Some applications of the present invention relate in general to cardiac repair. For example, some applications of the present invention relate to reshaping the heart or portions thereof.
Ischemic heart disease and/or the shape changes of the heart can cause valvular regurgitation (e.g., mitral regurgitation). For example, this can happen by the combination of ischemic dysfunction of the papillary muscles, and the dilatation of the left ventricle that is present in ischemic heart disease, with the subsequent displacement of the papillary muscles and the dilatation of the mitral valve annulus.
Dilatation of the annulus of a native valve (e.g., the mitral valve) can prevent the valve leaflets from fully coapting when the valve is closed or should be closed. Valvular regurgitation can result in increased total stroke volume, decreased cardiac output, and heart weakening. For example, mitral regurgitation of blood from the left ventricle into the left atrium can result in increased total stroke volume and decreased cardiac output, and ultimate weakening of the left ventricle secondary to a volume overload and a pressure overload of the left atrium.
This summary is meant to provide some examples and is not intended to be limiting of the scope of the invention in any way. For example, any feature included in an example of this summary is not required by the claims, unless the claims explicitly recite the features. Also, the features described can be combined in a variety of ways. The description herein relates to systems, assemblies, methods, devices, apparatuses, combinations, etc. that may be utilized for reshaping the heart and/or a portion thereof. Various features and steps as described elsewhere in this disclosure can be included in the examples summarized here.
An implant comprising a flexible sleeve and an elongate contraction member is affixed or anchored to heart tissue (e.g., ventricular tissue), and the contraction member is subsequently tensioned in order to reshape the heart or a chamber of the heart (e.g., a ventricle or atrium).
Methods for use with an implant (e.g., the implant above or any of the implants described elsewhere herein) can include a variety of steps. For example, methods can include, and in at least one application do include, providing or obtaining the implant, which can have (i) an elongate sleeve defining a lumen along a longitudinal axis of the sleeve, and (ii) an elongate contraction member that extends along the sleeve. The methods can be for treating a heart of a subject, the heart having a right atrium, a left atrium, a mitral valve that has an annulus, and/or a left ventricle.
The various methods herein include advancing a distal portion of a catheter (e.g., a delivery catheter/tube) into a chamber of the heart. For example, advancing the distal portion of the catheter transfemorally into the left ventricle, e.g., via the mitral valve. The methods can also include, and in at least one application do include, positioning the distal portion of the catheter such that an open distal end of the catheter faces a first tissue site, the first tissue site being on a wall of a chamber of the heart (e.g., on a ventricular wall of the left ventricle) between a valve annulus and a location remote from the valve annulus (e.g., between a papillary muscle of the left ventricle and the mitral annulus). Positioning the distal portion of the catheter such that the open distal end of the catheter faces the first tissue site can include passing the distal portion of the catheter between two chordae tendineae of the heart.
The methods also include affixing or anchoring a first part of the implant and/or sleeve to the first tissue site, for example, using a first anchor or first attachment means that includes a first tissue-engaging element or portion. This can be done, for example, by passing or driving the first tissue-engaging element through the first part of the implant and/or sleeve and into the first tissue site. Affixing or anchoring the first part of the sleeve can include, and in at least one application does include, affixing or anchoring the first part of the implant and/or sleeve while the catheter remains between the two chordae tendineae.
The methods can include, and in at least one application do include, subsequently, advancing, out of the open distal end of the catheter, a second part of the implant and/or sleeve that is proximal, along the longitudinal axis, from the first part of the implant and/or sleeve, and/or repositioning the distal portion of the catheter such that the open distal end of the catheter faces a second tissue site. The second tissue site can be on a wall of a chamber of the heart (e.g., on a ventricular wall of the left ventricle) between a valve annulus and a location remote from the valve annulus (e.g., between a papillary muscle of the left ventricle and the mitral annulus, or between an annulus and a lower portion of the chamber). Repositioning the distal portion of the catheter can include, and in at least one application does include, repositioning the distal portion of the catheter without capturing a chorda tendinea of the heart between the sleeve and the ventricular wall.
The methods herein also include affixing or anchoring a second part of the implant and/or sleeve to the second tissue site using a second anchor or a second attachment means. The second anchor or second attachment means can have a second tissue-engaging element. The affixing/anchoring can be done by passing or driving the second tissue-engaging element through the second part of the implant and/or sleeve and into the second tissue site. Anchoring the second part of the implant and/or sleeve can include, and in at least one application does include, anchoring the second part of the implant and/or sleeve while the catheter remains between the two chordae tendineae.
The above steps can be repeated with additional parts of the implant and/or sleeve and additional attachment means until the implant and/or sleeve is affixed/anchored to the treatment site as desired. In one application, 2-20 parts of the implant and/or sleeve and 2-20 attachment means or anchors can be used to affix/anchor the implant and/or sleeve to 2-20 tissue sites.
The methods herein also include subsequently, reshaping the heart/chamber or reducing a distance between locations on the heart (e.g., between the papillary muscle and the annulus or annulus and a lower portion of the chamber, etc.), by contracting the implant and/or sleeve. The implant and/or sleeve can be contracted along its length or along the longitudinal axis by applying tension to the contraction member.
The methods herein can include, and in at least one application do include, advancing the first anchor or first attachment means through the catheter to the implant and into the lumen; and subsequently to affixing or anchoring the first part of the sleeve to the first tissue site, advancing the second anchor or second attachment means through the catheter to the implant and into the lumen.
Optionally, the implant can include, and in at least one application does include, a spool, and applying tension to the contraction member can include applying tension to the contraction member by rotating the spool.
The methods herein can further include, and in at least one application do include, subsequently to anchoring or affixing the second part of the sleeve, advancing an adjustment tool through the catheter to the implant. And applying tension to the contraction member can include, and in at least one application does include, applying tension to the contraction member using the adjustment tool.
The methods can further include, and in at least one application do include, identifying the subject as having heart failure with reduced ejection fraction (HFrEF). Further, advancing the distal portion of the catheter transfemorally into the left ventricle via the mitral valve can include, and in at least one application does include, advancing the distal portion of the catheter transfemorally into the left ventricle via the mitral valve responsively to the identifying.
Optionally, the catheter (e.g., delivery catheter) is a third catheter. The distal portion of the catheter can be a distal portion of the third catheter.
Advancing the distal portion of the catheter into the chamber can include, and in at least one application does include, advancing the distal portion of the catheter transfemorally into the left ventricle via the mitral valve. Further, this can include, and in at least one application does include, one or more (or all) of the following: (i) advancing a distal portion of a first catheter into the left atrium, (ii) advancing a distal portion of a second catheter out of the distal portion of the first catheter and into the left ventricle via the mitral valve; and (iii) advancing the distal portion of the third catheter out of the distal portion of the second catheter within the left ventricle. Repositioning the distal portion of the catheter can include, and in at least one application does include, repositioning the distal portion of the third catheter by withdrawing the third catheter into the second catheter.
The second catheter can include, and in at least one application does include, a plurality of second-catheter pull-wires, and advancing the distal portion of the second catheter out of the distal portion of the first catheter and into the left ventricle can include, and in at least one application does include, deflecting the distal portion of the second catheter with respect to the distal portion of the first catheter by tensioning at least one pull-wire of the second-catheter plurality of pull-wires.
The methods herein can further include, and in at least one application do include, rotationally locking the distal portion of the first catheter with respect to the second catheter, wherein deflecting the distal portion of the second catheter includes deflecting the distal portion of the second catheter while the distal portion of the first catheter remains rotationally locked to the second catheter.
The third catheter can include, and in at least one application does include, a plurality of third-catheter pull-wires, and positioning the distal portion of the catheter such that the open distal end of the catheter faces the first tissue site can include deflecting the distal portion of the third catheter with respect to the distal portion of the second catheter by tensioning at least one pull-wire of the plurality of third-catheter pull-wires.
The third catheter can be configured to be rotatable with respect to the second catheter, and the methods can further include, and in at least one application do include, rotating the third catheter with respect to the second catheter while the distal end of the third catheter is disposed in the left ventricle.
The methods herein can further include, and in at least one application do include, rotationally locking the distal portion of the second catheter with respect to the third catheter, and deflecting the distal portion of the third catheter can include, and in at least one application does include, deflecting the distal portion of the third catheter while the distal portion of the second catheter remains rotationally locked to the third catheter.
The first catheter can include, and in at least one application does include, a plurality of first-catheter pull-wires, and the methods can further include, and in at least one application do include, deflecting the distal portion of the first catheter with respect to an immediately-proximal portion of the first catheter by tensioning at least one pull-wire of the plurality of first-catheter pull-wires.
The methods herein can further include, and in at least one application do include, rotationally locking the distal portion of the first catheter with respect to the second catheter, and deflecting the distal portion of the second catheter can include, and in at least one application does include, deflecting the distal portion of the second catheter while the distal portion of the first catheter remains rotationally locked to the second catheter.
Repositioning the distal portion of the catheter such that the open distal end of the catheter faces the second tissue site can include, and in at least one application does include, deflecting again the distal portion of the third catheter with respect to the distal portion of the second catheter by tensioning at least one pull-wire of the plurality of third-catheter pull-wires.
The methods herein can further include, and in at least one application do include, advancing the first anchor to the implant and into the lumen via a channel that extends through the catheter and into the lumen, and anchoring the first part of the sleeve can include, and in at least one application does include, anchoring the first part of the sleeve while a distal end of the channel is disposed at the first part of the sleeve.
The methods herein can further include, and in at least one application do include, partially withdrawing the channel from the lumen such that the distal end of the channel becomes disposed at the second part of the sleeve, and this can be done subsequently to anchoring the first part of the sleeve, and prior to anchoring the second part of the sleeve. Further, anchoring the second part of the sleeve can include, and in at least one application does include, anchoring the second part of the sleeve while the distal end of the channel is disposed at the second part of the sleeve.
For some applications, methods for treating a subject/subject's heart or for use with an implant include providing or obtaining the implant. The implant can be the same as or similar to other implants described in this disclosure, for example, the implant can include (i) an elongate sleeve defining a lumen along a longitudinal axis of the sleeve, and (ii) an elongate contraction member that extends along the sleeve.
The various methods herein can include, and in at least one application do include, one or more or all of the following steps:
advancing a distal portion of a delivery tube/delivery catheter into a chamber of the heart (e.g., left ventricle);
advancing, within the delivery tube, a sleeve to the heart, the sleeve having a first-end portion, a second-end portion, and a mid-portion disposed longitudinally between the first-end portion and the second-end portion;
within the chamber (e.g., ventricle), affixing or anchoring the sleeve in a curved path along a wall (e.g., ventricular wall) of the chamber (e.g., ventricle). This can be done such that an elongate contraction member extends outside of the sleeve between the first-end portion and the second-end portion, and a direct distance between the first-end portion and the second-end portion is shorter than a distance along the sleeve between the first-end portion and the second-end portion;
reshaping the wall of the chamber (e.g., ventricular wall) by reducing the direct distance between the first-end portion and the second-end portion by pulling on the elongate contraction member such that a length of the elongate contraction member that is disposed between the first-end portion and the second-end portion becomes reduced.
Affixing or anchoring the sleeve can include affixing or anchoring the sleeve without capturing a chorda tendinea of the heart between the sleeve and the ventricular wall.
Reducing the direct distance between the first-end portion and the second-end portion can include reducing a radius of curvature of the curved path of the sleeve.
Advancing the delivery tube into the ventricle can include advancing the delivery tube transfemorally to the heart, transseptally into a left atrium of the heart via an interatrial septum of the heart, and into the left ventricle via a mitral valve of the heart.
Advancing the delivery tube into the chamber or ventricle can include advancing the delivery tube transfemorally to the heart, into a right ventricle of the heart via a tricuspid valve of the heart, and transseptally into the left ventricle via an interventricular septum of the heart.
Advancing the delivery tube into the chamber or ventricle can include advancing the delivery tube transapically into the ventricle.
Advancing the sleeve to the heart can include advancing the sleeve within the delivery tube such that, within the delivery tube, the contraction member extends outside and alongside the sleeve, between the first-end portion and the second-end portion.
Affixing or anchoring the sleeve can include affixing or anchoring the first-end portion to an outer wall of the chamber (e.g., a wall opposite the septum or a posterior portion of the ventricular wall), and affixing or anchoring the second-end portion to a septum (e.g., an interventricular septum) of the heart. Optionally, affixing or anchoring the sleeve can include anchoring the mid-portion at an apex of the heart.
In at least one application, affixing or anchoring the sleeve includes affixing/anchoring the first-end portion to a posterior papillary muscle of the heart, and/or affixing/anchoring the second-end portion to an anterior papillary muscle of the heart. Optionally, affixing or anchoring the sleeve can include anchoring the mid-portion circumferentially around the ventricular wall.
Reducing the direct distance between the first-end portion and the second-end portion can include, and in at least one application does include, sliding the contraction member with respect to an end portion selected from the group consisting of: the first-end portion and the second-end portion.
The selected end portion can have a housing coupled thereto. Optionally, the housing can define an eyelet or other opening, and sliding the contraction member can include pulling the contraction member through the eyelet or other opening.
The housing can have a locking component or a locking mechanism coupled thereto. The locking component or locking mechanism can have an unlocked state in which the contraction member is pullable through the eyelet or other opening, and a locked state in which the locking component or locking mechanism inhibits pulling of the contraction member through the eyelet or other opening. Pulling the contraction member through the eyelet or other opening can include, and in at least one application does include, pulling the contraction member through the eyelet while the locking mechanism is in its unlocked state. The methods can further include, and in at least one application do include, subsequently to pulling the contraction member through the eyelet or other opening, transitioning the locking mechanism into its locked state.
Optionally, pulling on the contraction member can include pulling on the contraction member by actuating an adjustment component or mechanism coupled to the sleeve.
Optionally, the adjustment component or adjustment mechanism can include a spool, and actuating the adjustment component or adjustment mechanism can include rotating the spool such that the contraction member collected onto the spool.
The methods can further include, and in at least one application do include, subsequently to anchoring the sleeve, advancing an adjustment tool to the adjustment component or adjustment mechanism, wherein actuating the adjustment component or adjustment mechanism includes using the adjustment tool to actuate the adjustment mechanism.
Affixing or anchoring the sleeve can include, and in at least one application does include, progressively affixing or anchoring a plurality of sleeve-sites of the sleeve to a respective plurality of tissue sites on the wall of the chamber (e.g., on the ventricular wall), the plurality of sleeve-sites being distributed longitudinally along the sleeve, the plurality of sleeve sites including a first sleeve-site and a second sleeve-site, the first-end portion including the first sleeve-site, and the second-end portion including the second sleeve-site. Progressively affixing or anchoring the plurality of sleeve-sites can include, and in at least one application does include, for each sleeve-site of the plurality of sleeve-sites, advancing the sleeve-site out of an open distal end of the delivery tube, and passing or driving, from inside the sleeve, a tissue-engaging element of a respective attachment means or anchor through the sleeve-site and into the respective tissue site. In at least one application, affixing/anchoring involves using 2-20 attachment means or anchors to affix/anchor 2-20 parts of the implant and/or sleeve to 2-20 tissue sites.
Apparatuses and/or implants provided or used herein, e.g., for treating a heart of a subject) can include any of the features or components described with respect to implants in this disclosure, including, for example, a flexible sleeve having a first-end portion and a second-end portion. The flexible sleeve can include a circumferential wall that circumscribes and defines a longitudinal lumen between the first-end portion and the second-end portion.
An apparatus or implant can also include an elongate contraction member.
The elongate contraction member can be configured to define a first region and a second region. The first region can be designed/configured to extend along the sleeve from the first-end portion to the second-end portion, and the second region can be designed/configured to extend, outside of the sleeve, back from the second-end portion to the first-end portion. Optionally, the first region is disposed within the lumen of the sleeve. Alternatively, the first region can weave along the sleeve forming a part of the wall of the sleeve. Optionally, the first region of the contraction member can include a first end of the contraction member, and the second region of the contraction member can include a second end of the contraction member, and the first end of the contraction member can be attached to the first-end portion of the sleeve.
An apparatus or implant herein can optionally include, and in at least one application does include, a housing. The housing can be coupled to the first-end portion of the sleeve and to the contraction member. The housing can be configured to define an eyelet or other opening. The contraction member can be configured to extend through the eyelet or opening such that pulling of the contraction member through the eyelet or opening draws the second-end portion toward the first-end portion by reducing a length of the second region.
An apparatus or implant herein can optionally include, and in at least one application does include, a locking component or a locking mechanism. If the apparatus or implant includes a housing (e.g., similar to the housing described above), the locking component or locking mechanism can be coupled to the housing. The locking component or locking mechanism can have an unlocked state and a locked state. The unlocked state can be a state in which the contraction member is moveable or tensionable (e.g., pullable through the eyelet or opening), and the locked state can be a state in which the locking component or locking mechanism inhibits movement or tensioning (e.g., inhibits pulling of the contraction member through the eyelet). For example, in the unlocked state, the contraction member can be pullable/tensionable to shorten a length of the sleeve between the first-end portion and the second-end portion, and in the locked state, the locking component or locking mechanism inhibits movement of the contraction member relative to the locking component or locking mechanism.
An apparatus or implant herein can further include, and in at least one application do include, an adjustment component or an adjustment mechanism coupled to the contraction member and configured such that actuation of the adjustment component or adjustment mechanism tensions or pulls the contraction member. For example, if it has a housing with an eyelet or opening, it can be configured such that actuation of the adjustment component or adjustment mechanism pulls the contraction member through the eyelet or other opening and into the housing. In an application, the locking mechanism, in the locked state, inhibits actuation of the adjustment component or an adjustment mechanism. In an application, the adjustment component or adjustment mechanism includes a spool, configured such that rotation of the spool pulls the second region of the contraction member through the eyelet and into the housing.
An apparatus or implant herein (or a system including the apparatus or implant), can include, and in at least one application does include, a plurality of anchors. Optionally, each anchor of the plurality of anchors can define or include an anchor head and/or a tissue-engaging element, and can be advanceable through the lumen to a respective sleeve-site of the sleeve. The tissue-engaging element of each anchor can be configured to be driven through the circumferential wall and into tissue (e.g., ventricular tissue) of the heart.
The first region can be slidably coupled to the sleeve, and the pulling of the contraction member (e.g., through the eyelet or opening) slides the first region through the sleeve.
The housing and the contraction member can be arranged with respect the sleeve such that the pulling of the contraction member (e.g., through the eyelet or opening) longitudinally compresses the sleeve.
The contraction member can be slidably coupled to the second-end portion of the sleeve, and the pulling of the contraction member (e.g., through the eyelet or opening) slides the contraction member with respect to the first portion of the sleeve.
The housing can be coupled to the second region of the contraction member, and be arranged such that the second region of the contraction member extends through the eyelet or opening of the housing.
In at least one application, the second region of the contraction member can be pullable through the eyelet or opening such that the second-end portion is drawn toward the first-end portion. The housing can include an adjustment component or an adjustment mechanism coupled to the second region of the contraction member, and be configured such that actuation of the adjustment mechanism pulls the second region (e.g., a portion thereof) of the contraction member through the eyelet or opening and into the housing.
A system herein can include one or more of the components and/or features described above or elsewhere herein. The system can include an implant or apparatus that is the same as or similar to those described above or elsewhere herein. The system can comprise one or more (e.g., three, etc.) steerable catheters for positioning the sleeve within the heart. The system can comprise a delivery catheter for advancing the sleeve into a chamber of the heart.
The present invention will be more fully understood from the following detailed description of applications thereof, taken together with the drawings, in which:
Reference is made to
A catheter 16 is advanced to a desired treatment location in the heart, e.g., a chamber of the heart. For example, catheter 16 can be advanced transfemorally into the left ventricle 8 via the mitral valve 10 (
The catheter or delivery catheter can be advanced to the desired treatment location in a number of different ways, for example, using transfemoral, transseptal, and/or transapical approaches. For some applications, advancement of catheter 16 into the left ventricle is achieved by (i) advancing a distal portion of a first catheter 12 into the left atrium 6 (
The distal portion of catheter 16 is positioned such that a distal end 17 (e.g., an open distal end) of the catheter faces a first tissue site, e.g., site 30a (
In some applications, implant 22 comprises an elongate flexible sleeve 26 that has a circumferential wall that circumscribes and defines a lumen along a longitudinal axis of the sleeve. In some applications, Implant 22 also comprises an elongate contraction member 28 that extends along the sleeve, e.g., extending through the lumen, being woven into the material of the sleeve, extending through loops on the outside, or otherwise extending along the outside or the inside of the sleeve.
A first part of the implant 22 and/or sleeve 26 is affixed or anchored to first tissue site 30a. This can be done using a variety of attachment means or fastening means, e.g., with anchors, sutures, clips, clamps, staples, adhesive, etc. In one embodiment or application, as shown, this is done using an anchor 40 that includes a coiled or helical tissue-engaging element 44 that can be screwed into tissue, but other types of anchors and tissue-engaging element configurations are also possible. Anchor 40 and anchoring techniques are shown and described in more detail with reference to
Subsequently, a second part of implant 22 and/or sleeve 26 that is proximal from the first part of the implant and/or sleeve is advanced out of open distal end 17 of catheter 16, the distal portion of catheter 16 is repositioned such that the open distal end faces a second tissue site 30b, and the second part of the implant and/or sleeve is affixed or anchored to the second tissue site. Again, this can be done using a variety of attachment means. In one embodiment or application, as shown, this is done using a second tissue anchor 40 (
Optionally, second tissue site 30b can be closer to annulus 34 than is first site 30a. For some such applications, the repositioning of catheter 16 such that the open distal end faces second tissue site 30b can be performed by withdrawing catheter 16 into catheter 14, optionally without changing a degree of bending of the distal portion of catheter 16.
At least two parts of sleeve 26 can be anchored to corresponding tissue sites using corresponding tissue anchors or other attachment/fastening means. However, the above steps can be repeated with additional parts of the implant and/or sleeve and additional attachment means until the implant and/or sleeve is affixed/anchored to the treatment site as desired. In the example shown in the Figures, three parts of sleeve 26 are anchored to three respective tissue sites 30a, 30b, and 30c using three respective anchors 40 (
Each anchor 40 comprises a tissue-engaging element 44 and can comprise can comprise an anchor head 42. Tissue-engaging element 44 is shown as a coiled or helical portion that can be screwed or rotated into tissue, but other types of tissue-engaging elements and configurations are also possible. For some applications, the affixing or anchoring is performed by driving tissue-engaging element 44 through a portion of the implant 22, such as the circumferential wall of the corresponding part of sleeve 26 and into the corresponding tissue site. For some applications, a delivery channel 18 extends through catheter 16 and into the lumen of sleeve 26. Each anchor 40 can be delivered sequentially into the lumen of sleeve 26 via channel 18, and can be driven through the wall of the sleeve and into its tissue site using an anchor driver 46. A distal end of channel 18 can be disposed at the part of the sleeve being anchored. Between anchors, channel 18 can be partially withdrawn from the lumen of sleeve 26 such that the distal end of the channel becomes disposed at the next part of the sleeve to be anchored. The distal end of channel 18 can be used to press the part of the sleeve against the corresponding tissue site while the part of the sleeve is being anchored.
Sleeve 26 can be bent at the part of the sleeve being anchored, such that each anchor 40 can be driven in a straight line out of catheter 16 (and channel 18, if present) and through the circumferential wall of the sleeve.
Subsequently, to implantation of implant 22 (i.e., attachment/affixing/anchoring of the parts of implant 22 and/or sleeve 26 to the respective tissue sites), the implant 22 and/or sleeve 26 is contracted or reduced in length/distance from end to end to reshape the surrounding tissue and/or chamber of the heart by applying tension to the contraction member. In one embodiment, a distance between papillary muscle 32 (or lower portion of the chamber) and annulus 34 is reduced by contracting implant 22 and/or sleeve 26 along its longitudinal axis or length by applying tension to contraction member 28 (
For some subjects, if the papillary muscles and/or chordae tendineae restrain the leaflets of a native valve too much, this might prevent the leaflets from coming together and/or closing properly. For some subjects, the reduction in the distance between papillary muscle 32 and annulus 34 (e.g., by contracting the implant 22 and/or sleeve 26) may reduce mitral regurgitation by reducing tension and/or allowing the mitral leaflets to move further upstream and together during ventricular systole, thereby improving closure of mitral valve 10. Such subjects may include, for example, subjects with type IIIb mitral regurgitation and/or heart failure with reduced ejection fraction (HFrEF). Therefore, for some applications, the technique or methods of treatment include first identifying a subject as having one or more of these conditions.
The application of tension to contraction member 28 is generally achieved using an appropriate tool, such as adjustment tool 50. In
For some applications, implant 22, and the apparatus and techniques for its implantation, are implemented using technology the same as or similar to that described, mutatis mutandis, in one or more of the following publications, which are incorporated herein by reference:
U.S. Pat. No. 9,636,224 to Zipory et al.
U.S. Pat. No. 9,724,192 to Sheps et al.
US patent application publication 2015/0272734 to Sheps et al.
For some applications, implant 22 comprises an adjustment component 52 or other type of adjustment mechanism. For example, tension can be applied to contraction member 28 by actuating the adjustment component or other mechanism using tool 50. For example, adjustment component 52 can comprise a spool, drawstring(s), ratchet, tensioner, etc. Adjustment component 52 or other adjustment mechanism can comprise a lock, locking component, or other locking mechanism that locks a degree of tension of contraction member 28, e.g., by preventing further adjustment of the adjustment component or adjustment mechanism. For example, the lock, etc. may prevent rotation of a spool and/or hold the contraction member at a fixed tension, etc.
Optionally, for some applications, implant 22 may not comprise an actuatable adjustment mechanism as part of the implant, but instead can be contracted just by pulling on contraction member 28. For some such applications, implant 22 can comprise a locking component or mechanism (e.g., a lock, clamp, clip, etc.) that locks a degree of tension of contraction member 28, even in the absence of an actuatable adjustment mechanism.
For some applications, adjustment of implant 22 can be implemented using, alone or in combination, technology that is the same as or similar to that described, mutatis mutandis, in one or more of the following publications, which are incorporated herein by reference:
U.S. Pat. No. 9,636,224 to Zipory et al.
U.S. Pat. No. 9,724,192 to Sheps et al.
US patent application publication 2015/0272734 to Sheps et al.
Implant 22 can be implanted without capturing a chorda tendinea 36 between sleeve 26 and the ventricular wall. For some applications, this can be achieved by passing the distal portion of catheter 16 between two chordae tendineae when positioning the catheter at first tissue site 30a, and not withdrawing the catheter from between the two chordae tendineae until after all anchors 40 have been anchored. That is, the anchoring of all the parts of sleeve 26 can be performed while catheter 16 remains between the two chordae tendineae.
One or more of catheters (e.g., catheters 12, 14, and 16) can comprise one or more (e.g., two, three, four, etc.) pull-wires, and the distal end of the catheter can be deflectable (e.g., “steerable”) by tensioning at least one of or one or more of the pull-wires. For example, within left atrium 6, the distal portion of catheter 14 can be deflected with respect to the distal portion of catheter 12. Further, within left ventricle 8, the distal portion of catheter 16 can be deflected with respect to the distal portion of catheter 14. For some applications, the distal portion of catheter 12 can be deflected with respect to a portion of catheter 12 that is proximal (e.g., immediately proximal) to its distal portion, in order to facilitate transseptal access to left atrium 6.
For some applications, the catheters are configured such that the operator can rotationally lock the distal portion of catheter 12 with respect to catheter 14, and the deflecting of the distal portion of catheter 14 can be performed while the distal portion of the first catheter remains rotationally locked to the second catheter.
For some applications, the catheters of the present application, and their steering and locking, may be implemented using, alone or in combination, technology the same as or similar to that described, mutatis mutandis, in one or more of the following publications, which are incorporated herein by reference:
U.S. Pat. No. 9,636,224 to Zipory et al.
U.S. Pat. No. 9,724,192 to Sheps et al.
US patent application publication 2015/0272734 to Sheps et al.
For some applications, the operator can rotationally lock the distal portion of catheter 14 with respect to catheter 16, and the deflecting of the distal portion of catheter 16 can be performed while the distal portion of the first catheter remains rotationally locked to the second catheter. Optionally, catheter 16 can be rotatable with respect to (e.g., within) catheter 14, and the operator can rotate catheter 16 with respect to catheter 14, e.g., while the distal end of catheter 16 is disposed in left ventricle 8, for example, in order to position the open distal end of catheter 16 at the appropriate tissue site.
Reference is made to
Implant 122 comprises an elongate flexible sleeve 126 that has a circumferential wall that circumscribes and defines a lumen along a longitudinal axis of the sleeve. Implant 122 further comprises a contraction member 128 that can be elongate and extend along the sleeve. Sleeve 126 can be the same as or similar to sleeve 26, mutatis mutandis.
Sleeve 126 has a first-end portion 121, a second-end portion 125, and a mid-portion 123 longitudinally therebetween. The lumen of sleeve 126 can extend between first-end portion 121 and second-end portion 125.
Contraction member 128 can take a variety of shapes and forms. For example, contraction member 128 can be the same as or similar to contraction member 28 described above. In one embodiment or application, contraction member 128 defines a first region 130 and a second region 132. For some applications, first region 130 can extend along sleeve 126 from first-end portion 121 to second-end portion 125, and second region 132 can extend, outside of the sleeve, back from the second-end portion to the first-end portion.
For some applications, and as shown, first region 130 can extend along sleeve 126 by forming part of the circumferential wall and/or weaving in and out along the sleeve (i.e., along the circumferential wall). Alternatively, first region 130 can extend along sleeve 126 by being disposed within the lumen or extending through the lumen.
Implant 122 can comprise a housing 148 that is coupled to first-end portion 121 of sleeve 126, and/or to the contraction member 128. Housing 148 can define an opening or eyelet 149 through which contraction member 128 can extend, such that pulling of the contraction member (e.g., region 132 thereof) through the eyelet can draw second-end portion 125 toward first-end portion 121 by reducing a length of second region 132.
Implant 122 can further comprise a lock, locking device, and/or locking mechanism 151, e.g., coupled to housing 148. Lock or locking device 151 can have an unlocked state in which contraction member 128 is pullable through eyelet 149, and a locked state in which the locking mechanism inhibits pulling of the contraction member through the eyelet.
First region 130 can include a first end 131 of contraction member 128, and second region 132 can include a second end of the contraction member (not visible). Optionally, first end 131 can be attached to the first-end portion of the sleeve, e.g., as shown.
For some applications, implant 122 can comprise an adjustment component 152, or other adjustment mechanism, which can be coupled to second region 132 of contraction member 128, e.g., as shown in
U.S. Pat. No. 9,636,224 to Zipory et al.
U.S. Pat. No. 9,724,192 to Sheps et al.
US patent application publication 2015/0272734 to Sheps et al.
For some applications, adjustment component 152 comprises a spool, and can be configured such that rotation of the spool pulls second region 132 of contraction member 128 through eyelet 149 and into housing 148 where the spooled-in contraction member is stored on the spool.
Implant 122 is delivered via a delivery tube/catheter, such as delivery catheter 116.
Implant 122 can be implanted in the left ventricle 8 of the heart or in another chamber of the heart, e.g., the right ventricle. Implant 122 can be delivered to the chamber of the heart in a variety of ways, e.g., transfemorally, transapically, and/or transseptally. In one embodiment or application, implant 122 is delivered to the left ventricle 8 via the interatrial septum, e.g., as shown in
Within ventricle 8 (or within another chamber), implant 122 and/or sleeve 126 is affixed or anchored in a curved path along the ventricular wall (or other chamber wall) using an attachment means or anchor such that a direct distance between end portions 121 and 125 is shorter than a distance along the sleeve between the end portions. Sleeve 126 can be affixed/anchored using techniques described hereinabove for sleeve 26, mutatis mutandis. For example, anchors 40 can be sequentially delivered into the lumen of the sleeve, and can be used to progressively anchor respective sleeve-sites along the sleeve. That is, an exemplary method for implanting the sleeve comprises advancing progressively proximal sleeve-sites of the sleeve out of an open distal end of catheter 116, and anchoring (or otherwise fastening/attaching/affixing) the sleeve-sites to respective tissue sites. The plurality of sleeve-sites can include a first sleeve-site within first-end portion 121 and a second sleeve-site within second-end portion 125. As described for sleeve 26, mutatis mutandis, sleeve 126 can be implanted without capturing a chorda tendinea of the heart between the sleeve and the ventricular wall.
Subsequent to the anchoring (or fastening/attachment/affixing), the ventricular wall (or other chamber wall) is reshaped by cinching or contracting the implant by tensioning the contraction member. For some applications, this is done by reducing the direct distance between the first-end portion and the second-end portion by pulling on the elongate contraction member such that a length of the elongate contraction member that is disposed between the first-end portion and the second-end portion becomes reduced (e.g., reducing a radius of curvature of the curved path of the sleeve). As described hereinabove, this can be achieved with or without an adjustment component or adjustment mechanism that is part of the implant. It is believed that such reshaping of the ventricular wall may reduce mitral regurgitation and/or improve ventricular ejection fraction (and reshaping of other chambers/chamber walls may have similar advantages in other chambers).
As described hereinabove for implant 22, mutatis mutandis, implant 122 can be implanted with and adjustment tool attached thereto, or an adjustment tool can be advanced to the implant subsequent to implantation of the implant.
Subsequent to the adjustment, a lock, locking component 151 or other locking mechanism can be transitioned into its locked state, e.g., by releasing an element (not shown) that had been retaining the locking mechanism in its unlocked state.
For some applications, one of the end portions can be anchored to a portion of a wall of the chamber, e.g., an outer wall (i.e., non-septum wall), such as a ventricular wall, and the other end portion can be anchored to an interchamber (e.g., interventricular) septum of the heart, e.g., as shown in
It is to be noted that implant 122 can be arranged inversely, with housing 148, locking mechanism 151 and/or adjustment mechanism 152 disposed at second end portion 125. Similarly, implant 122 can be implanted the other way around to that shown or described, i.e., with the position of end portions 121 and 125 reversed.
For some applications, first region 130 can be slidably coupled to sleeve 126, such that the pulling of contraction member 128 through eyelet 149 slides the first region through the sleeve. For such applications, contraction member 128 can be slidably coupled to second-end portion 125 of sleeve 126, and the pulling of the contraction member through opening or eyelet 149 slides the contraction member with respect to the first portion of the sleeve. For example, and as shown, contraction member 128 can exit second-end portion 125 at a second opening or eyelet 134, such that eyelet 134 delimits first region 130 of the contraction member from second region 132 of the contraction member. For such applications, the pulling of contraction member 128 through eyelet 149 can compress sleeve 126 longitudinally. Therefore, for such applications, in addition to reducing the direct distance between end portions 121 and 125, the pulling of contraction member 128 through eyelet 149 can also contract the tissue along the curved path in which sleeve 126 is anchored.
The above systems, platforms, devices, features, aspects, methods, etc. have generally been described with respect to particular embodiments; however, the principles described can be applied to other types of systems, platforms, devices, features, aspects, methods, etc. Further, features described in one embodiment above, including embodiments described in the Summary section, can generally be combined with features described in other embodiments herein. The scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description. Methods described separately may be combined. In addition, where methods and steps described above indicate certain events occurring in certain order, the ordering of certain steps can be modified and that such modifications are in accordance with the variations of the invention. Additionally, certain of the steps may be performed concurrently in a parallel process when possible, as well as performed sequentially as described above. Many modifications can be made to adapt a particular situation or device to the teachings of the invention without departing from the essential scope thereof. Therefore, to the extent there are variations of the invention, which are within the spirit of the disclosure or equivalent to the inventions found in the claims, it is the intent that this patent will cover those variations as well.
The present application claims priority from U.S. Provisional Patent Application 62/588,813 to Keidar et al., filed Nov. 20, 2017, and entitled “Cinching of dilated heart muscle,” which is incorporated herein by reference.
Number | Name | Date | Kind |
---|---|---|---|
1527291 | Zorraquin | Feb 1925 | A |
2623521 | Shaw | Dec 1952 | A |
3604488 | Wishart et al. | Sep 1971 | A |
3656185 | Carpentier | Apr 1972 | A |
3840018 | Heifetz | Oct 1974 | A |
3881366 | Bradley et al. | May 1975 | A |
3898701 | La Russa | Aug 1975 | A |
4042979 | Angell | Aug 1977 | A |
4118805 | Reimels | Oct 1978 | A |
4214349 | Munch | Jul 1980 | A |
4261342 | Aranguren Duo | Apr 1981 | A |
4290151 | Massana | Sep 1981 | A |
4434828 | Trincia | Mar 1984 | A |
4473928 | Johnson | Oct 1984 | A |
4602911 | Ahmadi et al. | Jul 1986 | A |
4625727 | Leiboff | Dec 1986 | A |
4712549 | Peters et al. | Dec 1987 | A |
4742829 | Law et al. | May 1988 | A |
4778468 | Hunt et al. | Oct 1988 | A |
4917698 | Carpentier et al. | Apr 1990 | A |
4935027 | Yoon | Jun 1990 | A |
4961738 | Mackin | Oct 1990 | A |
5042707 | Taheri | Aug 1991 | A |
5061277 | Carpentier et al. | Oct 1991 | A |
5064431 | Gilbertson et al. | Nov 1991 | A |
5098388 | Kulkashi et al. | Mar 1992 | A |
5104407 | Lam et al. | Apr 1992 | A |
5108420 | Marks | Apr 1992 | A |
5139485 | Smith et al. | Aug 1992 | A |
5201880 | Wright et al. | Apr 1993 | A |
5226890 | Ianniruberto et al. | Jul 1993 | A |
5258003 | Ciaglia et al. | Nov 1993 | A |
5258008 | Wilk | Nov 1993 | A |
5292310 | Yoon | Mar 1994 | A |
5300034 | Behnke et al. | Apr 1994 | A |
5325845 | Adair | Jul 1994 | A |
5346498 | Greelis et al. | Sep 1994 | A |
5383852 | Stevens-Wright | Jan 1995 | A |
5449368 | Kuzmak | Sep 1995 | A |
5450860 | O'Connor | Sep 1995 | A |
5464404 | Abela et al. | Nov 1995 | A |
5474518 | Farrer Velazquez | Dec 1995 | A |
5477856 | Lundquist | Dec 1995 | A |
5478329 | Ternamian | Dec 1995 | A |
5591191 | Kieturakis | Jan 1997 | A |
5593424 | Northrup, III | Jan 1997 | A |
5601537 | Frassica | Feb 1997 | A |
5601572 | Middleman et al. | Feb 1997 | A |
5626609 | Zvenyatsky et al. | May 1997 | A |
5643317 | Pavcnik et al. | Jul 1997 | A |
5669883 | Scarfone et al. | Sep 1997 | A |
5669919 | Sanders et al. | Sep 1997 | A |
5671747 | Connor | Sep 1997 | A |
5676653 | Taylor et al. | Oct 1997 | A |
5676682 | Yoon | Oct 1997 | A |
5683402 | Cosgrove et al. | Nov 1997 | A |
5702397 | Goble et al. | Dec 1997 | A |
5702398 | Tarabishy | Dec 1997 | A |
5709695 | Northrup, III | Jan 1998 | A |
5716370 | Williamson, IV et al. | Feb 1998 | A |
5716397 | Myers | Feb 1998 | A |
5728116 | Rosenman | Mar 1998 | A |
5730150 | Peppel et al. | Mar 1998 | A |
5749371 | Zadini et al. | May 1998 | A |
5755697 | Jones et al. | May 1998 | A |
5782844 | Yoon et al. | Jul 1998 | A |
5810776 | Bacich et al. | Sep 1998 | A |
5810882 | Bolduc et al. | Sep 1998 | A |
5824066 | Gross | Oct 1998 | A |
5830221 | Stein et al. | Nov 1998 | A |
5843120 | Israel et al. | Dec 1998 | A |
5855614 | Stevens et al. | Jan 1999 | A |
5876373 | Giba et al. | Mar 1999 | A |
5935098 | Blaisdell et al. | Aug 1999 | A |
5957953 | DiPoto et al. | Sep 1999 | A |
5961440 | Schweich, Jr. et al. | Oct 1999 | A |
5961539 | Northrup, III et al. | Oct 1999 | A |
5984959 | Robertson et al. | Nov 1999 | A |
6007481 | Riek et al. | Dec 1999 | A |
6042554 | Rosenman et al. | Mar 2000 | A |
6045497 | Schweich, Jr. et al. | Apr 2000 | A |
6050936 | Schweich, Jr. et al. | Apr 2000 | A |
6059715 | Schweich, Jr. et al. | May 2000 | A |
6074341 | Anderson et al. | Jun 2000 | A |
6074401 | Gardiner et al. | Jun 2000 | A |
6074417 | Peredo | Jun 2000 | A |
6086582 | Altman et al. | Jul 2000 | A |
6102945 | Campbell | Aug 2000 | A |
6106550 | Magovern et al. | Aug 2000 | A |
6110200 | Hinnenkamp | Aug 2000 | A |
6132390 | Cookston et al. | Oct 2000 | A |
6143024 | Campbell et al. | Nov 2000 | A |
6156006 | Brosens et al. | Dec 2000 | A |
6159240 | Sparer et al. | Dec 2000 | A |
6165119 | Schweich, Jr. et al. | Dec 2000 | A |
6174332 | Loch et al. | Jan 2001 | B1 |
6183411 | Mortier et al. | Feb 2001 | B1 |
6187040 | Wright | Feb 2001 | B1 |
6210336 | Fredriksen | Apr 2001 | B1 |
6210347 | Forsell | Apr 2001 | B1 |
6217610 | Carpentier et al. | Apr 2001 | B1 |
6228032 | Eaton et al. | May 2001 | B1 |
6231602 | Carpentier et al. | May 2001 | B1 |
6251092 | Qin et al. | Jun 2001 | B1 |
6293952 | Brosens et al. | Sep 2001 | B1 |
6296656 | Bolduc et al. | Oct 2001 | B1 |
6315784 | Djurovic | Nov 2001 | B1 |
6319281 | Patel | Nov 2001 | B1 |
6328746 | Gambale | Dec 2001 | B1 |
6332893 | Mortier et al. | Dec 2001 | B1 |
6355030 | Aldrich et al. | Mar 2002 | B1 |
6361559 | Houser et al. | Mar 2002 | B1 |
6368348 | Gabbay | Apr 2002 | B1 |
6402780 | Williamson, IV et al. | Jun 2002 | B2 |
6406420 | McCarthy et al. | Jun 2002 | B1 |
6406493 | Tu et al. | Jun 2002 | B1 |
6419696 | Ortiz et al. | Jul 2002 | B1 |
6451054 | Stevens | Sep 2002 | B1 |
6458076 | Pruitt | Oct 2002 | B1 |
6461336 | Larre | Oct 2002 | B1 |
6461366 | Seguin | Oct 2002 | B1 |
6470892 | Forsell | Oct 2002 | B1 |
6503274 | Howanec, Jr. et al. | Jan 2003 | B1 |
6524338 | Gundry | Feb 2003 | B1 |
6527780 | Wallace et al. | Mar 2003 | B1 |
6530952 | Vesely | Mar 2003 | B2 |
6533772 | Sherts et al. | Mar 2003 | B1 |
6537314 | Langberg et al. | Mar 2003 | B2 |
6547801 | Dargent et al. | Apr 2003 | B1 |
6554845 | Fleenor et al. | Apr 2003 | B1 |
6564805 | Garrison et al. | May 2003 | B2 |
6565603 | Cox | May 2003 | B2 |
6569198 | Wilson et al. | May 2003 | B1 |
6579297 | Bicek et al. | Jun 2003 | B2 |
6589160 | Schweich, Jr. et al. | Jul 2003 | B2 |
6592593 | Parodi et al. | Jul 2003 | B1 |
6602288 | Cosgrove et al. | Aug 2003 | B1 |
6602289 | Colvin et al. | Aug 2003 | B1 |
6613078 | Barone | Sep 2003 | B1 |
6613079 | Wolinsky et al. | Sep 2003 | B1 |
6616684 | Vidlund et al. | Sep 2003 | B1 |
6619291 | Hlavka et al. | Sep 2003 | B2 |
6626899 | Houser et al. | Sep 2003 | B2 |
6626917 | Craig | Sep 2003 | B1 |
6626930 | Allen et al. | Sep 2003 | B1 |
6629534 | St. Goar et al. | Oct 2003 | B1 |
6629921 | Schweich, Jr. et al. | Oct 2003 | B1 |
6651671 | Donlon et al. | Nov 2003 | B1 |
6652556 | VanTassel et al. | Nov 2003 | B1 |
6682558 | Tu et al. | Jan 2004 | B2 |
6689125 | Keith et al. | Feb 2004 | B1 |
6689164 | Seguin | Feb 2004 | B1 |
6695866 | Kuehn et al. | Feb 2004 | B1 |
6702826 | Liddicoat et al. | Mar 2004 | B2 |
6702846 | Mikus et al. | Mar 2004 | B2 |
6706065 | Langberg et al. | Mar 2004 | B2 |
6709385 | Forsell | Mar 2004 | B2 |
6709456 | Langberg et al. | Mar 2004 | B2 |
6711444 | Koblish | Mar 2004 | B2 |
6719786 | Ryan et al. | Apr 2004 | B2 |
6723038 | Schroeder et al. | Apr 2004 | B1 |
6726716 | Marquez | Apr 2004 | B2 |
6726717 | Alfieri et al. | Apr 2004 | B2 |
6749630 | McCarthy et al. | Jun 2004 | B2 |
6752813 | Goldfarb et al. | Jun 2004 | B2 |
6764310 | Ichihashi et al. | Jul 2004 | B1 |
6764510 | Vidlund et al. | Jul 2004 | B2 |
6764810 | Ma et al. | Jul 2004 | B2 |
6770083 | Seguin | Aug 2004 | B2 |
6786924 | Ryan et al. | Sep 2004 | B2 |
6786925 | Schoon et al. | Sep 2004 | B1 |
6790231 | Liddicoat et al. | Sep 2004 | B2 |
6797001 | Mathis et al. | Sep 2004 | B2 |
6797002 | Spence et al. | Sep 2004 | B2 |
6802319 | Stevens et al. | Oct 2004 | B2 |
6805710 | Bolling et al. | Oct 2004 | B2 |
6805711 | Quijano et al. | Oct 2004 | B2 |
6855126 | Flinchbaugh | Feb 2005 | B2 |
6858039 | McCarthy | Feb 2005 | B2 |
6884250 | Monassevitch et al. | Apr 2005 | B2 |
6893459 | Macoviak | May 2005 | B1 |
6908478 | Alferness et al. | Jun 2005 | B2 |
6908482 | McCarthy et al. | Jun 2005 | B2 |
6918917 | Nguyen et al. | Jul 2005 | B1 |
6926730 | Nguyen et al. | Aug 2005 | B1 |
6960217 | Bolduc | Nov 2005 | B2 |
6969354 | Marian | Nov 2005 | B1 |
6976995 | Mathis et al. | Dec 2005 | B2 |
6986775 | Morales et al. | Jan 2006 | B2 |
6989028 | Lashinski et al. | Jan 2006 | B2 |
6997951 | Solem et al. | Feb 2006 | B2 |
7004176 | Lau | Feb 2006 | B2 |
7007798 | Happonen et al. | Mar 2006 | B2 |
7011669 | Kimblad | Mar 2006 | B2 |
7011682 | Lashinski et al. | Mar 2006 | B2 |
7018406 | Seguin et al. | Mar 2006 | B2 |
7037334 | Hlavka et al. | May 2006 | B1 |
7056294 | Khairkhahan et al. | Jun 2006 | B2 |
7077850 | Kortenbach | Jul 2006 | B2 |
7077862 | Vidlund et al. | Jul 2006 | B2 |
7087064 | Hyde | Aug 2006 | B1 |
7101395 | Tremulis et al. | Sep 2006 | B2 |
7101396 | Artof et al. | Sep 2006 | B2 |
7112207 | Allen et al. | Sep 2006 | B2 |
7118595 | Ryan et al. | Oct 2006 | B2 |
7125421 | Tremulis et al. | Oct 2006 | B2 |
7150737 | Purdy et al. | Dec 2006 | B2 |
7159593 | McCarthy et al. | Jan 2007 | B2 |
7166127 | Spence et al. | Jan 2007 | B2 |
7169187 | Datta et al. | Jan 2007 | B2 |
7172625 | Shu et al. | Feb 2007 | B2 |
7175660 | Cartledge et al. | Feb 2007 | B2 |
7186262 | Saadat | Mar 2007 | B2 |
7186264 | Liddicoat et al. | Mar 2007 | B2 |
7189199 | McCarthy et al. | Mar 2007 | B2 |
7192443 | Solem et al. | Mar 2007 | B2 |
7220277 | Arru et al. | May 2007 | B2 |
7226467 | Lucatero et al. | Jun 2007 | B2 |
7226477 | Cox | Jun 2007 | B2 |
7226647 | Kasperchik et al. | Jun 2007 | B2 |
7229452 | Kayan | Jun 2007 | B2 |
7238191 | Bachmann | Jul 2007 | B2 |
7241267 | Furia | Jul 2007 | B2 |
7288097 | Seguin | Oct 2007 | B2 |
7294148 | McCarthy | Nov 2007 | B2 |
7311728 | Solem et al. | Dec 2007 | B2 |
7311729 | Mathis et al. | Dec 2007 | B2 |
7314485 | Mathis | Jan 2008 | B2 |
7316710 | Cheng et al. | Jan 2008 | B1 |
7329279 | Haug et al. | Feb 2008 | B2 |
7329280 | Bolling et al. | Feb 2008 | B2 |
7335213 | Hyde et al. | Feb 2008 | B1 |
7361190 | Shaoulian et al. | Apr 2008 | B2 |
7364588 | Mathis et al. | Apr 2008 | B2 |
7377941 | Rhee et al. | May 2008 | B2 |
7390329 | Westra et al. | Jun 2008 | B2 |
7404824 | Webler et al. | Jul 2008 | B1 |
7431692 | Zollinger et al. | Oct 2008 | B2 |
7431726 | Spence et al. | Oct 2008 | B2 |
7442207 | Rafiee | Oct 2008 | B2 |
7452376 | Lim et al. | Nov 2008 | B2 |
7455690 | Cartledge et al. | Nov 2008 | B2 |
7485142 | Milo | Feb 2009 | B2 |
7485143 | Webler et al. | Feb 2009 | B2 |
7500989 | Solem et al. | Mar 2009 | B2 |
7507252 | Lashinski et al. | Mar 2009 | B2 |
7510575 | Spenser et al. | Mar 2009 | B2 |
7510577 | Moaddeb et al. | Mar 2009 | B2 |
7527647 | Spence | May 2009 | B2 |
7530995 | Quijano et al. | May 2009 | B2 |
7549983 | Roue et al. | Jun 2009 | B2 |
7559936 | Levine | Jul 2009 | B2 |
7562660 | Saadat | Jul 2009 | B2 |
7563267 | Goldfarb et al. | Jul 2009 | B2 |
7563273 | Goldfarb et al. | Jul 2009 | B2 |
7569062 | Kuehn et al. | Aug 2009 | B1 |
7585321 | Cribier | Sep 2009 | B2 |
7588582 | Starksen et al. | Sep 2009 | B2 |
7591826 | Alferness et al. | Sep 2009 | B2 |
7604646 | Goldfarb et al. | Oct 2009 | B2 |
7608091 | Goldfarb et al. | Oct 2009 | B2 |
7608103 | McCarthy | Oct 2009 | B2 |
7625403 | Krivoruchko | Dec 2009 | B2 |
7632303 | Stalker et al. | Dec 2009 | B1 |
7635329 | Goldfarb et al. | Dec 2009 | B2 |
7635386 | Gammie | Dec 2009 | B1 |
7655015 | Goldfarb et al. | Feb 2010 | B2 |
7666204 | Thornton et al. | Feb 2010 | B2 |
7682319 | Martin et al. | Mar 2010 | B2 |
7682369 | Seguin | Mar 2010 | B2 |
7686822 | Shayani | Mar 2010 | B2 |
7699892 | Rafiee et al. | Apr 2010 | B2 |
7704269 | St. Goar et al. | Apr 2010 | B2 |
7704277 | Zakay et al. | Apr 2010 | B2 |
7722666 | Lafontaine | May 2010 | B2 |
7736388 | Goldfarb et al. | Jun 2010 | B2 |
7748389 | Salahieh et al. | Jul 2010 | B2 |
7753924 | Starksen et al. | Jul 2010 | B2 |
7758632 | Hojeibane et al. | Jul 2010 | B2 |
7766812 | Schroeder et al. | Aug 2010 | B2 |
7780726 | Seguin | Aug 2010 | B2 |
7871368 | Zollinger et al. | Jan 2011 | B2 |
7871433 | Lattouf | Jan 2011 | B2 |
7883475 | Dupont et al. | Feb 2011 | B2 |
7883538 | To et al. | Feb 2011 | B2 |
7892281 | Seguin et al. | Feb 2011 | B2 |
7927370 | Webler et al. | Apr 2011 | B2 |
7927371 | Navia et al. | Apr 2011 | B2 |
7942927 | Kaye et al. | May 2011 | B2 |
7947056 | Griego et al. | May 2011 | B2 |
7955315 | Feinberg et al. | Jun 2011 | B2 |
7955377 | Melsheimer | Jun 2011 | B2 |
7981152 | Webler et al. | Jul 2011 | B1 |
7992567 | Hirotsuka et al. | Aug 2011 | B2 |
7993368 | Gambale et al. | Aug 2011 | B2 |
7993397 | Lashinski et al. | Aug 2011 | B2 |
8012201 | Lashinski et al. | Sep 2011 | B2 |
8034103 | Burriesci et al. | Oct 2011 | B2 |
8052592 | Goldfarb et al. | Nov 2011 | B2 |
8057493 | Goldfarb et al. | Nov 2011 | B2 |
8062355 | Figulia et al. | Nov 2011 | B2 |
8070804 | Hyde et al. | Dec 2011 | B2 |
8070805 | Vidlund et al. | Dec 2011 | B2 |
8075616 | Solem et al. | Dec 2011 | B2 |
8100964 | Spence | Jan 2012 | B2 |
8123801 | Milo | Feb 2012 | B2 |
8142493 | Spence et al. | Mar 2012 | B2 |
8142495 | Hasenkam et al. | Mar 2012 | B2 |
8142496 | Berreklouw | Mar 2012 | B2 |
8147542 | Maisano et al. | Apr 2012 | B2 |
8152844 | Rao et al. | Apr 2012 | B2 |
8163013 | Machold et al. | Apr 2012 | B2 |
8187299 | Goldfarb et al. | May 2012 | B2 |
8187324 | Webler et al. | May 2012 | B2 |
8202315 | Hlavka et al. | Jun 2012 | B2 |
8206439 | Gomez Duran | Jun 2012 | B2 |
8216302 | Wilson et al. | Jul 2012 | B2 |
8231671 | Kim | Jul 2012 | B2 |
8262725 | Subramanian | Sep 2012 | B2 |
8265758 | Policker et al. | Sep 2012 | B2 |
8277502 | Miller et al. | Oct 2012 | B2 |
8287584 | Salahieh et al. | Oct 2012 | B2 |
8287591 | Keidar et al. | Oct 2012 | B2 |
8292884 | Levine et al. | Oct 2012 | B2 |
8303608 | Goldfarb et al. | Nov 2012 | B2 |
8323334 | Deem et al. | Dec 2012 | B2 |
8328868 | Paul et al. | Dec 2012 | B2 |
8333777 | Schaller et al. | Dec 2012 | B2 |
8343173 | Starksen et al. | Jan 2013 | B2 |
8343174 | Goldfarb et al. | Jan 2013 | B2 |
8343213 | Salahieh et al. | Jan 2013 | B2 |
8349002 | Milo | Jan 2013 | B2 |
8353956 | Miller et al. | Jan 2013 | B2 |
8357195 | Kuehn | Jan 2013 | B2 |
8382829 | Call et al. | Feb 2013 | B1 |
8388680 | Starksen et al. | Mar 2013 | B2 |
8393517 | Milo | Mar 2013 | B2 |
8419825 | Burgler et al. | Apr 2013 | B2 |
8425402 | Annest et al. | Apr 2013 | B2 |
8430926 | Kirson | Apr 2013 | B2 |
8444566 | Agmon | May 2013 | B2 |
8449573 | Chu | May 2013 | B2 |
8449599 | Chau et al. | May 2013 | B2 |
8454686 | Alkhatib | Jun 2013 | B2 |
8460370 | Zakay | Jun 2013 | B2 |
8460371 | Hiavka et al. | Jun 2013 | B2 |
8475491 | Milo | Jul 2013 | B2 |
8475525 | Maisano et al. | Jul 2013 | B2 |
8480732 | Subramanian | Jul 2013 | B2 |
8500628 | Frassica et al. | Aug 2013 | B2 |
8518107 | Tsukashima et al. | Aug 2013 | B2 |
8523881 | Cabiri et al. | Sep 2013 | B2 |
8523940 | Richardson et al. | Sep 2013 | B2 |
8551161 | Dolan | Oct 2013 | B2 |
8585755 | Chau et al. | Nov 2013 | B2 |
8591576 | Hasenkam et al. | Nov 2013 | B2 |
8608797 | Gross et al. | Dec 2013 | B2 |
8628569 | Benichou et al. | Jan 2014 | B2 |
8628571 | Hacohen et al. | Jan 2014 | B1 |
8641727 | Starksen et al. | Feb 2014 | B2 |
8652202 | Alon et al. | Feb 2014 | B2 |
8652203 | Quadri et al. | Feb 2014 | B2 |
8679174 | Ottma et al. | Mar 2014 | B2 |
8685086 | Navia et al. | Apr 2014 | B2 |
8690939 | Miller et al. | Apr 2014 | B2 |
8728097 | Sugimoto et al. | May 2014 | B1 |
8728155 | Montorfano et al. | May 2014 | B2 |
8734467 | Miller et al. | May 2014 | B2 |
8734699 | Heideman et al. | May 2014 | B2 |
8740920 | Goldfarb et al. | Jun 2014 | B2 |
8747463 | Fogarty et al. | Jun 2014 | B2 |
8777841 | Frassica et al. | Jul 2014 | B2 |
8778021 | Cartledge | Jul 2014 | B2 |
8784481 | Alkhatib et al. | Jul 2014 | B2 |
8790367 | Nguyen et al. | Jul 2014 | B2 |
8790394 | Miller et al. | Jul 2014 | B2 |
8795298 | Hernlund et al. | Aug 2014 | B2 |
8795355 | Alkhatib | Aug 2014 | B2 |
8795356 | Quadri et al. | Aug 2014 | B2 |
8795357 | Yohanan et al. | Aug 2014 | B2 |
8808366 | Braido et al. | Aug 2014 | B2 |
8808368 | Maisano et al. | Aug 2014 | B2 |
8845717 | Khairkhahan et al. | Sep 2014 | B2 |
8845723 | Spence et al. | Sep 2014 | B2 |
8852261 | White | Oct 2014 | B2 |
8852272 | Gross et al. | Oct 2014 | B2 |
8858623 | Miller et al. | Oct 2014 | B2 |
8864822 | Spence et al. | Oct 2014 | B2 |
8870948 | Erzberger et al. | Oct 2014 | B1 |
8870949 | Rowe | Oct 2014 | B2 |
8888843 | Khairkhahan et al. | Nov 2014 | B2 |
8889861 | Skead et al. | Nov 2014 | B2 |
8894702 | Quadri et al. | Nov 2014 | B2 |
8911461 | Traynor et al. | Dec 2014 | B2 |
8911494 | Hammer et al. | Dec 2014 | B2 |
8926695 | Gross et al. | Jan 2015 | B2 |
8926696 | Cabiri et al. | Jan 2015 | B2 |
8926697 | Gross et al. | Jan 2015 | B2 |
8932343 | Alkhatib et al. | Jan 2015 | B2 |
8932348 | Solem et al. | Jan 2015 | B2 |
8940044 | Hammer et al. | Jan 2015 | B2 |
8945211 | Sugimoto | Feb 2015 | B2 |
8951285 | Sugimoto et al. | Feb 2015 | B2 |
8951286 | Sugimoto et al. | Feb 2015 | B2 |
8961595 | Alkhatib | Feb 2015 | B2 |
8961602 | Kovach et al. | Feb 2015 | B2 |
8979922 | Jayasinghe et al. | Mar 2015 | B2 |
8992604 | Gross et al. | Mar 2015 | B2 |
9005273 | Salahieh et al. | Apr 2015 | B2 |
9011520 | Miller et al. | Apr 2015 | B2 |
9011530 | Reich et al. | Apr 2015 | B2 |
9011531 | Rourke et al. | Apr 2015 | B2 |
9023100 | Quadri et al. | May 2015 | B2 |
9072603 | Tuval et al. | Jul 2015 | B2 |
9107749 | Bobo et al. | Aug 2015 | B2 |
9119719 | Zipory et al. | Sep 2015 | B2 |
9125632 | Loulmet et al. | Sep 2015 | B2 |
9125742 | Yoganathan et al. | Sep 2015 | B2 |
9138316 | Bielefeld | Sep 2015 | B2 |
9173646 | Fabro | Nov 2015 | B2 |
9180005 | Lashinski et al. | Nov 2015 | B1 |
9180007 | Reich et al. | Nov 2015 | B2 |
9192472 | Gross et al. | Nov 2015 | B2 |
9198756 | Aklog et al. | Dec 2015 | B2 |
9226825 | Starksen et al. | Jan 2016 | B2 |
9259218 | Robinson | Feb 2016 | B2 |
9265608 | Miller et al. | Feb 2016 | B2 |
9277994 | Miller et al. | Mar 2016 | B2 |
9326857 | Cartledge et al. | May 2016 | B2 |
9414921 | Miller et al. | Aug 2016 | B2 |
9427316 | Schweich, Jr. et al. | Aug 2016 | B2 |
9474606 | Zipory et al. | Oct 2016 | B2 |
9526613 | Gross et al. | Dec 2016 | B2 |
9561104 | Miller et al. | Feb 2017 | B2 |
9579090 | Simms et al. | Feb 2017 | B1 |
9610162 | Zipory et al. | Apr 2017 | B2 |
9622861 | Miller et al. | Apr 2017 | B2 |
9636224 | Zipory et al. | May 2017 | B2 |
9662209 | Gross et al. | May 2017 | B2 |
9693865 | Gilmore et al. | Jul 2017 | B2 |
9713530 | Cabiri et al. | Jul 2017 | B2 |
9724192 | Sheps et al. | Aug 2017 | B2 |
9730793 | Reich et al. | Aug 2017 | B2 |
9775709 | Miller et al. | Oct 2017 | B2 |
9788941 | Hacohen | Oct 2017 | B2 |
9801720 | Gilmore et al. | Oct 2017 | B2 |
9872769 | Gross et al. | Jan 2018 | B2 |
9907547 | Gilmore et al. | Mar 2018 | B2 |
9937042 | Cabiri et al. | Apr 2018 | B2 |
9949828 | Sheps et al. | Apr 2018 | B2 |
9968452 | Sheps et al. | May 2018 | B2 |
9968454 | Reich et al. | May 2018 | B2 |
10368852 | Gerhardt et al. | Aug 2019 | B2 |
20010021874 | Carpentier et al. | Sep 2001 | A1 |
20020022862 | Grafton et al. | Feb 2002 | A1 |
20020082525 | Oslund et al. | Jun 2002 | A1 |
20020087048 | Brock et al. | Jul 2002 | A1 |
20020103532 | Langberg et al. | Aug 2002 | A1 |
20020120292 | Morgan | Aug 2002 | A1 |
20020151916 | Muramatsu et al. | Oct 2002 | A1 |
20020151970 | Garrison et al. | Oct 2002 | A1 |
20020169358 | Mortier et al. | Nov 2002 | A1 |
20020177904 | Huxel et al. | Nov 2002 | A1 |
20020188301 | Dallara et al. | Dec 2002 | A1 |
20020188350 | Arru et al. | Dec 2002 | A1 |
20020198586 | Inoue | Dec 2002 | A1 |
20030050693 | Quijano et al. | Mar 2003 | A1 |
20030078465 | Pai et al. | Apr 2003 | A1 |
20030078653 | Vesely et al. | Apr 2003 | A1 |
20030105519 | Fasol et al. | Jun 2003 | A1 |
20030114901 | Loeb et al. | Jun 2003 | A1 |
20030120340 | Liska et al. | Jun 2003 | A1 |
20030144657 | Bowe et al. | Jul 2003 | A1 |
20030171760 | Gambale | Sep 2003 | A1 |
20030199974 | Lee et al. | Oct 2003 | A1 |
20030204193 | Gabriel et al. | Oct 2003 | A1 |
20030204195 | Keane et al. | Oct 2003 | A1 |
20030229350 | Kay | Dec 2003 | A1 |
20030229395 | Cox | Dec 2003 | A1 |
20040010287 | Bonutti | Jan 2004 | A1 |
20040019359 | Worley et al. | Jan 2004 | A1 |
20040019377 | Taylor et al. | Jan 2004 | A1 |
20040024451 | Johnson et al. | Feb 2004 | A1 |
20040039442 | St. Goar et al. | Feb 2004 | A1 |
20040044350 | Martin et al. | Mar 2004 | A1 |
20040059413 | Argento | Mar 2004 | A1 |
20040068273 | Fariss et al. | Apr 2004 | A1 |
20040111095 | Gordon et al. | Jun 2004 | A1 |
20040122514 | Fogarty et al. | Jun 2004 | A1 |
20040127982 | Machold et al. | Jul 2004 | A1 |
20040133274 | Webler et al. | Jul 2004 | A1 |
20040133374 | Kattan | Jul 2004 | A1 |
20040138744 | Lashinski et al. | Jul 2004 | A1 |
20040138745 | Macoviak et al. | Jul 2004 | A1 |
20040148019 | Vidlund et al. | Jul 2004 | A1 |
20040148020 | Vidlund et al. | Jul 2004 | A1 |
20040148021 | Cartledge et al. | Jul 2004 | A1 |
20040176788 | Opolski | Sep 2004 | A1 |
20040181287 | Gellman | Sep 2004 | A1 |
20040186566 | Hindrichs et al. | Sep 2004 | A1 |
20040193191 | Starksen et al. | Sep 2004 | A1 |
20040243227 | Starksen et al. | Dec 2004 | A1 |
20040260317 | Bloom et al. | Dec 2004 | A1 |
20040260344 | Lyons et al. | Dec 2004 | A1 |
20040260393 | Rahdert et al. | Dec 2004 | A1 |
20040260394 | Douk et al. | Dec 2004 | A1 |
20040267358 | Reitan | Dec 2004 | A1 |
20050004668 | Aklog et al. | Jan 2005 | A1 |
20050010287 | Macoviak et al. | Jan 2005 | A1 |
20050010787 | Tarbouriech | Jan 2005 | A1 |
20050016560 | Voughlohn | Jan 2005 | A1 |
20050049692 | Numamoto et al. | Mar 2005 | A1 |
20050055038 | Kelleher et al. | Mar 2005 | A1 |
20050055087 | Starksen | Mar 2005 | A1 |
20050060030 | Lashinski et al. | Mar 2005 | A1 |
20050065601 | Lee et al. | Mar 2005 | A1 |
20050070999 | Spence | Mar 2005 | A1 |
20050075723 | Schroeder et al. | Apr 2005 | A1 |
20050075727 | Wheatley | Apr 2005 | A1 |
20050090827 | Gedebou | Apr 2005 | A1 |
20050090834 | Chiang et al. | Apr 2005 | A1 |
20050096740 | Langberg et al. | May 2005 | A1 |
20050107871 | Realyvasquez et al. | May 2005 | A1 |
20050119734 | Spence et al. | Jun 2005 | A1 |
20050125002 | Baran et al. | Jun 2005 | A1 |
20050125011 | Spence et al. | Jun 2005 | A1 |
20050131533 | Alfieri et al. | Jun 2005 | A1 |
20050137686 | Salahieh et al. | Jun 2005 | A1 |
20050137688 | Salahieh et al. | Jun 2005 | A1 |
20050137695 | Salahieh et al. | Jun 2005 | A1 |
20050159728 | Armour et al. | Jul 2005 | A1 |
20050171601 | Cosgrove et al. | Aug 2005 | A1 |
20050177180 | Kaganov et al. | Aug 2005 | A1 |
20050177228 | Solem et al. | Aug 2005 | A1 |
20050187568 | Klenk et al. | Aug 2005 | A1 |
20050192596 | Jugenheimer et al. | Sep 2005 | A1 |
20050203549 | Realyvasquez | Sep 2005 | A1 |
20050203606 | VanCamp | Sep 2005 | A1 |
20050216039 | Lederman | Sep 2005 | A1 |
20050216079 | MaCoviak | Sep 2005 | A1 |
20050222488 | Chang et al. | Oct 2005 | A1 |
20050222665 | Aranyi | Oct 2005 | A1 |
20050256532 | Nayak et al. | Nov 2005 | A1 |
20050267478 | Corradi et al. | Dec 2005 | A1 |
20050273138 | To et al. | Dec 2005 | A1 |
20050288778 | Shaoulian et al. | Dec 2005 | A1 |
20060004442 | Spenser et al. | Jan 2006 | A1 |
20060004443 | Liddicoat et al. | Jan 2006 | A1 |
20060020326 | Bolduc et al. | Jan 2006 | A9 |
20060020327 | Lashinski et al. | Jan 2006 | A1 |
20060020333 | Lashinski et al. | Jan 2006 | A1 |
20060020336 | Liddicoat | Jan 2006 | A1 |
20060025787 | Morales et al. | Feb 2006 | A1 |
20060025858 | Alameddine | Feb 2006 | A1 |
20060030885 | Hyde | Feb 2006 | A1 |
20060041319 | Taylor et al. | Feb 2006 | A1 |
20060069429 | Spence et al. | Mar 2006 | A1 |
20060074486 | Liddicoat et al. | Apr 2006 | A1 |
20060085012 | Dolan | Apr 2006 | A1 |
20060095009 | Lampropoulos et al. | May 2006 | A1 |
20060106423 | Weisel et al. | May 2006 | A1 |
20060116757 | Lashinski et al. | Jun 2006 | A1 |
20060122633 | To et al. | Jun 2006 | A1 |
20060129166 | Lavelle | Jun 2006 | A1 |
20060142694 | Bednarek et al. | Jun 2006 | A1 |
20060149280 | Harvie et al. | Jul 2006 | A1 |
20060149368 | Spence | Jul 2006 | A1 |
20060161265 | Levine et al. | Jul 2006 | A1 |
20060184240 | Jimenez et al. | Aug 2006 | A1 |
20060184242 | Lichtenstein | Aug 2006 | A1 |
20060195134 | Crittenden | Aug 2006 | A1 |
20060206203 | Yang et al. | Sep 2006 | A1 |
20060241622 | Zergiebel | Oct 2006 | A1 |
20060241656 | Starksen et al. | Oct 2006 | A1 |
20060241748 | Lee et al. | Oct 2006 | A1 |
20060247763 | Slater | Nov 2006 | A1 |
20060259074 | Kelleher et al. | Nov 2006 | A1 |
20060259135 | Navia et al. | Nov 2006 | A1 |
20060271175 | Woolfson et al. | Nov 2006 | A1 |
20060276871 | Lamson et al. | Dec 2006 | A1 |
20060282161 | Huynh et al. | Dec 2006 | A1 |
20060287661 | Bolduc et al. | Dec 2006 | A1 |
20060287716 | Banbury et al. | Dec 2006 | A1 |
20070001627 | Lin et al. | Jan 2007 | A1 |
20070010800 | Weitzner et al. | Jan 2007 | A1 |
20070016287 | Cartledge et al. | Jan 2007 | A1 |
20070016288 | Gurskis et al. | Jan 2007 | A1 |
20070021781 | Jervis et al. | Jan 2007 | A1 |
20070027533 | Douk | Feb 2007 | A1 |
20070027536 | Mihaljevic et al. | Feb 2007 | A1 |
20070032823 | Tegg | Feb 2007 | A1 |
20070038221 | Fine et al. | Feb 2007 | A1 |
20070038293 | St.Goar et al. | Feb 2007 | A1 |
20070038296 | Navia et al. | Feb 2007 | A1 |
20070039425 | Wang | Feb 2007 | A1 |
20070049942 | Hindrichs et al. | Mar 2007 | A1 |
20070049970 | Belef et al. | Mar 2007 | A1 |
20070051377 | Douk et al. | Mar 2007 | A1 |
20070055206 | To et al. | Mar 2007 | A1 |
20070061010 | Hauser et al. | Mar 2007 | A1 |
20070066863 | Rafiee et al. | Mar 2007 | A1 |
20070078297 | Rafiee et al. | Apr 2007 | A1 |
20070080188 | Spence et al. | Apr 2007 | A1 |
20070083168 | Whiting et al. | Apr 2007 | A1 |
20070083235 | Jervis et al. | Apr 2007 | A1 |
20070100427 | Perouse | May 2007 | A1 |
20070106328 | Wardle et al. | May 2007 | A1 |
20070112359 | Kimura et al. | May 2007 | A1 |
20070112422 | Dehdashtian | May 2007 | A1 |
20070118151 | Davidson | May 2007 | A1 |
20070118154 | Crabtree | May 2007 | A1 |
20070118213 | Loulmet | May 2007 | A1 |
20070118215 | Moaddeb | May 2007 | A1 |
20070142907 | Moaddeb et al. | Jun 2007 | A1 |
20070162111 | Fukamachi et al. | Jul 2007 | A1 |
20070173931 | Tremulis et al. | Jul 2007 | A1 |
20070198082 | Kapadia et al. | Aug 2007 | A1 |
20070203391 | Bloom et al. | Aug 2007 | A1 |
20070219558 | Deutsch | Sep 2007 | A1 |
20070239208 | Crawford | Oct 2007 | A1 |
20070255397 | Ryan et al. | Nov 2007 | A1 |
20070255400 | Parravicini et al. | Nov 2007 | A1 |
20070265658 | Nelson et al. | Nov 2007 | A1 |
20070270755 | Von Oepen et al. | Nov 2007 | A1 |
20070276437 | Call et al. | Nov 2007 | A1 |
20070282375 | Hindrichs et al. | Dec 2007 | A1 |
20070282429 | Hauser et al. | Dec 2007 | A1 |
20070295172 | Swartz | Dec 2007 | A1 |
20070299424 | Cumming et al. | Dec 2007 | A1 |
20080004697 | Lichtenstein et al. | Jan 2008 | A1 |
20080027483 | Cartledge et al. | Jan 2008 | A1 |
20080027555 | Hawkins | Jan 2008 | A1 |
20080035160 | Woodson et al. | Feb 2008 | A1 |
20080039935 | Buch et al. | Feb 2008 | A1 |
20080051703 | Thornton et al. | Feb 2008 | A1 |
20080058595 | Snoke et al. | Mar 2008 | A1 |
20080065011 | Marchand et al. | Mar 2008 | A1 |
20080065204 | Macoviak et al. | Mar 2008 | A1 |
20080071366 | Tuval et al. | Mar 2008 | A1 |
20080086138 | Stone et al. | Apr 2008 | A1 |
20080086203 | Roberts | Apr 2008 | A1 |
20080091169 | Heideman et al. | Apr 2008 | A1 |
20080091257 | Andreas et al. | Apr 2008 | A1 |
20080097483 | Ortiz et al. | Apr 2008 | A1 |
20080097523 | Bolduc et al. | Apr 2008 | A1 |
20080103572 | Gerber | May 2008 | A1 |
20080140116 | Bonutti | Jun 2008 | A1 |
20080167713 | Bolling | Jul 2008 | A1 |
20080167714 | St. Goar et al. | Jul 2008 | A1 |
20080177380 | Starksen et al. | Jul 2008 | A1 |
20080195126 | Solem | Aug 2008 | A1 |
20080195200 | Vidlund et al. | Aug 2008 | A1 |
20080208265 | Frazier et al. | Aug 2008 | A1 |
20080221672 | Lamphere et al. | Sep 2008 | A1 |
20080234729 | Page et al. | Sep 2008 | A1 |
20080249467 | Burnett et al. | Oct 2008 | A1 |
20080262480 | Stahler et al. | Oct 2008 | A1 |
20080262609 | Gross et al. | Oct 2008 | A1 |
20080275300 | Rothe et al. | Nov 2008 | A1 |
20080275469 | Fanton et al. | Nov 2008 | A1 |
20080275551 | Alfieri | Nov 2008 | A1 |
20080281353 | Aranyi et al. | Nov 2008 | A1 |
20080281411 | Berreklouw | Nov 2008 | A1 |
20080287862 | Weitzner et al. | Nov 2008 | A1 |
20080288044 | Osborne | Nov 2008 | A1 |
20080288062 | Andrieu et al. | Nov 2008 | A1 |
20080294251 | Annest et al. | Nov 2008 | A1 |
20080300537 | Bowman | Dec 2008 | A1 |
20080300629 | Surti | Dec 2008 | A1 |
20080312506 | Spivey et al. | Dec 2008 | A1 |
20090024110 | Heideman et al. | Jan 2009 | A1 |
20090028670 | Garcia et al. | Jan 2009 | A1 |
20090043381 | Macoviak et al. | Feb 2009 | A1 |
20090054723 | Khairkhahan et al. | Feb 2009 | A1 |
20090054969 | Salahieh et al. | Feb 2009 | A1 |
20090062866 | Jackson | Mar 2009 | A1 |
20090076586 | Hauser et al. | Mar 2009 | A1 |
20090076600 | Quinn | Mar 2009 | A1 |
20090082797 | Fung et al. | Mar 2009 | A1 |
20090088678 | Noda et al. | Apr 2009 | A1 |
20090088837 | Gillinov et al. | Apr 2009 | A1 |
20090093726 | Takayama et al. | Apr 2009 | A1 |
20090093877 | Keidar et al. | Apr 2009 | A1 |
20090099650 | Bolduc et al. | Apr 2009 | A1 |
20090105816 | Olsen et al. | Apr 2009 | A1 |
20090118612 | Grunwald et al. | May 2009 | A1 |
20090125102 | Cartledge et al. | May 2009 | A1 |
20090166913 | Guo et al. | Jul 2009 | A1 |
20090171439 | Nissl | Jul 2009 | A1 |
20090177266 | Powell et al. | Jul 2009 | A1 |
20090177274 | Scorsin et al. | Jul 2009 | A1 |
20090248148 | Shaolian et al. | Oct 2009 | A1 |
20090254103 | Deutsch | Oct 2009 | A1 |
20090264994 | Saadat | Oct 2009 | A1 |
20090287231 | Brooks et al. | Nov 2009 | A1 |
20090287304 | Dahlgren et al. | Nov 2009 | A1 |
20090299409 | Coe et al. | Dec 2009 | A1 |
20090326648 | Machold et al. | Dec 2009 | A1 |
20100001038 | Levin et al. | Jan 2010 | A1 |
20100010538 | Juravic et al. | Jan 2010 | A1 |
20100016655 | Annest et al. | Jan 2010 | A1 |
20100023118 | Medlock et al. | Jan 2010 | A1 |
20100030014 | Ferrazzi | Feb 2010 | A1 |
20100030328 | Seguin et al. | Feb 2010 | A1 |
20100042147 | Janovsky et al. | Feb 2010 | A1 |
20100049213 | Serina et al. | Feb 2010 | A1 |
20100063542 | van der Burg et al. | Mar 2010 | A1 |
20100063550 | Felix et al. | Mar 2010 | A1 |
20100076408 | Krever et al. | Mar 2010 | A1 |
20100076499 | McNamara et al. | Mar 2010 | A1 |
20100094248 | Nguyen et al. | Apr 2010 | A1 |
20100094314 | Hernlund et al. | Apr 2010 | A1 |
20100106141 | Osypka et al. | Apr 2010 | A1 |
20100114180 | Rock et al. | May 2010 | A1 |
20100121349 | Meier et al. | May 2010 | A1 |
20100121435 | Subramanian et al. | May 2010 | A1 |
20100121437 | Subramanian et al. | May 2010 | A1 |
20100130989 | Bourque et al. | May 2010 | A1 |
20100130992 | Machold et al. | May 2010 | A1 |
20100152845 | Bloom et al. | Jun 2010 | A1 |
20100160788 | Davies et al. | Jun 2010 | A1 |
20100161043 | Maisano et al. | Jun 2010 | A1 |
20100168845 | Wright | Jul 2010 | A1 |
20100174358 | Rabkin et al. | Jul 2010 | A1 |
20100179574 | Longoria et al. | Jul 2010 | A1 |
20100217184 | Koblish et al. | Aug 2010 | A1 |
20100217382 | Chau et al. | Aug 2010 | A1 |
20100234935 | Bashiri et al. | Sep 2010 | A1 |
20100249497 | Peine et al. | Sep 2010 | A1 |
20100249908 | Chau et al. | Sep 2010 | A1 |
20100249915 | Zhang | Sep 2010 | A1 |
20100249920 | Bolling et al. | Sep 2010 | A1 |
20100262232 | Annest | Oct 2010 | A1 |
20100262233 | He | Oct 2010 | A1 |
20100274081 | Okoniewski | Oct 2010 | A1 |
20100280605 | Hammer | Nov 2010 | A1 |
20100286628 | Gross | Nov 2010 | A1 |
20100298929 | Thornton et al. | Nov 2010 | A1 |
20100305475 | Hinchliffe et al. | Dec 2010 | A1 |
20100324598 | Anderson | Dec 2010 | A1 |
20110004210 | Johnson et al. | Jan 2011 | A1 |
20110004298 | Lee et al. | Jan 2011 | A1 |
20110009956 | Cartledge et al. | Jan 2011 | A1 |
20110011917 | Loulmet | Jan 2011 | A1 |
20110026208 | Utsuro et al. | Feb 2011 | A1 |
20110029066 | Gilad et al. | Feb 2011 | A1 |
20110035000 | Nieminen et al. | Feb 2011 | A1 |
20110066231 | Cartledge et al. | Mar 2011 | A1 |
20110067770 | Pederson et al. | Mar 2011 | A1 |
20110071626 | Wright et al. | Mar 2011 | A1 |
20110082538 | Dahlgren et al. | Apr 2011 | A1 |
20110087146 | Ryan et al. | Apr 2011 | A1 |
20110093002 | Rucker et al. | Apr 2011 | A1 |
20110118832 | Punjabi | May 2011 | A1 |
20110137410 | Hacohen | Jun 2011 | A1 |
20110144703 | Krause et al. | Jun 2011 | A1 |
20110178537 | Whitman | Jul 2011 | A1 |
20110202130 | Cartledge et al. | Aug 2011 | A1 |
20110208283 | Rust | Aug 2011 | A1 |
20110230941 | Markus | Sep 2011 | A1 |
20110230961 | Langer et al. | Sep 2011 | A1 |
20110238088 | Bolduc et al. | Sep 2011 | A1 |
20110257433 | Walker | Oct 2011 | A1 |
20110257633 | Cartledge et al. | Oct 2011 | A1 |
20110264208 | Duffy et al. | Oct 2011 | A1 |
20110276062 | Bolduc | Nov 2011 | A1 |
20110288435 | Christy et al. | Nov 2011 | A1 |
20110301498 | Maenhout et al. | Dec 2011 | A1 |
20120053628 | Sojka et al. | Mar 2012 | A1 |
20120065464 | Ellis et al. | Mar 2012 | A1 |
20120078355 | Zipory et al. | Mar 2012 | A1 |
20120078359 | Li et al. | Mar 2012 | A1 |
20120089022 | House et al. | Apr 2012 | A1 |
20120089125 | Scheibe et al. | Apr 2012 | A1 |
20120095552 | Spence et al. | Apr 2012 | A1 |
20120109155 | Robinson et al. | May 2012 | A1 |
20120150290 | Gabbay | Jun 2012 | A1 |
20120158021 | Morrill | Jun 2012 | A1 |
20120158023 | Mitelberg et al. | Jun 2012 | A1 |
20120179086 | Shank et al. | Jul 2012 | A1 |
20120191182 | Hauser et al. | Jul 2012 | A1 |
20120226349 | Tuval et al. | Sep 2012 | A1 |
20120239142 | Liu et al. | Sep 2012 | A1 |
20120245604 | Tegzes | Sep 2012 | A1 |
20120271198 | Whittaker et al. | Oct 2012 | A1 |
20120296349 | Smith et al. | Nov 2012 | A1 |
20120296417 | Hill et al. | Nov 2012 | A1 |
20120310330 | Buchbinder et al. | Dec 2012 | A1 |
20120323313 | Seguin | Dec 2012 | A1 |
20130030522 | Rowe et al. | Jan 2013 | A1 |
20130046373 | Cartledge et al. | Feb 2013 | A1 |
20130053884 | Roorda | Feb 2013 | A1 |
20130079873 | Migliazza et al. | Mar 2013 | A1 |
20130085529 | Housman | Apr 2013 | A1 |
20130090724 | Subramanian et al. | Apr 2013 | A1 |
20130096673 | Hill et al. | Apr 2013 | A1 |
20130116776 | Gross et al. | May 2013 | A1 |
20130123910 | Cartledge et al. | May 2013 | A1 |
20130131791 | Hlavka et al. | May 2013 | A1 |
20130165735 | Khairkhahan et al. | Jun 2013 | A1 |
20130166017 | Cartledge et al. | Jun 2013 | A1 |
20130190863 | Call et al. | Jul 2013 | A1 |
20130204361 | Adams et al. | Aug 2013 | A1 |
20130226289 | Shaolian et al. | Aug 2013 | A1 |
20130226290 | Yellin et al. | Aug 2013 | A1 |
20130231701 | Voss et al. | Sep 2013 | A1 |
20130245450 | Prins et al. | Sep 2013 | A1 |
20130268069 | Zakai et al. | Oct 2013 | A1 |
20130282059 | Ketai et al. | Oct 2013 | A1 |
20130289718 | Tsukashima et al. | Oct 2013 | A1 |
20130296902 | Vonderwalde et al. | Nov 2013 | A1 |
20130297013 | Klima et al. | Nov 2013 | A1 |
20130304093 | Serina et al. | Nov 2013 | A1 |
20130310752 | Kawaura | Nov 2013 | A1 |
20130331930 | Rowe et al. | Dec 2013 | A1 |
20140067054 | Chau et al. | Mar 2014 | A1 |
20140081394 | Keranen et al. | Mar 2014 | A1 |
20140088368 | Park | Mar 2014 | A1 |
20140088646 | Wales et al. | Mar 2014 | A1 |
20140094647 | Schweich, Jr. et al. | Apr 2014 | A1 |
20140094826 | Sutherland et al. | Apr 2014 | A1 |
20140094903 | Miller et al. | Apr 2014 | A1 |
20140094906 | Spence et al. | Apr 2014 | A1 |
20140114390 | Tobis et al. | Apr 2014 | A1 |
20140135799 | Henderson | May 2014 | A1 |
20140142619 | Serina et al. | May 2014 | A1 |
20140142695 | Gross et al. | May 2014 | A1 |
20140148849 | Serina et al. | May 2014 | A1 |
20140155783 | Starksen et al. | Jun 2014 | A1 |
20140163670 | Alon et al. | Jun 2014 | A1 |
20140163690 | White | Jun 2014 | A1 |
20140188108 | Goodine et al. | Jul 2014 | A1 |
20140188140 | Meier et al. | Jul 2014 | A1 |
20140188215 | Hlavka et al. | Jul 2014 | A1 |
20140194976 | Starksen et al. | Jul 2014 | A1 |
20140207231 | Hacohen et al. | Jul 2014 | A1 |
20140243859 | Robinson | Aug 2014 | A1 |
20140243894 | Groothuis et al. | Aug 2014 | A1 |
20140243963 | Sheps et al. | Aug 2014 | A1 |
20140251042 | Asselin et al. | Sep 2014 | A1 |
20140275757 | Goodwin et al. | Sep 2014 | A1 |
20140276648 | Hammer et al. | Sep 2014 | A1 |
20140296962 | Cartledge et al. | Oct 2014 | A1 |
20140303649 | Nguyen et al. | Oct 2014 | A1 |
20140303720 | Sugimoto et al. | Oct 2014 | A1 |
20140309661 | Sheps et al. | Oct 2014 | A1 |
20140309730 | Alon et al. | Oct 2014 | A1 |
20140343668 | Zipory et al. | Nov 2014 | A1 |
20140350660 | Cocks et al. | Nov 2014 | A1 |
20140379006 | Sutherland et al. | Dec 2014 | A1 |
20150018876 | Ewers et al. | Jan 2015 | A1 |
20150018940 | Quill et al. | Jan 2015 | A1 |
20150051697 | Spence et al. | Feb 2015 | A1 |
20150081014 | Gross et al. | Mar 2015 | A1 |
20150094800 | Chawla | Apr 2015 | A1 |
20150100116 | Mohl et al. | Apr 2015 | A1 |
20150112432 | Reich et al. | Apr 2015 | A1 |
20150127097 | Neumann et al. | May 2015 | A1 |
20150133997 | Deitch et al. | May 2015 | A1 |
20150134055 | Spence et al. | May 2015 | A1 |
20150182336 | Zipory et al. | Jul 2015 | A1 |
20150230919 | Chau et al. | Aug 2015 | A1 |
20150272586 | Herman et al. | Oct 2015 | A1 |
20150272734 | Sheps et al. | Oct 2015 | A1 |
20150282931 | Brunnett et al. | Oct 2015 | A1 |
20150335430 | Loulmet et al. | Nov 2015 | A1 |
20150351910 | Gilmore et al. | Dec 2015 | A1 |
20160008132 | Cabiri | Jan 2016 | A1 |
20160015517 | Sutherland et al. | Jan 2016 | A1 |
20160058557 | Reich et al. | Mar 2016 | A1 |
20160113767 | Miller et al. | Apr 2016 | A1 |
20160120642 | Shaolian et al. | May 2016 | A1 |
20160120645 | Alon | May 2016 | A1 |
20160158008 | Miller et al. | Jun 2016 | A1 |
20160242762 | Gilmore et al. | Aug 2016 | A1 |
20160262755 | Zipory et al. | Sep 2016 | A1 |
20160270916 | Cahalane et al. | Sep 2016 | A1 |
20160302917 | Schewel | Oct 2016 | A1 |
20160317302 | Madjarov et al. | Nov 2016 | A1 |
20160354076 | Groothuis et al. | Dec 2016 | A1 |
20160361058 | Bolduc et al. | Dec 2016 | A1 |
20160361159 | Huber | Dec 2016 | A1 |
20160361168 | Gross et al. | Dec 2016 | A1 |
20160361169 | Gross et al. | Dec 2016 | A1 |
20170000609 | Gross et al. | Jan 2017 | A1 |
20170042670 | Shaolian et al. | Feb 2017 | A1 |
20170135817 | Tylis et al. | May 2017 | A1 |
20170189034 | Sutherland et al. | Jul 2017 | A1 |
20170224489 | Starksen et al. | Aug 2017 | A1 |
20170245850 | Call et al. | Aug 2017 | A1 |
20170245993 | Gross et al. | Aug 2017 | A1 |
20180008409 | Kutzik et al. | Jan 2018 | A1 |
20180049875 | Iflah et al. | Feb 2018 | A1 |
20180168803 | Pesce et al. | Jun 2018 | A1 |
20180228608 | Sheps et al. | Aug 2018 | A1 |
20180256334 | Sheps et al. | Sep 2018 | A1 |
20180289480 | D'ambra et al. | Oct 2018 | A1 |
20180318080 | Quill et al. | Nov 2018 | A1 |
20180318083 | Bolling et al. | Nov 2018 | A1 |
20190029498 | Mankowski et al. | Jan 2019 | A1 |
20190038411 | Alon | Feb 2019 | A1 |
20190111239 | Bolduc et al. | Apr 2019 | A1 |
20190117400 | Medema et al. | Apr 2019 | A1 |
20190125325 | Sheps et al. | May 2019 | A1 |
20190151093 | Keidar et al. | May 2019 | A1 |
20190175346 | Schaffner et al. | Jun 2019 | A1 |
20190183648 | Trapp et al. | Jun 2019 | A1 |
20190290260 | Caffes et al. | Sep 2019 | A1 |
20190290431 | Genovese et al. | Sep 2019 | A1 |
20190321049 | Herman et al. | Oct 2019 | A1 |
20190343633 | Garvin et al. | Nov 2019 | A1 |
20200015971 | Brauon et al. | Jan 2020 | A1 |
20200289267 | Peleg et al. | Sep 2020 | A1 |
20200337840 | Reich | Oct 2020 | A1 |
20210015475 | Lau | Jan 2021 | A1 |
20210093453 | Peleg et al. | Apr 2021 | A1 |
Number | Date | Country |
---|---|---|
1034753 | Sep 2000 | EP |
3531975 | Sep 2019 | EP |
9205093 | Apr 1992 | WO |
9846149 | Oct 1998 | WO |
02085250 | Feb 2003 | WO |
03047467 | Jun 2003 | WO |
2005102181 | Nov 2005 | WO |
2010000454 | Jan 2010 | WO |
2012176195 | Mar 2013 | WO |
2014064964 | May 2014 | WO |
2014134624 | Sep 2014 | WO |
2019145941 | Aug 2019 | WO |
2019145947 | Aug 2019 | WO |
2019182645 | Sep 2019 | WO |
2019224814 | Nov 2019 | WO |
2020240282 | Dec 2020 | WO |
2021014440 | Jan 2021 | WO |
2021038559 | Mar 2021 | WO |
2021038560 | Mar 2021 | WO |
Entry |
---|
Herlambang, et al., Realtime Integral Videography Using Intra-Operative 3-D Ultrasound for Minimally Invasive Heart Surgery. |
Flato et al., Ultrasound-Guided Venous Cannulation in a Critical Care Unit, Rev. bras. ter. intensiva vol. 21 No. 2 São Paulo Apr./Jun. 2009, pp. 1-11. |
Int'. Search Report for PCT/US2016/062581, Completed Mar. 3, 2017. |
Int'l. Search Report for PCT/US2016/062556, Completed Feb. 27, 2017. |
Agarwal et al. International Cardiology Perspective Functional Tricuspid Regurgitation, Circ Cardiovasc Interv 2009:2;2;565-573 (2009). |
Ahmadi, A., G. Spiliner, and Th Johannesson, “Hemodynamic changes following experimental production and correction of acute mitral regurgitation with an adjustable ring prosthesis.” The Thoracic and cardiovascular surgeon36.06 (1988): 313-319. |
Ahmadi, Ali et al. “Percutaneously adjustable pulmonary artery band.” The Annals of thoracic surgery 60 (1995): S520-S522. |
Alfieri et al. “Novel Suture Device for Beating-Heart Mitral Leaflet Approximation”, Ann Thorac Surg. 2002, 74:1488-1493. |
Alfieri et al., “An effective technique to correct anterior mitral leaflet prolapse,” J Card 14(6):468-470 (1999). |
Alfieri, “The edge-to-edge repair of the mitral valve,” [Abstract] 6th Annual NewEra Cardiac Care: Innovation & Technology, Heart Surgery Forum pp. 103. (2000). |
Amplatzer Cardiac Plug brochure (English pages), AGA Medical Corporation (Plymouth, MN) (copyright 2008-2010, downloaded Jan. 11, 2011). |
AMPLATZER® Cribriform Occluder. A patient guide to Percutaneous, Transcatheter, Atrial Septal Defect Closuer, AGA Medical Corporation, Apr. 2008. |
AMPLATZER® Septal Occluder. A patient guide to the Non-Surgicai Closuer of the Atrial Septal Defect Using the AMPLATZER Septal Occluder System, AGA Medical Corporation, Apr. 2008. |
Assad, Renato S. “Adjustable Pulmonary Artery Banding.” (2014). |
Brennan, Jennifer, 510(k) Summary of safety and effectiveness, Jan. 2008. |
Daebritz, S. et al. “Experience with an adjustable pulmonary artery banding device in two cases: initial success-midterm failure.” The Thoracic and cardiovascular surgeon 47.01 (1999): 51-52. |
Dang NC et al. “Simplified Placement of Multiple Artificial Mitral Valve Chords,” The Heart Surgery Forum #2005-1005, 8 (3) (2005). |
Dictionary.com definition of “lock”, Jul. 29, 2013. |
Dieter RS, “Percutaneous valve repair: Update on mitral regurgitation and endovascular approaches to the mitral valve,” Applications in Imaging, Cardiac Interventions, Supported by an educational grant from Amersham Health pp. 11-14 (2003). |
Elliott, Daniel S., Gerald W. Timm, and David M. Barrett. “An implantable mechanical urinary sphincter: a new nonhydraulic design concept.” Urology52.6 (1998): 1151-1154. |
Langer et al. Ring plus String; Papillary muscle repositioning as an adjunctive repair technique for ischemic mitral regurgitation, The Journal of Thoracic Cardiovascular surgery vol. 133 No. 1, Jan. 2007. |
Langer et al. RING+STRING, Successful Repair technique for ischemic mitral regurgitation with severe leaflet Tethering, The Department of Thoracic Caridovascular surgery, Hamburg, Germany, Nov. 2008. |
Maisano, “The double-orifice technique as a standardized approach to treat mitral,” European Journal of Cardio-thoracic Surgery 17 (2000) 201-205. |
O'Reilly S et al., “Heart valve surgery pushes the envelope,” Medtech Insight 8(3): 73, 99-108 (2006). |
Odell JA et al., “Early Results o4yf a Simplified Method of Mitral Valve Annuloplasty,” Circulation 92:150-154 (1995). |
Park, Sang C. et al. “A percutaneously adjustable device for banding of the pulmonary trunk.” International journal of cardiology 9.4 (1985): 477-484. |
Swain CP et al., “An endoscopically deliverable tissue-transfixing device for securing biosensors in the gastrointestinal tract,” Gastrointestinal Endoscopy 40(6): 730-734 (1994). |
Swenson, O. An experimental implantable urinary sphincter. Invest Urol. Sep. 1976;14(2):100-3. |
Swenson, O. and Malinin, T.I., 1978. An improved mechanical device for control of urinary incontinence. Investigative urology, 15(5), pp. 389-391. |
Swenson, Orvar. “Internal device for control of urinary incontinence.” Journal of pediatric surgery 7.5 (19/2): 542-545. |
Tajik, Abdul. “Two dimensional real-time ultrasonic imaging of the heart and great vessels”, Mayo Clin Proc. vol. 53:271-303, 1978. |
Number | Date | Country | |
---|---|---|---|
20190151093 A1 | May 2019 | US |
Number | Date | Country | |
---|---|---|---|
62588813 | Nov 2017 | US |