초록 ▼

Systems and methods for treating cardiac tissue are disclosed. A method in accordance with one embodiment of the invention is directed to treating cardiac tissue that includes a primum, a secundum adjacent to the primum, and a patent foramen ovale (PFO). The method can include shrinking the primum a

Systems and methods for treating cardiac tissue are disclosed. A method in accordance with one embodiment of the invention is directed to treating cardiac tissue that includes a primum, a secundum adjacent to the primum, and a patent foramen ovale (PFO). The method can include shrinking the primum at a first location spaced apart from the PFO, and at least partially sealing the PFO by applying energy at a second location at least closer to the PFO than the first location. A variety of techniques, including vacuum, mechanical, chemical, RF energy and ultrasound can be used to shrink the primum. In at least some embodiments, shrinking the primum can be performed independently of whether a PFO is also sealed, for example, if the patient receiving the treatment does not have a PFO.

대표청구항 ▼

I claim: 1. A method for treating cardiac tissue, the cardiac tissue including a primum, a secundum adjacent to the primum, and a patent foramen ovale, the method comprising: shrinking the primum at a first location spaced apart from the patent foramen ovale; and at least partially sealing the pate

I claim: 1. A method for treating cardiac tissue, the cardiac tissue including a primum, a secundum adjacent to the primum, and a patent foramen ovale, the method comprising: shrinking the primum at a first location spaced apart from the patent foramen ovale; and at least partially sealing the patent foramen ovale by applying energy at a second location at least closer to the patent foramen ovale than the first location. 2. The method of claim 1 wherein at least partially sealing the patent foramen ovale includes at least partially sealing the patent foramen ovale without simultaneously shrinking the primum at the first location. 3. The method of claim 1 wherein at least partially sealing the patent foramen ovale includes at least partially sealing the patent foramen ovale after shrinking the primum. 4. The method of claim 1 wherein at least partially sealing the patent foramen ovale includes at least partially sealing the patent foramen ovale before shrinking the primum. 5. The method of claim 1 wherein shrinking the primum includes tightening the primum. 6. The method of claim 1 wherein shrinking the primum includes heating the primum. 7. The method of claim 1 wherein shrinking the primum includes drawing portions of the primum together and fastening the portions with a mechanical fastener. 8. The method of claim 7 wherein fastening the portions includes fastening the portions with an adhesive. 9. The method of claim 1 wherein shrinking the primum includes exposing the primum to a chemical agent. 10. The method of claim 1 wherein shrinking the primum includes directing ultrasonic energy to the primum. 11. The method of claim 1, further comprising applying a vacuum to a first section and a second section of the primum to fold at least one of the first and second sections against the other, and wherein shrinking the primum includes applying heat to the first and second sections to fuse the first and second sections while the first and second sections are in contact with each other. 12. The method of claim 1 wherein shrinking the primum includes: placing an inflatable member against the primum, the inflatable member having at least one electrode; and applying energy to the at least one electrode. 13. The method of claim 1 wherein shrinking the primum includes placing multiple bi-polar electrodes against the primum and directing current to the electrodes. 14. The method of claim 1 wherein shrinking the primum includes placing at least one of a side surface and an end surface of an elongated electrode in contact with the primum, and passing an electrical current through the electrode. 15. The method of claim 1 wherein shrinking the primum includes placing an electrode in contact with the primum and passing electrical current through the electrode, and wherein the method further comprises bending and straightening a catheter working portion that includes the electrode so as to scan the electrode over the primum and shrink the primum at multiple locations. 16. The method of claim 1, further comprising clamping first and second sections of the primum between a first member and a second member to fold the first and second sections against each other, and wherein shrinking the primum includes heating the first and second sections with the first and second members while the first and second sections are in contact with each other. 17. The method of claim 1 wherein at least partially sealing the patent foramen ovale includes: inserting a portion of a catheter into the patent foramen ovale; drawing the primum and secundum into contact with each other by drawing a vacuum in a region adjacent to the primum and secundum via the catheter while the catheter is positioned within the patent foramen ovale; and applying RF energy to the primum and the secundum from an electrode positioned at least partially within the patency. 18. The method of claim 17 wherein shrinking the primum includes shrinking the primum prior to drawing a vacuum in the region adjacent to the primum and the secundum. 19. The method of claim 17, further comprising: guiding the insertion motion of the catheter with a guide wire; removing the guide wire from the opening; and applying RF energy after removing the guide wire from the opening. 20. The method of claim 17, further comprising: guiding the insertion motion of the catheter with a guide wire; and applying RF energy while the guide wire remains in the opening. 21. The method of claim 17 wherein applying RF energy includes applying RF energy via at least one monopolar electrode. 22. The method of claim 17, further comprising at least inhibiting sticking between the inserted portion of the catheter and the cardiac tissue by directing liquid outwardly from the catheter proximate to an interface between the catheter and the cardiac tissue. 23. The method of claim 17, further comprising maintaining a distal end of the catheter at a fixed position relative to the patent foramen ovale by drawing the primum and secundum toward the catheter while applying RF energy. 24. The method of claim 17, further comprising controlling an insertion distance of the catheter by inserting the catheter only as far as a vacuum port that is spaced apart from a distal tip of the catheter, and detecting the insertion distance when the vacuum port becomes sealed by cardiovascular tissue. 25. A method for treating cardiac tissue, the cardiac tissue including a primum, a secundum adjacent to the primum, and a patent foramen ovale, the method comprising: releasably tightening the primum at a first location spaced apart from the patent foramen ovale by drawing portions of the primum together; while the primum is releasably tightened, at least partially sealing the patent foramen ovale by applying energy at a second location at least closer to the patent foramen ovale than the first location; and releasing tension on the primum after at least partially sealing the patent foramen ovale and allowing the portions of the primum to move apart from each other. 26. The method of claim 25 wherein releasably tightening the primum includes clamping first and second sections of the primum between a first member and a second member to fold the first and second sections against each other. 27. The method of claim 25 wherein releasably tightening the primum includes clamping first and second sections of the primum between at least two members to fold the first and second sections against each other. 28. The method of claim 25 wherein releasably tightening the primum includes applying a vacuum to a first section and a second section of the primum to fold at least one of the first and second sections against the other. 29. The method of claim 25 wherein releasably tightening the primum includes applying a force to the primum via an inflatable member. 30. The method of claim 25 wherein at least partially sealing the patent foramen ovale includes: inserting a portion of a catheter into the patent foramen ovale; drawing the primum and secundum into contact with each other by drawing a vacuum in a region adjacent to the primum and secundum via the catheter while the catheter is positioned within the patent foramen ovale; and applying RF energy to the primum and the secundum from an electrode positioned at least partially within the patency. 31. A method for treating cardiac tissue, the cardiac tissue including a primum, a secundum adjacent to the primum, and a foramen ovale having a patency in the form of a tunnel between the primum and the secundum, the method comprising: inserting a catheter into a patient's heart; heating the primum at a location spaced apart from the patent foramen ovale to shrink the primum; moving at least a portion of the catheter toward the tunnel, while drawing a vacuum through the catheter via vacuum channels positioned in peripheral portions of at least one electrode located at a distal end of the catheter; inserting the distal end of the catheter into the tunnel; drawing at least one of the primum and the secundum into contact with the other by applying a vacuum to the primum and secundum from a location between the primum and the secundum and within the tunnel; detecting at least one of a drop in evacuated fluid flow and an increase in the differential pressure drawn as at least one of the primum and the secundum is drawn into contact with the other; continuing to apply a vacuum through the catheter via the vacuum channels to secure the position of the at least one electrode relative to the primum and the secundum; applying radio frequency energy to the primum and the secundum via the at least one electrode to seal the tunnel; and supplying an electrolyte through a porous portion of the at least one electrode to at least restrict sticking between the at least one electrode and the tunnel. 32. The method of claim 31, further comprising applying a vacuum to the primum at the location spaced apart from the patent foramen ovale to draw sections of the primum against each other, and wherein heating the primum includes supplying RF energy to the primum to shrink the primum. 33. A method for treating cardiac tissue, the cardiac tissue including a primum and a secundum adjacent to the primum, the method comprising: drawing a first section and a second section of the primum together; and applying energy to the first and second sections of the primum to fuse the first and second sections to each other. 34. The method of claim 33 wherein drawing the first and second sections of the primum together includes applying a vacuum to first and second sections. 35. The method of claim 33 wherein the cardiac tissue further includes a patent foramen ovale, and wherein drawing the first and second sections of the primum together includes applying a vacuum at a first location spaced apart from the patent foramen ovale, and wherein the method further comprises at least partially sealing the patent foramen ovale by applying energy at a second location closer to the patent foramen ovale than the first location, after applying energy to the primum. 36. The method of claim 33 wherein applying a vacuum includes drawing the first and second sections of the primum into a vacuum opening. 37. The method of claim 33 wherein applying a vacuum includes drawing the first and second sections of the primum into contact with corresponding first and second electrodes. 38. The method of claim 33 wherein applying a vacuum includes drawing the first and second sections of the primum into contact with corresponding first and second semi-cylindrical electrodes. 39. The method of claim 33 wherein drawing the first and second sections of the primum together includes folding at least one of the first and second sections against the other. 40. The method of claim 33 wherein drawing the first and second sections of the primum together includes clamping the first section of the primum against the second section of the primum between at least a first member and a second member to fold the first and second sections against each other. 41. The method of claim 33 wherein the cardiac tissue further includes a patent foramen ovale, and wherein applying energy to the first and second sections of the primum includes applying energy at a first location of the primum spaced apart from the patent foramen ovale, and wherein the method further comprises at least partially sealing the patent foramen ovale by applying energy at a second location at least closer to the patent foramen ovale than the first location. 42. The method of claim 33 wherein the cardiac tissue further includes a patent foramen ovale, and wherein applying energy to the first and second sections of the primum includes applying energy at a first location of the primum spaced apart from the patent foramen ovale, and wherein the method further comprises at least partially sealing the patent foramen ovale by applying energy at a second location at least partially within the patent foramen ovale.