초록 ▼

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascula

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascular delivery, and full intra-atrial retrievability. The implants or systems of implants and methods also make use of strong fluoroscopic landmarks. The implants or systems of implants and methods make use of an adjustable implant and a fixed length implant. The implants or systems of implants and methods may also utilize a bridge stop to secure the implant, and the methods of implantation employ various tools.

대표청구항 ▼

1. A system for establishing an access between a left atrium and a great cardiac vein, the system comprising a first catheter comprising a first catheter body sized and configured for axial advancement over a guide wire from a right atrium into in the great cardiac vein, the first catheter body havi

1. A system for establishing an access between a left atrium and a great cardiac vein, the system comprising a first catheter comprising a first catheter body sized and configured for axial advancement over a guide wire from a right atrium into in the great cardiac vein, the first catheter body having a center axis along which axial advancement occurs and including a distal end, the first catheter body including a guide wire lumen that extends along the center axis and an auxiliary lumen that extends along the center axis free of communication with the guide wire lumen,a second catheter comprising a second catheter body sized and configured for axial advancement over a guide wire from a right atrium, through a septum, and into in the left atrium, the second catheter body having a center axis along which axial advancement occurs and including a distal end, the second catheter body including an inner lumen that extends along the center axis of the second catheter body,a first head carried on the distal end of the first catheter body, the first head having a center axis and comprising a proximal region coupled to the distal end of the first catheter body, a distal region spaced from the distal end of the first catheter body, and a middle region between the proximal and distal regions, the first head including a guide lumen extension that communicates with the guide wire lumen of the first catheter body and extends along the center axis of the first head through the proximal, middle, and distal regions of the first head to a guide lumen exit opening at a distal end of the first head, the first head further having an auxiliary lumen extension that communicates with the auxiliary lumen of the first catheter body and extends along the center axis of the first head through the proximal region of the first head free of communication with the guide lumen extension, the auxiliary lumen extension including a ramped portion formed in the middle region of the first head that bends the auxiliary lumen extension away from the center axis of the first body to an auxiliary lumen exit opening formed in a side of the middle region of the first head, the proximal, middle, and distal regions of the first head each including, respectively, a proximal magnetic zone, a middle magnetic zone, and a distal magnetic zone, each magnetic zone comprising a magnetic or ferromagnetic material possessing poles of opposite polarity oppositely spaced apart along an axis, the axis of the middle magnetic zone extending in an orientation perpendicular to the center axis of the first head with one pole placed adjacent to the auxiliary lumen exit opening and the opposite pole placed on an opposite side of first body, the axis of the proximal magnetic zone extending in an orientation along the center axis of the first body with one pole placed adjacent to the middle magnetic zone and the opposite pole placed adjacent to the distal end of the first catheter body, the axis of the distal magnetic zone extending in an orientation along the center axis of the first body with one pole placed adjacent to the middle magnetic zone and the opposite pole placed adjacent to the guide lumen exit opening, the poles of the proximal magnetic zone and the distal magnetic zone placed adjacent to the middle magnetic zone having the same polarity as the pole of the middle magnetic zone placed adjacent to the auxiliary lumen exit opening to create a magnetic focus on the auxiliary lumen exit opening,a second head carried on the distal end of the second catheter body, the second head having a center axis and comprising a proximal region coupled to the distal end of the second catheter body and a distal region spaced from the distal end of the second catheter body, the second head including a lumen extension that communicates with the inner lumen of the second catheter body and extends along the center axis of the second head to a lumen exit opening at a distal end of the second head, the second head including a magnetic zone comprising a magnetic or ferromagnetic material possessing poles of opposite polarity oppositely spaced apart along an axis, the axis of the magnetic zone of the second head extending in an orientation along the center axis of the second head with one pole placed in the proximal region and the opposite pole placed in the distal region adjacent to the lumen exit opening of the second head, the pole placed adjacent to the lumen exit opening of the second head having a polarity opposite to the pole of the middle magnetic zone placed adjacent to auxiliary lumen exit opening of the first head, whereby the distal region of second head will magnetically couple to the middle region of the first head to place the lumen exit opening at a distal end of the second head in an alignment with the auxiliary lumen exit opening at the middle region of the first head,a first wire sized for passage through the guide wire lumen of the first catheter body, the guide lumen extension of the first head, and the guide lumen exit opening of the first head, to serve as the guide wire for the first catheter body for axially advancement of the first catheter body into a location within the great cardiac vein,a second wire sized for passage through the inner lumen of the second catheter body, the lumen extension of the second head, and the lumen exit opening of the second head, to serve as the guide wire for the second catheter body for axial advancement of the second catheter body into the left atrium to magnetically couple the distal region of the second head to the middle region of the first head, andan operative component sized for passage through the auxiliary lumen of the first catheter body, the auxiliary lumen extension of the first head, and the auxiliary lumen exit opening at the middle region of the first head, the operative component comprising a sharp distal tip to pierce tissue in the great cardiac vein for entry into the second catheter body through the magnetically coupled lumen exit opening at a distal end of the second head, to create between the first and second catheters an access between the left atrium and the great cardiac vein. 2. A system according to claim 1wherein the lumen exit opening at the distal end of the second head includes an interior surface shaped as a funnel to guide entry of the sharp distal tip from the auxiliary lumen exit opening at the middle region of the first head into the lumen exit opening. 3. A method comprising providing system as defined in claim 1,deploying the first and second catheters, respectively, over the first and second wires,magnetically coupling the distal region of the second head to the middle region of the first head to place the lumen exit opening at a distal end of the second head in an alignment with the auxiliary lumen exit opening at the middle region of the first head, andpassing the sharp distal tip of the operative component through the first catheter body to pierce tissue in the great cardiac vein and enter the second catheter body, to create between the first and second catheters an access between the left atrium and the great cardiac vein. 4. A method according to claim 3further including deploying an implant into the left atrium through the access created between the first and second catheters. 5. A method according to claim 4wherein deploying the implant reshapes a heart valve annulus.