WO1998024488A2 - Treatment method via the pericardial space - Google Patents
Treatment method via the pericardial space Download PDFInfo
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- WO1998024488A2 WO1998024488A2 PCT/US1997/022224 US9722224W WO9824488A2 WO 1998024488 A2 WO1998024488 A2 WO 1998024488A2 US 9722224 W US9722224 W US 9722224W WO 9824488 A2 WO9824488 A2 WO 9824488A2
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- WIPO (PCT)
- Prior art keywords
- fluid
- pericardial space
- catheter
- pericardial
- pericardium
- Prior art date
Links
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- MWUXSHHQAYIFBG-UHFFFAOYSA-N Nitric oxide Chemical class O=[N] MWUXSHHQAYIFBG-UHFFFAOYSA-N 0.000 description 4
- 208000005228 Pericardial Effusion Diseases 0.000 description 3
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
Definitions
- the present invention is directed to treating the heart muscle and associated coronary vessels by controlling the temperature of the pericardial space. More particularly, the present invention includes accessing the pericardial space by puncturing the pericardium (pericardial sac) without injuring the heart and associated coronary vessels, delivering and withdrawing the heated and/or cooled fluids for controlling the temperature of the pericardial space.
- pericardium pericardial sac
- Galen 129-200 A.D.
- the pericardium is a conical membranous sac in which the heart and the commencement of the great vessels are contained. Gray's Anatomy (1977 ed.) pp. 457-460.
- the pericardium is fluid-filled and functions to prevent dilatation of the chambers of the heart, lubricates the surfaces of the heart, and maintains the heart in a fixed geometric position. It also provides a barrier to the spread of infection from adjacent structures in the chest cavity and prevents surrounding tissue(s) from adhering to the heart.
- the space between the pericardium and the heart is normally small in volume and the fluid film within it is too thin to functionally separate the heart and the pericardium. It has been observed that when fluid is injected into the pericardial space, it accumulates in the atrio ventricular and interventricular grooves, but not over the ventricular surfaces. See, Shabetai R., "Pericardial and Cardiac Pressure", Circulation, 77: 1 (1988).
- Pericardiocentesis or puncture of the pericardium, heretofore has been performed for; 1) diagnosis of pericardial disease(s) by study of the pericardial fluid; 2) withdrawal of pericardial fluid for the treatment of acute cardiac tamponade; and 3) infusion of therapeutic agents for the treatment of malignant effusion or tumors.
- pericardiocentesis procedures were performed in the United States and that less than 200 of these patients underwent therapy with the intrapericardial injection of drugs.
- intrapericardial injection of drugs is clinically limited to the treatment of abnormal pericardial conditions and diseases, such as malignant or loculated pericardial effusions and tumors.
- Drugs that have been injected into the pericardial space include antibiotic (sclerosing) agents, such as tetracycline, bleyomycin and streptokinase.
- antibiotic sclerosing
- Intrapericardial drug delivery has not been clinically utilized for heart-specific treatments where pericardial pathology is normal, because the pericardial space is normally small and very difficult to access without invasive surgery or risk of cardiac injury by standard needle pericardiocentesis techniques.
- pericardiocentesis procedures are carried out by highly specialized, experienced personnel in the cardiac catheterization laboratory of medical facilities, assisted by fluoroscopy and electrocardiogram monitoring equipment.
- Electrocardiographic monitoring of the procedure using the pericardial needle as an electrode is commonly employed, as disclosed in Bishop L.H., et al., “The Electrocardiogram as a Safeguard in Pericardiocentesis", in JAMA, 162:264 (1956), and Neill J. R., et al., "A Pericardiocentesis Electrode", in The New England Journal of Medicine, 264:711 (1961); Gotsman M.S., et al. "A Pericardiocentesis Electrode Needle", in Br.
- needle pericardiocentesis there are complications associated with needle pericardiocentesis. These complications include laceration of a coronary artery or the right ventricle, perforation of the right atrium or ventricle, puncture of the stomach or colon, pneumothorax, arrhythmia, tamponade, hypertension, ventricular fibrillation, and death. Complication rates for needle pericardiocentesis are increased in situations where the pericardial space and fluid effusion volume is small (i.e. the pericardial size is more like normal).
- U.S. Patent No. 5,071,428 discloses a method and apparatus for accessing the pericardial space for the insertion of implantable defibrillation leads. This method requires griping the pericardium with a forceps device and cutting the pericardium with a scalpel (pericardiotomy) under direct vision through a subxiphoid surgical incision.
- the present invention improves on the prior art by providing a method for heating and/or cooling the pericardial space for controlling the temperature therein, for efficiently delivering therapeutic agents, drugs or the like, to the pericardial space for treating the heart and associated vessels and tissues and for thermally shocking or heating the heart without the contemporaneous delivery of drugs.
- This agent delivery approach directly into the pericardial space allows for lower doses of these therapeutic agents, drugs, or the like, longer duration of these agents, less toxicity and improved effectiveness (absorption).
- the method of the present invention is accomplished by providing a fluid (liquid(s), gas(es) or mixtures thereof), for example water, sterile saline, lactated Ringer's Solution that may optionally or preferably include therapeutic agents, drugs or the like, such as thrombolitic agents, nitric oxide donors, coronary vascodilators, oxygen radical scavengers, platelet inhibitors, and heating and/or cooling, this fluid, relative to normal body temperature (approximately 37°C).
- the pericardial space is accessed by pericardiocentesis, such that the pericardial space is instrumentized at a location, and in particular, a location where treatment is desired.
- the heated and/or cooled fluid is then delivered to the pericardial space, and at a time after delivery, is withdrawn from the pericardium, through either the same catheter, or through a different opening in the pericardium, also created by standard pericardiocentesis procedures, and instrumentized similarly.
- This delivery and withdrawal of the fluid may be coordinated, so as to form a circuit, and subsequent deliveries and withdrawals are continued for as long as desired to achieve the requisite effects.
- the delivery and withdrawal of the fluid can be from the same or separate points along the pericardium and can be done in batched, continuous, intermittent or pulsed manners, and heating and cooling can be used together (e.g., heating followed by cooling).
- FIGs. 1-4 show a method of pericardiocentesis for accessing the pericardial space to perform the method of the present invention
- FIG. 5 is an embodiment of the method of the present invention.
- FIG. 5 a is a cross sectional view of the catheter employed in performing the method of the present invention taken along line 5a-5a of FIG. 5;
- FIG. 6 is a second an embodiment of the method of the present invention.
- FIG. 7 is a third embodiment of the method of the present invention.
- FIG. 7a is a cross sectional view of the catheter employed in performing the method of the present invention taken along line 7a-7a of FIG. 7.
- the method of the present invention initially involves accessing the pericardial space. This is typically accomplished by a procedure, known as pericardiocentesis. In the present invention, it is preferred to perform this pericardiocentesis procedure, to access the pericardial space of the heart, using an instrument available under the name PerDUCERTM pericardial access device, available from Comedicus Incorporated, 3839 Central Avenue, NE, Columbia Heights, Minnesota 55421, and described in "A New Approach: Access the Pericardial Space with the PerDUCERTM Pericardial Access Device" from Comedicus Incorporated, this literature being incorporated by reference herein.
- FIGs. 1-4 While only one instrument and method for accessing the pericardial space is shown in FIGs. 1-4 and described below, other instruments and methods are also permissible to access the pericardial space.
- a small subxiphoid incision 10 is made in the skin into the chest cavity 11 of a patient.
- a standard Mediastinscopy endoscope (not shown) is inserted into this incision for direct vision and the apparatus 20 having an end 21 with a suction dome 22 is inserted through the endoscope, to the pericardium 24 surrounding the heart 26.
- a lifted section or "bleb" 28 of pericardium tissue is secured in the suction dome 22 for puncture and subsequently punctured by a retractable needle 30 having limited travel to prevent laceration of the heart 26.
- a guidewire 32 is passed through the needle 30 into the bleb 28 and into the pericardial space 34, as shown in FIG. 3.
- a catheter 36 preferably, a single or multiple lumen catheter, is then slid over the guidewire 32 to the requisite placement within the pericardial space 34, as shown in FIG. 4.
- the access apparatus 20 is ultimately removed from the chest cavity 11 and subsequently from the operating field.
- fluids liquids, gases, or mixtures thereof
- FIGs. 5 and 5a there is shown a method of the invention for controlling the temperature in the pericardial space 34 of the pericardium 24 of the heart 26, where only a single incision 100 (from a needle puncturing the tissue of the pericardium 24), was made in the pericardium 24 for accessing the pericardial space 34.
- a double lumen catheter 104 preferably of concentric inner 106 and outer 108 tubes (shown partially in broken lines) has been introduced into the pericardial space 34 by the apparatus 20 (FIGs. 1-4).
- the inner tube 106 functions to deliver fluid (liquid, gas, or mixtures thereof), through an opening 109, that may or may not contain drugs or other therapeutic agents, from the fluid source 110 to the pericardial space 34, while the outer tube 108, in communication with a suction source 112, functions to facilitate the withdrawal of fluid from the pericardial space 34, through an opening 113.
- the inner tube 106 preferably connects to the fluid source 110 by a detachable line(s) 114 at a connector 114a and the outer tube 108 preferably connects to the suction source 112 by a detachable line(s) 116 at a connector 116a.
- the catheter 104 have the inner (fluid delivery) tube 106 extend beyond the outer (fluid withdrawal) tube 108, for projecting further into the pericardial space 34 to prevent fluid from immediately returning into the catheter 104.
- the connectors 114a, 116a employed here, as well as those connectors (168a, 170a in FIG. 6 and 212a, 214a in FIG. 7) in the systems described below are standard, medical grade connectors, such as Luer-LockTM connectors. Other equivalent connectors are also suitable.
- the fluid source 110 includes a reservoir 120 for liquids and a gas source 122 for gases. Both the reservoir 120 and the gas source 122 include conduits 124, 125, through which the respective liquid or gas is transported to the respective valves 126, 127.
- An outflow conduit 130 extends from the valve 126, and passes through a heat exchanger 132, for heating and/or cooling the fluid in the conduit 130, and a pump 134, for delivering fluid to the pericardium.
- the conduit 130 terminates in a port 136, to which the line 114 attaches, by standard connection techniques (e.g., plug-type fits).
- the reservoir 120 is designed to hold liquids, such as water, sterile saline, lactated Ringer's Solution, therapeutic agents, drugs or the like, such as such as thrombolitic agents nitric oxide donors, coronary vascodilators, beta blockers, oxygen radical scavengers, platelet inhibitors, or mixtures thereof.
- the reservoir 120 may be surrounded by heating and/or cooling means, and if so, the fluid source 110 need not include the heat exchanger 132.
- the gas source 122 typically includes gases such as nitrogen, nitric oxide, and mixtures thereof. Alternately, either the reservoir 120 or gas source 122, or both, may be attached to the fluid source 110 at the time of use.
- valves 126, 127 are preferably two way valves, that are controllable either manually or automatically, to regulate precise amounts of liquid and gas. If automatic, the valves 126, 127 can be subject to microprocessor control.
- the heat exchanger 132 is capable of both heating and cooling the fluid passing through the outflow conduit 130, and if required, can alternately heat and cool the fluid passing through the heat exchanger 132.
- the heat exchanger 132 can be manually or automatically controlled, and if automatically controlled, may be done so by a microprocessor.
- the pump 134 preferably includes an internal valve (not shown) to assist in its control, and is capable of pumping at various speeds and in continuous and intermittent modes and is adjustable to various pressures.
- the intermittent modes can be timed or pulsatile.
- the pump 134 is also capable of pumping in reverse.
- the pump 134 may be manually or automatically controlled, and automatic control may be done with a microprocessor, to ensure proper fluid delivery, circulation therein and subsequent withdrawal from, of fluid in the pericardial space 34.
- the suction source 112 includes a port 140 for receiving the line 116, that attaches to the outer (fluid withdrawal) tube 108.
- This suction source 112 may include pumps, valves or the like and may be manually or automatically controlled.
- Automatic control includes microprocessor control, such that the actions of the valves 126, 127, heat exchanger 132, pump 134 and suction source 112 are integrated and coordinated by the microprocessor.
- a line with or without a pump along it, as well as additional devices, such as filters, for treating the withdrawn fluid prior to its return to the reservoir 120, could be connected from the suction source 112 to the reservoir 120 of the fluid source 110 to make a circuit. In this way fluid could be treated (for recycling) and subsequently returned to the pericardial space 34. This cycling could continue for as long as desired.
- Monitoring devices such as those for pressure or temperature, i.e., feedback sensors, may be placed along the outflow conduit 130, along the inner tube 106 or outer tube 108 of the catheter 104, or in the pericardial space 34, to monitor the fluid pressure and/or temperature at the requisite locations. If the system includes a microprocessor, the feedback sensors may be connected to the microprocessor for ultimately controlling the system components (e.g., valves, pumps, heat exchanger, etc.), as detailed above.
- the movement(s) of the pump 134 for delivering fluid into the pericardial space 34, heating and cooling of the fluid by the heat exchanger 132 and suction from the suction source 112, for withdrawing the fluid from the pericardial space 34, be coordinated to ensure proper fluid circulation within the pericardial space 34 for proper temperature control and treatment.
- the withdrawal by the suction source 112 could be coordinated with the fluid delivery process as one or several pulses of fluid could be accompanied by a pulse of suction.
- suction could be timed at predetermined intervals following a predetermined timed fluid delivery.
- a delivery/withdrawal of heated fluid could be followed by a delivery/withdrawal of cooled fluid.
- FIG. 6 shows another embodiment of the method of the present invention. This embodiment differs from that shown above (in FIGs. 5 and 5a), in that separate entries 160, 161 to the pericardial space 34 are provided by pericardiocentesis (described above) for fluid delivery 160 and fluid withdrawal 161, to and from the pericardial space 34. Additionally, different instrumentation is required as a result of instrumentizing two separate incisions 160, 161 in the pericardial space 34.
- these incisions 160, 161 be instrumentized (e.g., catheterized) with single lumen catheters 164, 166 (shown partially in broken lines in the pericardial space 34), with a delivery catheter 164 is used to deliver fluid through an opening 164a, while a withdrawal catheter 166 is used to withdraw fluid through an opening 166a, respectively, to and from the pericardial space 34.
- the delivery catheter 164 attaches to a line 168 at a connector 168a, that connects to the fluid source 110, while the withdrawal catheter 166 connects to a line 170 at a connector 170a, that connects to the suction source 112.
- either the reservoir 120 or gas source 122, or both may be attached to the fluid source 110 at the time of use. Additionally, fluid (liquid, gas or mixtures thereof) could be placed directly into the fluid delivery catheter 164 or its line 168 and/or fluid could be withdrawn directly from the withdrawal catheter 166 or its 170.
- monitoring devices such as those for pressure or temperature, i.e., feedback sensors, may be placed along the lines or along the catheters to monitor the pressure and/or temperature along the fluid delivery or withdrawal pathways.
- a line, with or without a pump along it, as well as additional devices, such as filters for treating the withdrawn fluid prior to its return to the reservoir 120 could be connected from the suction source 112 to the reservoir 120 of the fluid source 110 to make a circuit. In this way fluid could be treated (for recycling) and subsequently returned to the pericardial space 34. This cycling could continue for as long as desired.
- FIGs. 7 and 7a are similar to FIGs.
- the pericardial space 34 is catheterized with a double lumen catheter 204, in accordance with the methods described above.
- the catheter 204 has a first (fluid delivery) tube 206 for delivering fluid to the pericardial space 34, through an opening 207, and a second (fluid withdrawal) tube 208, extending beyond the first tube 206, for withdrawing fluid from the pericardial space 34, through an opening 209. This arrangement creates a circulation in the pericardial space 34 in the direction of arrows 210.
- a cooling pump 211 connects by lines 212, 214, at connectors 212a, 214a, to the first 206 and second 208 tubes, forming a circuit.
- Fluid for example, water, saline, or other fluid solutions including therapeutic agents, drugs or the like, or gases, or mixtures thereof (as discussed above), from a fluid source (not shown) is then introduced through a line (not shown) into this circuit, preferably at the cooling pump 211.
- fluid can be delivered to or withdrawn directly from the first 206 and second 208 tubes and/or lines 212, 214.
- the cooled fluid preferably cooled to approximately 0°C (just above freezing) to 25°C, by the cooling pump, in order to cool the heart approximately 2- 3°C below normal body temperature, is delivered, circulated in, and ultimately withdrawn from the pericardial space 34.
- the direction of this fluid transport is indicated by arrows 219.
- the fluid circulating in the pericardial space 34 cools the heart 26, in order to decrease the oxygen demand of the heart, and reduce heart attach size or possibly prevent a heart attack. Additionally, this might also reduce the chest pain associated with unstable angina pectoris.
- the cooling pump 211 preferably includes a valve (not shown) to release fluid from the circuit if necessary.
- the cooling pump 211 is capable of pumping in various speeds and modes (continuous and/or intermittent, as discussed above). Alternately, this cooling pump 211 could be a heating pump or a heating/cooling pump for providing therapy involving heating fluid as well as both heated and cooled fluid.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA002273954A CA2273954A1 (en) | 1996-12-06 | 1997-12-05 | Treatment method via the pericardial space |
AU53726/98A AU745717B2 (en) | 1996-12-06 | 1997-12-05 | Treatment method via the pericardial space |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/762,379 US6206004B1 (en) | 1996-12-06 | 1996-12-06 | Treatment method via the pericardial space |
US08/762,379 | 1996-12-06 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO1998024488A2 true WO1998024488A2 (en) | 1998-06-11 |
WO1998024488A3 WO1998024488A3 (en) | 1998-10-22 |
Family
ID=25064880
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1997/022224 WO1998024488A2 (en) | 1996-12-06 | 1997-12-05 | Treatment method via the pericardial space |
Country Status (4)
Country | Link |
---|---|
US (1) | US6206004B1 (en) |
AU (1) | AU745717B2 (en) |
CA (1) | CA2273954A1 (en) |
WO (1) | WO1998024488A2 (en) |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6237605B1 (en) | 1996-10-22 | 2001-05-29 | Epicor, Inc. | Methods of epicardial ablation |
US6569082B1 (en) | 1999-08-10 | 2003-05-27 | Origin Medsystems, Inc. | Apparatus and methods for cardiac restraint |
ITFI20080177A1 (en) * | 2008-09-16 | 2010-03-17 | El En Spa | "DEVICE FOR PERCUTARY SURGICAL TREATMENTS" |
US9055959B2 (en) | 1999-07-19 | 2015-06-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Methods and devices for ablation |
US10058380B2 (en) | 2007-10-05 | 2018-08-28 | Maquet Cordiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US10182824B2 (en) | 2010-11-11 | 2019-01-22 | Atricure, Inc. | Clip applicator |
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Families Citing this family (116)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5827216A (en) * | 1995-06-07 | 1998-10-27 | Cormedics Corp. | Method and apparatus for accessing the pericardial space |
US6123662A (en) * | 1998-07-13 | 2000-09-26 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US6406420B1 (en) * | 1997-01-02 | 2002-06-18 | Myocor, Inc. | Methods and devices for improving cardiac function in hearts |
US6183411B1 (en) * | 1998-09-21 | 2001-02-06 | Myocor, Inc. | External stress reduction device and method |
US6050936A (en) * | 1997-01-02 | 2000-04-18 | Myocor, Inc. | Heart wall tension reduction apparatus |
US6077214A (en) * | 1998-07-29 | 2000-06-20 | Myocor, Inc. | Stress reduction apparatus and method |
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US6332893B1 (en) * | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
US6585752B2 (en) * | 1998-06-23 | 2003-07-01 | Innercool Therapies, Inc. | Fever regulation method and apparatus |
US6231595B1 (en) | 1998-03-31 | 2001-05-15 | Innercool Therapies, Inc. | Circulating fluid hypothermia method and apparatus |
US6471717B1 (en) * | 1998-03-24 | 2002-10-29 | Innercool Therapies, Inc. | Selective organ cooling apparatus and method |
US6312452B1 (en) | 1998-01-23 | 2001-11-06 | Innercool Therapies, Inc. | Selective organ cooling catheter with guidewire apparatus and temperature-monitoring device |
US6096068A (en) | 1998-01-23 | 2000-08-01 | Innercool Therapies, Inc. | Selective organ cooling catheter and method of using the same |
US6379378B1 (en) | 2000-03-03 | 2002-04-30 | Innercool Therapies, Inc. | Lumen design for catheter |
US7371254B2 (en) * | 1998-01-23 | 2008-05-13 | Innercool Therapies, Inc. | Medical procedure |
US6325818B1 (en) | 1999-10-07 | 2001-12-04 | Innercool Therapies, Inc. | Inflatable cooling apparatus for selective organ hypothermia |
US6491039B1 (en) * | 1998-01-23 | 2002-12-10 | Innercool Therapies, Inc. | Medical procedure |
US6464716B1 (en) * | 1998-01-23 | 2002-10-15 | Innercool Therapies, Inc. | Selective organ cooling apparatus and method |
US7291144B2 (en) | 1998-03-31 | 2007-11-06 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation |
US6685732B2 (en) | 1998-03-31 | 2004-02-03 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation employing microporous balloon |
US7001378B2 (en) * | 1998-03-31 | 2006-02-21 | Innercool Therapies, Inc. | Method and device for performing cooling or cryo-therapies, for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation employing tissue protection |
US6602276B2 (en) | 1998-03-31 | 2003-08-05 | Innercool Therapies, Inc. | Method and device for performing cooling- or cryo-therapies for, e.g., angioplasty with reduced restenosis or pulmonary vein cell necrosis to inhibit atrial fibrillation |
US7922709B2 (en) | 1998-07-13 | 2011-04-12 | Genetronics, Inc. | Enhanced delivery of naked DNA to skin by non-invasive in vivo electroporation |
US6678556B1 (en) * | 1998-07-13 | 2004-01-13 | Genetronics, Inc. | Electrical field therapy with reduced histopathological change in muscle |
CA2337652C (en) * | 1998-07-13 | 2013-03-26 | Genetronics, Inc. | Skin and muscle-targeted gene therapy by pulsed electrical field |
US6260552B1 (en) * | 1998-07-29 | 2001-07-17 | Myocor, Inc. | Transventricular implant tools and devices |
US6673098B1 (en) * | 1998-08-24 | 2004-01-06 | Radiant Medical, Inc. | Disposable cassette for intravascular heat exchange catheter |
US6620189B1 (en) | 2000-02-28 | 2003-09-16 | Radiant Medical, Inc. | Method and system for control of a patient's body temperature by way of a transluminally insertable heat exchange catheter |
US6488689B1 (en) | 1999-05-20 | 2002-12-03 | Aaron V. Kaplan | Methods and apparatus for transpericardial left atrial appendage closure |
US7398781B1 (en) * | 1999-08-10 | 2008-07-15 | Maquet Cardiovascular, Llc | Method for subxiphoid endoscopic access |
US7526342B2 (en) * | 1999-08-10 | 2009-04-28 | Maquet Cardiovascular Llc | Apparatus for endoscopic cardiac mapping and lead placement |
US7264587B2 (en) * | 1999-08-10 | 2007-09-04 | Origin Medsystems, Inc. | Endoscopic subxiphoid surgical procedures |
US20030187460A1 (en) * | 1999-08-10 | 2003-10-02 | Chin Albert K. | Methods and apparatus for endoscopic cardiac surgery |
US20030187461A1 (en) * | 1999-08-10 | 2003-10-02 | Chin Albert K. | Releasable guide and method for endoscopic cardiac lead placement |
US7597698B2 (en) * | 1999-08-10 | 2009-10-06 | Maquet Cardiovascular Llc | Apparatus and method for endoscopic encirclement of pulmonary veins for epicardial ablation |
US6231594B1 (en) * | 1999-08-11 | 2001-05-15 | Radiant Medical, Inc. | Method of controlling body temperature while reducing shivering |
US20060287574A1 (en) * | 1999-08-25 | 2006-12-21 | Chin Albert K | Longitudinal dilator |
US6463332B1 (en) * | 1999-09-17 | 2002-10-08 | Core Medical, Inc. | Method and system for pericardial enhancement |
US20050154370A1 (en) * | 1999-10-29 | 2005-07-14 | Medtronic, Inc. | Methods and systems for providing therapies into the pericardial space |
US7758521B2 (en) * | 1999-10-29 | 2010-07-20 | Medtronic, Inc. | Methods and systems for accessing the pericardial space |
AU4523301A (en) * | 1999-12-14 | 2001-06-25 | Radiant Medical, Inc. | Method for reducing myocardial infarct by applicaton of intravascular hypothermia |
US6447443B1 (en) * | 2001-01-13 | 2002-09-10 | Medtronic, Inc. | Method for organ positioning and stabilization |
US20020107514A1 (en) * | 2000-04-27 | 2002-08-08 | Hooven Michael D. | Transmural ablation device with parallel jaws |
US6932811B2 (en) * | 2000-04-27 | 2005-08-23 | Atricure, Inc. | Transmural ablation device with integral EKG sensor |
US6425856B1 (en) * | 2000-05-10 | 2002-07-30 | Acorn Cardiovascular, Inc. | Cardiac disease treatment and device |
US6616684B1 (en) * | 2000-10-06 | 2003-09-09 | Myocor, Inc. | Endovascular splinting devices and methods |
US6723038B1 (en) | 2000-10-06 | 2004-04-20 | Myocor, Inc. | Methods and devices for improving mitral valve function |
US6719723B2 (en) | 2000-12-06 | 2004-04-13 | Innercool Therapies, Inc. | Multipurpose catheter assembly |
US6890295B2 (en) * | 2002-10-31 | 2005-05-10 | Medtronic, Inc. | Anatomical space access tools and methods |
US6450987B1 (en) | 2001-02-01 | 2002-09-17 | Innercool Therapies, Inc. | Collapsible guidewire lumen |
JP2003007916A (en) * | 2001-06-19 | 2003-01-10 | Sanyo Electric Co Ltd | Method of manufacturing circuit device |
DK1423066T3 (en) | 2001-09-07 | 2008-11-17 | Mardil Inc | Method and apparatus for external cardiac stabilization |
US6764510B2 (en) | 2002-01-09 | 2004-07-20 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7967816B2 (en) * | 2002-01-25 | 2011-06-28 | Medtronic, Inc. | Fluid-assisted electrosurgical instrument with shapeable electrode |
US7610104B2 (en) * | 2002-05-10 | 2009-10-27 | Cerebral Vascular Applications, Inc. | Methods and apparatus for lead placement on a surface of the heart |
US7247134B2 (en) * | 2002-11-12 | 2007-07-24 | Myocor, Inc. | Devices and methods for heart valve treatment |
AU2003295380A1 (en) | 2002-11-12 | 2004-06-03 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7112219B2 (en) * | 2002-11-12 | 2006-09-26 | Myocor, Inc. | Devices and methods for heart valve treatment |
US20040138521A1 (en) * | 2003-01-10 | 2004-07-15 | Grabek James R. | Myocardial constraint |
US20040167466A1 (en) * | 2003-02-21 | 2004-08-26 | Drasler William J. | Delivering cooled fluid to sites inside the body |
US7883500B2 (en) * | 2003-03-26 | 2011-02-08 | G&L Consulting, Llc | Method and system to treat and prevent myocardial infarct expansion |
US20040267338A1 (en) * | 2003-06-25 | 2004-12-30 | Kent Harrison | Targeted tissue cooling within a body |
EP1682034B1 (en) * | 2003-10-09 | 2018-11-21 | Sentreheart, Inc. | Apparatus for the ligation of tissue |
US7326195B2 (en) * | 2003-11-18 | 2008-02-05 | Boston Scientific Scimed, Inc. | Targeted cooling of tissue within a body |
US7186214B2 (en) * | 2004-02-12 | 2007-03-06 | Medtronic, Inc. | Instruments and methods for accessing an anatomic space |
US20060008449A1 (en) * | 2004-06-10 | 2006-01-12 | Van Tassel Jason R | Device and methods for treatment of necrotic tissue using stem cells |
US20060025840A1 (en) * | 2004-08-02 | 2006-02-02 | Martin Willard | Cooling tissue inside the body |
US7618410B2 (en) * | 2004-10-05 | 2009-11-17 | Cardia Access, Inc. | Devices and methods for access through a tissue wall |
US7226440B2 (en) * | 2005-01-31 | 2007-06-05 | G & L Consulting, Llc | Method and device for accessing a pericardial space |
US7918865B2 (en) * | 2005-04-07 | 2011-04-05 | Sentreheart, Inc. | Apparatus and method for the ligation of tissue |
EP2305188B1 (en) * | 2005-04-27 | 2015-06-03 | ZOLL Circulation, Inc. | Apparatus for providing enhanced heat transfer from a body |
US8500720B2 (en) * | 2005-05-09 | 2013-08-06 | Medtronic, Inc | Method and apparatus for treatment of cardiac disorders |
US8932208B2 (en) | 2005-05-26 | 2015-01-13 | Maquet Cardiovascular Llc | Apparatus and methods for performing minimally-invasive surgical procedures |
US20070010793A1 (en) * | 2005-06-23 | 2007-01-11 | Cardiac Pacemakers, Inc. | Method and system for accessing a pericardial space |
US7963940B2 (en) * | 2005-08-22 | 2011-06-21 | Boston Scientific Scimed, Inc. | Local perfusion device |
US20070233219A1 (en) * | 2006-02-16 | 2007-10-04 | Bilal Shafi | Polymeric heart restraint |
US20070208217A1 (en) * | 2006-03-03 | 2007-09-06 | Acorn Cardiovascular, Inc. | Self-adjusting attachment structure for a cardiac support device |
US20070270882A1 (en) * | 2006-05-19 | 2007-11-22 | Acorn Cardiovascular, Inc. | Pericardium management method for intra-pericardial surgical procedures |
US20080125708A1 (en) * | 2006-05-30 | 2008-05-29 | Da-Li Feng | Intra-pericardial protective device |
US20080004488A1 (en) * | 2006-06-29 | 2008-01-03 | Acorn Cardiovascular, Inc. | Low friction delivery tool for a cardiac support device |
US7651462B2 (en) | 2006-07-17 | 2010-01-26 | Acorn Cardiovascular, Inc. | Cardiac support device delivery tool with release mechanism |
US20080051864A1 (en) * | 2006-08-22 | 2008-02-28 | Cardiac Pacemakers, Inc. | Epicardial lead |
US10166066B2 (en) | 2007-03-13 | 2019-01-01 | University Of Virginia Patent Foundation | Epicardial ablation catheter and method of use |
WO2008118737A1 (en) * | 2007-03-22 | 2008-10-02 | University Of Virginia Patent Foundation | Electrode catheter for ablation purposes and related method thereof |
US9468396B2 (en) | 2007-03-19 | 2016-10-18 | University Of Virginia Patent Foundation | Systems and methods for determining location of an access needle in a subject |
US11058354B2 (en) | 2007-03-19 | 2021-07-13 | University Of Virginia Patent Foundation | Access needle with direct visualization and related methods |
CA2680639C (en) | 2007-03-19 | 2017-03-07 | University Of Virginia Patent Foundation | Access needle pressure sensor device and method of use |
EP2574287B1 (en) | 2007-03-30 | 2015-04-22 | Sentreheart, Inc. | Devices for closing the left atrial appendage |
WO2008147678A1 (en) * | 2007-05-21 | 2008-12-04 | Epitek, Inc. | Left atrial appendage closure |
US20080294175A1 (en) * | 2007-05-21 | 2008-11-27 | Epitek, Inc. | Left atrial appendage closure |
US20090036875A1 (en) * | 2007-07-30 | 2009-02-05 | Robert Glenmore Walsh | Cardiac tissue therapy |
US20090036965A1 (en) * | 2007-07-30 | 2009-02-05 | Robert Glenmore Walsh | Conjunctive stent therapy |
EP2214563B1 (en) | 2007-09-20 | 2017-04-19 | Sentreheart, Inc. | Devices and methods for remote suture management |
WO2009062061A1 (en) | 2007-11-09 | 2009-05-14 | University Of Virginia Patent Foundation | Steerable epicardial pacing catheter system placed via the subxiphoid process |
US8663321B2 (en) * | 2007-12-06 | 2014-03-04 | L. Van Thomas Crisco | Minimally invasive method for coronary bypass and other treatments |
US20090170933A1 (en) * | 2007-12-26 | 2009-07-02 | Cook Incorporated | Method for removing a medical device from a spasmodic constriction in a bodily passageway |
US9393023B2 (en) | 2009-01-13 | 2016-07-19 | Atricure, Inc. | Apparatus and methods for deploying a clip to occlude an anatomical structure |
US8332641B2 (en) * | 2009-01-30 | 2012-12-11 | Freescale Semiconductor, Inc. | Authenticated debug access for field returns |
US20100234827A1 (en) * | 2009-03-13 | 2010-09-16 | Sigg Daniel C | Method of treating heart failure |
US9198664B2 (en) | 2009-04-01 | 2015-12-01 | Sentreheart, Inc. | Tissue ligation devices and controls therefor |
US20100274129A1 (en) * | 2009-04-24 | 2010-10-28 | Hooven Michael D | Apparatus And Methods for Separating Pericardial Tissue From The Epicardium of the Heart |
US9642534B2 (en) | 2009-09-11 | 2017-05-09 | University Of Virginia Patent Foundation | Systems and methods for determining location of an access needle in a subject |
CA2790328C (en) | 2010-02-18 | 2017-04-18 | University Of Virginia Patent Foundation | System, method, and computer program product for simulating epicardial electrophysiology procedures |
EP2558014A4 (en) | 2010-04-13 | 2017-11-29 | Sentreheart, Inc. | Methods and devices for treating atrial fibrillation |
CN106974692B (en) | 2011-06-08 | 2021-06-01 | 森特里心脏股份有限公司 | Tissue ligation device and tensioning device therefor |
CA2898620C (en) | 2012-10-12 | 2022-10-04 | Mardil, Inc. | Cardiac treatment system and method |
US9278023B2 (en) | 2012-12-14 | 2016-03-08 | Zoll Circulation, Inc. | System and method for management of body temperature |
CA2902064C (en) | 2013-03-12 | 2021-06-01 | Sentreheart, Inc. | Tissue ligation devices and methods therefor |
USD717954S1 (en) | 2013-10-14 | 2014-11-18 | Mardil, Inc. | Heart treatment device |
WO2015066549A1 (en) | 2013-10-31 | 2015-05-07 | Sentreheart, Inc. | Devices and methods for left atrial appendage closure |
US9709609B2 (en) | 2014-07-14 | 2017-07-18 | Covidien Lp | Systems and methods for improving the range of sensor systems |
EP4282371A3 (en) | 2015-03-24 | 2024-03-06 | AtriCure, Inc. | Devices for left atrial appendage closure |
US10130369B2 (en) | 2015-03-24 | 2018-11-20 | Sentreheart, Inc. | Tissue ligation devices and methods therefor |
KR20180088656A (en) | 2015-11-25 | 2018-08-06 | 탈론 메디컬, 엘엘씨 | Tissue coupling device, system, and method |
EP3419531B1 (en) | 2016-02-26 | 2024-04-03 | AtriCure, Inc. | Devices for left atrial appendage closure |
WO2017164752A1 (en) * | 2016-03-22 | 2017-09-28 | Kameczura Tomasz | Cooling liquid, method, device and pericardial catheter for the heart hypothermia and application of the cooling liquid |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5452733A (en) * | 1993-02-22 | 1995-09-26 | Stanford Surgical Technologies, Inc. | Methods for performing thoracoscopic coronary artery bypass |
US5735290A (en) * | 1993-02-22 | 1998-04-07 | Heartport, Inc. | Methods and systems for performing thoracoscopic coronary bypass and other procedures |
Family Cites Families (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4003379A (en) | 1974-04-23 | 1977-01-18 | Ellinwood Jr Everett H | Apparatus and method for implanted self-powered medication dispensing |
US3923060A (en) | 1974-04-23 | 1975-12-02 | Jr Everett H Ellinwood | Apparatus and method for implanted self-powered medication dispensing having timing and evaluator means |
US4531935A (en) * | 1983-01-13 | 1985-07-30 | Med-West, Incorporated | Cardioplegia/air aspiration cannula |
US5387419A (en) | 1988-03-31 | 1995-02-07 | The University Of Michigan | System for controlled release of antiarrhythmic agents |
US4991578A (en) | 1989-04-04 | 1991-02-12 | Siemens-Pacesetter, Inc. | Method and system for implanting self-anchoring epicardial defibrillation electrodes |
IT1251509B (en) | 1989-11-24 | 1995-05-16 | Leonardo Cammilli | IMPLANTABLE DEFIBRILLATOR WITH AUTOMATIC RECOGNITION OF VENTRICULAR FIBRILLATION, WITH PHARMACOLOGICAL ACTION |
US5213570A (en) | 1990-12-14 | 1993-05-25 | Mallinckrodt Medical, Inc. | System and method for oxygenation of the pericardium |
US5269326A (en) | 1991-10-24 | 1993-12-14 | Georgetown University | Method for transvenously accessing the pericardial space via the right auricle for medical procedures |
US5336252A (en) | 1992-06-22 | 1994-08-09 | Cohen Donald M | System and method for implanting cardiac electrical leads |
US5358481A (en) * | 1993-06-03 | 1994-10-25 | Research Medical, Inc. | Apparatus and methods for controlling mixtures of blood and cardioplegia |
US5505698A (en) * | 1993-10-29 | 1996-04-09 | Medtronic, Inc. | Cardioplegia catheter with elongated cuff |
US5681278A (en) | 1994-06-23 | 1997-10-28 | Cormedics Corp. | Coronary vasculature treatment method |
US5702358A (en) * | 1995-02-23 | 1997-12-30 | Sorin Biomedical Inc. | Cardioplegia delivery apparatus and method of use |
US5827216A (en) | 1995-06-07 | 1998-10-27 | Cormedics Corp. | Method and apparatus for accessing the pericardial space |
US5762868A (en) * | 1995-11-30 | 1998-06-09 | Minnesota Mining And Manufacturing Company | Blood oxygenator and heat exchanger |
-
1996
- 1996-12-06 US US08/762,379 patent/US6206004B1/en not_active Expired - Fee Related
-
1997
- 1997-12-05 WO PCT/US1997/022224 patent/WO1998024488A2/en active IP Right Grant
- 1997-12-05 CA CA002273954A patent/CA2273954A1/en not_active Abandoned
- 1997-12-05 AU AU53726/98A patent/AU745717B2/en not_active Ceased
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5452733A (en) * | 1993-02-22 | 1995-09-26 | Stanford Surgical Technologies, Inc. | Methods for performing thoracoscopic coronary artery bypass |
US5735290A (en) * | 1993-02-22 | 1998-04-07 | Heartport, Inc. | Methods and systems for performing thoracoscopic coronary bypass and other procedures |
Cited By (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US6237605B1 (en) | 1996-10-22 | 2001-05-29 | Epicor, Inc. | Methods of epicardial ablation |
US9055959B2 (en) | 1999-07-19 | 2015-06-16 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Methods and devices for ablation |
US6569082B1 (en) | 1999-08-10 | 2003-05-27 | Origin Medsystems, Inc. | Apparatus and methods for cardiac restraint |
US10058380B2 (en) | 2007-10-05 | 2018-08-28 | Maquet Cordiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
US10993766B2 (en) | 2007-10-05 | 2021-05-04 | Maquet Cardiovascular Llc | Devices and methods for minimally-invasive surgical procedures |
ITFI20080177A1 (en) * | 2008-09-16 | 2010-03-17 | El En Spa | "DEVICE FOR PERCUTARY SURGICAL TREATMENTS" |
US10433854B2 (en) | 2010-10-27 | 2019-10-08 | Atricure, Inc. | Appendage clamp deployment assist device |
US11883035B2 (en) | 2010-10-27 | 2024-01-30 | Atricure, Inc. | Appendage clamp deployment assist device |
US10182824B2 (en) | 2010-11-11 | 2019-01-22 | Atricure, Inc. | Clip applicator |
Also Published As
Publication number | Publication date |
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AU5372698A (en) | 1998-06-29 |
AU745717B2 (en) | 2002-03-28 |
WO1998024488A3 (en) | 1998-10-22 |
CA2273954A1 (en) | 1998-06-11 |
US6206004B1 (en) | 2001-03-27 |
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