 32 ) is made by laminating two or more layers together. Lamination can be achieved through many techniques known to those skilled in art. In some embodiments, the lamination is achieved by using heating, solvents, adhesives, tie layers, or other like methods.
- the material used to construct the flexible wall ( 32 ) of the device is sufficiently flexible in the thickness ranges selected for the present teachings. Since the device is subject to external pressures, the device's material in various embodiments is able to transmit the pressure from the sternum to the right heart. In various embodiments, the material used to construct the flexible wall ( 32 ) is selected to produce an appropriate compression to the right heart. In various embodiments, the pressure and volume of the inflation medium (injection medium) is selected to produce an appropriate compression to the right heart. For example, in its deployed profile, the device is sufficiently stiff to compress the right heart. In some embodiments, the compression leads to a change of the profile of the tricuspid annulus. In some embodiments, the device is flexible enough to accommodate the right heart expansion during the diastolic cycles.
- the right heart pressure such as the right ventricle pressure
- the pulmonary capillary wedge pressure can be monitored and the PCWP can sometimes serve as a good indicator for the right ventricle pressure.
- a clinician can deflate the balloon.
- the balloon is designed in such way that after deployed, it can still be reattached to a catheter in order to further inflate or deflate the balloon to achieve the optimum treatment result.
- a balloon can include an injection port which can be reattached by an injection catheter after the procedure.
- a balloon can also include a lead which can be left behind and used to be re-attached for pressure adjustment after the procedure.
- a pumping mechanism between the components of the balloons is also incorporated in the design in order to allow fluid transfer between the components.
- such pumping mechanism allows pressure adjustment in each component of the balloon and can be used to avoid over pressuring certain part of the heart, or create a messaging effect to the heart.
- the flexible wall ( 32 ) comprises a continuous layer of material.
- the flexible wall ( 42 ) comprises a first component and a second component, where the first and second components are bonded together.
- the first component and second component of the balloon ( 40 ) expands, while the bonding seam between the first component and second component, remains unchanged, or only slightly stretched, forming a waist in its deployed profiled, such as shown in FIG. 6 .
- the bonding seam is configured to be positioned outside of the tricuspid valve ( 5 ) annulus.
- the two components can be identical or different in sizes.
- the components to be deployed against the right ventricle are larger than the component to be deployed against right atrium.
- the seams are accomplished in any of a variety of manners known to those skilled in the art.
- the bonding of the two components are achieved by using heat bonding, chemical bonding, mechanism bonding, and the like.
- more than two components can be included in forming the device. Thus, the embodiments disclosed herein should not be viewed as limiting.
- the balloon ( 10 ) device as illustrated in FIGS. 5 - 6 expand evenly in all directions.
- the expansion of the balloon ( 10 ) is controlled with the most expansion inwardly toward the heart, and less or no expansion in other directions so that once deployed, the portion of the balloon ( 10 ) facing the heart wall expands and compresses the right heart.
- the balloon is expanded in a sequential motion with one component expanding after another.
- the balloon expansion is controlled by a dynamic pulse control, such that one component is expanded with a long pulse, and another component is expanded with a high pulse.
- a dynamic pulse control such that one component is expanded with a long pulse, and another component is expanded with a high pulse.
- the balloon ( 10 ) once inflated, has an overall width of 2 mm-4 cm and an overall height of 4 mm-6 cm. In some embodiments, the portion of the balloon ( 10 ) against the right ventricle is greater than the portion of the balloon ( 10 ) against the right atrium.
- the balloon is designed to be compliant only up to a predetermined size and shape. After the balloon is inflated to this shape by the injectable fluid, the balloon resists further inflation. In some embodiments, the resistance to additional inflation is accomplished by the composite construction of the balloon.
- the wall of the balloon includes fibrous members such as suture material, braided polyester fibers, nylon strands, or other materials.
- the balloon is loosely defined as a non-compliant balloon.
- the balloon is designed to inflate in a stepwise manner. In various embodiments, in the first step, the balloon is designed to expand in a manner that is largely flat, expanding along the contact surface of the right heart and the sternum.
- the balloon expands largely by increasing in thickness.
- the balloon incudes two fluid sealed cavities/chambers.
- the first cavity/chamber includes a large flat shape which contours to the wall of the sternum and to the shape of the heart.
- the second cavity/chamber is designed to expand largely in the thickness dimension, thereby pushing against the sternum and the heart but not expanding in other directions.
- the injection port ( 34 ) of the device includes an injection tube ( 36 ) and a valve ( 38 ).
- the injection tube ( 36 ) creates a fluid communication path between the interior cavity ( 37 ) and the injection catheter ( 26 ).
- the valve ( 38 ) is configured to permit one way flow through the injection tube ( 36 ). Upon removal of the injection catheter ( 26 ), the valve ( 38 ) closes automatically and prevents the escape of the injection medium from the interior cavity ( 37 ) through the injection tube ( 36 ).
- the injection tube ( 36 ) has a connected end joining to the flexible wall ( 32 ) and a free end ( 35 ) extending into the cavity ( 37 ) of the balloon ( 10 ).
- the tube includes a tubular lumen ( 33 ) extending from the connected end to its free end ( 35 ).
- the tubular lumen ( 33 ) forms a flow path for the injection medium to be delivered inside the cavity ( 37 ) of the balloon ( 10 ).
- the valve ( 38 ) is positioned inside the tubular lumen ( 33 ) of the Tube.
- valve ( 38 ) in the middle portion of the tubular lumen ( 33 ), one skilled in the art would understand that the valve ( 38 ) can be at or near the connected end of the injection tube ( 36 ), at or near the free end ( 35 ) of the injection tube ( 36 ), or anywhere inside the lumen between the connected and free end ( 35 ) of the injection tube ( 36 ).
- the injection tube ( 36 ) is made of polyethylene, Pebax, polyurethane, etc. In various embodiments, the injection tube ( 36 ) is made by a known technique in the field. In some embodiments, the injection tube ( 36 ) is made by extrusion. According to various embodiments, the valve ( 38 ) and flap are made from a flexible material such as polyurethane, silicone, or polyethylene. According to some embodiments, the bonding between the valve ( 38 ) and tube, the tube and the flexible wall ( 32 ) of the balloon ( 30 ), and the flap and the tube is achieved by a known technique in the field. In certain embodiments, the bonding is achieved through a mechanical means.
- the bonding is through a screw, a bolt, a clamp, or the like.
- the bonding is achieved through a chemical means.
- the bonding is achieved through an adhesive or the like.
- the bonding is achieved through a thermal means.
- the bonding is achieved by ultrasonic welding, laser welding, overmolding, or the like. Other attachment methods known to the skilled artisan can also be used.
- the device upon the device being filled with the medium content, the device resumes a predesigned deployed profile.
- the device upon inflation, the device assumes a general spherical profile, a pillow profile, or a snow man profile with a waist.
- an inflated device can assume any profile that is suitable for its intended function.
- the valve ( 38 ) inside the injection tube ( 36 ) has a duckbill configuration.
- the valve ( 38 ) includes a first and a second duck bill valve ( 38 ) leaflets which are attached to the tubular wall.
- the leaflets extend in the direction toward the free end ( 35 ) of the injection tube ( 36 ) and form a pair of coaptive edges. This configuration allows a distal-direction flow to separate the coaptive edges, thereby enabling inflation of the device.
- the inflation medium within the device in combination with the natural bias of the leaflets cause the leaflets to coapt, thereby preventing any proximal flow of medium through the flow path.
- valve ( 38 ) design such as tricuspid, flap, biased valve ( 38 ), known in the field could also be used here.
- valve ( 38 ) design such as tricuspid, flap, biased valve ( 38 ), known in the field could also be used here.
- FIG. 7 illustrates another embodiment of the present teachings, where the balloon ( 50 ) further includes a binding mechanism that is configured to secure a deployed balloon ( 50 ) at a treatment location.
- the inflatable balloon ( 50 ) has two cavities.
- the primary cavity ( 54 ) is configured to be filled with an inject medium which causes the balloon ( 50 ) to expand.
- the secondary cavity ( 52 ) is configured to contain a bio-adhesive.
- the secondary cavity ( 52 ) is located radially outside of the primary cavity ( 54 ) as shown. According to one embodiment, the secondary cavity ( 52 ) is located radially outside of the primary cavity ( 54 ).
- a barrier ( 56 ) exists between the primary and secondary cavities ( 52 ), which prevents the injection medium from exiting the primary cavity ( 54 ) and entering the secondary cavity ( 52 ).
- the secondary cavity ( 52 ) is covered with an external stretchable and porous layer ( 58 ).
- the balloon ( 50 ) includes an injection port ( 64 ), an injection tube ( 36 ) and a valve ( 68 ) disposed within the injection tube ( 36 ).
- the adhesive is stored inside the secondary cavity ( 52 ).
- the delivery system carries the collapsed balloon ( 50 ) into the treatment location.
- the balloon ( 50 ) is filled with injection medium, as the balloon ( 50 ) expands, the external porous layer ( 58 ) outside of the secondary cavity ( 52 ) also stretches, allowing the pores to be opened up.
- the balloon ( 50 ) further expands, it squeezes the adhesive, letting it exit the pores ( 62 ).
- the adhesive is configured to bond the balloon ( 50 ) with the sternum.
- the barrier ( 56 ) separating the primary and second cavities ( 54 , 52 ) expands more than the portion of the flexible outer wall outside of the secondary cavity ( 52 ).
- the difference in stretchability would allow the primary cavity ( 54 ) to expand at a greater rate than the secondary cavity, thereby pushing the tissue binding adhesive out of the pores ( 62 ) in the flexible wall ( 58 ).
- the balloon ( 50 ) is designed such that under certain inflation pressures, the adhesive remains inside the secondary cavity ( 52 ). Once a clinician is satisfied with the deployment and/or apposition, the balloon ( 50 ) is inflated to a final pressure and the adhesive is then pushed out to the external surface ( 58 ). In some embodiments, the adhesive is activated upon being exposed to the moisture of the anatomy.
- the secondary cavity is configured to be positioned approximately to the right ventricle, so that after an adhesive is applied to the exterior surface, the balloon is bonded to the right ventricle.
- the secondary cavity is configured to be positioned approximately to the right atrium, so that the adhesive is used to bond the balloon to the right atrium of the heart.
- FIG. 8 further illustrates a balloon delivery system configured to join the balloon ( 40 ) at its injection port ( 44 ).
- the balloon delivery system controls the movement of the balloon ( 40 ) and injects the inflation medium into the cavity ( 47 ) of the inflatable balloon ( 40 ).
- the balloon delivery system comprises an elongate delivery catheter ( 24 ) having a proximal end and a distal end.
- the delivery catheter ( 24 ) is configured to slide through an access sheath ( 22 ) (not shown) placed at the treatment location.
- the delivery catheter ( 24 ) preferably has an outside diameter of no more than about 8 mm.
- the length of the delivery catheter ( 24 ) may vary, depending upon each patient. In general, an axial length of delivery catheter ( 24 ) is within the range of from about 1′′ to about 10′′ for adult patients.
- the delivery catheter ( 24 ) has a central lumen extending axially therethrough.
- the central lumen axially slideably receives an injection catheter ( 26 ) for filling the balloon ( 40 ).
- the injection catheter ( 26 ) comprises a tubular body having a proximal end, a distal end, and a medium injection lumen extending throughout the length from its distal end to a proximal hub where a connector is typically used for coupling the proximal hub to a source of inflation medium.
- the injection catheter ( 26 ) extends distally, or retracts proximally, independent of the delivery catheter ( 24 ).
- the distal end of the injection catheter ( 26 ) has a generally tubular shape and is configured to be positioned within the valve ( 48 ) inside the injection port ( 44 ) of the balloon ( 40 ).
- the distal end of the delivery catheter ( 24 ) is dimensioned such that it fits through the injection port ( 44 ) of the balloon ( 40 ).
- the delivery catheter ( 24 ) further includes a distal stop surface configured to stop the proximal movement of the device as shown in FIG. 8 .
- FIG. 8 illustrates an embodiment of the present teachings where the balloon delivery system is fully engaged with the balloon ( 40 ).
- the distal end portion of the injection catheter ( 26 ) is fit inside the injection tube ( 46 ) and positioned across the valve ( 48 ).
- the distal end portion of the injection catheter ( 26 ) is capable of opening the valve ( 48 ).
- the distal end of the injection catheter ( 26 ) is within the injection tube ( 46 ) and distal to the valve ( 48 ).
- the distal end of the delivery catheter ( 24 ) contacts the proximal end of the injection tube ( 46 ).
- the balloon ( 40 ) is pushed distally, retracted proximally, torqued radially, and otherwise manipulated by the balloon delivery system.
- the valve ( 48 ) inside the injection tube ( 46 ) of the balloon ( 40 ) has a mechanism that prevents the injection medium from back-flowing to the outside of the balloon ( 10 ). According to some embodiments, once the injection catheter ( 26 ) is placed inside the injection port ( 44 ), a clinician can inject the inflation medium into the cavity ( 47 ) of the balloon ( 40 ).
- a clinician in various embodiments stops the medium injection and removes the injection catheter ( 26 ).
- the injection catheter ( 26 ) can be withdrawn proximally and exit the injection port ( 44 ) of the balloon ( 40 ).
- the one-way valve ( 48 ) inside the injection port ( 44 ) closes automatically and seals the injection medium inside the balloon ( 40 ).
- FIGS. 10 - 11 illustrate a deployment process of the balloon ( 10 ).
- an access sheath ( 22 ) is first placed at the treatment location following a subxiphoid puncture described above.
- the access sheath ( 22 ) is used to slideably carry the balloon delivery system assembly.
- the balloon delivery system assembly slides from a proximal end of the access sheath ( 22 ) to its distal portion after proper placement of the access sheath ( 22 ).
- the deflated balloon ( 10 ) is rolled around a distal end portion of the injection catheter ( 26 ) and carried within the tubular lumen of the access sheath ( 22 ) during the placement.
- the access sheath ( 22 ) is retracted proximally with respect to the balloon delivery system ( 20 ) in order to expose the deflated balloon ( 10 ).
- a medium is then introduced distally from the proximal hub of the injection catheter ( 26 ) to inflate the balloon ( 10 ) to an intended degree.
- the injection catheter ( 26 ) is disengaged from the injection port ( 34 ) of the balloon ( 10 ) by retracting the injection catheter ( 26 ) with respect to the delivery catheter ( 24 ).
- a distal stop surface on the delivery catheter ( 24 ) prevents the proximal movement of the balloon ( 10 ) as the injection catheter ( 26 ) is proximally retracted.
- the balloon delivery system ( 20 ) is thereafter removed from the patient, leaving the inflated balloon ( 10 ) within the body.
- the balloon device expands in a step-wise fashion. In some embodiments, the balloon device expands to a first length. In some embodiments, the balloon device expands to a first width. In some embodiments, the balloon expands to a first length first and a first width second. In some embodiments, the balloon expands to a first width first and a first length second. In certain embodiments, the first length is predetermined. In certain embodiments, the first length is adjustable according to the patient's need. For example, as shown in FIG. 12 , the first length can be approximately the length of the pericardial cavity. In another example, as shown in FIG. 12 , the width can be the width of the pericardial cavity.
- the first width varies along the length of the balloon.
- the balloon expands inwardly toward the right atrium.
- the balloon expands inwardly toward the right ventricle.
- FIG. 12 shows a particular length and width of a balloon device, one with ordinary skill in the art would understand that the length or/and the width of the balloon device can be greater or less than what are shown in FIG. 12 .
- the devices disclosed above are merely embodiments of the present teachings.
- the balloons illustrated in the drawings show only one injection port for inflation.
- more than one injection ports can be incorporated in the balloon design without departing from the scope of the present teachings.
- the implantation of the balloon at a desired treatment site is done through a subxiphoid puncture procedure.
- An alternative to such implantation route can be to insert the balloon into the right atrium through a standard right heart catheterization procedure followed by a puncture to the heart wall from inside the right atrium.
- a further alternative can be to insert the balloon into the right atrium, then to extend through the tricuspid valve into the right ventricle, and finally to puncture through the right ventricular wall.
- Other alternative implantation route(s) can also be incorporated, and all of which should be considered as part of the present teachings.
- the methods and devices disclosed above are useful for treating one or more symptoms of tricuspid regurgitation, by reducing the right heart size.
- One skilled in the art would further recognize that devices according to the present teachings could be used to treat various symptoms of mitral regurgitation.
- the devices disclosed herein can be deployed against the left heart.
Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Biomedical Technology (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Vascular Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
- Surgery (AREA)
- Reproductive Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Child & Adolescent Psychology (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
Abstract
The present teachings provide systems, devices, and methods for treating the heart and reducing valve regurgitation. A delivery catheter is used to advance a balloon to a treatment site outside the heart. The balloon includes a flexible outer layer encasing a primary cavity and a secondary cavity outside of the primary cavity. The secondary cavity contains a tissue-binding adhesive. While the balloon is at the treatment site, an injection medium is introduced into the primary cavity in a manner that inflates the balloon from a collapsed delivery profile into an inflated deployment profile, and squeezes the tissue-binding adhesive out of the secondary cavity. Other embodiments are also described.
Description
- The present application is a continuation of U.S. patent application Ser. No. 17/001,597 filed on Aug. 24, 2020, which published as US 2020/0383786, and which is a continuation of U.S. patent application Ser. No. 15/393,867 filed on Dec. 29, 2016 (now U.S. Pat. No. 10,751,182), which claims priority to Provisional U.S.
patent application 62/272,882, filed Dec. 30, 2015, each of which is hereby incorporated by reference in its entirety. - The present teachings generally relate to an inflatable device, and its use in reshaping the right heart, reducing tricuspid regurgitations, or/and delaying progression of heart failure due to tricuspid regurgitation.
- Tricuspid valve diseases relate to conditions in which the valve between the two right heart chambers (i.e., the right ventricle and the right atrium) doesn't function properly and these diseases often occur with other heart valve problems. Examples of the tricuspid valve diseases include tricuspid valve regurgitation, tricuspid valve stenosis, tricuspid valve atresia, and the Ebstein's anomaly. In the tricuspid valve regurgitation, the tricuspid valve doesn't close properly and blood flows back into the right atrium; in the tricuspid valve stenosis, the tricuspid valve is narrowed and reduces the amount of blood flowing into the right ventricle; in the tricuspid atresia, a congenital heart disease, a solid wall of tissues blocks the blood from flowing between the two right heart chambers; and in the Ebstein's anomaly, a malformed tricuspid valve situates at a position lower than the normal position in the right ventricle and causes blood to flow back into the right atrium. There are other tricuspid valve diseases generally known to a person with ordinary skill in the art and these tricuspid valve diseases are also included in the present teachings.
- A tricuspid valve disease can be corrected by an annuloplasty ring. In some instances, this device is preferred for surgically repairing a defective tricuspid valve. An annuloplasty ring is an anatomically-correct three-dimensional (3D) ring and can flexibly conform to the heart valve opening. This ring is implanted into a defective tricuspid valve and reduces the valve opening. Properly implanted, an annuloplasty ring allows the valve to open and close properly.
- Tricuspid valve repair surgeries can be done in one of the following two ways: a minimally invasive surgery or an open-heart surgery. A minimally invasive method involves making a small incision in the upper or lower chest and inserting a valve repairing system/device percutaneously. After the valve is repaired, the incision is closed with dissolving sutures. Comparing to an open-heart surgery, advantages of a minimally invasive approach include a shorter recovery time, less post-operation pain, and earlier return to work and normal daily activities.
- However, there are drawbacks in valve replacement therapies and, as a result, needs exist for repairing a diseased tricuspid valve percutaneously.
- One aspect of the present teachings provides a device configured to be positioned against a right heart. The device has a collapsed delivery profile and an inflated deployment profile. The flexible outer layer is configured to prevent moisture and gas from crossing the flexible outer layer. The device comprises a flexible outer layer encasing a cavity. The cavity is configured to be filled with an injection medium. The device further includes an injection port configured to be used to allow the injection medium enter into the cavity.
- In one embodiment, the device has a portion of the flexible outer layer which inflates to a greater extent than the rest of the flexible outer layer.
- In another embodiment, the flexible outer layer further comprises a first component and a second component, wherein the first component and the second component are binding together to form a waist. The first component is configured to be positioned against the right atrium. The second component is configured to be positioned against a right ventricle. The waist is configured to be positioned outside of the tricuspid annulus. In its deployed configuration, the waist of the flexible outer layer inflates to a less extent than the first and second components.
- Another aspect of the present teachings provides a device configured to be positioned against a right heart, wherein the device has a collapsed delivery profile and an inflated deployment profile. The device comprises a flexible outer layer encasing a primary cavity and a secondary cavity radially outside of the primary cavity. The primary cavity is configured to be filled with an injection medium. The secondary cavity is configured to be filled with tissue binding adhesives. A barrier separates the primary and second cavities, preventing moisture and gas from crossing the barrier. And a portion of the flexible outer layer outside of the secondary cavity has a plurality of pores, allowing the tissue binding adhesive to exit the secondary cavity to the outside of the flexible outer layer.
- In one embodiment, when filled with injection medium, the barrier separating the primary and second cavities expands to a greater extent than the portion of the flexible outer layer outside of the secondary cavity.
-
FIG. 1 is a perspective view of an embodiment of the present teachings where an inflatable balloon is positioned against the right heart free wall according to the present teachings. -
FIG. 2 is a perspective view of an embodiment of the present teachings where a needle is used to puncture subxiphoid to access the treatment space according to the present teachings. -
FIG. 3 is an embodiment of the inflatable balloon in its delivery profile and attached to a delivery system in accordance with the present teachings. -
FIG. 4 is an embodiment of the inflatable balloon positioned against the right heart wall according to the present teachings. -
FIG. 5 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings. -
FIG. 6 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings. -
FIG. 7 is an embodiment of the inflatable balloon in its delivery profile according to the present teachings. -
FIG. 8 is an embodiment of the inflatable balloon attached to a delivery system in accordance with the present teachings. -
FIG. 9 is an embodiment of the inflatable balloon disengaging from a delivery system in accordance with the present teachings. -
FIG. 10 is a perspective view of an embodiment of the present teachings where an inflatable balloon is delivered to the treatment location via a delivery system. -
FIG. 11 is a perspective view of an embodiment of the present teachings where an inflatable balloon is deployed at the treatment location via a delivery system. -
FIG. 12 is a perspective view of an embodiment of the present teachings where an inflatable balloon is deployed at the treatment location via a delivery system. - Certain specific details are set forth in the following description and figures to provide an understanding of various embodiments of the present teachings. Those of ordinary skill in the relevant art would understand that they can practice other embodiments of the present teachings without one or more of the details described herein. Thus, it is not the intention of the Applicant(s) to restrict or in any way limit the scope of the appended claims to such details. While various processes are described with reference to steps and sequences in the following disclosure, the steps and sequences of steps should not be taken as required to practice all embodiments of the present teachings.
- As used herein, the term “lumen” means a canal, a duct, or a generally tubular space or cavity in the body of a subject, including a vein, an artery, a blood vessel, a capillary, an intestine, and the like. The term “lumen” can also refer to a tubular space in a catheter, a sheath, a hollow needle, a tube, or the like.
- As used herein, the term “proximal” shall mean close to the operator (less into the body) and “distal” shall mean away from the operator (further into the body). In positioning a medical device inside a patient, “distal” refers to the direction away from a catheter insertion location and “proximal” refers to the direction close to the insertion location.
- As used herein, the term “wire” can be a strand, a cord, a fiber, a yarn, a filament, a cable, a thread, or the like, and these terms may be used interchangeably.
- As used herein, the term “sheath” may also be described as a “catheter” and, thus, these terms can be used interchangeably.
- Unless otherwise specified, all numbers expressing quantities, measurements, and other properties or parameters used in the specification and claims are to be understood as being modified in all instances by the term “about.” Accordingly, unless otherwise indicated, it should be understood that the numerical parameters set forth in the following specification and attached claims are approximations. At the very least and not as an attempt to limit the application of the doctrine of equivalents to the scope of the attached claims, numerical parameters should be read in light of the number of reported significant digits and the application of ordinary rounding techniques.
- The present teachings relate to devices and methods for treating a tricuspid valve regurgitation percutaneously. A person with ordinary skill in the art would recognize that the figures and description thereto refer to various embodiments of the present teachings and, unless indicated otherwise by their contexts, do not limit the scope of the attached claims.
- An aspect of the present teachings relates to methods of reducing the size of the right heart, and subsequently reducing the tricuspid regurgitation. In various embodiments, the method includes deploying a balloon (10) through a percutaneous subxiphoid approach to the outside of the pericardium (2) as illustrated in
FIG. 1 . The balloon (10) squeezes the right side of the heart, both the right atrium (RA) and the right ventricle (RV). As a consequence, the tricuspid annulus changes it shape, which leads to more coaptation among the leaflets of the tricuspid valve (5). - In various embodiments, the balloon is positioned inside or outside of the pericardium. In various embodiments, the balloon is positioned approximately to the anterior and posterior commissure with a small portion, such as 30%, against the right atrium and a relatively larger portion against the right ventricle. In various embodiments, the balloon is anchored to the sternum. In various embodiments, the balloon is shaped to be self-anchoring, self-aligning, or self-stabilizing. In some embodiments, the balloon in its deployed configuration includes an indentation. In certain embodiments, the indentation is in a shape of wedge. In certain embodiments, the indentation is configured to fit the heart into the wedge when the balloon is in its deployed configuration. In particular embodiments, the wedge pushes posteriorly on the anterior portion of the right heart. In particular embodiments, the balloon is stabilized between the heart and the sternum by the wedge cupping with the right heart.
-
FIG. 2 illustrates insertion of a needle (8) to the space between the heart and the sternum. According to some embodiments of the present teachings, the access to the space is done through a subxiphoid approach. The procedure starts with a small vertical incision to the left of the subxiphoid. A puncture through the skin and subcutaneous tissue is made straight or at a 45-degree angle pointing toward the right shoulder. One skilled in the art should understand that the puncture is done by using a Tuohy needle, with appropriate endocardial and/or fluoroscopy guidance. Additionally contrasts should be used to ascertain the puncture location. - In various embodiments, access for an insertion catheter is created through a needle and wire exchange. In some embodiments, a needle is used to puncture the chest cavity starting from below the xiphoid process and angling the needle superior and left. In some embodiments, a needle is used to puncture the chest cavity through the 5th or 6th intercostal space on the left side of the sternum. In some embodiments, once a needle is passed through the sternum, a wire is advanced through the needle into the space between the sternum and the pericardial sac. In various embodiments, the wire is specially designed to help remove any adhesions between the pericardium and the sternum. In some embodiments, the wire is left behind and the needle is removed. In various embodiments, an insertion catheter is advanced over the wire and into the target region of the anatomy. In some embodiments, the insertion catheter includes a dilating sheath or dilating tip designed to increase the diameter of the needle hole. In some embodiments, a separate dilating member is used prior to insertion of the catheter. In some embodiments, a fluid is injected into the target space of the anatomy in order to facilitate the subsequent inflation of the balloon. In some embodiments, the fluid is saline or nitrogen gas. In some embodiments, the fluid includes a biocompatible, bio-resorbable lubricant.
- In various embodiments, access for an insertion catheter is accomplished through a novel modification of a pericardiocentesis kit. In some embodiments, a needle is advanced through the sternum and through the pericardium as is commonly done to aspirate effusions from the pericardium. In some embodiments, a wire is advanced through the needle and into the pericardial space and the needle is retracted out of the body. In some embodiments, an access catheter is advanced over the wire. In various embodiments, the access catheter is designed with a blunted tip such that it passes through the sternum but does not dilate the hole in the pericardium created by the needle. In some embodiments, the access catheter is advanced through the sternum and up to but not through the pericardium. In some embodiments, the wire is withdrawn and the catheter is repositioned in order to deliver the balloon.
- In various embodiments, the delivery of the access catheter is aided by fluoroscopy, transesophageal echocardiography, or transthoracic echocardiography. In some embodiments, the delivery catheter or delivery system includes piezo electric elements designed to function as a specially designed echo probe. In some embodiments, the access catheter delivery system is designed to engage a separate and commercially available TTE probe for imaging assistance during the procedure.
- In various embodiments, the access to the space between the pericardium and the heart chambers is facilitated by an indwelling catheter in the right heart. In some embodiments, the right heart catheter is designed to create a small puncture in the right atrial appendage. In some embodiments, the right heart catheter is used to inject a predetermined amount of saline or other fluid into the pericardial space. In some embodiments, the fluid is echogenic. In some embodiments, the fluid is used to create separation between the right heart and the pericardium. In some embodiments, the fluid is injected into the pericardium and then aspirated back through the access catheter or through the right heart catheter. In some embodiments, a space is created between the pericardium and the right heart by a right heart catheter. In certain embodiments, the right heart catheter is designed to grasp a portion of the right heart, for example, the right atrial appendage, or the anterior wall of the right atrium. In some embodiments, the right heart catheter is designed to grasp the anterior wall of the right heart above the plane of the right coronary artery. In certain embodiments, the right heart catheter is retracted by 2-3 cm in order to create some space between the pericardium and the right heart.
- In various embodiments, the distal end of the insertion needle (8) is positioned outside of the pericardium. In other embodiments, the distal end of the insertion needle (8) is further advanced slightly to puncture the pericardium and reach inside the pericardial space.
- Another aspect of the present teachings provides an inflatable balloon (10) that can be deployed at a treatment location, as shown in
FIG. 4 . In various embodiments, the inflatable balloon (10) has a cavity (37) (FIG. 5 ) encased by at least one layer of a flexible material. In some embodiments, the inflatable balloon (10) has a delivery state where it is housed and delivered through a delivery system (20) as shown inFIG. 3 . In one embodiment, the delivery system (20) includes an access sheath (22), a delivery catheter (24), and an injection catheter (26). In some embodiments, the inflatable balloon (10) has a deployed state, where it is filled with an injectable medium, such as a liquid, a gel, a gas, foam, or another medium. In some embodiments, the delivery state of the inflatable balloon (10) is referred to as a state wherein the device is completely free of injectable medium. Alternatively, in some embodiments, the balloon (10) is partially filled with some injectable medium during delivery. In some embodiments, any state that is greater in size than the delivery state is considered to be a deployed state. - In various embodiments, as shown in
FIG. 4 , at its deployed state, the balloon (10) is positioned against the right heart anterior free wall approximate to the outside of the tricuspid valve (5) annulus location. As shown inFIG. 4 , a portion of the balloon (10) is placed and compresses against the right atrium, and another portion of the balloon (10) is placed and compresses against the right ventricle. In some embodiments, the balloon (10) at its deployed state is configured to compress the right side of the heart, changes the profile of the tricuspid annulus, and, as a result, improves the coaptation of the tricuspid leaflets and reduces tricuspid regurgitation. One skilled in the art should understand that the deployed state of the balloon (10) could vary from a patient to another patient due to the individual anatomy and the amount of compression needed to achieve a reduction in tricuspid regurgitation. Thus, the amount of the medium injected inside the cavity (37) of the inflatable balloon (10) is determined based on each patient's needs and controlled by a clinician. - According to some embodiments, the medium filled inside the cavity (37) of the balloon (10) could be an injectable medium, such as a liquid, a hydrogel, a gas, or foam. In an embodiment, other materials or structures, that is capable of maintaining its volume as well as changing its shape to conform to the anatomic space at the implanting location while under compression, could also be used. In another embodiment, the injectable medium is capable of reducing its volume while under compression, and increasing its volume after the compression is removed, for example, a material capable of undergoing a phase change from a first volume to a second volume at the temperature and/or pressure ranges inside a body cavity (37) may also be used.
- Now referring to
FIG. 5 , where an exemplary embodiment of an inflatable balloon (30) is illustrated in its deployed profile. In various embodiments, the inflatable balloon (30) comprises a flexible wall (32) and an injection port (34). In various embodiments, the flexible wall (32) is configured to transfer the pressure from the inside to the outside of the balloon (10). As a result, in some embodiments, the inflatable balloon (10) exerts a force to the heart. In various embodiments, the flexible wall (32) is flexible. In some embodiments, the flexible wall (32) allows shape change of the balloon (30) while the balloon (30) is exposed to an external pressure from the anatomy. In various embodiments, the flexible wall (32) is stiff enough to hold the pressure exerted by the medium inside the balloon (30). - Continue referring to
FIG. 5 , according to some embodiments, the injection port (34) joins, releasably, a medium injection catheter (26) (See,FIG. 3 ). As later described, in some embodiments, once joined, the injection catheter (26) is configured to push, pull, or otherwise manipulate the inflatable balloon (30). In some embodiments, the injection catheter (26) is configured to deliver a medium into the cavity (37) of the balloon (30). - According to some embodiments, the flexible wall (32) of the device comprises at least one gas barrier layer. According to some embodiments, the flexible wall (32) comprises at least one moisture barrier layer. According to some embodiments, the gas barrier layer and moisture barrier layer are laminated together. In some embodiments, the gas barrier is constructed as an external layer of the flexible wall (32). In some embodiments, the moisture barrier is constructed as an internal layer of the flexible wall (32). In other embodiments, the moisture barrier is constructed as an external layer of the flexible wall (32). In other embodiments, the gas barrier is constructed as an internal layer of the flexible wall (32). In other embodiments, the gas barrier material and moisture barrier material are blended together to form a single barrier layer. Yet in other embodiments, more than one layer of the gas barrier and/or more than one layer of the moisture barrier layer are incorporated. In some embodiments, the more than one layer of the gas barrier and the more than one layer of the moisture barrier layer are arranged in an alternating manner. In yet other embodiments, any other arrangements are equally applicable as long as they are suitable for the purpose of the present teachings and their manufacturing capability.
- A variety of gas barrier materials, including polyvinylidene chloride, ethyl vinyl alcohol, fluoropolymers, or etc., can be used for constructing a device of the present teachings. Gas barrier materials are generally relatively stiff, have high moisture vapor permeability, and low impact strength. Consequently, a layer of flexible material with high moisture barrier and high impact strength should also be incorporated into the flexible wall (32) of the device.
- A variety of moisture barrier materials, including polyamide, polyethylene, polypropylene, polyurethane, polyamide/polyester copolymer, polystyrene/polybutadiene copolymer, and etc., can be used for constructing a device of the present teachings. The moisture barrier materials are generally flexible and have high impact strength.
- In some embodiments, an additional reinforcement layer is incorporated into the flexible wall (32) in order to enhance the structural integrity of the device. In some embodiments, the reinforcement layer has high impact strength. In certain embodiments, the reinforcement layer is made of a polymer, including polyurethane, EVA, PE, polypropylene, or silicone. In various embodiments, the reinforcement layer is an external layer of the flexible wall (32). In various embodiments, the reinforcement layer is an internal layer of the flexible wall (32). In various embodiments, the reinforcement layer is a middle layer of the flexible wall (32). In some embodiments, the flexible wall (32) includes more than one reinforcement layer. In certain embodiments, at least one of the more than one reinforcement layers is between a gas barrier layer and a moisture barrier layer.
- In some embodiments, the device have three, four, five, or more layers including a gas barrier layer, a moisture barrier layer, and one or more reinforcement layers. In some embodiments, the device has multiple gas barrier layers and/or multiple moisture barrier layers, arranged in a sequential or non-sequential arrangement.
- In various embodiments, the overall thickness of the flexible wall (32) is preferably minimized. In some embodiments, the overall thickness of the flexible wall (32) ranges between 0.003 to 0.03 inches. In some embodiments, each layer of the flexible wall (32) has a same thickness. In some embodiments, at least two layers have different thickness. In certain embodiments, each layer of the flexible wall (32) has a different thickness from the other layers.
- The layers of the flexible wall (32) can be made in any number of ways known to those skilled in the art, including, but not limited to, lamination, co-extrusion, dip molding, spray molding, or the like. In various embodiments, the flexible wall (32) is made by laminating two or more layers together. Lamination can be achieved through many techniques known to those skilled in art. In some embodiments, the lamination is achieved by using heating, solvents, adhesives, tie layers, or other like methods.
- One skill in the art would understand that the material used to construct the flexible wall (32) of the device is sufficiently flexible in the thickness ranges selected for the present teachings. Since the device is subject to external pressures, the device's material in various embodiments is able to transmit the pressure from the sternum to the right heart. In various embodiments, the material used to construct the flexible wall (32) is selected to produce an appropriate compression to the right heart. In various embodiments, the pressure and volume of the inflation medium (injection medium) is selected to produce an appropriate compression to the right heart. For example, in its deployed profile, the device is sufficiently stiff to compress the right heart. In some embodiments, the compression leads to a change of the profile of the tricuspid annulus. In some embodiments, the device is flexible enough to accommodate the right heart expansion during the diastolic cycles.
- According to some embodiments, the right heart pressure, such as the right ventricle pressure, is closely monitored during the balloon expansion in order to prevent from over-pressuring the right heart. For example, during the balloon expansion, the pulmonary capillary wedge pressure (PCWP) can be monitored and the PCWP can sometimes serve as a good indicator for the right ventricle pressure. When it shows that the right ventricle is over pressured, for example, beyond 40 mmHg, a clinician can deflate the balloon.
- According to some other embodiments of the present teachings, the balloon is designed in such way that after deployed, it can still be reattached to a catheter in order to further inflate or deflate the balloon to achieve the optimum treatment result. For example, a balloon can include an injection port which can be reattached by an injection catheter after the procedure. In another example, a balloon can also include a lead which can be left behind and used to be re-attached for pressure adjustment after the procedure.
- According to other embodiments of the present teachings, a pumping mechanism between the components of the balloons is also incorporated in the design in order to allow fluid transfer between the components. In some embodiments, such pumping mechanism allows pressure adjustment in each component of the balloon and can be used to avoid over pressuring certain part of the heart, or create a messaging effect to the heart.
- In some embodiments, the flexible wall (32) comprises a continuous layer of material. In some embodiments, such as
FIG. 6 , the flexible wall (42) comprises a first component and a second component, where the first and second components are bonded together. Once injected with the medium, the first component and second component of the balloon (40) expands, while the bonding seam between the first component and second component, remains unchanged, or only slightly stretched, forming a waist in its deployed profiled, such as shown inFIG. 6 . In some embodiments, the bonding seam is configured to be positioned outside of the tricuspid valve (5) annulus. - One skilled in the art should understand that the two components can be identical or different in sizes. In some embodiments, the components to be deployed against the right ventricle are larger than the component to be deployed against right atrium. According to some embodiments, the seams are accomplished in any of a variety of manners known to those skilled in the art. In certain embodiments, the bonding of the two components are achieved by using heat bonding, chemical bonding, mechanism bonding, and the like. One skilled the art should understand that more than two components can be included in forming the device. Thus, the embodiments disclosed herein should not be viewed as limiting.
- According to some embodiments, once injected with a medium of the present teachings, the balloon (10) device as illustrated in
FIGS. 5-6 expand evenly in all directions. In other embodiments, the expansion of the balloon (10) is controlled with the most expansion inwardly toward the heart, and less or no expansion in other directions so that once deployed, the portion of the balloon (10) facing the heart wall expands and compresses the right heart. - According to some embodiments of the present teachings, the balloon is expanded in a sequential motion with one component expanding after another. In other embodiments of the present teachings, the balloon expansion is controlled by a dynamic pulse control, such that one component is expanded with a long pulse, and another component is expanded with a high pulse. One skilled in the art should understand that balloon expansion can be achieved by many other ways, and the exemplary approaches described herein should not be viewed as limiting to the scope of the present teachings.
- In some embodiments, once inflated, the balloon (10) has an overall width of 2 mm-4 cm and an overall height of 4 mm-6 cm. In some embodiments, the portion of the balloon (10) against the right ventricle is greater than the portion of the balloon (10) against the right atrium.
- In various embodiments, the balloon is designed to be compliant only up to a predetermined size and shape. After the balloon is inflated to this shape by the injectable fluid, the balloon resists further inflation. In some embodiments, the resistance to additional inflation is accomplished by the composite construction of the balloon. In some embodiments, the wall of the balloon includes fibrous members such as suture material, braided polyester fibers, nylon strands, or other materials. In some embodiments, the balloon is loosely defined as a non-compliant balloon. In some embodiments, the balloon is designed to inflate in a stepwise manner. In various embodiments, in the first step, the balloon is designed to expand in a manner that is largely flat, expanding along the contact surface of the right heart and the sternum. In some embodiments, as the inflation pressure increases and the largely flat expansion of the balloon nears its final size, the balloon expands largely by increasing in thickness. In some embodiments, the balloon incudes two fluid sealed cavities/chambers. In some embodiments, the first cavity/chamber includes a large flat shape which contours to the wall of the sternum and to the shape of the heart. In some embodiments, the second cavity/chamber is designed to expand largely in the thickness dimension, thereby pushing against the sternum and the heart but not expanding in other directions.
- According to various embodiments (e.g.,
FIG. 5 ), the injection port (34) of the device includes an injection tube (36) and a valve (38). The injection tube (36) creates a fluid communication path between the interior cavity (37) and the injection catheter (26). The valve (38) is configured to permit one way flow through the injection tube (36). Upon removal of the injection catheter (26), the valve (38) closes automatically and prevents the escape of the injection medium from the interior cavity (37) through the injection tube (36). - According to some embodiments, the injection tube (36) has a connected end joining to the flexible wall (32) and a free end (35) extending into the cavity (37) of the balloon (10). In certain embodiments, the tube includes a tubular lumen (33) extending from the connected end to its free end (35). The tubular lumen (33) forms a flow path for the injection medium to be delivered inside the cavity (37) of the balloon (10). In other embodiments, the valve (38) is positioned inside the tubular lumen (33) of the Tube. Although
FIG. 5 illustrates a valve (38) in the middle portion of the tubular lumen (33), one skilled in the art would understand that the valve (38) can be at or near the connected end of the injection tube (36), at or near the free end (35) of the injection tube (36), or anywhere inside the lumen between the connected and free end (35) of the injection tube (36). - According to various embodiments, the injection tube (36) is made of polyethylene, Pebax, polyurethane, etc. In various embodiments, the injection tube (36) is made by a known technique in the field. In some embodiments, the injection tube (36) is made by extrusion. According to various embodiments, the valve (38) and flap are made from a flexible material such as polyurethane, silicone, or polyethylene. According to some embodiments, the bonding between the valve (38) and tube, the tube and the flexible wall (32) of the balloon (30), and the flap and the tube is achieved by a known technique in the field. In certain embodiments, the bonding is achieved through a mechanical means. In particular embodiments, the bonding is through a screw, a bolt, a clamp, or the like. In certain embodiments, the bonding is achieved through a chemical means. In particular embodiments, the bonding is achieved through an adhesive or the like. In some embodiments, the bonding is achieved through a thermal means. In particular embodiments, the bonding is achieved by ultrasonic welding, laser welding, overmolding, or the like. Other attachment methods known to the skilled artisan can also be used.
- According to various embodiments of the present teachings, upon the device being filled with the medium content, the device resumes a predesigned deployed profile. In some embodiments, upon inflation, the device assumes a general spherical profile, a pillow profile, or a snow man profile with a waist. One skilled in the art should understand that an inflated device can assume any profile that is suitable for its intended function.
- According to various embodiments, the valve (38) inside the injection tube (36) has a duckbill configuration. In some embodiments, the valve (38) includes a first and a second duck bill valve (38) leaflets which are attached to the tubular wall. In some embodiments, the leaflets extend in the direction toward the free end (35) of the injection tube (36) and form a pair of coaptive edges. This configuration allows a distal-direction flow to separate the coaptive edges, thereby enabling inflation of the device. Upon removal of the injection medium source, the inflation medium within the device in combination with the natural bias of the leaflets cause the leaflets to coapt, thereby preventing any proximal flow of medium through the flow path. One skilled in the art should understand that other suitable valve (38) design, such as tricuspid, flap, biased valve (38), known in the field could also be used here. Thus, the embodiments disclosed herein should not be viewed as limiting to the overall scope of the present teachings.
-
FIG. 7 illustrates another embodiment of the present teachings, where the balloon (50) further includes a binding mechanism that is configured to secure a deployed balloon (50) at a treatment location. As shown in the figure, the inflatable balloon (50) has two cavities. The primary cavity (54) is configured to be filled with an inject medium which causes the balloon (50) to expand. The secondary cavity (52) is configured to contain a bio-adhesive. And the secondary cavity (52) is located radially outside of the primary cavity (54) as shown. According to one embodiment, the secondary cavity (52) is located radially outside of the primary cavity (54). A barrier (56) exists between the primary and secondary cavities (52), which prevents the injection medium from exiting the primary cavity (54) and entering the secondary cavity (52). According to some embodiments, the secondary cavity (52) is covered with an external stretchable and porous layer (58). Similar to the previous embodiments, the balloon (50) includes an injection port (64), an injection tube (36) and a valve (68) disposed within the injection tube (36). - When the balloon (50) is in its collapsed delivery profile, the adhesive is stored inside the secondary cavity (52). The delivery system carries the collapsed balloon (50) into the treatment location. Once the balloon (50) is filled with injection medium, as the balloon (50) expands, the external porous layer (58) outside of the secondary cavity (52) also stretches, allowing the pores to be opened up. As the balloon (50) further expands, it squeezes the adhesive, letting it exit the pores (62). The adhesive is configured to bond the balloon (50) with the sternum.
- In some embodiments, when filled with the injection medium, the barrier (56) separating the primary and second cavities (54, 52) expands more than the portion of the flexible outer wall outside of the secondary cavity (52). As a result, the difference in stretchability would allow the primary cavity (54) to expand at a greater rate than the secondary cavity, thereby pushing the tissue binding adhesive out of the pores (62) in the flexible wall (58).
- In some embodiments, the balloon (50) is designed such that under certain inflation pressures, the adhesive remains inside the secondary cavity (52). Once a clinician is satisfied with the deployment and/or apposition, the balloon (50) is inflated to a final pressure and the adhesive is then pushed out to the external surface (58). In some embodiments, the adhesive is activated upon being exposed to the moisture of the anatomy.
- According to one embodiment of the present teachings, the secondary cavity is configured to be positioned approximately to the right ventricle, so that after an adhesive is applied to the exterior surface, the balloon is bonded to the right ventricle. In another embodiment, the secondary cavity is configured to be positioned approximately to the right atrium, so that the adhesive is used to bond the balloon to the right atrium of the heart.
-
FIG. 8 further illustrates a balloon delivery system configured to join the balloon (40) at its injection port (44). In various embodiments, the balloon delivery system controls the movement of the balloon (40) and injects the inflation medium into the cavity (47) of the inflatable balloon (40). According to some embodiments, the balloon delivery system comprises an elongate delivery catheter (24) having a proximal end and a distal end. The delivery catheter (24) is configured to slide through an access sheath (22) (not shown) placed at the treatment location. Thus, the delivery catheter (24) preferably has an outside diameter of no more than about 8 mm. The length of the delivery catheter (24) may vary, depending upon each patient. In general, an axial length of delivery catheter (24) is within the range of from about 1″ to about 10″ for adult patients. - According to various embodiments, the delivery catheter (24) has a central lumen extending axially therethrough. The central lumen axially slideably receives an injection catheter (26) for filling the balloon (40). The injection catheter (26) comprises a tubular body having a proximal end, a distal end, and a medium injection lumen extending throughout the length from its distal end to a proximal hub where a connector is typically used for coupling the proximal hub to a source of inflation medium.
- According to various embodiments, the injection catheter (26) extends distally, or retracts proximally, independent of the delivery catheter (24). The distal end of the injection catheter (26) has a generally tubular shape and is configured to be positioned within the valve (48) inside the injection port (44) of the balloon (40). The distal end of the delivery catheter (24) is dimensioned such that it fits through the injection port (44) of the balloon (40). In some embodiments, the delivery catheter (24) further includes a distal stop surface configured to stop the proximal movement of the device as shown in
FIG. 8 . -
FIG. 8 illustrates an embodiment of the present teachings where the balloon delivery system is fully engaged with the balloon (40). As illustrated, the distal end portion of the injection catheter (26) is fit inside the injection tube (46) and positioned across the valve (48). In some embodiments, the distal end portion of the injection catheter (26) is capable of opening the valve (48). The distal end of the injection catheter (26) is within the injection tube (46) and distal to the valve (48). The distal end of the delivery catheter (24) contacts the proximal end of the injection tube (46). In some embodiments, the balloon (40) is pushed distally, retracted proximally, torqued radially, and otherwise manipulated by the balloon delivery system. - In various embodiments, the valve (48) inside the injection tube (46) of the balloon (40) has a mechanism that prevents the injection medium from back-flowing to the outside of the balloon (10). According to some embodiments, once the injection catheter (26) is placed inside the injection port (44), a clinician can inject the inflation medium into the cavity (47) of the balloon (40).
- After the balloon (40) is inflated to a desired size, a clinician in various embodiments stops the medium injection and removes the injection catheter (26). As shown in
FIG. 9 , with the delivery catheter (24) remains steady, the injection catheter (26) can be withdrawn proximally and exit the injection port (44) of the balloon (40). The one-way valve (48) inside the injection port (44) closes automatically and seals the injection medium inside the balloon (40). -
FIGS. 10-11 illustrate a deployment process of the balloon (10). As shown inFIG. 10 , an access sheath (22) is first placed at the treatment location following a subxiphoid puncture described above. According to some embodiments, the access sheath (22) is used to slideably carry the balloon delivery system assembly. In some embodiments, the balloon delivery system assembly slides from a proximal end of the access sheath (22) to its distal portion after proper placement of the access sheath (22). In some embodiments, during delivery, the deflated balloon (10) is rolled around a distal end portion of the injection catheter (26) and carried within the tubular lumen of the access sheath (22) during the placement. - As shown in
FIG. 10 , once the system is properly positioned, the access sheath (22) is retracted proximally with respect to the balloon delivery system (20) in order to expose the deflated balloon (10). A medium is then introduced distally from the proximal hub of the injection catheter (26) to inflate the balloon (10) to an intended degree. - Following the inflation of the balloon (10), as shown in
FIG. 11 , the injection catheter (26) is disengaged from the injection port (34) of the balloon (10) by retracting the injection catheter (26) with respect to the delivery catheter (24). A distal stop surface on the delivery catheter (24) prevents the proximal movement of the balloon (10) as the injection catheter (26) is proximally retracted. The balloon delivery system (20) is thereafter removed from the patient, leaving the inflated balloon (10) within the body. - In various embodiments, the balloon device expands in a step-wise fashion. In some embodiments, the balloon device expands to a first length. In some embodiments, the balloon device expands to a first width. In some embodiments, the balloon expands to a first length first and a first width second. In some embodiments, the balloon expands to a first width first and a first length second. In certain embodiments, the first length is predetermined. In certain embodiments, the first length is adjustable according to the patient's need. For example, as shown in
FIG. 12 , the first length can be approximately the length of the pericardial cavity. In another example, as shown inFIG. 12 , the width can be the width of the pericardial cavity. In some embodiments, the first width varies along the length of the balloon. As such, in certain embodiments, the balloon expands inwardly toward the right atrium. In certain embodiments, the balloon expands inwardly toward the right ventricle. AlthoughFIG. 12 shows a particular length and width of a balloon device, one with ordinary skill in the art would understand that the length or/and the width of the balloon device can be greater or less than what are shown inFIG. 12 . - One skilled in the art should understand that the devices disclosed above are merely embodiments of the present teachings. For example, the balloons illustrated in the drawings show only one injection port for inflation. One skilled in the art should understand that more than one injection ports can be incorporated in the balloon design without departing from the scope of the present teachings. In another example, the implantation of the balloon at a desired treatment site is done through a subxiphoid puncture procedure. An alternative to such implantation route can be to insert the balloon into the right atrium through a standard right heart catheterization procedure followed by a puncture to the heart wall from inside the right atrium. A further alternative can be to insert the balloon into the right atrium, then to extend through the tricuspid valve into the right ventricle, and finally to puncture through the right ventricular wall. Other alternative implantation route(s) can also be incorporated, and all of which should be considered as part of the present teachings.
- The methods and devices disclosed above are useful for treating one or more symptoms of tricuspid regurgitation, by reducing the right heart size. One skilled in the art would further recognize that devices according to the present teachings could be used to treat various symptoms of mitral regurgitation. For example, the devices disclosed herein can be deployed against the left heart.
- Various embodiments have been illustrated and described herein by way of examples, and one of ordinary skill in the art would recognize that variations can be made without departing from the spirit and scope of the present teachings. The present teachings are capable of other embodiments or of being practiced or carried out in various other ways. Also, it is to be understood that the phraseology and terminology employed herein is for the purpose of description and should not be regarded as limiting.
- Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this present teachings belong. Methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present teachings. In case of conflict, the patent specification, including definitions, will control. In addition, the materials, methods, and examples are illustrative only and not intended to be limiting.
Claims (18)
1. A method for internal use outside a heart of a subject, the method comprising:
using a delivery catheter, advancing a balloon to a treatment site outside the heart, the balloon including:
a flexible outer layer encasing a primary cavity and a secondary cavity outside of the primary cavity, the secondary cavity containing a tissue-binding adhesive; and
while the balloon is at the treatment site, introducing an injection medium into the primary cavity, in a manner that:
inflates the balloon from a collapsed delivery profile into an inflated deployment profile, and
squeezes the tissue-binding adhesive out of the secondary cavity.
2. The method according to claim 1 , wherein:
a portion of the outer layer encasing the secondary cavity defines a plurality of pores; and
introducing the injection medium into the primary cavity comprises introducing the injection medium into the primary cavity such that the tissue-binding adhesive is squeezed out of the secondary cavity via the pores.
3. The method according to claim 1 , further comprising disengaging the delivery catheter from the balloon and withdrawing the delivery catheter from the subject.
4. The method according to claim 1 , wherein the step of introducing comprises:
introducing a first portion of the injection medium into the primary cavity such that the primary cavity reaches a first inflation pressure at which the balloon assumes the inflated deployment profile but that does not squeeze the tissue-binding adhesive out of the secondary cavity, and
subsequently, introducing a second portion of the injection medium into the primary cavity such that the primary cavity reaches a second inflation pressure that is greater than the first inflation pressure, and at which the tissue-binding adhesive is squeezed out of the secondary cavity.
5. The method according to claim 1 , wherein inflating the balloon from the collapsed delivery profile into the inflated deployment profile comprises inflating the balloon into a flat shape.
6. The method according to claim 5 , wherein the step of inflating comprises inflating the balloon such that the balloon has an overall width of 2 mm-4 cm and an overall height of 4 mm-6 cm.
7. The method according to claim 5 , wherein the step of inflating comprises:
inflating the balloon, during a first step of inflation, to the flat shape, and
further inflating the balloon, during a subsequent step of inflation in which the balloon expands by increasing in thickness.
8. The method according to claim 1 , wherein:
the balloon includes an expandable barrier between the primary cavity and the secondary cavity; and
the step of introducing the injection medium comprises, while the balloon is at the treatment site, introducing the injection medium into the primary cavity in a manner that:
inflates the balloon from the collapsed delivery profile into the inflated deployment profile such that the barrier expands more than a portion of the outer layer encasing the secondary cavity, and
squeezes the tissue-binding adhesive out of the secondary cavity.
9. The method according to claim 8 , wherein the step of introducing the injection medium comprises, while the balloon is at the treatment site, introducing the injection medium into the primary cavity in a manner that inflates the balloon from the collapsed delivery profile into the inflated deployment profile such that:
the barrier expands more than a portion of the outer layer encasing the secondary cavity, and
the primary cavity expands at a greater rate than the secondary cavity and squeezes the tissue-binding adhesive out of the secondary cavity.
10. The method according to claim 1 , wherein:
introducing the injection medium into the primary cavity comprises introducing the injection medium into the primary cavity via an injection catheter; and
the method further comprises, while the balloon remains at the treatment site, and prior to introducing the injection medium into the primary cavity, placing the injection catheter into fluid communication with the primary cavity but not with the secondary cavity.
11. The method according to claim 10 , further comprising:
detaching the injection catheter from the balloon; and
withdrawing the injection catheter from the subject.
12. The method according to claim 11 , further comprising, prior to the step of withdrawing:
reattaching the injection catheter to the balloon; and
using the injection catheter, adjusting pressure within the balloon.
13. The method according to claim 10 , wherein placing the injection catheter into fluid communication with the primary cavity comprises coupling the injection catheter to an injection port that is:
in fluid communication with the primary cavity, and
not in fluid communication with the secondary cavity.
14. The method according to claim 13 , wherein:
the injection port comprises a valve; and
the step of coupling comprises coupling the injection catheter to the injection port such that a distal end portion of the injection catheter opens the valve.
15. The method according to claim 1 , wherein:
the treatment site is outside a right side of the heart, and
advancing the balloon to the treatment site comprises advancing the balloon to outside the right side of the heart.
16. The method according to claim 15 , wherein:
the treatment site is between the right side of the heart and a sternum of the subject, and
the step of advancing comprises advancing the balloon to a space between the right side of the heart and the sternum of the subject.
17. The method according to claim 16 , wherein:
the outer layer defines:
a first balloon component, and
a second balloon component, larger than the first balloon component, and bonded to the first balloon component at a seam, and
the step of advancing comprises positioning the balloon such that the first balloon component is disposed against an outside of a right atrium of the heart, and the second balloon component is disposed against an outside of a right ventricle of the heart.
18. The method according to claim 16 , wherein:
the outer layer defines:
a first balloon component, and
a second balloon component, bonded to the first balloon component at a waist of the balloon, and
the step of advancing comprises positioning the balloon such that the waist is disposed against the heart outside a tricuspid valve of the heart.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US18/303,542 US20230255773A1 (en) | 2015-12-30 | 2023-04-19 | System and method for reshaping heart |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201562272882P | 2015-12-30 | 2015-12-30 | |
US15/393,867 US10751182B2 (en) | 2015-12-30 | 2016-12-29 | System and method for reshaping right heart |
US17/001,597 US11660192B2 (en) | 2015-12-30 | 2020-08-24 | System and method for reshaping heart |
US18/303,542 US20230255773A1 (en) | 2015-12-30 | 2023-04-19 | System and method for reshaping heart |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US17/001,597 Continuation US11660192B2 (en) | 2015-12-30 | 2020-08-24 | System and method for reshaping heart |
Publications (1)
Publication Number | Publication Date |
---|---|
US20230255773A1 true US20230255773A1 (en) | 2023-08-17 |
Family
ID=59235223
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/393,867 Active US10751182B2 (en) | 2015-12-30 | 2016-12-29 | System and method for reshaping right heart |
US17/001,597 Active 2037-11-26 US11660192B2 (en) | 2015-12-30 | 2020-08-24 | System and method for reshaping heart |
US18/303,542 Pending US20230255773A1 (en) | 2015-12-30 | 2023-04-19 | System and method for reshaping heart |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US15/393,867 Active US10751182B2 (en) | 2015-12-30 | 2016-12-29 | System and method for reshaping right heart |
US17/001,597 Active 2037-11-26 US11660192B2 (en) | 2015-12-30 | 2020-08-24 | System and method for reshaping heart |
Country Status (1)
Country | Link |
---|---|
US (3) | US10751182B2 (en) |
Families Citing this family (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US10702274B2 (en) * | 2016-05-26 | 2020-07-07 | Edwards Lifesciences Corporation | Method and system for closing left atrial appendage |
US10842619B2 (en) | 2017-05-12 | 2020-11-24 | Edwards Lifesciences Corporation | Prosthetic heart valve docking assembly |
US10952740B2 (en) | 2017-05-25 | 2021-03-23 | Terumo Corporation | Adhesive occlusion systems |
US11135062B2 (en) | 2017-11-20 | 2021-10-05 | Valtech Cardio Ltd. | Cinching of dilated heart muscle |
JP2023525675A (en) * | 2020-04-28 | 2023-06-19 | テルモ株式会社 | occlusion system |
Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5041090A (en) * | 1988-01-12 | 1991-08-20 | Scheglov Viktor I | Occluding device |
US7338511B2 (en) * | 2002-05-24 | 2008-03-04 | Boston Scientific-Scimed, Inc. | Solid embolic material with variable expansion |
US20150352337A1 (en) * | 2013-02-21 | 2015-12-10 | Olympus Corporation | Device for sustained release of liquid, endoscope having the same, and instrument for endoscopic surgery having the same |
Family Cites Families (717)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
NL143127B (en) | 1969-02-04 | 1974-09-16 | Rhone Poulenc Sa | REINFORCEMENT DEVICE FOR A DEFECTIVE HEART VALVE. |
US3604488A (en) | 1969-11-19 | 1971-09-14 | Vermont American Corp | Screwdriver attachment |
US3840018A (en) | 1973-01-31 | 1974-10-08 | M Heifetz | Clamp for occluding tubular conduits in the human body |
US3881366A (en) | 1973-11-19 | 1975-05-06 | Gen Motors Corp | Adjustable steering column |
US3898701A (en) | 1974-01-17 | 1975-08-12 | Russa Joseph | Implantable heart valve |
US4042979A (en) | 1976-07-12 | 1977-08-23 | Angell William W | Valvuloplasty ring and prosthetic method |
US4118805A (en) | 1977-02-28 | 1978-10-10 | Codman & Shurtleff, Inc. | Artificial sphincter |
ES474582A1 (en) | 1978-10-26 | 1979-11-01 | Aranguren Duo Iker | Process for installing mitral valves in their anatomical space by attaching cords to an artificial stent |
US4214349A (en) | 1978-11-30 | 1980-07-29 | Midland-Ross Corporation | Tie wrap |
ES244903Y (en) | 1979-07-31 | 1980-12-01 | ADJUSTABLE CANCELLATION OF PROSTHESIS FOR CARDIAC SURGERY | |
GB2084468B (en) | 1980-09-25 | 1984-06-06 | South African Inventions | Surgical implant |
US4473928A (en) | 1980-11-20 | 1984-10-02 | Tridon Limited | Hose clamps |
DE3230858C2 (en) | 1982-08-19 | 1985-01-24 | Ahmadi, Ali, Dr. med., 7809 Denzlingen | Ring prosthesis |
US4434828A (en) | 1982-12-20 | 1984-03-06 | Richard Trincia | Screwdriver with handle for storing bits |
US4625727A (en) | 1985-01-24 | 1986-12-02 | Leiboff Arnold R | Anastomosis device with excisable frame |
US4712549A (en) | 1985-07-01 | 1987-12-15 | Edward Weck & Co. | Automatic hemostatic clip applier |
CA1303298C (en) | 1986-08-06 | 1992-06-16 | Alain Carpentier | Flexible cardiac valvular support prosthesis |
US4961738A (en) | 1987-01-28 | 1990-10-09 | Mackin Robert A | Angioplasty catheter with illumination and visualization within angioplasty balloon |
US4819637A (en) * | 1987-09-01 | 1989-04-11 | Interventional Therapeutics Corporation | System for artificial vessel embolization and devices for use therewith |
US4917698A (en) | 1988-12-22 | 1990-04-17 | Baxter International Inc. | Multi-segmented annuloplasty ring prosthesis |
JP3174883B2 (en) | 1989-02-13 | 2001-06-11 | バクスター インターナショナル インコーポレーテッド | Selectively flexible annuloplasty ring |
US5290300A (en) | 1989-07-31 | 1994-03-01 | Baxter International Inc. | Flexible suture guide and holder |
US5632746A (en) | 1989-08-16 | 1997-05-27 | Medtronic, Inc. | Device or apparatus for manipulating matter |
SE467459B (en) | 1990-09-25 | 1992-07-20 | Allset Marine Lashing Ab | WIRELESS BEFORE HEARING CHARGES TO CONTAINERS |
US5626609A (en) | 1990-10-05 | 1997-05-06 | United States Surgical Corporation | Endoscopic surgical instrument |
US5042707A (en) | 1990-10-16 | 1991-08-27 | Taheri Syde A | Intravascular stapler, and method of operating same |
US5064431A (en) | 1991-01-16 | 1991-11-12 | St. Jude Medical Incorporated | Annuloplasty ring |
US5108420A (en) | 1991-02-01 | 1992-04-28 | Temple University | Aperture occlusion device |
US5329923A (en) | 1991-02-15 | 1994-07-19 | Lundquist Ingemar H | Torquable catheter |
US5346498A (en) | 1991-11-06 | 1994-09-13 | Imagyn Medical, Inc. | Controller for manipulation of instruments within a catheter |
US5201880A (en) | 1992-01-27 | 1993-04-13 | Pioneering Technologies, Inc. | Mitral and tricuspid annuloplasty rings |
US5332402A (en) | 1992-05-12 | 1994-07-26 | Teitelbaum George P | Percutaneously-inserted cardiac valve |
US5325845A (en) | 1992-06-08 | 1994-07-05 | Adair Edwin Lloyd | Steerable sheath for use with selected removable optical catheter |
US5733331A (en) | 1992-07-28 | 1998-03-31 | Newcor Industrial S.A. | Total mitral heterologous bioprosthesis to be used in mitral or tricuspid heat replacement |
US5258008A (en) | 1992-07-29 | 1993-11-02 | Wilk Peter J | Surgical stapling device and associated method |
US5300034A (en) | 1992-07-29 | 1994-04-05 | Minnesota Mining And Manufacturing Company | Iv injection site for the reception of a blunt cannula |
US6048351A (en) | 1992-09-04 | 2000-04-11 | Scimed Life Systems, Inc. | Transvaginal suturing system |
US5364408A (en) | 1992-09-04 | 1994-11-15 | Laurus Medical Corporation | Endoscopic suture system |
ES2049653B1 (en) | 1992-10-05 | 1994-12-16 | Velazquez Francisco Farrer | CORRECTIVE DEVICE FOR FEMALE URINARY INCONTINENCE. |
US6074417A (en) | 1992-11-16 | 2000-06-13 | St. Jude Medical, Inc. | Total mitral heterologous bioprosthesis to be used in mitral or tricuspid heart replacement |
US5643317A (en) | 1992-11-25 | 1997-07-01 | William Cook Europe S.A. | Closure prosthesis for transcatheter placement |
US5383852A (en) | 1992-12-04 | 1995-01-24 | C. R. Bard, Inc. | Catheter with independent proximal and distal control |
US5449368A (en) | 1993-02-18 | 1995-09-12 | Kuzmak; Lubomyr I. | Laparoscopic adjustable gastric banding device and method for implantation and removal thereof |
US6125852A (en) | 1993-02-22 | 2000-10-03 | Heartport, Inc. | Minimally-invasive devices and methods for treatment of congestive heart failure |
US6010531A (en) | 1993-02-22 | 2000-01-04 | Heartport, Inc. | Less-invasive devices and methods for cardiac valve surgery |
US5797960A (en) | 1993-02-22 | 1998-08-25 | Stevens; John H. | Method and apparatus for thoracoscopic intracardiac procedures |
US5972030A (en) | 1993-02-22 | 1999-10-26 | Heartport, Inc. | Less-invasive devices and methods for treatment of cardiac valves |
US5450860A (en) | 1993-08-31 | 1995-09-19 | W. L. Gore & Associates, Inc. | Device for tissue repair and method for employing same |
US5464404A (en) | 1993-09-20 | 1995-11-07 | Abela Laser Systems, Inc. | Cardiac ablation catheters and method |
AU1011595A (en) | 1994-01-13 | 1995-07-20 | Ethicon Inc. | Spiral surgical tack |
US5843120A (en) | 1994-03-17 | 1998-12-01 | Medinol Ltd. | Flexible-expandable stent |
US6217610B1 (en) | 1994-07-29 | 2001-04-17 | Edwards Lifesciences Corporation | Expandable annuloplasty ring |
US5582616A (en) | 1994-08-05 | 1996-12-10 | Origin Medsystems, Inc. | Surgical helical fastener with applicator |
US5593424A (en) | 1994-08-10 | 1997-01-14 | Segmed, Inc. | Apparatus and method for reducing and stabilizing the circumference of a vascular structure |
US5634936A (en) * | 1995-02-06 | 1997-06-03 | Scimed Life Systems, Inc. | Device for closing a septal defect |
WO1996040006A1 (en) | 1995-06-07 | 1996-12-19 | St. Jude Medical, Inc. | Adjustable sizing apparatus for heart annulus |
US5676653A (en) | 1995-06-27 | 1997-10-14 | Arrow International Investment Corp. | Kink-resistant steerable catheter assembly |
US5662683A (en) | 1995-08-22 | 1997-09-02 | Ortho Helix Limited | Open helical organic tissue anchor and method of facilitating healing |
US5749371A (en) | 1995-10-06 | 1998-05-12 | Zadini; Filiberto P. | Automatic guidewire placement device for medical catheters |
WO1997019655A1 (en) | 1995-12-01 | 1997-06-05 | Medtronic, Inc. | Annuloplasty prosthesis |
US5730150A (en) | 1996-01-16 | 1998-03-24 | B. Braun Medical Inc. | Guidewire dispenser |
US5957953A (en) | 1996-02-16 | 1999-09-28 | Smith & Nephew, Inc. | Expandable suture anchor |
US5702397A (en) | 1996-02-20 | 1997-12-30 | Medicinelodge, Inc. | Ligament bone anchor and method for its use |
US6402780B2 (en) | 1996-02-23 | 2002-06-11 | Cardiovascular Technologies, L.L.C. | Means and method of replacing a heart valve in a minimally invasive manner |
US5716370A (en) | 1996-02-23 | 1998-02-10 | Williamson, Iv; Warren | Means for replacing a heart valve in a minimally invasive manner |
US6132390A (en) | 1996-02-28 | 2000-10-17 | Eupalamus Llc | Handle for manipulation of a stylet used for deflecting a tip of a lead or catheter |
US5782844A (en) | 1996-03-05 | 1998-07-21 | Inbae Yoon | Suture spring device applicator |
US6702846B2 (en) | 1996-04-09 | 2004-03-09 | Endocare, Inc. | Urological stent therapy system and method |
US5885228A (en) | 1996-05-08 | 1999-03-23 | Heartport, Inc. | Valve sizer and method of use |
US6569188B2 (en) | 1996-08-05 | 2003-05-27 | Arthrex, Inc. | Hex drive bioabsorbable tissue anchor |
US5669919A (en) | 1996-08-16 | 1997-09-23 | Medtronic, Inc. | Annuloplasty system |
US5752963A (en) | 1996-08-19 | 1998-05-19 | Bristol-Myers Squibb Company | Suture anchor driver |
US5830221A (en) | 1996-09-20 | 1998-11-03 | United States Surgical Corporation | Coil fastener applier |
CA2217406C (en) | 1996-10-04 | 2006-05-30 | United States Surgical Corporation | Suture anchor installation system with disposable loading unit |
US5810746A (en) | 1996-11-21 | 1998-09-22 | Daig Corporation | Guiding introducer for endomyocardial biopsy procedures |
US5716397A (en) | 1996-12-06 | 1998-02-10 | Medtronic, Inc. | Annuloplasty device with removable stiffening element |
US6364901B1 (en) | 1996-12-20 | 2002-04-02 | Kanji Inoue | Appliance collapsible for insertion into a human organ and capable of resilient restoration |
US5935098A (en) | 1996-12-23 | 1999-08-10 | Conceptus, Inc. | Apparatus and method for accessing and manipulating the uterus |
EP0850607A1 (en) | 1996-12-31 | 1998-07-01 | Cordis Corporation | Valve prosthesis for implantation in body channels |
US6183411B1 (en) | 1998-09-21 | 2001-02-06 | Myocor, Inc. | External stress reduction device and method |
US6050936A (en) | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US5961440A (en) | 1997-01-02 | 1999-10-05 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US6045497A (en) | 1997-01-02 | 2000-04-04 | Myocor, Inc. | Heart wall tension reduction apparatus and method |
US6406420B1 (en) | 1997-01-02 | 2002-06-18 | Myocor, Inc. | Methods and devices for improving cardiac function in hearts |
US6074401A (en) | 1997-01-09 | 2000-06-13 | Coalescent Surgical, Inc. | Pinned retainer surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery |
US5961539A (en) | 1997-01-17 | 1999-10-05 | Segmed, Inc. | Method and apparatus for sizing, stabilizing and/or reducing the circumference of an anatomical structure |
US5938616A (en) | 1997-01-31 | 1999-08-17 | Acuson Corporation | Steering mechanism and steering line for a catheter-mounted ultrasonic transducer |
US5702398A (en) | 1997-02-21 | 1997-12-30 | Tarabishy; Sam | Tension screw |
US6086582A (en) | 1997-03-13 | 2000-07-11 | Altman; Peter A. | Cardiac drug delivery system |
US5876373A (en) | 1997-04-04 | 1999-03-02 | Eclipse Surgical Technologies, Inc. | Steerable catheter |
WO1998046149A1 (en) | 1997-04-11 | 1998-10-22 | Taccor, Inc. | Steerable catheter with rotatable tip electrode and method of use |
AU9225598A (en) | 1997-09-04 | 1999-03-22 | Endocore, Inc. | Artificial chordae replacement |
FR2768324B1 (en) | 1997-09-12 | 1999-12-10 | Jacques Seguin | SURGICAL INSTRUMENT FOR PERCUTANEOUSLY FIXING TWO AREAS OF SOFT TISSUE, NORMALLY MUTUALLY REMOTE, TO ONE ANOTHER |
US5984959A (en) | 1997-09-19 | 1999-11-16 | United States Surgical | Heart valve replacement tools and procedures |
US6206888B1 (en) | 1997-10-01 | 2001-03-27 | Scimed Life Systems, Inc. | Stent delivery system using shape memory retraction |
US6174332B1 (en) | 1997-12-05 | 2001-01-16 | St. Jude Medical, Inc. | Annuloplasty ring with cut zone |
US6332893B1 (en) | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
US6530952B2 (en) | 1997-12-29 | 2003-03-11 | The Cleveland Clinic Foundation | Bioprosthetic cardiovascular valve system |
US6251092B1 (en) | 1997-12-30 | 2001-06-26 | Medtronic, Inc. | Deflectable guiding catheter |
US6533807B2 (en) | 1998-02-05 | 2003-03-18 | Medtronic, Inc. | Radially-expandable stent and delivery system |
US20020087048A1 (en) | 1998-02-24 | 2002-07-04 | Brock David L. | Flexible instrument |
US6592593B1 (en) | 1998-09-18 | 2003-07-15 | United States Surgical Corporation | Endovascular fastener applicator |
US6074418A (en) | 1998-04-20 | 2000-06-13 | St. Jude Medical, Inc. | Driver tool for heart valve prosthesis fasteners |
US6143024A (en) | 1998-06-04 | 2000-11-07 | Sulzer Carbomedics Inc. | Annuloplasty ring having flexible anterior portion |
US6074341A (en) | 1998-06-09 | 2000-06-13 | Timm Medical Technologies, Inc. | Vessel occlusive apparatus and method |
JP2002518082A (en) | 1998-06-10 | 2002-06-25 | コンバージ メディカル, インコーポレイテッド | Sutureless anastomosis system |
US6250308B1 (en) | 1998-06-16 | 2001-06-26 | Cardiac Concepts, Inc. | Mitral valve annuloplasty ring and method of implanting |
US6106550A (en) | 1998-07-10 | 2000-08-22 | Sulzer Carbomedics Inc. | Implantable attaching ring |
US6165183A (en) | 1998-07-15 | 2000-12-26 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
US7569062B1 (en) | 1998-07-15 | 2009-08-04 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
WO2000007510A1 (en) | 1998-08-06 | 2000-02-17 | Jordan Medical Llc | Surgical screw cartridge, screw holder/magazine and pistol-type screwdriver for bone fixation |
US6210347B1 (en) | 1998-08-13 | 2001-04-03 | Peter Forsell | Remote control food intake restriction device |
US6159240A (en) | 1998-08-31 | 2000-12-12 | Medtronic, Inc. | Rigid annuloplasty device that becomes compliant after implantation |
FR2783153B1 (en) | 1998-09-14 | 2000-12-01 | Jerome Dargent | GASTRIC CONSTRICTION DEVICE |
US6355030B1 (en) | 1998-09-25 | 2002-03-12 | Cardiothoracic Systems, Inc. | Instruments and methods employing thermal energy for the repair and replacement of cardiac valves |
US6102945A (en) | 1998-10-16 | 2000-08-15 | Sulzer Carbomedics, Inc. | Separable annuloplasty ring |
US6315784B1 (en) | 1999-02-03 | 2001-11-13 | Zarija Djurovic | Surgical suturing unit |
US6425916B1 (en) | 1999-02-10 | 2002-07-30 | Michi E. Garrison | Methods and devices for implanting cardiac valves |
DE19910233A1 (en) | 1999-03-09 | 2000-09-21 | Jostra Medizintechnik Ag | Anuloplasty prosthesis |
US6319281B1 (en) | 1999-03-22 | 2001-11-20 | Kumar R. Patel | Artificial venous valve and sizing catheter |
US20040044350A1 (en) | 1999-04-09 | 2004-03-04 | Evalve, Inc. | Steerable access sheath and methods of use |
US7811296B2 (en) | 1999-04-09 | 2010-10-12 | Evalve, Inc. | Fixation devices for variation in engagement of tissue |
US10327743B2 (en) | 1999-04-09 | 2019-06-25 | Evalve, Inc. | Device and methods for endoscopic annuloplasty |
DE60045096D1 (en) | 1999-04-09 | 2010-11-25 | Evalve Inc | METHOD AND DEVICE FOR HEART LAPSE REPERATION |
US6752813B2 (en) | 1999-04-09 | 2004-06-22 | Evalve, Inc. | Methods and devices for capturing and fixing leaflets in valve repair |
US7226467B2 (en) | 1999-04-09 | 2007-06-05 | Evalve, Inc. | Fixation device delivery catheter, systems and methods of use |
US6231602B1 (en) | 1999-04-16 | 2001-05-15 | Edwards Lifesciences Corporation | Aortic annuloplasty ring |
US6183512B1 (en) | 1999-04-16 | 2001-02-06 | Edwards Lifesciences Corporation | Flexible annuloplasty system |
US20050222665A1 (en) | 1999-04-23 | 2005-10-06 | Ernest Aranyi | Endovascular fastener applicator |
US6674993B1 (en) | 1999-04-30 | 2004-01-06 | Microvision, Inc. | Method and system for identifying data locations associated with real world observations |
US6187040B1 (en) | 1999-05-03 | 2001-02-13 | John T. M. Wright | Mitral and tricuspid annuloplasty rings |
US6964686B2 (en) | 1999-05-17 | 2005-11-15 | Vanderbilt University | Intervertebral disc replacement prosthesis |
US6790229B1 (en) | 1999-05-25 | 2004-09-14 | Eric Berreklouw | Fixing device, in particular for fixing to vascular wall tissue |
US6602289B1 (en) | 1999-06-08 | 2003-08-05 | S&A Rings, Llc | Annuloplasty rings of particular use in surgery for the mitral valve |
US6626899B2 (en) | 1999-06-25 | 2003-09-30 | Nidus Medical, Llc | Apparatus and methods for treating tissue |
SE514718C2 (en) | 1999-06-29 | 2001-04-09 | Jan Otto Solem | Apparatus for treating defective closure of the mitral valve apparatus |
US6997951B2 (en) | 1999-06-30 | 2006-02-14 | Edwards Lifesciences Ag | Method and device for treatment of mitral insufficiency |
US6592609B1 (en) | 1999-08-09 | 2003-07-15 | Bonutti 2003 Trust-A | Method and apparatus for securing tissue |
US6231561B1 (en) | 1999-09-20 | 2001-05-15 | Appriva Medical, Inc. | Method and apparatus for closing a body lumen |
JP3553432B2 (en) | 1999-09-24 | 2004-08-11 | 本田技研工業株式会社 | Riding simulation device |
FR2799364B1 (en) | 1999-10-12 | 2001-11-23 | Jacques Seguin | MINIMALLY INVASIVE CANCELING DEVICE |
US6626930B1 (en) | 1999-10-21 | 2003-09-30 | Edwards Lifesciences Corporation | Minimally invasive mitral valve repair method and apparatus |
WO2001030245A1 (en) | 1999-10-26 | 2001-05-03 | H Randall Craig | Helical suture instrument |
AUPQ366099A0 (en) | 1999-10-26 | 1999-11-18 | Queensland University Of Technology | Ortho paedic screw |
US6689150B1 (en) | 1999-10-27 | 2004-02-10 | Atritech, Inc. | Filter apparatus for ostium of left atrial appendage |
US6926730B1 (en) | 2000-10-10 | 2005-08-09 | Medtronic, Inc. | Minimally invasive valve repair procedure and apparatus |
US7018406B2 (en) | 1999-11-17 | 2006-03-28 | Corevalve Sa | Prosthetic valve for transluminal delivery |
US6911032B2 (en) | 1999-11-18 | 2005-06-28 | Scimed Life Systems, Inc. | Apparatus and method for compressing body tissue |
US6711444B2 (en) | 1999-11-22 | 2004-03-23 | Scimed Life Systems, Inc. | Methods of deploying helical diagnostic and therapeutic element supporting structures within the body |
US6494908B1 (en) | 1999-12-22 | 2002-12-17 | Ethicon, Inc. | Removable stent for body lumens |
US7169187B2 (en) | 1999-12-22 | 2007-01-30 | Ethicon, Inc. | Biodegradable stent |
WO2001050985A1 (en) | 2000-01-14 | 2001-07-19 | Viacor Incorporated | Tissue annuloplasty band and apparatus and method for fashioning, sizing and implanting the same |
US6402781B1 (en) | 2000-01-31 | 2002-06-11 | Mitralife | Percutaneous mitral annuloplasty and cardiac reinforcement |
US6989028B2 (en) | 2000-01-31 | 2006-01-24 | Edwards Lifesciences Ag | Medical system and method for remodeling an extravascular tissue structure |
US7296577B2 (en) | 2000-01-31 | 2007-11-20 | Edwards Lifescience Ag | Transluminal mitral annuloplasty with active anchoring |
US6458076B1 (en) | 2000-02-01 | 2002-10-01 | 5 Star Medical | Multi-lumen medical device |
US6797002B2 (en) | 2000-02-02 | 2004-09-28 | Paul A. Spence | Heart valve repair apparatus and methods |
US20050070999A1 (en) | 2000-02-02 | 2005-03-31 | Spence Paul A. | Heart valve repair apparatus and methods |
US6470892B1 (en) | 2000-02-10 | 2002-10-29 | Obtech Medical Ag | Mechanical heartburn and reflux treatment |
ATE348579T1 (en) | 2000-02-11 | 2007-01-15 | Potencia Medical Ag | URINARY INCONTINENCE TREATMENT DEVICE |
US7993368B2 (en) | 2003-03-13 | 2011-08-09 | C.R. Bard, Inc. | Suture clips, delivery devices and methods |
US6569198B1 (en) | 2000-03-31 | 2003-05-27 | Richard A. Wilson | Mitral or tricuspid valve annuloplasty prosthetic device |
US6689125B1 (en) | 2000-04-04 | 2004-02-10 | Spinalabs, Llc | Devices and methods for the treatment of spinal disorders |
US6533772B1 (en) | 2000-04-07 | 2003-03-18 | Innex Corporation | Guide wire torque device |
US6368348B1 (en) | 2000-05-15 | 2002-04-09 | Shlomo Gabbay | Annuloplasty prosthesis for supporting an annulus of a heart valve |
US7220266B2 (en) | 2000-05-19 | 2007-05-22 | C. R. Bard, Inc. | Tissue capturing and suturing device and method |
ES2251408T3 (en) | 2000-05-25 | 2006-05-01 | Bioring Sa | DEVICE FOR STRENGTHENING AND / OR REINFORCING THE VALVULAR HOLES OF THE HEART. |
US6805711B2 (en) | 2000-06-02 | 2004-10-19 | 3F Therapeutics, Inc. | Expandable medical implant and percutaneous delivery |
US6406493B1 (en) | 2000-06-02 | 2002-06-18 | Hosheng Tu | Expandable annuloplasty ring and methods of use |
US7632303B1 (en) | 2000-06-07 | 2009-12-15 | Advanced Cardiovascular Systems, Inc. | Variable stiffness medical devices |
ATE381291T1 (en) | 2000-06-23 | 2008-01-15 | Viacor Inc | AUTOMATIC ANNUAL FOLDING FOR MITRAL VALVE REPAIR |
US7144414B2 (en) | 2000-06-27 | 2006-12-05 | Smith & Nephew, Inc. | Surgical procedures and instruments |
US6419696B1 (en) | 2000-07-06 | 2002-07-16 | Paul A. Spence | Annuloplasty devices and related heart valve repair methods |
US6613078B1 (en) | 2000-08-02 | 2003-09-02 | Hector Daniel Barone | Multi-component endoluminal graft assembly, use thereof and method of implanting |
SE0002878D0 (en) | 2000-08-11 | 2000-08-11 | Kimblad Ola | Device and method of treatment of atrioventricular regurgitation |
US6719766B1 (en) | 2000-08-24 | 2004-04-13 | Novare Surgical Systems, Inc. | Surgical clamp pads having surface overlay |
US6524338B1 (en) | 2000-08-25 | 2003-02-25 | Steven R. Gundry | Method and apparatus for stapling an annuloplasty band in-situ |
US6554845B1 (en) | 2000-09-15 | 2003-04-29 | PARÉ Surgical, Inc. | Suturing apparatus and method |
US20080091264A1 (en) | 2002-11-26 | 2008-04-17 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US20060106278A1 (en) | 2004-05-14 | 2006-05-18 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of an adjustable bridge implant system |
US6893459B1 (en) | 2000-09-20 | 2005-05-17 | Ample Medical, Inc. | Heart valve annulus device and method of using same |
WO2004030568A2 (en) | 2002-10-01 | 2004-04-15 | Ample Medical, Inc. | Device and method for repairing a native heart valve leaflet |
US20090287179A1 (en) | 2003-10-01 | 2009-11-19 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools |
US8784482B2 (en) | 2000-09-20 | 2014-07-22 | Mvrx, Inc. | Method of reshaping a heart valve annulus using an intravascular device |
US6602288B1 (en) | 2000-10-05 | 2003-08-05 | Edwards Lifesciences Corporation | Minimally-invasive annuloplasty repair segment delivery template, system and method of use |
US6723038B1 (en) | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US6918917B1 (en) | 2000-10-10 | 2005-07-19 | Medtronic, Inc. | Minimally invasive annuloplasty procedure and apparatus |
US20020082525A1 (en) | 2000-10-18 | 2002-06-27 | Oslund John C. | Rapid exchange delivery catheter |
US6913608B2 (en) | 2000-10-23 | 2005-07-05 | Viacor, Inc. | Automated annular plication for mitral valve repair |
US7591826B2 (en) | 2000-12-28 | 2009-09-22 | Cardiac Dimensions, Inc. | Device implantable in the coronary sinus to provide mitral valve therapy |
US6579300B2 (en) | 2001-01-18 | 2003-06-17 | Scimed Life Systems, Inc. | Steerable sphincterotome and methods for cannulation, papillotomy and sphincterotomy |
US7510576B2 (en) | 2001-01-30 | 2009-03-31 | Edwards Lifesciences Ag | Transluminal mitral annuloplasty |
US6810882B2 (en) | 2001-01-30 | 2004-11-02 | Ev3 Santa Rosa, Inc. | Transluminal mitral annuloplasty |
AU2002243851A1 (en) | 2001-02-05 | 2002-08-19 | Viacor, Inc. | Apparatus and method for reducing mitral regurgitation |
JP4097924B2 (en) | 2001-02-05 | 2008-06-11 | オリンパス株式会社 | Biological tissue clip device |
US20020107531A1 (en) | 2001-02-06 | 2002-08-08 | Schreck Stefan G. | Method and system for tissue repair using dual catheters |
US6786924B2 (en) | 2001-03-15 | 2004-09-07 | Medtronic, Inc. | Annuloplasty band and method |
US7186264B2 (en) | 2001-03-29 | 2007-03-06 | Viacor, Inc. | Method and apparatus for improving mitral valve function |
EP1383557B1 (en) | 2001-04-02 | 2008-05-21 | Bladder Management Systems, LLC. | Conformable balloonless catheter |
DE10119096A1 (en) | 2001-04-19 | 2002-10-24 | Keramed Medizintechnik Gmbh | New biologically functionalized coatings, useful for e.g. accelerating osteo-integration of implants, e.g. dental or joint implants, comprise resorbable calcium-phosphorus phase containing adhesion and/or signal proteins |
US8202315B2 (en) | 2001-04-24 | 2012-06-19 | Mitralign, Inc. | Catheter-based annuloplasty using ventricularly positioned catheter |
US6619291B2 (en) | 2001-04-24 | 2003-09-16 | Edwin J. Hlavka | Method and apparatus for catheter-based annuloplasty |
US20060069429A1 (en) | 2001-04-24 | 2006-03-30 | Spence Paul A | Tissue fastening systems and methods utilizing magnetic guidance |
US7037334B1 (en) | 2001-04-24 | 2006-05-02 | Mitralign, Inc. | Method and apparatus for catheter-based annuloplasty using local plications |
US20050125011A1 (en) | 2001-04-24 | 2005-06-09 | Spence Paul A. | Tissue fastening systems and methods utilizing magnetic guidance |
US6682558B2 (en) | 2001-05-10 | 2004-01-27 | 3F Therapeutics, Inc. | Delivery system for a stentless valve bioprosthesis |
ITMI20011012A1 (en) | 2001-05-17 | 2002-11-17 | Ottavio Alfieri | ANNULAR PROSTHESIS FOR MITRAL VALVE |
US6858039B2 (en) | 2002-07-08 | 2005-02-22 | Edwards Lifesciences Corporation | Mitral valve annuloplasty ring having a posterior bow |
FI114150B (en) | 2001-05-17 | 2004-08-31 | Inion Ltd | Magazine for surgical fixation instruments and arrangement for a magazine for surgical fixation instruments |
US7935145B2 (en) | 2001-05-17 | 2011-05-03 | Edwards Lifesciences Corporation | Annuloplasty ring for ischemic mitral valve insuffuciency |
US20020188301A1 (en) | 2001-06-11 | 2002-12-12 | Dallara Mark Douglas | Tissue anchor insertion system |
ES2230262T3 (en) | 2001-06-11 | 2005-05-01 | Sorin Biomedica Cardio S.R.L. | PROTECTION OF ANULOPLASTY AND METHOD FOR THEIR PRODUCTION. |
AU2002322255A1 (en) | 2001-06-15 | 2003-01-02 | The Cleveland Clinic Foundation | Tissue engineered mitral valve chrodae and methods of making and using same |
US6958079B1 (en) | 2001-07-03 | 2005-10-25 | Reflux Corporation | Perorally insertable/removable anti-reflux valve |
FR2826863B1 (en) | 2001-07-04 | 2003-09-26 | Jacques Seguin | ASSEMBLY FOR PLACING A PROSTHETIC VALVE IN A BODY CONDUIT |
US7150737B2 (en) | 2001-07-13 | 2006-12-19 | Sci/Med Life Systems, Inc. | Methods and apparatuses for navigating the subarachnoid space |
US6726716B2 (en) | 2001-08-24 | 2004-04-27 | Edwards Lifesciences Corporation | Self-molding annuloplasty ring |
US6908482B2 (en) | 2001-08-28 | 2005-06-21 | Edwards Lifesciences Corporation | Three-dimensional annuloplasty ring and template |
US6749630B2 (en) | 2001-08-28 | 2004-06-15 | Edwards Lifesciences Corporation | Tricuspid ring and template |
DE60225303T2 (en) | 2001-08-31 | 2009-02-26 | Mitral Interventions, Redwood City | DEVICE FOR A HEART LAPSE REPAIR |
US7097659B2 (en) | 2001-09-07 | 2006-08-29 | Medtronic, Inc. | Fixation band for affixing a prosthetic heart valve to tissue |
US20030050693A1 (en) | 2001-09-10 | 2003-03-13 | Quijano Rodolfo C. | Minimally invasive delivery system for annuloplasty rings |
EP1434542A2 (en) | 2001-10-01 | 2004-07-07 | Ample Medical, Inc. | Methods and devices for heart valve treatments |
US6893460B2 (en) | 2001-10-11 | 2005-05-17 | Percutaneous Valve Technologies Inc. | Implantable prosthetic valve |
US7144363B2 (en) | 2001-10-16 | 2006-12-05 | Extensia Medical, Inc. | Systems for heart treatment |
US20060020336A1 (en) | 2001-10-23 | 2006-01-26 | Liddicoat John R | Automated annular plication for mitral valve repair |
US7052487B2 (en) | 2001-10-26 | 2006-05-30 | Cohn William E | Method and apparatus for reducing mitral regurgitation |
GB0125925D0 (en) | 2001-10-29 | 2001-12-19 | Univ Glasgow | Mitral valve prosthesis |
US7311729B2 (en) | 2002-01-30 | 2007-12-25 | Cardiac Dimensions, Inc. | Device and method for modifying the shape of a body organ |
US6805710B2 (en) | 2001-11-13 | 2004-10-19 | Edwards Lifesciences Corporation | Mitral valve annuloplasty ring for molding left ventricle geometry |
US8231639B2 (en) | 2001-11-28 | 2012-07-31 | Aptus Endosystems, Inc. | Systems and methods for attaching a prosthesis within a body lumen or hollow organ |
CA2464048C (en) | 2001-11-28 | 2010-06-15 | Lee Bolduc | Endovascular aneurysm repair system |
US20050177180A1 (en) | 2001-11-28 | 2005-08-11 | Aptus Endosystems, Inc. | Devices, systems, and methods for supporting tissue and/or structures within a hollow body organ |
US20090112302A1 (en) | 2001-11-28 | 2009-04-30 | Josh Stafford | Devices, systems, and methods for endovascular staple and/or prosthesis delivery and implantation |
US7147657B2 (en) | 2003-10-23 | 2006-12-12 | Aptus Endosystems, Inc. | Prosthesis delivery systems and methods |
US20030176914A1 (en) | 2003-01-21 | 2003-09-18 | Rabkin Dmitry J. | Multi-segment modular stent and methods for manufacturing stents |
AU2002228753A1 (en) | 2001-12-04 | 2003-06-17 | Edwards Lifesciences Corporation | Minimally-invasive annuloplasty repair segment delivery template system |
US6908478B2 (en) | 2001-12-05 | 2005-06-21 | Cardiac Dimensions, Inc. | Anchor and pull mitral valve device and method |
US6976995B2 (en) | 2002-01-30 | 2005-12-20 | Cardiac Dimensions, Inc. | Fixed length anchor and pull mitral valve device and method |
US6978176B2 (en) | 2001-12-08 | 2005-12-20 | Lattouf Omar M | Treatment for patient with congestive heart failure |
DE10161543B4 (en) | 2001-12-11 | 2004-02-19 | REITAN, Öyvind | Implant for the treatment of heart valve insufficiency |
US6740107B2 (en) | 2001-12-19 | 2004-05-25 | Trimedyne, Inc. | Device for treatment of atrioventricular valve regurgitation |
WO2003053289A1 (en) | 2001-12-21 | 2003-07-03 | Simcha Milo | Implantation system for annuloplasty rings |
US8123801B2 (en) | 2001-12-21 | 2012-02-28 | QuickRing Medical Technologies, Ltd. | Implantation system for annuloplasty rings |
US20030120340A1 (en) | 2001-12-26 | 2003-06-26 | Jan Liska | Mitral and tricuspid valve repair |
EP2181668A1 (en) | 2001-12-28 | 2010-05-05 | Edwards Lifesciences AG | Device for treating mitral annulus dilatation comprising a balloon catheter and a stent |
SE524709C2 (en) | 2002-01-11 | 2004-09-21 | Edwards Lifesciences Ag | Device for delayed reshaping of a heart vessel and a heart valve |
US7033390B2 (en) | 2002-01-02 | 2006-04-25 | Medtronic, Inc. | Prosthetic heart valve system |
US6764510B2 (en) | 2002-01-09 | 2004-07-20 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7717899B2 (en) | 2002-01-28 | 2010-05-18 | Cardiac Pacemakers, Inc. | Inner and outer telescoping catheter delivery system |
US6797001B2 (en) | 2002-03-11 | 2004-09-28 | Cardiac Dimensions, Inc. | Device, assembly and method for mitral valve repair |
US6719786B2 (en) | 2002-03-18 | 2004-04-13 | Medtronic, Inc. | Flexible annuloplasty prosthesis and holder |
US7118595B2 (en) | 2002-03-18 | 2006-10-10 | Medtronic, Inc. | Flexible annuloplasty prosthesis and holder |
ATE518501T1 (en) | 2002-03-27 | 2011-08-15 | Sorin Biomedica Cardio Srl | ANNULOPLASTY PROSTHESIS WITH PERFORATED ELEMENT |
US20030199974A1 (en) | 2002-04-18 | 2003-10-23 | Coalescent Surgical, Inc. | Annuloplasty apparatus and methods |
WO2003088846A1 (en) | 2002-04-22 | 2003-10-30 | Tyco Healthcare Group, Lp | Tack and tack applier |
US6951565B2 (en) | 2002-04-24 | 2005-10-04 | Linvatec Biomaterials Ltd. | Device for inserting surgical implants |
US6764810B2 (en) | 2002-04-25 | 2004-07-20 | Taiwan Semiconductor Manufacturing Co., Ltd | Method for dual-damascene formation using a via plug |
US7077850B2 (en) | 2002-05-01 | 2006-07-18 | Scimed Life Systems, Inc. | Tissue fastening devices and related insertion tools and methods |
CA2485285A1 (en) | 2002-05-10 | 2003-11-20 | Cordis Corporation | Method of making a medical device having a thin wall tubular membrane over a structural frame |
EP1521550A4 (en) | 2002-06-12 | 2011-02-23 | Mitral Interventions Inc | Method and apparatus for tissue connection |
US7753924B2 (en) | 2003-09-04 | 2010-07-13 | Guided Delivery Systems, Inc. | Delivery devices and methods for heart valve repair |
US7883538B2 (en) | 2002-06-13 | 2011-02-08 | Guided Delivery Systems Inc. | Methods and devices for termination |
US20060241656A1 (en) | 2002-06-13 | 2006-10-26 | Starksen Niel F | Delivery devices and methods for heart valve repair |
US20040243227A1 (en) | 2002-06-13 | 2004-12-02 | Guided Delivery Systems, Inc. | Delivery devices and methods for heart valve repair |
US6986775B2 (en) | 2002-06-13 | 2006-01-17 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US8641727B2 (en) | 2002-06-13 | 2014-02-04 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US7753922B2 (en) | 2003-09-04 | 2010-07-13 | Guided Delivery Systems, Inc. | Devices and methods for cardiac annulus stabilization and treatment |
US7588582B2 (en) | 2002-06-13 | 2009-09-15 | Guided Delivery Systems Inc. | Methods for remodeling cardiac tissue |
US8287555B2 (en) | 2003-02-06 | 2012-10-16 | Guided Delivery Systems, Inc. | Devices and methods for heart valve repair |
US20060122633A1 (en) | 2002-06-13 | 2006-06-08 | John To | Methods and devices for termination |
US6932834B2 (en) | 2002-06-27 | 2005-08-23 | Ethicon, Inc. | Suture anchor |
US7608103B2 (en) | 2002-07-08 | 2009-10-27 | Edwards Lifesciences Corporation | Mitral valve annuloplasty ring having a posterior bow |
US7172625B2 (en) | 2002-07-16 | 2007-02-06 | Medtronic, Inc. | Suturing rings for implantable heart valve prostheses |
IL150855A (en) | 2002-07-22 | 2007-06-03 | Leonid Monassevitch | Intratubular anastomosis apparatus |
US7993351B2 (en) | 2002-07-24 | 2011-08-09 | Pressure Products Medical Supplies, Inc. | Telescopic introducer with a compound curvature for inducing alignment and method of using the same |
CA2494758C (en) | 2002-08-01 | 2013-03-19 | The General Hospital Corporation | Cardiac devices and methods for minimally invasive repair of ischemic mitral regurgitation |
WO2004014282A2 (en) | 2002-08-13 | 2004-02-19 | The General Hospital Corporation | Cardiac devices and methods for percutaneous repair of atrioventricular valves |
MXPA05002284A (en) | 2002-08-29 | 2006-02-10 | Mitralsolutions Inc | Implantable devices for controlling the internal circumference of an anatomic orifice or lumen. |
US8758372B2 (en) | 2002-08-29 | 2014-06-24 | St. Jude Medical, Cardiology Division, Inc. | Implantable devices for controlling the size and shape of an anatomical structure or lumen |
ES2291405T3 (en) | 2002-09-04 | 2008-03-01 | Endoart S.A. | SURGICAL RING PROVIDED WITH A REMOTE CONTROL SYSTEM AND REVERSIBLE IN THE VARIATION OF YOUR DIAMETER. |
WO2004021894A1 (en) | 2002-09-09 | 2004-03-18 | Brian Kelleher | Device and method for endoluminal therapy |
US20040059413A1 (en) | 2002-09-20 | 2004-03-25 | Claudio Argento | Suture template for facilitating implantation of a prosthetic heart valve |
WO2004028348A2 (en) | 2002-09-26 | 2004-04-08 | Savacor, Inc. | Cardiovascular anchoring device and method of deploying same |
ATE418938T1 (en) | 2002-10-01 | 2009-01-15 | Ample Medical Inc | DEVICES AND SYSTEMS FOR REFORMING A HEART VALVE ANNULUS |
US7087064B1 (en) | 2002-10-15 | 2006-08-08 | Advanced Cardiovascular Systems, Inc. | Apparatuses and methods for heart valve repair |
US20050119735A1 (en) | 2002-10-21 | 2005-06-02 | Spence Paul A. | Tissue fastening systems and methods utilizing magnetic guidance |
BR0315392A (en) | 2002-10-21 | 2005-08-23 | Mitralign Inc | Incrementing catheters and methods of performing annuloplasty |
US6733536B1 (en) | 2002-10-22 | 2004-05-11 | Scimed Life Systems | Male urethral stent device |
US7247134B2 (en) | 2002-11-12 | 2007-07-24 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7112219B2 (en) | 2002-11-12 | 2006-09-26 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7335213B1 (en) | 2002-11-15 | 2008-02-26 | Abbott Cardiovascular Systems Inc. | Apparatus and methods for heart valve repair |
US8187324B2 (en) | 2002-11-15 | 2012-05-29 | Advanced Cardiovascular Systems, Inc. | Telescoping apparatus for delivering and adjusting a medical device in a vessel |
US7404824B1 (en) | 2002-11-15 | 2008-07-29 | Advanced Cardiovascular Systems, Inc. | Valve aptation assist device |
WO2004045378A2 (en) | 2002-11-15 | 2004-06-03 | The Government Of The United States Of America As Represented By The Secretary Of Health And Human Services | Method and device for catheter-based repair of cardiac valves |
US7981152B1 (en) | 2004-12-10 | 2011-07-19 | Advanced Cardiovascular Systems, Inc. | Vascular delivery system for accessing and delivering devices into coronary sinus and other vascular sites |
US7485143B2 (en) | 2002-11-15 | 2009-02-03 | Abbott Cardiovascular Systems Inc. | Apparatuses and methods for heart valve repair |
US7108710B2 (en) | 2002-11-26 | 2006-09-19 | Abbott Laboratories | Multi-element biased suture clip |
US7608114B2 (en) | 2002-12-02 | 2009-10-27 | Gi Dynamics, Inc. | Bariatric sleeve |
US8551162B2 (en) | 2002-12-20 | 2013-10-08 | Medtronic, Inc. | Biologically implantable prosthesis |
US7316710B1 (en) | 2002-12-30 | 2008-01-08 | Advanced Cardiovascular Systems, Inc. | Flexible stent |
US6931338B2 (en) | 2003-01-07 | 2005-08-16 | Guide Technology, Inc. | System for providing a calibrated path for multi-signal cables in testing of integrated circuits |
US7314485B2 (en) | 2003-02-03 | 2008-01-01 | Cardiac Dimensions, Inc. | Mitral valve device using conditioned shape memory alloy |
US20040176788A1 (en) | 2003-03-07 | 2004-09-09 | Nmt Medical, Inc. | Vacuum attachment system |
US20040186566A1 (en) | 2003-03-18 | 2004-09-23 | Hindrichs Paul J. | Body tissue remodeling methods and apparatus |
US20050107871A1 (en) | 2003-03-30 | 2005-05-19 | Fidel Realyvasquez | Apparatus and methods for valve repair |
DE602004010895T2 (en) | 2003-04-02 | 2008-12-11 | Boston Scientific Ltd., St. Michael | REMOVABLE AND RETRACTABLE STENT ARRANGEMENT |
US7530995B2 (en) | 2003-04-17 | 2009-05-12 | 3F Therapeutics, Inc. | Device for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US7159593B2 (en) | 2003-04-17 | 2007-01-09 | 3F Therapeutics, Inc. | Methods for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US20040225233A1 (en) | 2003-05-09 | 2004-11-11 | Frankowski Brian J. | Magnetic guidewires |
US20040230208A1 (en) | 2003-05-13 | 2004-11-18 | Vafa Shayani | Article for positioning mesh over tissue |
CA2527778C (en) | 2003-06-13 | 2011-11-08 | Tyco Healthcare Group Lp | Multiple member interconnect for surgical instrument and absorbable screw fastener |
US7967850B2 (en) | 2003-06-18 | 2011-06-28 | Jackson Roger P | Polyaxial bone anchor with helical capture connection, insert and dual locking assembly |
US20040260394A1 (en) | 2003-06-20 | 2004-12-23 | Medtronic Vascular, Inc. | Cardiac valve annulus compressor system |
US20060282161A1 (en) | 2003-06-20 | 2006-12-14 | Medtronic Vascular, Inc. | Valve annulus reduction system |
US7316706B2 (en) | 2003-06-20 | 2008-01-08 | Medtronic Vascular, Inc. | Tensioning device, system, and method for treating mitral valve regurgitation |
US20060184240A1 (en) | 2003-06-25 | 2006-08-17 | Georgia Tech Research Corporation | Annuloplasty chain |
US8052751B2 (en) | 2003-07-02 | 2011-11-08 | Flexcor, Inc. | Annuloplasty rings for repairing cardiac valves |
WO2005018507A2 (en) | 2003-07-18 | 2005-03-03 | Ev3 Santa Rosa, Inc. | Remotely activated mitral annuloplasty system and methods |
US20050016560A1 (en) | 2003-07-21 | 2005-01-27 | Dee Voughlohn | Unique hair-styling system and method |
US8021421B2 (en) | 2003-08-22 | 2011-09-20 | Medtronic, Inc. | Prosthesis heart valve fixturing device |
US20050049692A1 (en) | 2003-09-02 | 2005-03-03 | Numamoto Michael J. | Medical device for reduction of pressure effects of cardiac tricuspid valve regurgitation |
US20050075728A1 (en) | 2003-10-06 | 2005-04-07 | Nguyen Tuoc Tan | Minimally invasive valve replacement system |
US7226647B2 (en) | 2003-10-16 | 2007-06-05 | Hewlett-Packard Development Company, L.P. | Permanent fixation of dyes to surface-modified inorganic particulate-coated media |
US7004176B2 (en) | 2003-10-17 | 2006-02-28 | Edwards Lifesciences Ag | Heart valve leaflet locator |
US20060184242A1 (en) | 2003-10-20 | 2006-08-17 | Samuel Lichtenstein | Method and apparatus for percutaneous reduction of anterior-posterior diameter of mitral valve |
ITBO20030631A1 (en) | 2003-10-23 | 2005-04-24 | Roberto Erminio Parravicini | VALVULAR PROSTHETIC EQUIPMENT, IN PARTICULAR FOR HEART APPLICATIONS. |
US20050090827A1 (en) | 2003-10-28 | 2005-04-28 | Tewodros Gedebou | Comprehensive tissue attachment system |
WO2005042079A1 (en) | 2003-10-31 | 2005-05-12 | Trudell Medical International | System and method for manipulating a catheter for delivering a substance to a body cavity |
US7655040B2 (en) | 2003-11-12 | 2010-02-02 | Medtronic Vascular, Inc. | Cardiac valve annulus reduction system |
WO2005046530A1 (en) | 2003-11-12 | 2005-05-26 | Medtronic Vascular, Inc. | Coronary sinus approach for repair of mitral valve reguritation |
US7226413B2 (en) | 2003-11-17 | 2007-06-05 | Aeolin Llc | Nerve root retractor and sucker |
JP2007512919A (en) | 2003-12-04 | 2007-05-24 | ザ ブリガム アンド ウィメンズ ホスピタル インコーポレイテッド | Aortic annuloplasty ring |
US7220230B2 (en) | 2003-12-05 | 2007-05-22 | Edwards Lifesciences Corporation | Pressure-based system and method for determining cardiac stroke volume |
US20050177228A1 (en) | 2003-12-16 | 2005-08-11 | Solem Jan O. | Device for changing the shape of the mitral annulus |
US20050273138A1 (en) | 2003-12-19 | 2005-12-08 | Guided Delivery Systems, Inc. | Devices and methods for anchoring tissue |
US20050137686A1 (en) | 2003-12-23 | 2005-06-23 | Sadra Medical, A Delaware Corporation | Externally expandable heart valve anchor and method |
US8182528B2 (en) | 2003-12-23 | 2012-05-22 | Sadra Medical, Inc. | Locking heart valve anchor |
US7329279B2 (en) | 2003-12-23 | 2008-02-12 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US7326236B2 (en) | 2003-12-23 | 2008-02-05 | Xtent, Inc. | Devices and methods for controlling and indicating the length of an interventional element |
US9005273B2 (en) | 2003-12-23 | 2015-04-14 | Sadra Medical, Inc. | Assessing the location and performance of replacement heart valves |
US8328868B2 (en) | 2004-11-05 | 2012-12-11 | Sadra Medical, Inc. | Medical devices and delivery systems for delivering medical devices |
US8287584B2 (en) | 2005-11-14 | 2012-10-16 | Sadra Medical, Inc. | Medical implant deployment tool |
US8343213B2 (en) | 2003-12-23 | 2013-01-01 | Sadra Medical, Inc. | Leaflet engagement elements and methods for use thereof |
US8864822B2 (en) | 2003-12-23 | 2014-10-21 | Mitralign, Inc. | Devices and methods for introducing elements into tissue |
US7748389B2 (en) | 2003-12-23 | 2010-07-06 | Sadra Medical, Inc. | Leaflet engagement elements and methods for use thereof |
US7166127B2 (en) | 2003-12-23 | 2007-01-23 | Mitralign, Inc. | Tissue fastening systems and methods utilizing magnetic guidance |
US8828078B2 (en) | 2003-12-23 | 2014-09-09 | Sadra Medical, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
US7445631B2 (en) | 2003-12-23 | 2008-11-04 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a patient's heart valve |
US8840663B2 (en) | 2003-12-23 | 2014-09-23 | Sadra Medical, Inc. | Repositionable heart valve method |
US7288115B2 (en) | 2004-01-02 | 2007-10-30 | Zimmer Technology, Inc. | Multipart component for an orthopaedic implant |
US20050159810A1 (en) | 2004-01-15 | 2005-07-21 | Farzan Filsoufi | Devices and methods for repairing cardiac valves |
US20050159728A1 (en) | 2004-01-15 | 2005-07-21 | Thomas Medical Products, Inc. | Steerable sheath |
US20050187568A1 (en) | 2004-02-20 | 2005-08-25 | Klenk Alan R. | Devices and methods for closing a patent foramen ovale with a coil-shaped closure device |
US8206439B2 (en) | 2004-02-23 | 2012-06-26 | International Heart Institute Of Montana Foundation | Internal prosthesis for reconstruction of cardiac geometry |
US20050203606A1 (en) | 2004-03-09 | 2005-09-15 | Vancamp Daniel H. | Stent system for preventing restenosis |
US20050203549A1 (en) | 2004-03-09 | 2005-09-15 | Fidel Realyvasquez | Methods and apparatus for off pump aortic valve replacement with a valve prosthesis |
US8979922B2 (en) | 2004-03-11 | 2015-03-17 | Percutaneous Cardiovascular Solutions Pty Limited | Percutaneous heart valve prosthesis |
WO2005087139A1 (en) | 2004-03-15 | 2005-09-22 | Baker Medical Research Institute | Treating valve failure |
NL1025830C2 (en) | 2004-03-26 | 2005-02-22 | Eric Berreklouw | Prosthesis e.g. heart valve secured in place by ring with shape memory material anchor, includes anchor temperature control system |
US20050234481A1 (en) | 2004-03-31 | 2005-10-20 | Wilson-Cook Medical Inc. | Suture cutting device |
US7993397B2 (en) | 2004-04-05 | 2011-08-09 | Edwards Lifesciences Ag | Remotely adjustable coronary sinus implant |
GB0407908D0 (en) | 2004-04-07 | 2004-05-12 | Univ York | Ionic liquids |
US7645293B2 (en) | 2004-04-21 | 2010-01-12 | United States Surgical Corporation | Suture anchor installation system and method |
US7294148B2 (en) | 2004-04-29 | 2007-11-13 | Edwards Lifesciences Corporation | Annuloplasty ring for mitral valve prolapse |
US8012201B2 (en) | 2004-05-05 | 2011-09-06 | Direct Flow Medical, Inc. | Translumenally implantable heart valve with multiple chamber formed in place support |
US7390329B2 (en) | 2004-05-07 | 2008-06-24 | Usgi Medical, Inc. | Methods for grasping and cinching tissue anchors |
US20060122692A1 (en) | 2004-05-10 | 2006-06-08 | Ran Gilad | Stent valve and method of using same |
US20050256532A1 (en) | 2004-05-12 | 2005-11-17 | Asha Nayak | Cardiovascular defect patch device and method |
US7845380B2 (en) | 2004-05-14 | 2010-12-07 | Mcneil-Ppc, Inc. | Intravaginal device with fluid transport plates |
EP3398522B1 (en) | 2004-05-14 | 2019-12-25 | Evalve, Inc. | Locking mechanisms for fixation devices |
US7452376B2 (en) | 2004-05-14 | 2008-11-18 | St. Jude Medical, Inc. | Flexible, non-planar annuloplasty rings |
US7713298B2 (en) | 2004-06-29 | 2010-05-11 | Micardia Corporation | Methods for treating cardiac valves with adjustable implants |
US7276078B2 (en) | 2004-06-30 | 2007-10-02 | Edwards Lifesciences Pvt | Paravalvular leak detection, sealing, and prevention |
US8012202B2 (en) | 2004-07-27 | 2011-09-06 | Alameddine Abdallah K | Mitral valve ring for treatment of mitral valve regurgitation |
US7126289B2 (en) | 2004-08-20 | 2006-10-24 | O2 Micro Inc | Protection for external electrode fluorescent lamp system |
WO2006032051A2 (en) | 2004-09-14 | 2006-03-23 | Edwards Lifesciences Ag | Device and method for treatment of heart valve regurgitation |
AU2005289474B2 (en) | 2004-09-27 | 2010-12-09 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
US8052592B2 (en) | 2005-09-27 | 2011-11-08 | Evalve, Inc. | Methods and devices for tissue grasping and assessment |
US20060085012A1 (en) | 2004-09-28 | 2006-04-20 | Medtronic Vascular, Inc. | Torquing device delivered over a guidewire to rotate a medical fastener |
AU2005290341B2 (en) | 2004-09-28 | 2012-01-19 | Surgical Solutions Llc | Suture anchor |
US20070083168A1 (en) | 2004-09-30 | 2007-04-12 | Whiting James S | Transmembrane access systems and methods |
US20090043381A1 (en) | 2004-10-05 | 2009-02-12 | Macoviak John A | Atrioventricular valve annulus repair systems and methods including retro-chordal anchors |
US7470256B2 (en) | 2004-10-29 | 2008-12-30 | Merit Medical Systems, Inc., | Self-suturing anchor device for a catheter |
CN100475165C (en) | 2004-12-07 | 2009-04-08 | 奥林巴斯株式会社 | Endo-therapy product system used for endoscope and cartridge including treatment device |
AU2005316431A1 (en) | 2004-12-15 | 2006-06-22 | Cook Ireland Limited | Radiopaque manipulation devices |
US20060178700A1 (en) | 2004-12-15 | 2006-08-10 | Martin Quinn | Medical device suitable for use in treatment of a valve |
DE102005003632A1 (en) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Catheter for the transvascular implantation of heart valve prostheses |
US20110060407A1 (en) | 2005-02-07 | 2011-03-10 | Ted Ketai | Methods, systems and devices for cardiac valve repair |
US20100298929A1 (en) | 2005-02-07 | 2010-11-25 | Thornton Troy L | Methods, systems and devices for cardiac valve repair |
WO2006086434A1 (en) | 2005-02-07 | 2006-08-17 | Evalve, Inc. | Methods, systems and devices for cardiac valve repair |
US8220466B2 (en) | 2005-02-08 | 2012-07-17 | Koninklijke Philips Electronics N.V. | System and method for percutaneous palate remodeling |
EP1850728B1 (en) | 2005-02-08 | 2010-04-28 | Koninklijke Philips Electronics N.V. | System for percutaneous glossoplasty |
US7955385B2 (en) | 2005-02-28 | 2011-06-07 | Medtronic Vascular, Inc. | Device, system, and method for aiding valve annuloplasty |
US20060206203A1 (en) | 2005-03-10 | 2006-09-14 | Jun Yang | Valvular support prosthesis |
WO2006097931A2 (en) | 2005-03-17 | 2006-09-21 | Valtech Cardio, Ltd. | Mitral valve treatment techniques |
US8608726B2 (en) | 2005-03-24 | 2013-12-17 | The Cleveland Clinic Foundation | Vascular guidewire control apparatus |
WO2006102626A2 (en) | 2005-03-24 | 2006-09-28 | Metacure Nv | Wireless leads for gastrointestinal tract applications |
US9492276B2 (en) | 2005-03-25 | 2016-11-15 | St. Jude Medical, Cardiology Division, Inc. | Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen |
US8864823B2 (en) | 2005-03-25 | 2014-10-21 | StJude Medical, Cardiology Division, Inc. | Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen |
US7722666B2 (en) | 2005-04-15 | 2010-05-25 | Boston Scientific Scimed, Inc. | Valve apparatus, system and method |
US20060259135A1 (en) | 2005-04-20 | 2006-11-16 | The Cleveland Clinic Foundation | Apparatus and method for replacing a cardiac valve |
US8333777B2 (en) | 2005-04-22 | 2012-12-18 | Benvenue Medical, Inc. | Catheter-based tissue remodeling devices and methods |
US7500989B2 (en) | 2005-06-03 | 2009-03-10 | Edwards Lifesciences Corp. | Devices and methods for percutaneous repair of the mitral valve via the coronary sinus |
US20060287716A1 (en) | 2005-06-08 | 2006-12-21 | The Cleveland Clinic Foundation | Artificial chordae |
US8951285B2 (en) | 2005-07-05 | 2015-02-10 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
US20070162111A1 (en) | 2005-07-06 | 2007-07-12 | The Cleveland Clinic Foundation | Apparatus and method for replacing a cardiac valve |
US20070016288A1 (en) | 2005-07-13 | 2007-01-18 | Gurskis Donnell W | Two-piece percutaneous prosthetic heart valves and methods for making and using them |
DE102006017873A1 (en) | 2005-07-14 | 2007-01-25 | Qualimed Innovative Medizinprodukte Gmbh | Temporary stent |
EP1903991B1 (en) | 2005-07-15 | 2009-09-09 | The Cleveland Clinic Foundation | Apparatus for remodelling a cardiac valve annulus |
US7927371B2 (en) | 2005-07-15 | 2011-04-19 | The Cleveland Clinic Foundation | Apparatus and method for reducing cardiac valve regurgitation |
US7875056B2 (en) | 2005-07-22 | 2011-01-25 | Anpa Medical, Inc. | Wedge operated retainer device and methods |
US20070027533A1 (en) | 2005-07-28 | 2007-02-01 | Medtronic Vascular, Inc. | Cardiac valve annulus restraining device |
US20070055206A1 (en) | 2005-08-10 | 2007-03-08 | Guided Delivery Systems, Inc. | Methods and devices for deployment of tissue anchors |
US7222559B2 (en) | 2005-08-16 | 2007-05-29 | Chun Fu Wang | Screwdriver with torque setting mechanism |
US9492277B2 (en) | 2005-08-30 | 2016-11-15 | Mayo Foundation For Medical Education And Research | Soft body tissue remodeling methods and apparatus |
US20070078297A1 (en) | 2005-08-31 | 2007-04-05 | Medtronic Vascular, Inc. | Device for Treating Mitral Valve Regurgitation |
US7846179B2 (en) | 2005-09-01 | 2010-12-07 | Ovalis, Inc. | Suture-based systems and methods for treating septal defects |
WO2007030823A2 (en) | 2005-09-09 | 2007-03-15 | Edwards Lifesciences Corporation | Device and method for reshaping mitral valve annulus |
CA2561034C (en) | 2005-09-30 | 2014-12-09 | Sherwood Services Ag | Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue |
US7695510B2 (en) | 2005-10-11 | 2010-04-13 | Medtronic Vascular, Inc. | Annuloplasty device having shape-adjusting tension filaments |
US20070083235A1 (en) | 2005-10-11 | 2007-04-12 | Jervis James E | Helical retainer, tool for using the helical retainer, and methods |
CN101466316B (en) | 2005-10-20 | 2012-06-27 | 阿普特斯内系统公司 | Devices systems and methods for prosthesis delivery and implantation including the use of a fastener tool |
US8216302B2 (en) | 2005-10-26 | 2012-07-10 | Cardiosolutions, Inc. | Implant delivery and deployment system and method |
US8343204B2 (en) | 2005-10-31 | 2013-01-01 | Cook Medical Technologies Llc | Composite stent graft |
DE102005052628B4 (en) | 2005-11-04 | 2014-06-05 | Jenavalve Technology Inc. | Self-expanding, flexible wire mesh with integrated valvular prosthesis for the transvascular heart valve replacement and a system with such a device and a delivery catheter |
WO2007056590A1 (en) | 2005-11-08 | 2007-05-18 | Trustees Of Boston University | Manipulators employing multiple deformable elongate members |
US8764820B2 (en) | 2005-11-16 | 2014-07-01 | Edwards Lifesciences Corporation | Transapical heart valve delivery system and method |
ATE429194T1 (en) | 2005-11-16 | 2009-05-15 | Micardia Corp | MAGNETIC ATTACHMENT OF A CATHETER TO AN IMPLANT |
WO2007062054A2 (en) | 2005-11-21 | 2007-05-31 | The Brigham And Women's Hospital, Inc. | Percutaneous cardiac valve repair with adjustable artificial chordae |
US8043368B2 (en) | 2005-11-23 | 2011-10-25 | Traves Dean Crabtree | Methods and apparatus for atrioventricular valve repair |
US7632308B2 (en) | 2005-11-23 | 2009-12-15 | Didier Loulmet | Methods, devices, and kits for treating mitral valve prolapse |
FR2894131B1 (en) | 2005-12-02 | 2008-12-05 | Perouse Soc Par Actions Simpli | DEVICE FOR TREATING A BLOOD VESSEL, AND ASSOCIATED TREATMENT NECESSARY. |
US10039531B2 (en) | 2005-12-15 | 2018-08-07 | Georgia Tech Research Corporation | Systems and methods to control the dimension of a heart valve |
US7901454B2 (en) | 2005-12-15 | 2011-03-08 | The Cleveland Clinic Foundation | Apparatus and method for treating a regurgitant valve |
WO2007100408A2 (en) | 2005-12-15 | 2007-09-07 | Georgia Tech Research Corporation | Papillary muscle position control devices, systems & methods |
US20070142907A1 (en) | 2005-12-16 | 2007-06-21 | Micardia Corporation | Adjustable prosthetic valve implant |
EP1803420B1 (en) | 2005-12-28 | 2009-07-01 | Sorin Biomedica Cardio S.R.L. | Annuloplasty prosthesis with an auxetic structure |
US7635386B1 (en) | 2006-03-07 | 2009-12-22 | University Of Maryland, Baltimore | Methods and devices for performing cardiac valve repair |
US7431692B2 (en) | 2006-03-09 | 2008-10-07 | Edwards Lifesciences Corporation | Apparatus, system, and method for applying and adjusting a tensioning element to a hollow body organ |
US20070219558A1 (en) | 2006-03-15 | 2007-09-20 | Allen Deutsch | Method and apparatus for arthroscopic surgery using suture anchors |
WO2007110866A2 (en) | 2006-03-28 | 2007-10-04 | Spatz-Fgia Inc | Floating gastrointestinal anchor |
WO2007115110A2 (en) | 2006-03-29 | 2007-10-11 | The Catheter Exchange, Inc. | Method and device for cavity obliteration |
US7625403B2 (en) | 2006-04-04 | 2009-12-01 | Medtronic Vascular, Inc. | Valved conduit designed for subsequent catheter delivered valve therapy |
US20070239208A1 (en) | 2006-04-05 | 2007-10-11 | Crawford Bruce S | Surgical implantation device and method |
JP5198431B2 (en) | 2006-04-12 | 2013-05-15 | メドトロニック ヴァスキュラー インコーポレイテッド | Annuloplasty device with helical anchor |
US7699892B2 (en) | 2006-04-12 | 2010-04-20 | Medtronic Vascular, Inc. | Minimally invasive procedure for implanting an annuloplasty device |
WO2007124076A1 (en) | 2006-04-21 | 2007-11-01 | Abbott Laboratories | Guidewire handling device |
US7442207B2 (en) | 2006-04-21 | 2008-10-28 | Medtronic Vascular, Inc. | Device, system, and method for treating cardiac valve regurgitation |
US8551161B2 (en) | 2006-04-25 | 2013-10-08 | Medtronic Vascular, Inc. | Cardiac valve annulus restraining device |
WO2007136532A2 (en) | 2006-05-03 | 2007-11-29 | St. Jude Medical, Inc. | Soft body tissue remodeling methods and apparatus |
WO2007131513A1 (en) | 2006-05-15 | 2007-11-22 | Enovacor Aps | A system and a method for altering the geometry of the heart |
US20080091169A1 (en) | 2006-05-16 | 2008-04-17 | Wayne Heideman | Steerable catheter using flat pull wires and having torque transfer layer made of braided flat wires |
US8932348B2 (en) | 2006-05-18 | 2015-01-13 | Edwards Lifesciences Corporation | Device and method for improving heart valve function |
WO2007137228A2 (en) | 2006-05-19 | 2007-11-29 | Norman Godin | Medical staple, system and methods of use |
EP2032044A2 (en) | 2006-05-25 | 2009-03-11 | Mitralign, Inc. | Lockers for surgical tensioning members and methods of using the same to secure surgical tensioning members |
CN102283721B (en) | 2006-06-01 | 2015-08-26 | 爱德华兹生命科学公司 | For improving the prosthetic insert of heart valve function |
ITTO20060413A1 (en) | 2006-06-07 | 2007-12-08 | Arrigo Lessana | REPLACEMENT DEVICE OF THE TENDONE ROPES OF AN ATRIOVENTRICULAR VALVE |
US20080058595A1 (en) | 2006-06-14 | 2008-03-06 | Snoke Phillip J | Medical device introduction systems and methods |
US7934506B2 (en) | 2006-06-21 | 2011-05-03 | Koninklijke Philips Electronics N.V. | System and method for temporary tongue suspension |
US20070295172A1 (en) | 2006-06-23 | 2007-12-27 | Darian Swartz | Fastener Holding Device |
US8449605B2 (en) | 2006-06-28 | 2013-05-28 | Kardium Inc. | Method for anchoring a mitral valve |
US7955315B2 (en) | 2006-07-24 | 2011-06-07 | Ethicon, Inc. | Articulating laparoscopic device and method for delivery of medical fluid |
US8430926B2 (en) | 2006-08-11 | 2013-04-30 | Japd Consulting Inc. | Annuloplasty with enhanced anchoring to the annulus based on tissue healing |
US20080039935A1 (en) | 2006-08-14 | 2008-02-14 | Wally Buch | Methods and apparatus for mitral valve repair |
ATE470410T1 (en) | 2006-09-08 | 2010-06-15 | Edwards Lifesciences Corp | INTEGRATED SYSTEM FOR INSERTING A HEART VALVE |
US8876895B2 (en) | 2006-09-19 | 2014-11-04 | Medtronic Ventor Technologies Ltd. | Valve fixation member having engagement arms |
US9211115B2 (en) | 2006-09-28 | 2015-12-15 | Bioventrix, Inc. | Location, time, and/or pressure determining devices, systems, and methods for deployment of lesion-excluding heart implants for treatment of cardiac heart failure and other disease states |
US8029556B2 (en) | 2006-10-04 | 2011-10-04 | Edwards Lifesciences Corporation | Method and apparatus for reshaping a ventricle |
US7879087B2 (en) | 2006-10-06 | 2011-02-01 | Edwards Lifesciences Corporation | Mitral and tricuspid annuloplasty rings |
US7674276B2 (en) | 2006-10-06 | 2010-03-09 | Biomet Sports Medicine, Llc | Rotational securing of a suture |
US8388680B2 (en) | 2006-10-18 | 2013-03-05 | Guided Delivery Systems, Inc. | Methods and devices for catheter advancement and delivery of substances therethrough |
US20080103572A1 (en) | 2006-10-31 | 2008-05-01 | Medtronic, Inc. | Implantable medical lead with threaded fixation |
US9883943B2 (en) | 2006-12-05 | 2018-02-06 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
US8926695B2 (en) | 2006-12-05 | 2015-01-06 | Valtech Cardio, Ltd. | Segmented ring placement |
US8236045B2 (en) | 2006-12-22 | 2012-08-07 | Edwards Lifesciences Corporation | Implantable prosthetic valve assembly and method of making the same |
US9107750B2 (en) | 2007-01-03 | 2015-08-18 | St. Jude Medical, Cardiology Division, Inc. | Implantable devices for controlling the size and shape of an anatomical structure or lumen |
US9192471B2 (en) | 2007-01-08 | 2015-11-24 | Millipede, Inc. | Device for translumenal reshaping of a mitral valve annulus |
US20100249920A1 (en) | 2007-01-08 | 2010-09-30 | Millipede Llc | Reconfiguring heart features |
US20080177380A1 (en) | 2007-01-19 | 2008-07-24 | Starksen Niel F | Methods and devices for heart tissue repair |
US8162804B2 (en) | 2007-02-14 | 2012-04-24 | Nike, Inc. | Collection and display of athletic information |
EP2114304B1 (en) | 2007-02-14 | 2017-09-06 | Edwards Lifesciences Corporation | implantable medical device for repairing heart |
WO2008101228A2 (en) | 2007-02-15 | 2008-08-21 | Hansen Medical, Inc. | Robotic medical instrument system |
US8070802B2 (en) | 2007-02-23 | 2011-12-06 | The Trustees Of The University Of Pennsylvania | Mitral valve system |
US8758406B2 (en) | 2007-03-05 | 2014-06-24 | Tomier, Inc. | Tack anchor systems, bone anchor systems, and methods of use |
US8911461B2 (en) | 2007-03-13 | 2014-12-16 | Mitralign, Inc. | Suture cutter and method of cutting suture |
US11660190B2 (en) | 2007-03-13 | 2023-05-30 | Edwards Lifesciences Corporation | Tissue anchors, systems and methods, and devices |
US20080228266A1 (en) | 2007-03-13 | 2008-09-18 | Mitralign, Inc. | Plication assistance devices and methods |
FR2915087B1 (en) | 2007-04-20 | 2021-11-26 | Corevalve Inc | IMPLANT FOR TREATMENT OF A HEART VALVE, IN PARTICULAR OF A MITRAL VALVE, EQUIPMENT INCLUDING THIS IMPLANT AND MATERIAL FOR PLACING THIS IMPLANT. |
US9387308B2 (en) | 2007-04-23 | 2016-07-12 | Cardioguidance Biomedical, Llc | Guidewire with adjustable stiffness |
EP2148608A4 (en) | 2007-04-27 | 2010-04-28 | Voyage Medical Inc | Complex shape steerable tissue visualization and manipulation catheter |
US8529620B2 (en) | 2007-05-01 | 2013-09-10 | Ottavio Alfieri | Inwardly-bowed tricuspid annuloplasty ring |
US7931660B2 (en) | 2007-05-10 | 2011-04-26 | Tyco Healthcare Group Lp | Powered tacker instrument |
WO2008147875A1 (en) | 2007-05-31 | 2008-12-04 | Wilson-Cook Medical, Inc. | Suture lock |
US20080300537A1 (en) | 2007-06-03 | 2008-12-04 | David Allen Bowman | Method and system for steering a catheter end in multiple planes |
AU2008269018B2 (en) | 2007-06-26 | 2014-07-31 | St. Jude Medical, Inc. | Apparatus and methods for implanting collapsible/expandable prosthetic heart valves |
JP2010534571A (en) | 2007-07-26 | 2010-11-11 | エスアールアイ インターナショナル | Selectably curable and actively steerable articulatable device |
US9566178B2 (en) | 2010-06-24 | 2017-02-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US9814611B2 (en) | 2007-07-31 | 2017-11-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
CN103393485B (en) | 2007-09-07 | 2016-08-10 | 爱德华兹生命科学公司 | For carrying the travel(l)ing rest of annuloplasty ring |
ES2628732T3 (en) | 2007-09-20 | 2017-08-03 | Sentreheart, Inc. | Devices and methods for remote suture management. |
US20090088837A1 (en) | 2007-09-28 | 2009-04-02 | The Cleveland Clinic Foundation | Prosthetic chordae assembly and method of use |
WO2009045334A1 (en) | 2007-09-28 | 2009-04-09 | St. Jude Medical, Inc. | Collapsible/expandable prosthetic heart valves with native calcified leaflet retention features |
US8454686B2 (en) | 2007-09-28 | 2013-06-04 | St. Jude Medical, Inc. | Two-stage collapsible/expandable prosthetic heart valves and anchoring systems |
US8491455B2 (en) | 2007-10-03 | 2013-07-23 | Bioventrix, Inc. | Treating dysfunctional cardiac tissue |
WO2009052188A1 (en) | 2007-10-15 | 2009-04-23 | Edwards Lifesciences Corporation | Transcatheter heart valve with micro-anchors |
WO2009052438A2 (en) | 2007-10-19 | 2009-04-23 | Guided Delivery Systems Inc. | Devices for termination of tethers |
EP2217153B1 (en) | 2007-10-19 | 2021-03-03 | Ancora Heart, Inc. | Systems for cardiac remodeling |
US8226709B2 (en) | 2007-10-19 | 2012-07-24 | Cordis Corporation | Method and system for plicating tissue in a minimally invasive medical procedure for the treatment of mitral valve regurgitation |
WO2009090564A2 (en) | 2008-01-16 | 2009-07-23 | Simcha Milo | Adjustable annuloplasty rings |
WO2009094373A1 (en) | 2008-01-22 | 2009-07-30 | Cook Incorporated | Valve frame |
EP2249711B1 (en) | 2008-02-06 | 2021-10-06 | Ancora Heart, Inc. | Multi-window guide tunnel |
US8728097B1 (en) | 2008-02-26 | 2014-05-20 | Mitralign, Inc. | Tissue plication devices and methods for their use |
US8679168B2 (en) | 2008-03-03 | 2014-03-25 | Alaska Hand Research, Llc | Cannulated anchor and system |
US8382829B1 (en) | 2008-03-10 | 2013-02-26 | Mitralign, Inc. | Method to reduce mitral regurgitation by cinching the commissure of the mitral valve |
WO2009120764A2 (en) | 2008-03-25 | 2009-10-01 | Ellipse Technologies, Inc. | Systems and methods for adjusting an annuloplasty ring with an integrated magnetic drive |
US20100121435A1 (en) | 2008-04-16 | 2010-05-13 | Cardiovascular Technologies, Llc | Percutaneous transvalvular intrannular band for mitral valve repair |
US8262725B2 (en) | 2008-04-16 | 2012-09-11 | Cardiovascular Technologies, Llc | Transvalvular intraannular band for valve repair |
US20100121437A1 (en) | 2008-04-16 | 2010-05-13 | Cardiovascular Technologies, Llc | Transvalvular intraannular band and chordae cutting for ischemic and dilated cardiomyopathy |
FR2930137B1 (en) | 2008-04-18 | 2010-04-23 | Corevalve Inc | TREATMENT EQUIPMENT FOR A CARDIAC VALVE, IN PARTICULAR A MITRAL VALVE. |
WO2009130631A2 (en) | 2008-04-21 | 2009-10-29 | Simcha Milo | Surgical stapling systems |
EP3760165A1 (en) | 2008-04-23 | 2021-01-06 | Medtronic, Inc. | Stented heart valve devices |
US8152844B2 (en) | 2008-05-09 | 2012-04-10 | Edwards Lifesciences Corporation | Quick-release annuloplasty ring holder |
EP2291123A2 (en) | 2008-05-12 | 2011-03-09 | John T.M. Wright | Device and method for the surgical treatment of ischemic mitral regurgitation |
US20090287304A1 (en) | 2008-05-13 | 2009-11-19 | Kardium Inc. | Medical Device for Constricting Tissue or a Bodily Orifice, for example a mitral valve |
GB0809357D0 (en) | 2008-05-22 | 2008-07-02 | Punjabi Prakash | Heart valve repair device |
US8317806B2 (en) | 2008-05-30 | 2012-11-27 | Ethicon Endo-Surgery, Inc. | Endoscopic suturing tension controlling and indication devices |
EP2296744B1 (en) | 2008-06-16 | 2019-07-31 | Valtech Cardio, Ltd. | Annuloplasty devices |
US8087142B2 (en) | 2008-07-02 | 2012-01-03 | Easylap Ltd. | Pivoting tacker |
WO2010000454A1 (en) | 2008-07-04 | 2010-01-07 | Corus Uk Limited | Method for coating a steel substrate, and coated steel substrate |
US20100010538A1 (en) | 2008-07-11 | 2010-01-14 | Maquet Cardiovascular Llc | Reshaping the mitral valve of a heart |
AT507113B1 (en) | 2008-07-17 | 2010-07-15 | Siemens Vai Metals Tech Gmbh | METHOD AND APPARATUS FOR ENERGY AND CO2 EMISSION OPTIMIZED IRON PRODUCTION |
JP6023427B2 (en) | 2008-07-21 | 2016-11-09 | ジェニファー ケー. ホワイト, | Repositionable intraluminal support structure and its application |
US20100023118A1 (en) | 2008-07-24 | 2010-01-28 | Edwards Lifesciences Corporation | Method and apparatus for repairing or replacing chordae tendinae |
BRPI0916696A2 (en) | 2008-07-29 | 2015-11-17 | St Jude Medical Cardiology Div | method and system for long term adjustment of an implant device |
US8337390B2 (en) | 2008-07-30 | 2012-12-25 | Cube S.R.L. | Intracardiac device for restoring the functional elasticity of the cardiac structures, holding tool for the intracardiac device, and method for implantation of the intracardiac device in the heart |
US8778016B2 (en) | 2008-08-14 | 2014-07-15 | Edwards Lifesciences Corporation | Method and apparatus for repairing or replacing chordae tendinae |
US8652202B2 (en) | 2008-08-22 | 2014-02-18 | Edwards Lifesciences Corporation | Prosthetic heart valve and delivery apparatus |
US8777990B2 (en) | 2008-09-08 | 2014-07-15 | Howmedica Osteonics Corp. | Knotless suture anchor for soft tissue repair and method of use |
US9408649B2 (en) | 2008-09-11 | 2016-08-09 | Innovasis, Inc. | Radiolucent screw with radiopaque marker |
US8945211B2 (en) | 2008-09-12 | 2015-02-03 | Mitralign, Inc. | Tissue plication device and method for its use |
US8287591B2 (en) | 2008-09-19 | 2012-10-16 | Edwards Lifesciences Corporation | Transformable annuloplasty ring configured to receive a percutaneous prosthetic heart valve implantation |
JP2012504031A (en) | 2008-09-29 | 2012-02-16 | カルディアック バルブ テクノロジーズ,インコーポレーテッド | Heart valve |
CN102245109A (en) | 2008-10-10 | 2011-11-16 | 导向传输系统股份有限公司 | Termination devices and related methods |
US8795298B2 (en) | 2008-10-10 | 2014-08-05 | Guided Delivery Systems Inc. | Tether tensioning devices and related methods |
EP2349086B1 (en) | 2008-10-16 | 2017-03-22 | Medtronic Vascular, Inc. | Devices and systems for endovascular staple and/or prosthesis delivery and implantation |
US8696717B2 (en) | 2008-11-05 | 2014-04-15 | K2M, Inc. | Multi-planar, taper lock screw with additional lock |
DE102008058894B3 (en) | 2008-11-26 | 2010-06-17 | Vimecon Gmbh | laser applicator |
US8449573B2 (en) | 2008-12-05 | 2013-05-28 | Boston Scientific Scimed, Inc. | Insertion device and method for delivery of a mesh carrier |
US20110026208A1 (en) | 2008-12-19 | 2011-02-03 | Panasonic Corporation | Exterior parts and method of manufacturing the same and electronic equipment using the same |
US8940044B2 (en) | 2011-06-23 | 2015-01-27 | Valtech Cardio, Ltd. | Closure element for use with an annuloplasty structure |
US8808368B2 (en) | 2008-12-22 | 2014-08-19 | Valtech Cardio, Ltd. | Implantation of repair chords in the heart |
US8926697B2 (en) | 2011-06-23 | 2015-01-06 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
US9011530B2 (en) | 2008-12-22 | 2015-04-21 | Valtech Cardio, Ltd. | Partially-adjustable annuloplasty structure |
US8545553B2 (en) | 2009-05-04 | 2013-10-01 | Valtech Cardio, Ltd. | Over-wire rotation tool |
US8715342B2 (en) | 2009-05-07 | 2014-05-06 | Valtech Cardio, Ltd. | Annuloplasty ring with intra-ring anchoring |
US8147542B2 (en) | 2008-12-22 | 2012-04-03 | Valtech Cardio, Ltd. | Adjustable repair chords and spool mechanism therefor |
CN102341063B (en) | 2008-12-22 | 2015-11-25 | 瓦尔泰克卡迪欧有限公司 | Adjustable annuloplasty device and governor motion thereof |
US10517719B2 (en) | 2008-12-22 | 2019-12-31 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
EP2381895B1 (en) | 2008-12-31 | 2021-07-07 | Medtronic, Inc. | Semi-rigid annuloplasty ring and band and method of making an annuloplasty ring |
US20110011917A1 (en) | 2008-12-31 | 2011-01-20 | Hansen Medical, Inc. | Methods, devices, and kits for treating valve prolapse |
US9204965B2 (en) | 2009-01-14 | 2015-12-08 | Lc Therapeutics, Inc. | Synthetic chord |
US20100198192A1 (en) | 2009-01-20 | 2010-08-05 | Eugene Serina | Anchor deployment devices and related methods |
US20100210899A1 (en) | 2009-01-21 | 2010-08-19 | Tendyne Medical, Inc. | Method for percutaneous lateral access to the left ventricle for treatment of mitral insufficiency by papillary muscle alignment |
AU2010206732A1 (en) | 2009-01-22 | 2011-08-25 | St. Jude Medical, Cardiology Division, Inc. | Post-operative adjustment tool, minimally invasive attachment apparatus, and adjustable tricuspid ring |
AU2010206658A1 (en) | 2009-01-22 | 2011-08-25 | St. Jude Medical, Cardiology Division, Inc. | Magnetic docking system and method for the long term adjustment of an implantable device |
JP5687634B2 (en) | 2009-02-06 | 2015-03-18 | セント・ジュード・メディカル,インコーポレイテッド | Adjustable annuloplasty ring support |
EP2393442A4 (en) | 2009-02-09 | 2017-08-09 | St. Jude Medical, Cardiology Division, Inc. | Inflatable minimally invasive system for delivering and securing an annular implant |
AU2010212842A1 (en) | 2009-02-16 | 2011-09-08 | Dokter Yves Fortems Bvba | Biopsy device |
US8353956B2 (en) | 2009-02-17 | 2013-01-15 | Valtech Cardio, Ltd. | Actively-engageable movement-restriction mechanism for use with an annuloplasty structure |
WO2010096579A1 (en) | 2009-02-20 | 2010-08-26 | Boston Scientific Scimed, Inc. | Steerable catheter having intermediate stiffness transition zone |
US20110144703A1 (en) | 2009-02-24 | 2011-06-16 | Krause William R | Flexible Screw |
US20100217382A1 (en) | 2009-02-25 | 2010-08-26 | Edwards Lifesciences | Mitral valve replacement with atrial anchoring |
EP2400924B1 (en) | 2009-02-27 | 2017-06-28 | St. Jude Medical, Inc. | Prosthetic heart valve |
US20110015476A1 (en) | 2009-03-04 | 2011-01-20 | Jeff Franco | Devices and Methods for Treating Cardiomyopathy |
US8366767B2 (en) | 2009-03-30 | 2013-02-05 | Causper Medical Inc. | Methods and devices for transapical delivery of a sutureless valve prosthesis |
US9980818B2 (en) | 2009-03-31 | 2018-05-29 | Edwards Lifesciences Corporation | Prosthetic heart valve system with positioning markers |
EP3081195B1 (en) | 2009-04-10 | 2018-10-03 | Lon Sutherland Annest | An implantable scaffolding containing an orifice for use with a prosthetic or bio-prosthetic valve |
US9011522B2 (en) | 2009-04-10 | 2015-04-21 | Lon Sutherland ANNEST | Device and method for temporary or permanent suspension of an implantable scaffolding containing an orifice for placement of a prosthetic or bio-prosthetic valve |
US20100262233A1 (en) | 2009-04-12 | 2010-10-14 | Texas Tech University System | Mitral Valve Coaptation Plate For Mitral Valve Regurgitation |
WO2010121076A2 (en) | 2009-04-15 | 2010-10-21 | Cardiaq Valve Technologies, Inc. | Vascular implant and delivery system |
US9486208B2 (en) | 2009-05-01 | 2016-11-08 | Cayenne Medical, Inc. | Meniscal repair systems and methods |
US9968452B2 (en) | 2009-05-04 | 2018-05-15 | Valtech Cardio, Ltd. | Annuloplasty ring delivery cathethers |
US20100286628A1 (en) | 2009-05-07 | 2010-11-11 | Rainbow Medical Ltd | Gastric anchor |
JP2012531240A (en) | 2009-06-26 | 2012-12-10 | クイックリング メディカル テクノロジーズ リミテッド | Surgical stapler and method of surgical stapling |
WO2011002996A2 (en) | 2009-07-02 | 2011-01-06 | The Cleveland Clinic Foundation | Apparatus and method for replacing a diseased cardiac valve |
KR101116867B1 (en) | 2009-08-28 | 2012-03-06 | 김준홍 | The device for delivering optimal tension safaely and effectively in cerclage annuloplasty procedure |
CN102647957B (en) | 2009-09-11 | 2015-04-29 | Gi动力公司 | Anchors with open heads |
US8459302B2 (en) | 2009-09-21 | 2013-06-11 | Gulf Sea Ventures LLC | Fluid-directing multiport rotary valve |
IT1398518B1 (en) | 2009-09-25 | 2013-03-01 | Colombo | SAFE MILANO |
US8652203B2 (en) | 2010-09-23 | 2014-02-18 | Cardiaq Valve Technologies, Inc. | Replacement heart valves, delivery devices and methods |
US20110082538A1 (en) | 2009-10-01 | 2011-04-07 | Jonathan Dahlgren | Medical device, kit and method for constricting tissue or a bodily orifice, for example, a mitral valve |
EP2485689B1 (en) | 2009-10-09 | 2020-03-18 | Boston Scientific Scimed, Inc. | Stomach bypass |
US20110093002A1 (en) | 2009-10-20 | 2011-04-21 | Wilson-Cook Medical Inc. | Stent-within-stent arrangements |
US9011520B2 (en) | 2009-10-29 | 2015-04-21 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
US9180007B2 (en) | 2009-10-29 | 2015-11-10 | Valtech Cardio, Ltd. | Apparatus and method for guide-wire based advancement of an adjustable implant |
US8277502B2 (en) | 2009-10-29 | 2012-10-02 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
WO2011067770A1 (en) | 2009-12-02 | 2011-06-09 | Valtech Cardio, Ltd. | Delivery tool for implantation of spool assembly coupled to a helical anchor |
US8449599B2 (en) | 2009-12-04 | 2013-05-28 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
US8870950B2 (en) | 2009-12-08 | 2014-10-28 | Mitral Tech Ltd. | Rotation-based anchoring of an implant |
US20110230961A1 (en) | 2010-01-05 | 2011-09-22 | Micardia Corporation | Dynamically adjustable annuloplasty ring and papillary muscle repositioning suture |
GB201001075D0 (en) | 2010-01-22 | 2010-03-10 | Cyclacel Ltd | Crystalline forms |
US8961596B2 (en) | 2010-01-22 | 2015-02-24 | 4Tech Inc. | Method and apparatus for tricuspid valve repair using tension |
US9307980B2 (en) | 2010-01-22 | 2016-04-12 | 4Tech Inc. | Tricuspid valve repair using tension |
US8475525B2 (en) | 2010-01-22 | 2013-07-02 | 4Tech Inc. | Tricuspid valve repair using tension |
US9107749B2 (en) | 2010-02-03 | 2015-08-18 | Edwards Lifesciences Corporation | Methods for treating a heart |
EP2531143B1 (en) | 2010-02-03 | 2018-01-17 | Medtronic GBI, Inc. | Semi-flexible annuloplasty ring |
US9072603B2 (en) | 2010-02-24 | 2015-07-07 | Medtronic Ventor Technologies, Ltd. | Mitral prosthesis and methods for implantation |
US9226826B2 (en) | 2010-02-24 | 2016-01-05 | Medtronic, Inc. | Transcatheter valve structure and methods for valve delivery |
US20110224785A1 (en) | 2010-03-10 | 2011-09-15 | Hacohen Gil | Prosthetic mitral valve with tissue anchors |
US8357195B2 (en) | 2010-04-15 | 2013-01-22 | Medtronic, Inc. | Catheter based annuloplasty system and method |
US9795482B2 (en) | 2010-04-27 | 2017-10-24 | Medtronic, Inc. | Prosthetic heart valve devices and methods of valve repair |
US20110288435A1 (en) | 2010-05-19 | 2011-11-24 | George Michael Christy | Tactile sensory testing instrument |
US8790394B2 (en) | 2010-05-24 | 2014-07-29 | Valtech Cardio, Ltd. | Adjustable artificial chordeae tendineae with suture loops |
US20130030522A1 (en) | 2010-06-16 | 2013-01-31 | Rowe Stanton J | Devices and methods for heart treatments |
US9095277B2 (en) | 2010-07-09 | 2015-08-04 | Mitralign, Inc. | Delivery catheter with forward-looking ultrasound imaging |
ES2554260T3 (en) | 2010-07-09 | 2015-12-17 | Highlife Sas | Transcatheter atrio-ventricular valve prosthesis |
US8992604B2 (en) | 2010-07-21 | 2015-03-31 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
WO2012019052A2 (en) | 2010-08-04 | 2012-02-09 | Micardia Corporation | Percutaneous transcatheter repair of heart valves |
US9861350B2 (en) | 2010-09-03 | 2018-01-09 | Ancora Heart, Inc. | Devices and methods for anchoring tissue |
US10076327B2 (en) | 2010-09-14 | 2018-09-18 | Evalve, Inc. | Flexible actuator mandrel for tissue apposition systems |
US8968335B2 (en) | 2010-10-27 | 2015-03-03 | Mitralign, Inc. | Hand operated device for controlled deployment of a tissue anchor and method of using the same |
US9005279B2 (en) | 2010-11-12 | 2015-04-14 | Shlomo Gabbay | Beating heart buttress and implantation method to prevent prolapse of a heart valve |
US9198756B2 (en) | 2010-11-18 | 2015-12-01 | Pavilion Medical Innovations, Llc | Tissue restraining devices and methods of use |
US8540735B2 (en) | 2010-12-16 | 2013-09-24 | Apollo Endosurgery, Inc. | Endoscopic suture cinch system |
US20120158021A1 (en) | 2010-12-19 | 2012-06-21 | Mitralign, Inc. | Steerable guide catheter having preformed curved shape |
US8647358B2 (en) * | 2011-01-21 | 2014-02-11 | Obalon Therapeutics Inc. | Intragastric device |
US8888843B2 (en) | 2011-01-28 | 2014-11-18 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valve regurgitation |
US8845717B2 (en) | 2011-01-28 | 2014-09-30 | Middle Park Medical, Inc. | Coaptation enhancement implant, system, and method |
EP2670354B1 (en) | 2011-01-31 | 2016-04-27 | St. Jude Medical, Inc. | Adjustable annuloplasty ring sizing indicator |
US8932343B2 (en) | 2011-02-01 | 2015-01-13 | St. Jude Medical, Cardiology Division, Inc. | Blunt ended stent for prosthetic heart valve |
EP2675410B1 (en) | 2011-02-18 | 2020-06-17 | Ancora Heart, Inc. | Implant retrieval device |
EP2675515B1 (en) | 2011-02-18 | 2020-07-15 | Ancora Heart, Inc. | Systems and methods for variable stiffness tethers |
US9155619B2 (en) | 2011-02-25 | 2015-10-13 | Edwards Lifesciences Corporation | Prosthetic heart valve delivery apparatus |
US9445898B2 (en) | 2011-03-01 | 2016-09-20 | Medtronic Ventor Technologies Ltd. | Mitral valve repair |
EP4119095A1 (en) | 2011-03-21 | 2023-01-18 | Cephea Valve Technologies, Inc. | Disk-based valve apparatus |
US9072511B2 (en) | 2011-03-25 | 2015-07-07 | Kardium Inc. | Medical kit for constricting tissue or a bodily orifice, for example, a mitral valve |
EP2520250B1 (en) | 2011-05-04 | 2014-02-19 | Medtentia International Ltd Oy | Medical device for a cardiac valve implant |
WO2012158187A1 (en) | 2011-05-17 | 2012-11-22 | Boston Scientific Scimed, Inc. | Corkscrew annuloplasty device |
US20120296349A1 (en) | 2011-05-17 | 2012-11-22 | Boston Scientific Scimed, Inc. | Percutaneous Mitral Annulus Mini-Plication |
US8523940B2 (en) | 2011-05-17 | 2013-09-03 | Boston Scientific Scimed, Inc. | Annuloplasty ring with anchors fixed by curing polymer |
US9402721B2 (en) | 2011-06-01 | 2016-08-02 | Valcare, Inc. | Percutaneous transcatheter repair of heart valves via trans-apical access |
US9011523B2 (en) | 2011-06-20 | 2015-04-21 | Jacques Seguin | Prosthetic leaflet assembly for repairing a defective cardiac valve and methods of using the same |
US9918840B2 (en) | 2011-06-23 | 2018-03-20 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
ES2664243T3 (en) | 2011-06-23 | 2018-04-18 | Valtech Cardio, Ltd. | Closure element for use with an annuloplasty structure |
EP2723272A4 (en) | 2011-06-24 | 2015-01-28 | Inceptus Medical LLC | Percutaneously implantable artificial heart valve system and associated methods and devices |
US8795357B2 (en) | 2011-07-15 | 2014-08-05 | Edwards Lifesciences Corporation | Perivalvular sealing for transcatheter heart valve |
EP2734157B1 (en) | 2011-07-21 | 2018-09-05 | 4Tech Inc. | Apparatus for tricuspid valve repair using tension |
US8852272B2 (en) | 2011-08-05 | 2014-10-07 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
US8900295B2 (en) | 2011-09-26 | 2014-12-02 | Edwards Lifesciences Corporation | Prosthetic valve with ventricular tethers |
US8764798B2 (en) | 2011-10-03 | 2014-07-01 | Smith & Nephew, Inc. | Knotless suture anchor |
US9827093B2 (en) | 2011-10-21 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US20130116776A1 (en) | 2011-11-04 | 2013-05-09 | Valtech Cardio, Ltd. | External aortic ring and spool mechanism therefor |
US8858623B2 (en) | 2011-11-04 | 2014-10-14 | Valtech Cardio, Ltd. | Implant having multiple rotational assemblies |
EP3656434B1 (en) | 2011-11-08 | 2021-10-20 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
WO2013076724A2 (en) | 2011-11-21 | 2013-05-30 | Mor Research Applications Ltd. | Device for placement in the tricuspid annulus |
US20140350660A1 (en) | 2011-12-01 | 2014-11-27 | Graeme Cocks | Endoluminal Prosthesis |
CA2858149C (en) | 2011-12-12 | 2017-04-18 | David Alon | Heart valve repair device |
KR101198775B1 (en) | 2012-01-18 | 2012-11-12 | 박광태 | Surgical instrument, and surgical mesh and surgical retractor for the same, and surgical method using the same |
US8961602B2 (en) | 2012-01-27 | 2015-02-24 | St. Jude Medical, Cardiology Division, Inc. | Adjustment suture markers for adjustable annuloplasty ring |
US10420645B2 (en) | 2012-02-15 | 2019-09-24 | Children's Medical Center Corporation | Right ventricular papillary approximation |
US9180008B2 (en) | 2012-02-29 | 2015-11-10 | Valcare, Inc. | Methods, devices, and systems for percutaneously anchoring annuloplasty rings |
US9839519B2 (en) | 2012-02-29 | 2017-12-12 | Valcare, Inc. | Percutaneous annuloplasty system with anterior-posterior adjustment |
US9138214B2 (en) | 2012-03-02 | 2015-09-22 | Abbott Cardiovascular Systems, Inc. | Suture securing systems, devices and methods |
US9427315B2 (en) | 2012-04-19 | 2016-08-30 | Caisson Interventional, LLC | Valve replacement systems and methods |
US9277990B2 (en) | 2012-05-04 | 2016-03-08 | St. Jude Medical, Cardiology Division, Inc. | Hypotube shaft with articulation mechanism |
US8961594B2 (en) | 2012-05-31 | 2015-02-24 | 4Tech Inc. | Heart valve repair system |
DE102012010798A1 (en) | 2012-06-01 | 2013-12-05 | Universität Duisburg-Essen | Implantable device for improving or eliminating heart valve insufficiency |
US9211521B2 (en) | 2012-09-19 | 2015-12-15 | Millifluidica, Llc | Fluidic channel coated with metal catalysts and devices and methods relating thereto |
CA2885354A1 (en) | 2012-09-29 | 2014-04-03 | Mitralign, Inc. | Plication lock delivery system and method of use thereof |
EP2911594B1 (en) | 2012-10-23 | 2018-12-05 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
US10376266B2 (en) | 2012-10-23 | 2019-08-13 | Valtech Cardio, Ltd. | Percutaneous tissue anchor techniques |
JP2014085548A (en) | 2012-10-24 | 2014-05-12 | Hamamatsu Photonics Kk | Optical scanning device and light source device |
US8628571B1 (en) | 2012-11-13 | 2014-01-14 | Mitraltech Ltd. | Percutaneously-deliverable mechanical valve |
US10016276B2 (en) | 2012-11-21 | 2018-07-10 | Edwards Lifesciences Corporation | Retaining mechanisms for prosthetic heart valves |
US9730793B2 (en) | 2012-12-06 | 2017-08-15 | Valtech Cardio, Ltd. | Techniques for guide-wire based advancement of a tool |
CN103908729B (en) | 2012-12-28 | 2016-12-28 | 米特拉利根公司 | Energy aid in tissue sting device and using method thereof |
EP2943132B1 (en) | 2013-01-09 | 2018-03-28 | 4Tech Inc. | Soft tissue anchors |
EP4166111A1 (en) | 2013-01-24 | 2023-04-19 | Cardiovalve Ltd. | Ventricularly-anchored prosthetic valves |
WO2014134183A1 (en) | 2013-02-26 | 2014-09-04 | Mitralign, Inc. | Devices and methods for percutaneous tricuspid valve repair |
US10449333B2 (en) | 2013-03-14 | 2019-10-22 | Valtech Cardio, Ltd. | Guidewire feeder |
US9724195B2 (en) | 2013-03-15 | 2017-08-08 | Mitralign, Inc. | Translation catheters and systems |
EP2783624A1 (en) | 2013-03-28 | 2014-10-01 | Injeq Oy | Bioimpedance sensor, mandrine, cannula and method for measuring bioimpedance |
CN105392449B (en) | 2013-06-06 | 2017-09-05 | 戴维·阿隆 | Heart valve repair and replacing |
WO2014207575A2 (en) | 2013-06-14 | 2014-12-31 | Hazu Gmbh | Method and device for treatment of valve regurgitation |
WO2014210108A1 (en) | 2013-06-25 | 2014-12-31 | Mitralign, Inc. | Percutaneous valve repair by reshaping and resizing right ventricle |
CN105592808B (en) | 2013-06-26 | 2018-11-09 | Sat集团(控股)有限公司 | Orienting device for mitral valve reparation |
EP3019092B1 (en) | 2013-07-10 | 2022-08-31 | Medtronic Inc. | Helical coil mitral valve annuloplasty systems |
US9561103B2 (en) | 2013-07-17 | 2017-02-07 | Cephea Valve Technologies, Inc. | System and method for cardiac valve repair and replacement |
US10299793B2 (en) | 2013-10-23 | 2019-05-28 | Valtech Cardio, Ltd. | Anchor magazine |
US10022114B2 (en) | 2013-10-30 | 2018-07-17 | 4Tech Inc. | Percutaneous tether locking |
US10052095B2 (en) | 2013-10-30 | 2018-08-21 | 4Tech Inc. | Multiple anchoring-point tension system |
US10111750B2 (en) | 2013-12-16 | 2018-10-30 | Jeko Metodiev Madjarov | Method and apparatus for therapy of aortic valve |
US9610162B2 (en) | 2013-12-26 | 2017-04-04 | Valtech Cardio, Ltd. | Implantation of flexible implant |
CN104906682A (en) * | 2014-01-24 | 2015-09-16 | 史蒂文·沙勒布瓦 | Articulating balloon catheter and method for using the same |
CN106573129B (en) | 2014-06-19 | 2019-09-24 | 4科技有限公司 | Heart tissue is tightened |
US9180005B1 (en) | 2014-07-17 | 2015-11-10 | Millipede, Inc. | Adjustable endolumenal mitral valve ring |
EP3206629B1 (en) | 2014-10-14 | 2021-07-14 | Valtech Cardio, Ltd. | Apparatus for heart valve leaflet restraining |
WO2016087934A1 (en) | 2014-12-02 | 2016-06-09 | 4Tech Inc. | Off-center tissue anchors |
EP3087952A1 (en) | 2015-04-29 | 2016-11-02 | Kephalios S.A.S. | An annuloplasty system and a method for monitoring the effectiveness of an annuloplasty treatment |
CN107847320B (en) | 2015-04-30 | 2020-03-17 | 瓦尔泰克卡迪欧有限公司 | Valvuloplasty techniques |
EP4241698A3 (en) | 2015-10-21 | 2024-01-17 | Coremedic AG | Medical implant for heart valve repair |
CA3042021A1 (en) | 2016-10-31 | 2018-05-03 | Cardiac Implants Llc | Flexible radio-opaque protrusions for revealing the position of a constricting cord or annulus ring prior to installation onto a cardiac valve annulus |
US10478303B2 (en) | 2017-03-13 | 2019-11-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
WO2019145947A1 (en) | 2018-01-24 | 2019-08-01 | Valtech Cardio, Ltd. | Contraction of an annuloplasty structure |
EP3743014B1 (en) | 2018-01-26 | 2023-07-19 | Edwards Lifesciences Innovation (Israel) Ltd. | Techniques for facilitating heart valve tethering and chord replacement |
CN112312862A (en) | 2018-05-24 | 2021-02-02 | 瓦尔泰克卡迪欧有限公司 | Implantable annuloplasty structures to accommodate multiple annulus sizes |
EP4406490A3 (en) | 2018-07-12 | 2024-08-14 | Edwards Lifesciences Innovation (Israel) Ltd. | Annuloplasty systems and locking tools therefor |
AU2020284630A1 (en) | 2019-05-29 | 2021-11-18 | Edwards Lifesciences Innovation (Israel) Ltd. | Tissue anchor handling systems and methods |
CN114423356A (en) | 2019-07-16 | 2022-04-29 | 心弦医疗公司 | Systems and methods for tissue remodeling |
EP4003231A2 (en) | 2019-07-23 | 2022-06-01 | Valtech Cardio, Ltd. | Contraction of an annuloplasty structure |
CA3143177A1 (en) | 2019-08-28 | 2021-03-04 | Valtech Cardio, Ltd. | Low-profile steerable catheter |
CN114302697A (en) | 2019-08-28 | 2022-04-08 | 波士顿科学国际有限公司 | Method and apparatus for mitral valve repair including papillary muscle repositioning |
JP2022546160A (en) | 2019-08-30 | 2022-11-04 | エドワーズ ライフサイエンシーズ イノベーション (イスラエル) リミテッド | Anchor channel tip |
CN114727863A (en) | 2019-09-25 | 2022-07-08 | 心脏植入物有限公司 | Heart valve annulus reduction system |
CN113331995A (en) | 2020-02-18 | 2021-09-03 | 杭州德晋医疗科技有限公司 | Anchor with locking function, anchor component and ring-retracting system |
WO2022066525A2 (en) | 2020-09-25 | 2022-03-31 | Boston Scientific Scimed, Inc. | Tissue anchors minimizing migration and maximizing engagement |
-
2016
- 2016-12-29 US US15/393,867 patent/US10751182B2/en active Active
-
2020
- 2020-08-24 US US17/001,597 patent/US11660192B2/en active Active
-
2023
- 2023-04-19 US US18/303,542 patent/US20230255773A1/en active Pending
Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5041090A (en) * | 1988-01-12 | 1991-08-20 | Scheglov Viktor I | Occluding device |
US7338511B2 (en) * | 2002-05-24 | 2008-03-04 | Boston Scientific-Scimed, Inc. | Solid embolic material with variable expansion |
US20150352337A1 (en) * | 2013-02-21 | 2015-12-10 | Olympus Corporation | Device for sustained release of liquid, endoscope having the same, and instrument for endoscopic surgery having the same |
Also Published As
Publication number | Publication date |
---|---|
US20170189034A1 (en) | 2017-07-06 |
US20200383786A1 (en) | 2020-12-10 |
US10751182B2 (en) | 2020-08-25 |
US11660192B2 (en) | 2023-05-30 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US11660192B2 (en) | System and method for reshaping heart | |
US9545305B2 (en) | Mitral valve spacer and system and method for implanting the same | |
US9510948B2 (en) | Systems, devices and methods for repair of heart valve lesions | |
US9833316B2 (en) | Trans-apical implant systems, implants and methods | |
US9463268B2 (en) | Cannula systems and methods | |
US8894705B2 (en) | Balloon mitral spacer | |
AU2012212215B2 (en) | Systems for implanting and using a conduit within a tissue wall | |
US20080004485A1 (en) | Trans-Septal Heart Assist Devices and Methods of Use | |
US20060189840A1 (en) | Transmyocardial delivery of cardiac wall tension relief | |
US20130226288A1 (en) | Minimally invasive surgical techniques | |
KR20160002781A (en) | Mitral valve spacer and system and method for implanting the same | |
EP2157916A2 (en) | Cardiac valve leaflet augmentation | |
US20130197559A1 (en) | Minimally invasive surgical techniques | |
US20230211132A1 (en) | Pulmonary arterial compliance enhancement and control device | |
US20230329722A1 (en) | Left atrial appendage occlusion methods and devices | |
US20130197571A1 (en) | Minimally invasive surgical techniques |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
STPP | Information on status: patent application and granting procedure in general |
Free format text: DOCKETED NEW CASE - READY FOR EXAMINATION |
|
STPP | Information on status: patent application and granting procedure in general |
Free format text: NON FINAL ACTION MAILED |