US20040176840A1
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US
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Percutaneous mitral annuloplasty with hemodynamic monitoring
Assignee: Edwards Lifesciences AG
•
Filing: 2004-03-23
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Granted: —
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Expires: 2024-03-23
Abstract
Abstract A minimally invasive method of performing mitral annuloplasty is disclosed. An implantable device is positioned within the coronary sinus and tightened around the mitral annulus. Mitral valve regurgitation is monitored before, during, and/or after the tightening step. An on-going drug therapy may be determined, taking into account post-implantation hemodynamic function.
Inventors
- 👤 Jonathan Langberg
- 👤 Michael Lesh
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 12:41
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: 39
Claim 1
Independent Claim
51 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; monitoring hemodynamic function to assess mitral valve regurgitation; and adjusting the prosthesis in response to the monitoring step.
Claim 2
Dependent Claim
51 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; monitoring hemodynamic function to assess mitral valve regurgitation; and adjusting the prosthesis in response to the monitoring step.
Claim 3
Dependent Claim
25 words
2 . A method as in claim 1 , further comprising the step of percutaneously accessing the venous system prior to the transluminally advancing step.
Claim 4
Dependent Claim
26 words
3 . A method as in claim 2 , wherein the accessing step is accomplished by accessing one of the internal jugular, subclavian or femoral veins.
Claim 5
Dependent Claim
28 words
4 . 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 6
Dependent Claim
19 words
5 . A method as in claim 1 , wherein the transluminally advancing step is accomplished using a catheter.
Claim 7
Dependent Claim
29 words
6 . A method as in claim 1 , further comprising the step of locking the prosthesis to retain a compressive force on the annulus following the adjusting step.
Claim 8
Dependent Claim
26 words
7 . A method as in claim 6 , wherein the locking step comprises moving an engagement surface from a disengaged configuration to an engaged configuration.
Claim 9
Dependent Claim
18 words
8 . A method as in claim 6 , wherein the locking step comprises providing an interference fit.
Claim 10
Dependent Claim
18 words
9 . A method as in claim 6 , wherein the locking step comprises providing an adhesive bond.
Claim 11
Dependent Claim
17 words
10 . A method as in claim 6 , wherein the locking step comprises providing a knot.
Claim 12
Dependent Claim
18 words
11 . A method as in claim 6 , wherein the locking step comprises providing a compression fit.
Claim 13
Dependent Claim
31 words
12 . 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 advancing step.
Claim 14
Dependent Claim
22 words
13 . A method as in claim 1 , wherein the step of monitoring hemodynamic function is accomplished using transesophageal echo cardiography.
Claim 15
Dependent Claim
23 words
14 . A method as in claim 1 , wherein the step of monitoring hemodynamic function is accomplished using surface echo cardiographic imaging.
Claim 16
Dependent Claim
23 words
15 . A method as in claim 1 , wherein the step of monitoring hemodynamic function is accomplished using intracardiac echo cardiographic imaging.
Claim 17
Dependent Claim
23 words
16 . A method as in claim 1 , wherein the step of monitoring hemodynamic function is accomplished using fluoroscopy with radiocontrast media.
Claim 18
Dependent Claim
27 words
17 . A method as in claim 1 , wherein the step of monitoring hemodynamic function is accomplished using left atrial or pulmonary capillary wedge pressure measurements.
Claim 19
Dependent Claim
26 words
18 . A method as in claim 1 , further comprising the step of determining an ongoing drug therapy taking into account post implantation hemodynamic function.
Claim 20
Dependent Claim
84 words
19 . 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 positioning adjacent the mitral valve annulus and a second configuration for exerting a compressive force against the mitral valve annulus; advancing the prosthesis to a position adjacent the mitral valve annulus; manipulating the prosthesis to reduce mitral valve regurgitation; monitoring the degree of regurgitation; and adjusting the prosthesis in response to the monitoring step.
Claim 21
Dependent Claim
84 words
19 . 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 positioning adjacent the mitral valve annulus and a second configuration for exerting a compressive force against the mitral valve annulus; advancing the prosthesis to a position adjacent the mitral valve annulus; manipulating the prosthesis to reduce mitral valve regurgitation; monitoring the degree of regurgitation; and adjusting the prosthesis in response to the monitoring step.
Claim 22
Dependent Claim
30 words
20 . 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 23
Dependent Claim
25 words
21 . A method as in claim 19 , further comprising the step of percutaneously accessing the venous system prior to the transluminally advancing step.
Claim 24
Dependent Claim
26 words
22 . A method as in claim 21 , wherein the accessing step is accomplished by accessing one of the internal jugular, subclavian or femoral veins.
Claim 25
Dependent Claim
28 words
23 . A method as in claim 19 , wherein the tightening step comprises axially moving a forming element with respect to the prosthesis, to bend the prosthesis.
Claim 26
Dependent Claim
29 words
24 . A method as in claim 19 , further comprising the step of locking the prosthesis to retain a compressive force on the annulus following the tightening step.
Claim 27
Dependent Claim
26 words
25 . A method as in claim 24 , wherein the locking step comprises moving an engagement surface from a disengaged configuration to an engaged configuration.
Claim 28
Dependent Claim
18 words
26 . A method as in claim 24 , wherein the locking step comprises providing an interference fit.
Claim 29
Dependent Claim
18 words
27 . A method as in claim 24 , wherein the locking step comprises providing an adhesive bond.
Claim 30
Dependent Claim
17 words
28 . A method as in claim 24 , wherein the locking step comprises providing a knot.
Claim 31
Dependent Claim
18 words
29 . A method as in claim 24 , wherein the locking step comprises providing a compression fit.
Claim 32
Dependent Claim
32 words
30 . A method as in claim 19 , further comprising the steps of first measuring the coronary sinus and then selecting an appropriately sized prosthesis prior to the transluminally advancing step.
Claim 33
Dependent Claim
19 words
31 . A method as in claim 19 , wherein the monitoring step is accomplished using transesophageal echo cardiography.
Claim 34
Dependent Claim
20 words
32 . A method as in claim 19 , wherein the monitoring step is accomplished using surface echo cardiographic imaging.
Claim 35
Dependent Claim
20 words
33 . A method as in claim 19 , wherein the monitoring step is accomplished using intracardiac echo cardiographic imaging.
Claim 36
Dependent Claim
20 words
34 . A method as in claim 19 , wherein the monitoring step is accomplished using fluoroscopy with radiocontrast media.
Claim 37
Dependent Claim
24 words
35 . A method as in claim 19 , wherein the monitoring step is accomplished using left atrial or pulmonary capillary wedge pressure measurements.
Claim 38
Dependent Claim
26 words
36 . A method as in claim 19 , further comprising the step of determining an ongoing drug therapy taking into account post implantation hemodynamic function.
Claim 39
Dependent Claim
27 words
37 . A method as in claim 36 , comprising measuring residual regurgitation following implantation and formulating an ongoing drug therapy taking into account the residual regurgitation.
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