Patent US20020161443A1 successfully refreshed from Google Patents.
US20040102841A1
Expired / Lapsed
US
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Percutaneous mitral annuloplasty with cardiac rhythm management
Assignee: Edwards Lifesciences AG
•
Filing: 2003-11-17
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Granted: —
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Expires: 2023-11-17
Abstract
Abstract An implantable device is positioned within the coronary sinus and tightened around the mitral annulus to reduce mitral valve regurgitation. The device carries at least one electrode, in electronic communication with a cardiac rhythm management device.
Inventors
- 👤 Jonathan Langberg
- 👤 Michael Lesh
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 14:59
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2442; A61F2/2451; A61F2/2466; A61N; A61N1/00; A61N1/02; A61N1/04; A61N1/05; A61N1/056; A61N2001/0585
Claims Analysis
Total Claims: 53
Claim 1
Independent Claim
46 words
1 . A method of treating a patient, comprising the steps of: transluminally advancing a prosthesis into the coronary sinus; manipulating the prosthesis to exert a compressive force on the mitral valve annulus; and conducting a signal to the prosthesis from a cardiac rhythm management device.
Claim 2
Dependent Claim
46 words
1 . A method of treating a patient, comprising the steps of: transluminally advancing a prosthesis into the coronary sinus; manipulating the prosthesis to exert a compressive force on the mitral valve annulus; and conducting a signal to the prosthesis from a cardiac rhythm management device.
Claim 3
Dependent Claim
33 words
2 . A method as in claim 1 , wherein the conducting step comprises conducting a signal from the cardiac rhythm management device to at least one electrically conductive element on the prosthesis.
Claim 4
Dependent Claim
34 words
3 . A method as in claim 1 , wherein the conducting step comprises conducting a signal from the cardiac rhythm management device to at least one electrically conductive annular band on the prosthesis.
Claim 5
Dependent Claim
37 words
4 . A method as in claim 1 , wherein the conducting step comprises conducting a signal from the cardiac rhythm management device to at least one externally facing electrically conductive axially extending strip on the prosthesis.
Claim 6
Dependent Claim
19 words
5 . A method as in claim 1 , additionally comprising monitoring hemodynamic function prior to the manipulation step.
Claim 7
Dependent Claim
18 words
6 . A method as in claim 1 , additionally comprising monitoring hemodynamic function during the manipulation step.
Claim 8
Dependent Claim
18 words
7 . A method as in claim 1 , additionally comprising monitoring hemodynamic function following the manipulation step.
Claim 9
Dependent Claim
25 words
8 . A method as in claim 1 , further comprising the step of percutaneously accessing the venous system prior to the transluminally advancing step.
Claim 10
Dependent Claim
26 words
9 . A method as in claim 5 , wherein the accessing step is accomplished by accessing one of the internal jugular, subclavian or femoral veins.
Claim 11
Dependent Claim
28 words
10 . A method as in claim 1 , wherein the manipulating step comprises axially moving a forming element with respect to the prosthesis, to bend the prosthesis.
Claim 12
Dependent Claim
31 words
11 . A method as in claim 1 , further comprising the steps of first measuring the coronary sinus and then selecting an appropriately sized prosthesis prior to the inserting step.
Claim 13
Dependent Claim
22 words
12 . A method as in claim 6 , wherein the step of monitoring hemodynamic function is accomplished using transesophageal echo cardiography.
Claim 14
Dependent Claim
23 words
13 . A method as in claim 6 , wherein the step of monitoring hemodynamic function is accomplished using surface echo cardiographic imaging.
Claim 15
Dependent Claim
23 words
14 . A method as in claim 6 , wherein the step of monitoring hemodynamic function is accomplished using intracardiac echo cardiographic imaging.
Claim 16
Dependent Claim
23 words
15 . A method as in claim 6 , wherein the step of monitoring hemodynamic function is accomplished using fluoroscopy with radiocontrast media.
Claim 17
Dependent Claim
27 words
16 . A method as in claim 6 , wherein the step of monitoring hemodynamic function is accomplished using left atrial or pulmonary capillary wedge pressure measurements.
Claim 18
Dependent Claim
26 words
17 . A method as in claim 6 , further comprising the step of determining an ongoing drug therapy taking into account post implantation hemodynamic function.
Claim 19
Dependent Claim
88 words
18 . A method of remodeling a mitral valve annulus to reduce mitral valve regurgitation, comprising the steps of: providing a prosthesis which is adjustable between a first configuration for transluminal deployment within the coronary sinus and a second configuration for exerting a compressive force against the mitral valve annulus from within the coronary sinus; transluminally advancing the prosthesis to a position at least partially within the coronary sinus; manipulating the prosthesis to reduce mitral valve regurgitation; and placing the prosthesis into electrical communication with a pacing source.
Claim 20
Dependent Claim
88 words
18 . A method of remodeling a mitral valve annulus to reduce mitral valve regurgitation, comprising the steps of: providing a prosthesis which is adjustable between a first configuration for transluminal deployment within the coronary sinus and a second configuration for exerting a compressive force against the mitral valve annulus from within the coronary sinus; transluminally advancing the prosthesis to a position at least partially within the coronary sinus; manipulating the prosthesis to reduce mitral valve regurgitation; and placing the prosthesis into electrical communication with a pacing source.
Claim 21
Dependent Claim
17 words
19 . A method as in claim 18 , additionally comprising the step of monitoring the regurgitation.
Claim 22
Dependent Claim
24 words
20 . A method as in claim 19 , wherein the monitoring step comprises monitoring the degree of regurgitation prior to the tightening step.
Claim 23
Dependent Claim
23 words
21 . A method as in claim 19 , wherein the monitoring step comprises monitoring the degree of regurgitation during the tightening step.
Claim 24
Dependent Claim
23 words
22 . A method as in claim 19 , wherein the monitoring step comprises monitoring the degree of regurgitation following the tightening step.
Claim 25
Dependent Claim
30 words
23 . A method of remodeling a mitral valve annulus as in claim 19 , wherein sufficient tightening is accomplished to achieve at least a one grade reduction in regurgitation.
Claim 26
Dependent Claim
82 words
24 . A medical apparatus for remodeling a mitral valve annulus adjacent to the coronary sinus, comprising: an elongate body, movable between a first configuration for transluminal delivery to at least a portion of the coronary sinus and a second configuration for remodeling the mitral valve annulus from within the coronary sinus; a forming element attached to the elongate body for manipulating the elongate body between the first transluminal configuration and the second remodeling configuration; and an electrode, carried by the body.
Claim 27
Dependent Claim
82 words
24 . A medical apparatus for remodeling a mitral valve annulus adjacent to the coronary sinus, comprising: an elongate body, movable between a first configuration for transluminal delivery to at least a portion of the coronary sinus and a second configuration for remodeling the mitral valve annulus from within the coronary sinus; a forming element attached to the elongate body for manipulating the elongate body between the first transluminal configuration and the second remodeling configuration; and an electrode, carried by the body.
Claim 28
Dependent Claim
18 words
25 . The medical apparatus according to claim 24 , wherein the electrode comprises an axially extending strip.
Claim 29
Dependent Claim
17 words
26 . The medical apparatus according to claim 24 , wherein the electrode comprises an annular band.
Claim 30
Dependent Claim
22 words
27 . The medical apparatus according to claim 24 , further comprising at least one electrical conductor extending away from the body.
Claim 31
Dependent Claim
22 words
28 . The medical apparatus according to claim 27 , further comprising a pacing source in electrical communication with the electrical conductor.
Claim 32
Dependent Claim
24 words
29 . The medical apparatus according to claim 27 , further comprising a cardiac rhythm management device in electrical communication with the electrical conductor.
Claim 33
Dependent Claim
22 words
30 . The medical apparatus according to claim 27 , further comprising a diagnostic instrument in electrical communication with the electrical conductor.
Claim 34
Dependent Claim
53 words
31 . The medical apparatus according to claim 24 , wherein the forming element is secured to the elongate body at a point of attachment and the forming element is movable relative to the elongate body in order to adjust the elongate body within the coronary sinus between the first and second configurations.
Claim 35
Dependent Claim
22 words
32 . The medical apparatus according to claim 24 , wherein the elongate body defines an arc when in the remodeling configuration.
Claim 36
Dependent Claim
36 words
33 . The medical apparatus according to claim 32 , wherein a best fit constant radius curve corresponding to the arc has a radius within the range of from about 10 mm to about 20 mm.
Claim 37
Dependent Claim
22 words
34 . The medical apparatus according to claim 24 , further comprising a lock, for retaining the body in the second configuration.
Claim 38
Dependent Claim
17 words
35 . The medical apparatus according to claim 34 , wherein the lock comprises an interference fit.
Claim 39
Dependent Claim
30 words
36 . The medical apparatus according to claim 34 , wherein the lock comprises an engagement surface, which is movable between a first, disengaged configuration and a second, engaged configuration.
Claim 40
Dependent Claim
17 words
37 . The medical apparatus according to claim 24 , further comprising a coating on the body.
Claim 41
Dependent Claim
32 words
38 . The medical apparatus according to claim 24 , wherein the apparatus is movable from the implantation configuration to the remodeling configuration in response to proximal retraction of the forming element.
Claim 42
Dependent Claim
32 words
39 . The medical apparatus according to claim 24 , wherein the apparatus is movable from the implantation configuration to the remodeling configuration in response to distal advancement of the forming element.
Claim 43
Dependent Claim
25 words
40 . The medical apparatus according to claim 24 , further comprising an anchor for retaining the apparatus at a deployment site within a vessel.
Claim 44
Dependent Claim
20 words
41 . The medical apparatus according to claim 40 , wherein the anchor comprises a distal extension of the apparatus.
Claim 45
Dependent Claim
26 words
42 . The medical apparatus according to claim 40 , wherein the anchor comprises a friction enhancing surface structure for engaging the wall of the vessel.
Claim 46
Dependent Claim
25 words
43 . The medical apparatus according to claim 40 , wherein the anchor comprises at least one barb for piercing the wall of the vessel.
Claim 47
Dependent Claim
24 words
44 . The medical apparatus according to claim 40 , wherein the apparatus has an axial length of no more than about 10 cm.
Claim 48
Dependent Claim
26 words
45 . The medical apparatus according to claim 24 , wherein the maximum cross sectional dimension through the apparatus is no more than about 10 mm.
Claim 49
Dependent Claim
24 words
46 . The medical apparatus according to claim 24 , further comprising an axially extending support in the body, attached to the forming element.
Claim 50
Dependent Claim
79 words
47 . A method of treating a patient, comprising the steps of conducting a signal from a cardiac rhythm management device to a prosthesis in the coronary sinus, the prosthesis comprising an elongate body, movable between a first configuration for transluminal delivery to at least a portion of the coronary sinus and a second configuration for remodeling the mitral valve annulus from within the coronary sinus, and an electrode for receiving the signal from the cardiac rhythm management device.
Claim 51
Dependent Claim
79 words
47 . A method of treating a patient, comprising the steps of conducting a signal from a cardiac rhythm management device to a prosthesis in the coronary sinus, the prosthesis comprising an elongate body, movable between a first configuration for transluminal delivery to at least a portion of the coronary sinus and a second configuration for remodeling the mitral valve annulus from within the coronary sinus, and an electrode for receiving the signal from the cardiac rhythm management device.
Claim 52
Dependent Claim
34 words
48 . A method as in claim 47 , wherein the conducting step comprises conducting a signal from the cardiac rhythm management device to at least one electrically conductive annular band on the prosthesis.
Claim 53
Dependent Claim
35 words
49 . A method as in claim 47 , wherein the conducting step comprises conducting a signal from the cardiac rhythm management device to at least one electrically conductive axially extending strip on the prosthesis.
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