US6186972B1
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Methods and apparatus for treating ischemic heart disease by providing transvenous myocardial perfusion
Assignee: Medtronic Vascular Inc
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Filing: 1998-12-09
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Granted: 2001-02-13
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Expires: 2018-12-09
Abstract
Abstract Methods and apparatus for supplying retrograde perfusion of chronically ischemic myocardium by forming one or more transmural passageways between a cardiac chamber and the coronary venous vasculature. The placement, size and number of the passageways are selected, and portions of the venous vasculature or coronary ostium optionally partially or completely occluded, to maintain a parameter related to the pressure attained in the venous vasculature to a value less than a predetermined value.
Inventors
- 👤 James A. Nelson
- 👤 Ascher Shmulewitz
- 👤 John Burton
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-27 06:16
CPC Classifications
A; A61; A61B; A61B17/00; A61B17/34; A61B17/3478; A61B17/32; A61B17/3205; A61B17/3207; A61B17/320758; A61B18/00; A61B18/04; A61B18/12; A61B18/14; A61B18/1492; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B2017/00247; A61B2017/00252; A61B17/22; A61B2017/22072; A61B2017/22074; A61B2017/22077
Claims Analysis
Total Claims: 24
Claim 1
Independent Claim
74 words
Apparatus for use in treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the apparatus comprising: a catheter configured to be disposed in a patient's venous vasculature, the catheter having a lumen; and means for forming one or more transmural passageways between a portion of the patient's venous vasculature and a cardiac chamber so that a parameter corresponding to a peak pressure attained in the venous vasculature is less than a predetermined value.
Claim 2
Dependent Claim
74 words
Apparatus for use in treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the apparatus comprising: a catheter configured to be disposed in a patient's venous vasculature, the catheter having a lumen; and means for forming one or more transmural passageways between a portion of the patient's venous vasculature and a cardiac chamber so that a parameter corresponding to a peak pressure attained in the venous vasculature is less than a predetermined value.
Claim 3
Dependent Claim
24 words
The apparatus of claim 1 wherein the lumen comprises a curved portion that communicates with a skive in a lateral surface of the catheter.
Claim 4
Dependent Claim
23 words
The apparatus of claim 1 wherein further comprising means for achieving a preselected degree of occlusion of a segment of the venous vasculature.
Claim 5
Dependent Claim
14 words
The apparatus of claim 1 wherein the means for forming comprises a sharpened stylet.
Claim 6
Dependent Claim
16 words
The apparatus of claim 4 wherein the stylet further comprises an electrode for delivering RF energy.
Claim 7
Dependent Claim
24 words
The apparatus of claim 3 wherein the means for achieving a preselected degree of occlusion comprises a plug of open-cell foam having high durometer.
Claim 8
Dependent Claim
63 words
The apparatus of claim 3 wherein the means for achieving a preselected degree of occlusion comprises: a deformable tubular member having a delivery diameter for transluminal delivery, and an expanded diameter, wherein the tubular member is deformably expanded by internal application of a radially outwardly directed force; and a layer of open-cell foam affixed to an exterior surface of the deformable tubular member.
Claim 9
Dependent Claim
29 words
The apparatus of claim 3 wherein the means for achieving a preselected degree of occlusion comprises: a volume of biocompatible polymer that is injected to form a plug in-situ.
Claim 10
Independent Claim
102 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; inserting the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; and actuating the means for forming to form a transmural passageway between the position and a cardiac chamber, the transmural passageway having a size selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 11
Independent Claim
102 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; inserting the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; and actuating the means for forming to form a transmural passageway between the position and a cardiac chamber, the transmural passageway having a size selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 12
Dependent Claim
45 words
The method of claim 9 wherein actuating the means for forming comprises actuating the means for forming to form a transmural passageway having a size selected to maintain a peak pressure attained in the patient's venous vasculature to a value less than 40 mm Hg.
Claim 13
Dependent Claim
20 words
The method of claim 9 further comprising implanting a plug in the patient's venous vasculature proximally of the transmural passageway.
Claim 14
Dependent Claim
22 words
The method of claim 9 wherein implanting a plug further comprises depositing a volume of bio-compatible polymer that forms a plug in-situ.
Claim 15
Independent Claim
105 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; inserting the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; actuating the means for forming to form a transmural passageway between the position and a cardiac chamber, the position at which the transmural passageway is formed being selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 16
Independent Claim
105 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; inserting the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; actuating the means for forming to form a transmural passageway between the position and a cardiac chamber, the position at which the transmural passageway is formed being selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 17
Dependent Claim
42 words
The method of claim 13 wherein inserting the catheter comprises inserting the catheter to a position selected to maintain a peak pressure attained in the patient's venous vasculature to a value less than 40 mm Hg when the transmural passageway is formed.
Claim 18
Dependent Claim
20 words
The method of claim 13 further comprising implanting a plug in the patient's venous vasculature proximally of the transmural passageway.
Claim 19
Dependent Claim
22 words
The method of claim 15 wherein implanting a plug further comprises depositing a volume of bio-compatible polymer that forms a plug in-situ.
Claim 20
Independent Claim
121 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: (a) providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; (b) advancing the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; (c) actuating the means for forming to form a transmural passageway between the position and a cardiac chamber; and (d) repeating (b) and (c) at a plurality of positions to form a number of transmural passageways, the number of transmural passageways selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 21
Independent Claim
121 words
A method of treating ischemic heart disease by providing retrograde transvenous myocardial perfusion, the method comprising: (a) providing a catheter configured for transluminal, percutaneous insertion, the catheter having means for forming a transmural passageway in myocardial tissue; (b) advancing the catheter transluminally and percutaneously through a patient's coronary sinus to a position in the patient's venous vasculature; (c) actuating the means for forming to form a transmural passageway between the position and a cardiac chamber; and (d) repeating (b) and (c) at a plurality of positions to form a number of transmural passageways, the number of transmural passageways selected to maintain a parameter related to a pressure attained in the patient's venous vasculature to a value less than a predetermined value.
Claim 22
Dependent Claim
42 words
The method of claim 17 wherein repeating (b) and (c) comprises repeating (b) and (c) to form a number of transmural passageways selected to maintain a peak pressure attained in the patient's venous vasculature to a value less than 40 mm Hg.
Claim 23
Dependent Claim
26 words
The method of claim 17 further comprising implanting a plug in the patient's venous vasculature proximally of at least one of the number of transmural passageways.
Claim 24
Dependent Claim
22 words
The method of claim 19 wherein implanting a plug further comprises depositing a volume of bio-compatible polymer that forms a plug in-situ.
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| Annuity Stage | Window Opens | Payment Deadline | Surcharge Period Until | Estimated Fee | Status |
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| 3.5 Years (Year 4) | 2004-02-13 | 2004-08-14 | 2005-02-13 | $2000.00 | Window Closed / Lapsed |
| 7.5 Years (Year 8) | 2008-02-13 | 2008-08-14 | 2009-02-13 | $3760.00 | Window Closed / Lapsed |
| 11.5 Years (Year 12) | 2012-02-13 | 2012-08-14 | 2013-02-13 | $7700.00 | Window Closed / Lapsed |