Methods and apparatus for remodeling an extravascular tissue structure

Abstract

A medical apparatus and method for remodeling a mitral valve annulus adjacent to the coronary sinus includes an elongate body having a proximal end and a distal end. The elongate body is movable from a first, flexible configuration for transluminal delivery to at least a portion of the coronary sinus to a second configuration for remodeling the mitral valve annulus.

Description

RELATED APPLICATIONS [0001] This is a divisional of U.S. application Ser. No. 10 / 634,655, filed Aug. 5, 2003, which claims priority under 35 U.S.C. § 119 to U.S. Provisional Application No. 60 / 429,281, filed on Nov. 25, 2002, and U.S. Provisional Application No. 60 / 488,334, filed Jul. 18, 2003, and is a continuation-in-part of U.S. application Ser. No. 10 / 066,302, filed Jan. 30, 2002, which claims the benefit under 35 U.S.C. § 119 to U.S. Provisional Application No. 60 / 265,995, filed Feb. 1, 2001, and is a continuation-in-part of U.S. application Ser. No. 09 / 774,869, filed Jan. 30, 2001, now U.S. Pat. No. 6,537,314, the entire disclosures of which are incorporated by reference herein. In addition, this application is a continuation-in-part of U.S. application Ser. No. 10 / 715,221, filed Nov. 17, 2003, which is a continuation of U.S. application Ser. No. 09 / 968,272, filed Oct. 1, 2001, now U.S. Pat. No. 6,709,456, which is a continuation-in-part of U.S. application Ser. No. 09 / 494,233...

AI Technical Summary

Benefits of technology

[0038] There is provided in accordance with another aspect of the present invention a method of performing annuloplasty of the mitral valve. The method comprises positioning a prosthesis in the coronary sinus; rotating a first portion of the device with respect to a second portion of the device to cause the device to bend into an arcuate configuration having a proximal concavity and a distal concavity both concave toward the mitral valve and a central concavity concave away from the mitral valve, to provide a compressive force on the mitral valve annulus; and securing the device in the arcuate configuration within the coronary sinus.

Problems solved by technology

The resulting increase in pulmonary venous pressure and reduction in cardiac output cause congestive heart failure.

This in turn, causes volume overload that exacerbates the myopathy, leading to a vicious cycle of progressive enlargement and worsening mitral regurgitation.

Although mitral valve repair and replacement can successfully treat many patients with mitral valvular insufficiency, techniques currently in use are attended by significant morbidity and mortality.

However, the morbidity, risks and expense of surgical annuloplasty are very high in patients with cardiomyopathy and congestive heart failure.

These techniques may provide some benefits over open chest procedures, but they are still attended by significant morbidity and mortality risks.

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