Claims
- 1. A method of treating a patient at risk of loss of cardiac function by cardiac ischemia, comprising
(a) imaging the patient's heart, or a portion thereof, to identify (i) an underperfused region of cardiac muscle, (ii) a source of oxygenated blood that is proximate a boundary of the underperfused region, and (ii) a target area that includes said underperfused region boundary and a tissue expanse lying between said oxygenated blood supply and said boundary; and (b) at each of a plurality of sites throughout the target area, applying a tool effective to produce an annulus of injury about a core of healthy cells in the myocardial layer of the heart.
- 2. The method of claim 1, wherein the diameter of core of healthy tissue in the myocardial layer has a dimension of between about 1-4 mm.
- 3. The method of claim 1, wherein step (b) is carried out with a cutting tool that has a distal tissue-piercing end, and an annular cutting edge, by cutting through the epicardial or endocardial region of heart, to a depth of 1-4 mm into the underlying myocardium.
- 4. The method of claim 1, wherein step (b) is carried out with a cutting tool that has a distal tissue-piercing end, and a plurality of retractable cutting elements arrayed about said end, where the cutting elements can be retracted for insertion of the cutting tool into said target site, and deployed once in the target site.
- 5. The method of claim 1, wherein step (b) is carried out with a macerating tool that has (i) a distal tissue-piercing conical end piece defining a plurality of fluid-dispensing openings, and (ii) a fluid-injection conduit communicating with the end piece, wherein fluid supplied to the conduit under pressure, when the tool is positioned in the myocardium of the heart, is effective to produce tissue maceration in the vicinity of the end-piece openings.
- 6. A tool for use in stimulating angiogenesis in a patient's heart, comprising
a tapered tissue-piercing portion adapted to pierce a selected target site in the heart, injury producing elements that are disposed or can be deployed in a 1-4 mm inner-diameter annulus about the tissue piercing portion, and a handle operatively connected to the tissue-piercing portion and injury-producing elements, for use in (i) placing the tissue-piercing portion at a selected target site outside the heart (ii) inserting said portion into the site, to a depth which disposes the injury-producing elements within the upper 1-3 mm of the myocardium, and (iii) manipulating the tool to effect an annulus of tissue injury within the myocardium.
- 7. The tool of claim 6, wherein the injury-producing elements include a serrated annulus disposed about the tissue-piercing portion.
- 8. The tool of claim 6, wherein the injury-producing elements include a plurality of blades that are retractable into said handle, during initial piercing at the target site, and extendable within the site.
- 9. The tool of claim 6, wherein the tissue-piercing portion is a conical end piece and said injury-producing elements include (i) a plurality of fluid-dispensing openings formed in said end piece, and a fluid-conduit mounted on said handle and communicating with said openings, wherein fluid introduced under pressure through said conduit is effective to macerate myocardial tissue when the tool is placed at a target site.
Parent Case Info
[0001] This application claims priority of U.S. Provisional Patent Application Serial No. 60/163,704 filed on Nov. 5, 1999, herein incorporated in its entirety by reference.
Provisional Applications (1)
|
Number |
Date |
Country |
|
60163704 |
Nov 1999 |
US |
Divisions (1)
|
Number |
Date |
Country |
Parent |
09706016 |
Nov 2000 |
US |
Child |
10304025 |
Nov 2002 |
US |