300 results about "Coronary sinus" patented technology

A method for reducing mitral regurgitation comprising: providing a plication assembly comprising a first anchoring element, a second anchoring element, and a linkage construct connecting the first anchoring element to the second anchoring element; positioning the first anchoring element in the coronary sinus adjacent to the mitral annulus, and positioning the second anchoring element in another area of the mitral annulus so that the linkage construct extends across the opening of the mitral valve and holds the mitral valve in a reconfigured configuration so as to reduce mitral regurgitation. An apparatus for reducing mitral regurgitation comprising: a plication assembly comprising a first anchoring element, a second anchoring element, and a linkage construct connecting the first anchoring element to the second anchoring element; and a catheter adapted to deliver the first anchoring element to the coronary sinus.

A medical apparatus and method suitable for remodeling a mitral valve annulus adjacent to the coronary sinus. The apparatus comprises an elongate body having a proximal region and a distal region. Each of the proximal and distal regions is dimensioned to reside completely within the vascular system. The elongate body may be moved from a first configuration for transluminal delivery to at least a portion of the coronary sinus to a second configuration for remodeling the mitral valve annulus proximate the coronary sinus. A forming element may be attached to the elongate body for manipulating the elongate body from the first transluminal configuration to the second remodeling configuration. Further, the elongate body may comprise a tube having a plurality of transverse slots therein.

A body implantable lead comprises a lead body including a conductive polymer electrode disposed along a distal end portion of the lead body for performing one or more of the functions consisting of pacing, sensing, cardioversion and defibrillation. An electrical conductor, preferably in the form of a multistrand cable conductor, couples the conductive polymer electrode with a proximal end of the lead body. The conductive polymer electrode encapsulates the conductor and is in electrical contact therewith along the length, and preferably along substantially the entire length, of the conductive polymer electrode. The lead body may comprise a multilumen polymer housing, the conductor being contained within one of the lumens of the housing. The conductive polymer electrode may be disposed within a window formed in the lead body. Alternatively, the conductive polymer electrode may comprise multiple electrode sections within a corresponding number of windows formed in the lead body and spaced apart along the length thereof. Further, the window and the conductive polymer electrode disposed therein may extend helically about the lead body. Because of its flexibility and because it can have a small diameter, the lead of the invention is particularly advantageous for implantation in the small, tortuous vessels of the coronary sinus region of the heart for left side stimulation and / or sensing.Methods of fabricating lead bodies incorporating conductive polymer electrodes are also disclosed.

Apparatus for reducing mitral regurgitation, by applying a force to the wall of the coronary sinus so as to force the posterior leaflet anteriorly and thereby reduce mitral regurgitation.

A device for treatment of mitral annulus dilation is disclosed, wherein the device comprises two states. In a first of these states the device is insertable into the coronary sinus and has a shape of the coronary sinus. When positioned in the coronary sinus, the device is transferable to the second state assuming a reduced radius of curvature, whereby the radius of curvature of the coronary sinus and the radius of curvature as well as the circumference of the mitral annulus is reduced.

A device, system, and method effects mitral valve annulus geometry of a heart. The device includes a first anchor configured to be positioned within and fixed to the coronary sinus of the heart adjacent the mitral valve annulus within the heart. A cable is fixed to the first anchor and extends proximately therefrom and slidingly through a second anchor which is positioned and fixed in the heart proximal to the first anchor. A lock locks the cable to the second anchor when tension is applied to the cable for effecting the mitral valve annulus geometry.

An artificial mitral valve is anchored in the left atrium by placing the valve between the annulus of the natural mitral valve and an artificial annulus. The artificial annulus is formed by inserting a tool into the coronary sinus, and adjusting the tool to force the wall of the left atrium to form an annulus above the artificial valve, this locking it in place and forming a hemostatic seal.

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.

A mitral valve therapy device and method treats dilated cardiomyopathy. The device is configured to be placed in the coronary sinus of a heart adjacent to the mitral valve annulus. The device includes a force distributor that distributes an applied force along a pericardial wall of the coronary sinus, and a force applier that applies the applied force to one or more discrete portions of a wall of the coronary sinus adjacent to the mitral valve annulus to reshape the mitral valve annulus in a localized manner.

An evacuation sheath assembly and method of treating occluded vessels which reduces the risk of distal embolization during vascular interventions is provided. The evacuation sheath assembly includes an elongated tube defining an evacuation lumen having proximal and distal ends. A proximal sealing surface is provided on a proximal portion of the tube and is configured to form a seal with a lumen of a guided catheter. A distal sealing surface is provided on a distal portion of the tube and is configured to form a seal with a blood vessel. Obturator assemblies and infusion catheter assemblies are provided to be used with the evacuation sheath assembly. A method of treatment of a blood vessel using the evacuation sheath assembly includes advancing the evacuation sheath assembly into the blood vessel through a guide catheter. Normal antegrade blood flow in the blood vessel proximate to the stenosis is stopped and the stenosis is treated. Retrograde blood flow is induced within the blood vessel to carry embolic material dislodged during treating into the evacuation sheath assembly. If necessary to increase retrograde flow, the coronary sinus may be at least partially occluded. Alternatively, antegrade flow may be permitted while flow is occluded at the treatment site.

Apparatus is provided including an implantable sensor, adapted to sense an electrical parameter of a heart of a subject, and a first control unit, adapted to apply pulses to the heart responsively to the sensed parameter, the pulses selected from the list consisting of: pacing pulses and anti-arrhythmic energy. The apparatus further includes an electrode device, adapted to be coupled to a site of the subject selected from the list consisting of: a vagus nerve of the subject, an epicardial fat pad of the subject, a pulmonary vein of the subject, a carotid artery of the subject, a carotid sinus of the subject, a coronary sinus of the subject, a vena cava vein of the subject, a right ventricle of the subject, and a jugular vein of the subject; and a second control unit, adapted to drive the electrode device to apply to the site a current that increases parasympathetic tone of the subject and affects a heart rate of the subject. The first and second control units are not under common control. At least one of the control units is adapted to coordinate an aspect of its operation with an aspect of operation of the other control unit. Other embodiments are also described.

A device, system and method for treating cardiac valve regurgitation. The device includes a compression member disposed on a tube and a sleeve rotatably disposed about the tube and the compression member. The sleeve includes a side port, and is rotatable to align the compression member with the side port to transform the compression member from a delivery configuration to a compression configuration. One method includes positioning the compression member adjacent a cardiac valve and rotating the sleeve to align the compression member with the side port to release the compression member from the delivery configuration to the compression configuration to apply a compressive force to the cardiac valve.

Methods and apparatus for mitral valve repair are disclosed herein where the posterior mitral leaflet is supported or buttressed in a frozen or immobile position to facilitate the proper coaptation of the leaflets. An implantable apparatus may be advanced and positioned intravascularly beneath the posterior leaflet of the mitral valve. The apparatus may include one or more individual balloon members, each of which may be optionally configured with supporting integrated structures. A magnet chain catheter may be positioned within the coronary sinus and adjacent to the mitral valve to magnetically secure the apparatus in position beneath the posterior mitral leaflet. Alternatively, a split-ring device may be placed about the chordae tendineae supporting the mitral valve such that the ring slides along the chordae tendineae alternately against the mitral leaflet and towards the papillary muscles during systole and diastole.

Disclosed are methods and devices for applying pressure to an adjacent tissue structure, such as the annulus of the mitral valve. An adjustable implant is provided with an elongate control line having a distal end connected to the implant and a proximal end spaced apart from the implant. The device enables post implantation adjustment, by accessing the proximal end of the control line and manipulating the control line to adjust the implant.

A system and method for monitoring left ventricular cardiac contractility and for optimizing a cardiac therapy based on left ventricular lateral wall acceleration (LVA) are provided. The system includes an implantable or external cardiac stimulation device in association with a set of leads including a left ventricular epicardial or coronary sinus lead equipped with an acceleration sensor. The device receives and processes acceleration sensor signals to determine a signal characteristic indicative of LVA during isovolumic contraction. A therapy optimization method evaluates the LVA during varying therapy settings and selects the setting(s) that correspond to a maximum LVA during isovolumic contraction. In one embodiment, the optimal inter-ventricular pacing interval for use in cardiac resynchronization therapy is determined as the interval corresponding to the highest amplitude of the first LVA peak during isovolumic contraction.

A system and method is provided for treating a mitral valve. The method preferably includes advancing a guide catheter to an ostium of the coronary sinus and advancing a delivery catheter containing a medical implant through the guide catheter and into the coronary sinus. The delivery catheter has an inner member on which the medical implant is held and an outer sheath which is retractable for deploying and releasing the medical implant. In one embodiment, the medical implant has proximal and distal anchors and a bridge containing resorbable material. The inner member may have a flexible sleeve for gripping and holding a portion of the outer sheath, thereby providing a releasable attachment mechanism. In another embodiment, the inner member may include an inflatable balloon having a tapered distal region which extends from the outer sheath for providing an atraumatic tip. The inflatable balloon may also be used to expand the medical implant and to grip the outer sheath.

A method and apparatus for treating mitral regurgitation by approximating the septal and lateral (clinically referred to as anterior and posterior) annulus of the mitral valve. The distal end of the device is inserted into the coronary sinus of the heart and the proximal end of the device rests within the right atrium along the tendon of Todaro and extends to at least the membranous septum of the tricuspid valve. Because the coronary sinus approximates the lateral (posterior) annulus of the mitral valve and the tendon of Todaro approximates the septal (anterior) annulus of the mitral valve, the device encircles approximately one half of the mitral valve annulus. The apparatus is then adapted to deform the underlying structures i.e. the septal annulus and lateral annulus of the mitral valve in order to move the posterior leaflet anteriorly and the anterior leaflet posteriorly and thereby improve leaflet coaptation and eliminate mitral regurgitation.

A device effects the mitral valve annulus geometry of a heart. The device includes first and second anchors configured to be positioned within the coronary sinus of the heart adjacent the mitral valve annulus of the heart and a fixed length connecting member permanently attached to the first and second anchors. With the first anchor anchored in the coronary sinus, the second anchor may be displaced proximally to effect the geometry of the mitral valve annulus and released to maintain the effect on the mitral valve geometry.

A device for modifying the shape of a mitral valve annulus. In one embodiment, the device includes a connector disposed between first and second anchors, the first and second anchors each adapted to be deployed in a coronary sinus adjacent the mitral valve annulus to anchor the device in the coronary sinus; and an actuation element adapted to receive a proximally or distally directed actuation force from an actuator and to transmit the actuation force to the first and second anchors simultaneously. The invention also includes a system for modifying the shape of a mitral valve annulus, including a percutaneous deployment apparatus, including an actuator; and a percutaneous mitral valve annuloplasty device with a connector disposed between first and second anchors, the first and second anchors each adapted to be deployed in a coronary sinus adjacent the mitral valve annulus to anchor the device in the coronary sinus; and an actuation element adapted to receive a distally proximally directed actuation force from the actuator and to transmit the actuation force to the first and second anchors simultaneously. The invention also includes a method of using such devices and systems.

Devices and methods for treating mitral regurgitation by reshaping the mitral annulus in a heart. One preferred device for reshaping the mitral annulus is provided as an elongate body having dimensions as to be insertable into a coronary sinus. The elongate body includes a proximal frame having a proximal anchor and a distal frame having a distal anchor. A ratcheting strip is attached to the distal frame and an accepting member is attached to the proximal frame, wherein the accepting member is adapted for engagement with the ratcheting strip. An actuating member is provided for pulling the ratcheting strip relative to the proximal anchor after deployment in the coronary sinus. In one preferred embodiment, the ratcheting strip is pulled through the proximal anchor for pulling the proximal and distal anchors together, thereby reshaping the mitral annulus.

A device and method for treating cardiac valve regurgitation. The device includes a tubular member including a lumen there through and a locking mechanism and a compression device carried on the tubular member. The compression device is transformable to a compression configuration in response to axial displacement and is locked in the compression configuration by the locking mechanism. The method includes positioning the compression device adjacent a cardiac valve and applying an axial displacement to the compression device to transform the compression device into a compression configuration and locking the compression device in the compression configuration to apply a compressive force to the cardiac valve.

An assembly and method for effecting the condition of a mitral valve annulus of a heart includes a guide wire configured to be fed into the coronary sinus of the heart, and a mitral valve annulus therapy device configured to be slidingly received on the guide wire and advanced into the coronary sinus of the heart on the guide wire. A guide tube may further be employed for guiding the device into the coronary sinus. An introducer which may be employed for pushing the device into or pulling device out of the heart has a mechanism for releasably locking to the device. This enables substitution of the device if needed. Also, the crossover point of the circumflex artery and coronary sinus may be determined and avoided when the device is deployed.

The present invention concerns a novel stent and a method for communicating oxygenated blood directly from the left ventricle to the coronary sinus to provide retrograde perfusion to the myocardium. The stent is placed substantially within the coronary sinus with its trailing end protruding into the right atrium and the leading end protruding into the left ventricle. The stent has a smaller passageway at or near the trailing (right ventricular) end and at or near the leading (left ventricle) end, and has a covering at the trailing end. The smaller passageway and the cover at the trailing end to promote retrograde flow into the venous system of the hear and specifically the myocardium of the left ventricle and to reduce a significant left-to-right shunt.

An implantable stimulation lead is disclosed for placement in the coronary sinus region and its associated coronary vessels overlying the left side of a patient's heart. The lead comprises at least one proximal connector; at least one tissue stimulation electrode; at least one conductor coupled between the at least one proximal connector and the at least one stimulation electrode; and a lead body including a housing of insulating material enclosing the at least one conductor, the lead body having a relatively flexible distal portion of, for example, silicone rubber, having a length corresponding to the coronary sinus region of the heart, and a stiffer proximal portion of, for example, polyurethane. A robust transition joint comprising telescoped sections of the distal and proximal portions of the lead body couples the two portions of the lead body.Also provided is a versatile lead delivery system including a stylet stop disposed within the distal portion of the lead body. The stylet stop defines an aperture dimensioned to pass a guide wire but not the enlarged distal tip of a stylet. The lead includes a tip electrode having a longitudinally extending bore dimensioned to permit passage of the guide wire through the tip electrode.

A treatment method is provided, including identifying a subject as one who is selected to undergo an interventional medical procedure, and, in response to the identifying, reducing a likelihood of a potential adverse effect of the procedure by applying an electrical current to a parasympathetic site of the subject selected from the group consisting of: a vagus nerve of the subject, an epicardial fat pad of the subject, a pulmonary vein of the subject, a carotid artery of the subject, a carotid sinus of the subject, a coronary sinus of the subject, a vena cava vein of the subject, a jugular vein of the subject, a right ventricle of the subject, a parasympathetic ganglion of the subject, and a parasympathetic nerve of the subject.

A method and devices for relieving pressure in the left atrium of a patient's heart is disclosed. The method includes using an ablative catheter in a minimally invasive procedure to prepare an opening from the coronary sinus into a left atrium of the patient's heart. Once the opening is prepared, the opening may be enlarged by a technique such as expanding a balloon within the opening. A stent is then placed within the coronary sinus of the patient, with a transverse portion expanding within the opening, allowing blood to flow from the left atrium to the coronary sinus and then to the right atrium. Pressure within the left atrium is thus relieved.

Apparatus and methods are provided for accessing a body lumen within a patient's body. Generally, the apparatus includes a tubular member including proximal and distal ends, a steering element extending between the proximal and distal ends, and an actuator for directing the distal end between a relaxed configuration and a complex curved configuration. In the relaxed configuration, the distal end may assume a straight or curved shape. In the complex curved configuration, the distal end may assume a curvilinear shape. In one embodiment, the complex curved configuration may include a first curved portion defining an arc within a plane, and a second portion that extends out of the plane. An embodiment with a left hand rule configuration may be introduced into the right atrium of a heart from a superior approach, and the complex curved configuration may facilitate accessing the coronary sinus.

Apparatus is provided including an electrode device and a control unit. The electrode device is configured to be coupled to a site of a subject selected from the group consisting of: a vagus nerve, an epicardial fat pad, a pulmonary vein, a carotid artery, a carotid sinus, a coronary sinus, a vena cava vein, a right ventricle, a right atrium, and a jugular vein. The control unit is configured to drive the electrode device to apply to the site a current in at least first and second bursts, the first burst including a plurality of pulses, and the second burst including at least one pulse, and set (a) a pulse repetition interval (PRI) of the first burst to be on average at least 20 ms, (b) an interburst interval between initiation of the first burst and initiation of the second burst to be less than 10 seconds, (c) an interburst gap between a conclusion of the first burst and the initiation of the second burst to have a duration greater than the average PRI, and (d) a burst duration of the first burst to be less than a percentage of the interburst interval between, the percentage being less than 67%. Other embodiments are also described.