adjustable self-locking papillary muscle band

专利摘要:
  The present invention relates to a device for repositioning papillary muscles. The device may comprise a band configured to engage a group of papillary muscles. The papillary muscle group may have an external peripheral limit defined by the surrounding band, and the band may comprise a first end and a second end. The device may further comprise an adjustable latch coupled to a location close to the first end of the strip. The lock can be configured to move from an open configuration to a closed configuration to connect the second end of the strip to the first end of the strip, thus forming a circuit. The lock can be selectively triggerable to adjust a length of the circuit.
公开号:BR112020008123A2
申请号:R112020008123-0
申请日:2018-10-22
公开日:2020-10-27
发明作者:David Neustadter
申请人:Cardiac Success Ltd.；
IPC主号:

专利说明:

[0001] [0001] This application claims the priority of the application for US Provisional Patent 62 / 575,538, filed on October 23, 2017, which is incorporated by reference in its entirety in this application. Field of the Invention
[0002] [0002] Some applications of the present invention relate, in general, to devices and methods for repositioning papillary muscles. More specifically, some applications of the present invention relate to an adjustable self-locking band for, by transcatheter, repositioning the papillary muscles in a heart of a body. Background
[0003] [0003] Repositioning the papillary muscles within the ventricles of the heart during atrioventricular valve repair surgery can improve results. The displacement of the papillary muscles, due to ischemia, heart failure or other causes of ventricular remodeling, can result in the binding of the valve leaflets, which can interfere with their normal functioning. Repairs that focus only on the valve ring usually result in a recurrence of regurgitation due to the leaflet tying.
[0004] [0004] Methods of repositioning the papillary muscle include sutures of the papillary muscle (s) to the valve or aortic ring, slings that involve various papillary muscles to join the papillary muscles and sutures to join the papillary muscles. However, these methods of repositioning the papillary muscle are typically performed during open heart surgery.
[0005] [0005] Therefore, there is a need for less invasive systems and methods to perform the repositioning of the papillary muscle.
[0006] [0006] The currently disclosed modalities recognize that there is a need for improved devices and methods to reposition the papillary muscles, which can be more easily positioned, adjusted and locked in place than conventional devices and methods. In addition, the modalities currently disclosed may address the need for devices and methods to reposition the papillary muscles that have the potential to allow the repositioning of the papillary muscle to be performed in a heart pumped through a catheter. In addition, conventional devices and methods for repositioning the papillary muscle have had little commercial success. Therefore, there is a need for improved devices and methods, regardless of whether they are provided by a catheter or in some other way.
[0007] [0007] The embodiments of the present invention include devices and methods for repositioning papillary muscles. Advantageously, the exemplary modalities provide a method of repositioning the papillary muscles by delivering a band to surround a plurality of papillary muscles and an adjustable closure at a first end of the band to connect to a second end of the band in order to form a circuit. Various description modalities can include one or more of the following aspects.
[0008] [0008] In accordance with an embodiment of the present invention, a device for repositioning papillary muscles is provided, the device comprising a band configured to surround a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band, in that the strip comprises a first end and a second end, and an adjustable latch coupled to a location close to the first end of the strip, where the latch is configured to move from an open configuration to a closed configuration to connect the second end from the strip to the first end of the strip, thus forming a circuit. In some embodiments of the present invention, the plurality of papillary muscles can include two and / or three papillary muscles within a ventricle of a heart. Certainly, the band can be configured to be passed through a plurality of spaces between the trabeculae between the papillary muscles and a wall of a ventricle.
[0009] [0009] According to another embodiment of the present invention, the adjustable closure may include a plurality of clips projecting radially inward so that, in the closed configuration, the clips are configured to tighten the second end of the band between them. In other embodiments, the adjustable closure may include metal.
[0010] [0010] According to another embodiment of the present invention, the adjustable lock can be configured to be kept in an open configuration by a lock retaining ring located inside the lock. Certainly, in some embodiments, the adjustable closure can be configured to return to a closed configuration upon retraction of the closure retainer ring from within the closure. In the closed configuration, the adjustable lock can be configured to secure the second end of the strip to form a circuit.
[0011] [0011] In another embodiment of the present invention, the band can surround a group of papillary muscles, and the group of papillary muscles can include an internal region on the sides of the papillary muscles opposite the outer peripheral limit. Certainly, in some modalities, the band can be configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the internal region and so that the inner region is devoid of any portion of the strip. In another embodiment of the present invention,
[0012] [0012] In yet another embodiment of the present invention, the adjustable closure can be configured to fix a length of the circuit so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference. Certainly, the length of the circuit around the papillary muscles can be adjusted over a range of at least 8 mm.
[0013] [0013] In some embodiments of the present invention, at least a portion of the strip may include a tube. For example, at least a portion of the strip may include a concave tube. Certainly, in some embodiments, the adjustable closure can be configured to be fitted within the portion of the strip that includes the tube. In some embodiments, the width of the strip may vary over different portions of a strip length. According to an embodiment of the present invention, the adjustable closure can be operated within a heart. In other embodiments of the present invention, the adjustable closure can be operated from the outside of a body via a catheter.
[0014] [0014] According to another embodiment of the present invention, a device for repositioning papillary muscles is provided, the device comprising a band configured to surround a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band, in that the strip comprises a first end and a second end, and an adjustable latch coupled to a location close to the first end of the strip, where the latch is configured to move from an open configuration to a closed configuration to connect the second end from the strip to the first end of the strip, thus forming a circuit, and the lock is selectively operable to adjust a length of the loop. The papillary muscle group may include an internal region on the sides of the papillary muscles opposite the outer peripheral limit. Certainly, the band can be configured to pull the pillar muscles towards each other so that the band comes into contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the region internal area is stripped of any portion of the strip. The adjustable closure can be configured to fix a length of the circuit so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference. Certainly, the length of the circuit around the papillary muscles can be adjustable over a range of at least 8 mm.
[0015] [0015] In some embodiments of the present invention, the plurality of papillary muscles can include two and / or three papillary muscles within a ventricle of a heart. Certainly, the band can be configured to be passed through a plurality of spaces between the trabeculae between the papillary muscles and a wall of a ventricle.
[0016] [0016] According to another embodiment of the present invention, the adjustable closure may include a plurality of clips projecting radially inward so that, in the closed configuration, the clips are configured to tighten the second end of the band between them.
[0017] [0017] According to another embodiment of the present invention, the adjustable lock can be configured to be kept in an open configuration by a lock retainer ring located inside the lock. Certainly, in some embodiments, the adjustable closure can be configured to return to a closed configuration upon retraction of the closure retainer ring from within the closure. In the closed configuration, the adjustable lock can be configured to secure the second end of the strip to form a circuit.
[0018] [0018] In accordance with another embodiment of the present invention, a transcatheter system for surrounding a plurality of papillary muscles is provided, the system comprising a band comprising a first end, a second end, and an opening in a side wall of the band . The band can be configured to involve a group of papillary muscles, and the group can have an external peripheral limit defined by the surrounding band. The system can also comprise an administration device, which can be configured to be inserted at the opening of the strip. The system may also comprise an actionable lock coupled to a second end of the strip. The administration device can be configured to activate the closing.
[0019] [0019] In some modalities, the group may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. The group of papillary muscles can include two or more papillary muscles within a ventricle of a heart. The band can be configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle. The band can be configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track. In other modalities, the band can also be configured to pull the papillary muscles towards each other, thus reducing a distance between opposite surfaces of the papillary muscles. The lock can be selectively triggerable for
[0020] [0020] In some embodiments, the delivery device may also include an outer tube and an inner tube extending distally beyond a distal end of the outer tube. The inner tube can be positioned inside the actionable lock, thus retaining the lock in an open configuration. Certainly, a retraction of the inner tube from within the closure to the outer tube can be configured to allow the closure to return to a closed configuration.
[0021] [0021] In other embodiments, the actionable closure may include a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten a first end of the strip between them. The actionable lock can include metal.
[0022] [0022] According to another embodiment of the present invention, a transcatheter system to surround a plurality of papillary muscles can be provided. The system can comprise a full range
[0023] [0023] In some embodiments, the delivery device may also include an outer tube and an inner tube extending distally beyond a distal end of the outer tube. The inner tube can be positioned inside the actionable lock, thus retaining the lock in an open configuration. Certainly, a retraction of the inner tube from within the closure to the outer tube can be configured to allow the closure to return to a closed configuration.
[0024] [0024] In other embodiments, the actionable closure may include a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten a first end of the strip between them.
[0025] [0025] The group of papillary muscles may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. Certainly, the band can be configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the internal region and so that the region internal area is stripped of any portion of the strip. The adjustable closure can be configured to fix a length of the circuit so that the outer peripheral limit of the papillary muscle group reaches a circumference
[0026] [0026] According to another embodiment of the present invention, a transcatheter device for surrounding a plurality of papillary muscles is provided. The device may comprise an adjustable band configured to engage a group of papillary muscles, a spring clasp attached to a location close to the first end of the adjustable band, an elongated positioner attached to a location close to a second end of the adjustable band, and a closure seal arranged, at least partially, within the spring closure. The group may have an external peripheral limit defined by the surrounding band. The elongated positioner can be configured to selectively position the second end of the adjustable strip adjacent to the spring lock. The lock retainer can be configured to resist bias in the spring lock. In some embodiments, a retraction of the retainer from within the spring closure can be configured to return the spring closure to a closed configuration, thus forming a circuit around the group of papillary muscles.
[0027] [0027] In some embodiments, the spring lock may include a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the adjustable band between them. The spring lock may include metal.
[0028] [0028] In some modalities, the group may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. The group of papillary muscles can include two or more papillary muscles within a ventricle of a heart. The band can be configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle. The adjustable band can be configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any adjustable range portion. In other ways, the adjustable band can also be configured to pull the papillary muscles towards each other, thus reducing a distance between opposing surfaces of the papillary muscles. The spring lock can be configured to fix a length of a formed circuit so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference. The length of the circuit can be adjusted over a range of at least 8 mm.
[0029] [0029] In some embodiments, at least a portion of the adjustable band may include a tube. The spring lock can be configured to be fitted within the portion of the tube close to the first end of the adjustable range. The polarized spring can also be configured to be activated within a heart. In other ways, the spring lock can be configured to be activated, through a catheter, from the outside of a body.
[0030] [0030] According to another embodiment of the present invention, a transcatheter device for surrounding a plurality of papillary muscles is provided. The device may comprise an adjustable band configured to engage a group of papillary muscles, a spring clasp attached within the adjustable band at a location close to the first end of the adjustable band, an elongated positioner attached to a location close to a second end of the adjustable band, and a lock retainer arranged, at least partially, within the spring lock. The group may have an external peripheral limit defined by the surrounding range. The extended positioner can be configured to selectively position the second
[0031] [0031] In some embodiments, the spring lock may include a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the adjustable band between them. The spring lock may include metal.
[0032] [0032] In some modalities, the group may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. The band can be configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle. The adjustable band can be configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region be stripped of any portion of the adjustable range. The length of the circuit can be adjusted over a range of at least 8 mm.
[0033] [0033] In some embodiments, at least a portion of the adjustable band may include a tube. The spring lock can be configured to be fitted within the portion of the tube close to the first end of the adjustable range. The polarized spring can also be configured to be activated within a heart. In other ways, the spring lock can be configured to be activated, through a catheter, from the outside of a body.
[0034] [0034] According to another embodiment of the present invention, a transcatheter device for surrounding a plurality of papillary muscles is provided. The device may comprise a strip comprising a first end and a second end, a first connector coupled to the first end of the strip, an administration device comprising a second connector, and a lock at the second end of the strip. The second connector can be initially connected to the first connector and can be configured to be remotely actionable to disconnect from the first connector to allow removal of the body's administration device. The lock can be configured to be remotely operable to permanently connect the lock to a portion of the strip near the first end, thus forming a circuit.
[0035] [0035] In other modalities, the band can be configured to involve a group of papillary muscles, and the group can have an external peripheral limit defined by the surrounding band. In other respects, the closure may be a spring closure comprising a movable retainer disposed, at least partially, within the closure to resist biasing of the spring closure.
[0036] [0036] In some modalities, the group may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. The group of papillary muscles can include two or more papillary muscles within a ventricle of a heart. The strip can be configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and the wall of a ventricle. The band can be configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[0037] [0037] In other modalities, the band can also be configured to pull the papillary muscles towards each other, thus reducing a distance between opposite surfaces of the papillary muscles. The plug can be selectively operable to adjust a length of the circuit. The closure can also be configured to fix a length of a formed circuit so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference. The length of the circuit can be adjusted over a range of at least 8 mm.
[0038] [0038] In other respects, the closure may include a plurality of clamps projecting radially inward so that, in a closed configuration, the clamps are configured to tighten the first end of the strip between them. The closure can be configured to be triggered within a heart. Additionally or alternatively, the closure can be configured to be activated, via a catheter, from the outside of a body.
[0039] [0039] According to another embodiment of the present invention, a transcatheter device for surrounding a plurality of papillary muscles is provided. The device may comprise a strip comprising a first end and a second end, a first connector coupled to the first end of the strip, an administration device comprising a second connector, and a spring lock at the second end of the strip. The second connector can be initially connected to the first connector and can be configured to be remotely actionable to disconnect from the first connector to allow removal of the body's delivery device. The spring lock can be configured to be remotely actionable to permanently connect the spring lock to a portion of the strip near the first end, thus forming a circuit.
[0040] [0040] In other modalities, the band can be configured to involve a group of papillary muscles, and the group can have an external peripheral limit defined by the surrounding band. In other respects, the spring lock may also include a movable retainer arranged, at least partially, within the spring lock to resist the spring lock being bent.
[0041] [0041] In some modalities, the group may include an internal region on the sides of the papillary muscles opposite the external peripheral limit. The group of papillary muscles can include two or more papillary muscles within a ventricle of a heart. The band can be configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle. The band can be configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track. In other modalities, the band can also be configured to pull the papillary muscles towards each other, thus reducing a distance between opposite surfaces of the papillary muscles. The lock can selectively be operable to adjust a length of the circuit. The length of the circuit can be adjusted over a range of at least 8 mm.
[0042] [0042] Additional objects and advantages of the modalities will be presented in part in the description that follows, and in part will be obvious from the description or can be learned by practicing the modalities. The objectives and advantages of the modalities will be realized and achieved through the elements and combinations particularly pointed out in the attached claims.
[0043] [0043] It should be understood that both the general description above and the detailed description below are exemplary and explanatory and are not restrictive of the claims.
[0044] [0044] The new features of the invention are presented with particularity in the following claims. A better understanding of the characteristics and advantages of the present invention will be obtained by reference to the following detailed description which presents illustrative modalities, in which the principles of the invention are used and the accompanying drawings:
[0045] [0045] Figure 1A illustrates an exemplary device for repositioning papillary muscles, according to an embodiment of the present invention;
[0046] [0046] Figure 1 B illustrates an exemplary device for repositioning papillary muscles, according to another embodiment of the present invention;
[0047] [0047] Figure 1 C illustrates an enlarged view of the exemplary device of Figure 1B.
[0048] [0048] Figure 2 illustrates an exemplary band for repositioning papillary muscles in a circuit, according to another embodiment of the present invention;
[0049] [0049] Figure 3 illustrates an exemplary anatomy of a human heart in which the modalities of the present invention can be used;
[0050] [0050] Figure 4 illustrates an exemplary embodiment of an adjustable closure, according to an embodiment of the present invention;
[0051] [0051] Figure 5 illustrates another exemplary embodiment of an adjustable closure, according to one embodiment of the present invention;
[0052] [0052] Figure 6 illustrates another exemplary embodiment of an adjustable closure, according to one embodiment of the present invention;
[0053] [0053] Figure 7 A illustrates an exemplary embodiment of an adjustable closure, according to an embodiment of the present invention;
[0054] [0054] Figure 7B illustrates another exemplary embodiment of an adjustable closure, according to one embodiment of the present invention;
[0055] [0055] Figure 7C illustrates another exemplary embodiment of an adjustable closure, according to one embodiment of the present invention;
[0056] [0056] Figure 7D illustrates another exemplary embodiment of an adjustable closure, according to one embodiment of the present invention;
[0057] [0057] Figure 8 illustrates an exemplary human body in which the modalities of the present invention can be employed;
[0058] [0058] Figure 9 illustrates an exemplary delivery device in which the embodiments of the present invention can be employed;
[0059] [0059] Figure 10 illustrates an exemplary administration device with an exemplary insertion cable, according to the modalities of the present invention; and
[0060] [0060] Figure 11 illustrates another exemplary administration device in which the modalities of the present invention can be used. Detailed Description of the Modalities
[0061] [0061] The present invention relates to methods and devices for repositioning papillary muscles. While the present invention provides examples of repositioning of the papillary muscles by circu- lating a band around the plurality of papillary muscles, it should be noted that aspects of the description in its broadest sense should not be limited to circuiting a band around the plurality of papillary muscles. Still, it is contemplated that the aforementioned principles can be applied to other devices to reposition papillary muscles as well. The term strip refers, generally, to any element that is capable of partially or completely surrounding a desired anatomy. For example, a band may be an element that is capable of partially or completely surrounding a plurality of papillary muscles in the ventricle of the heart in order to bring the papillary muscles closer together. A band surrounding the plurality of papillary muscles, as illustrated in Figure 3, is an example of a device for repositioning the papillary muscles, in accordance with the present invention. Winding may involve partially or completely surrounding one or more papillary muscles.
[0062] [0062] With reference to Figures 1A-1 C, an exemplary device 100 for repositioning papillary muscles, according to the present invention, may include a band 110. Band 110 may comprise a first end 120 and a second end 130. A band 110 can be positioned around at least one, optionally at least two, papillary muscles within a ventricle of a heart. The band 110 can be selectively configurable between an elongated configuration, in which the first end 120 is disconnected from the second end 130, and a circuit configuration, in which the band 110 is formed in a circuit, as shown in Figures 1A- 1 C. In some modalities, the band can be dimensioned to simultaneously surround a plurality of papillary muscles, thus forming a circuit around the papillary muscles, and pulling the papillary muscles towards each other. The term "strip" can include a tube. Alternatively, strip 110 may be a tube. In some embodiments, a portion of the strip 110 may be a tube and another portion of the strip 110 may not be a tube. Strip 110 can have different widths over different portions of its length as shown in Figures 1A-1 C.
[0063] [0063] In some embodiments of the present invention, strip 110 may be made of polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), Dacron and / or any other biologically inert synthetic material with tensile strength suitable for use in traction of the papillary muscles closer together. In other embodiments, strip 110 can be manufactured by extrusion, knitting, weaving, braiding or any other method to form a biologically inert synthetic material in a strip or tubular strip. Band 110 can be elastic, non-elastic, partially elastic or any combination thereof. For example, a portion of strip 110 may be elastic while another portion of strip 110 may be non-elastic. In some embodiments, track 110 may be made of more than one material. For example, a portion of the strip 110 may be made of a material while another portion of the strip 110 may be made of a different material. Alternatively, strip 110 may be made of biological material from the patient, another human donor, or material derived from animals.
[0064] [0064] At or near the first end 120 of track 110, at least one fastener, such as a fastener 150, can be provided. The closure 150, for example, can be formed by a nitinol tube cut in the shape of a crown. Additionally or alternatively, the closure 150 can be formed in the form of a cylinder with multiple flaps projecting from one end. Lock 150 can be configured to move from an open configuration (an example of which is illustrated in Figure 1A) to a closed configuration (an example of which is illustrated in Figures 1B and 1C), and vice versa. In the closed configuration, as shown in Figure 1B, the tabs of the lock 150 can be angled inward towards the center of the cylinder to form a lock that grips a portion of the strip 110 that passes through the lock 150. The tabs they can be postponed at the tip to hold firmly and / or perforate the material of track 110 in closed configuration. Alternatively, the flaps can be flat or rounded at the tip in order to close between one or more protrusions in range 110 and prevent a protrusion from passing through the lock 150. In the open configuration, as shown in Figure 1A, the tabs can be straight with the cylinder wall and allow the strip 110 to pass through the lock 150. The tabs can be tilted towards the closed configuration and can be elastically tilted in the open configuration during positioning and adjusting the strip 110. Flaps may be allowed to return to the closed configuration under activation by a lock actuator (not shown).
[0065] [0065] As illustrated as an example in Figures 1A-1C, the closure 150 can be fixed to the first end 120 of the strip
[0066] [0066] The second end 130 of the strip 110 may further comprise projection elements 140 (still called "gripping elements") between which the closure 150 can close. The projection elements 140 can be objects, soft or rigid spheres of plastic, metal, and / or polymer, protrusions, clamps, or any material that is capable of being fastened by a clasp. In some embodiments, as shown in Figures 1B and 1C, the projection elements 140 cannot pass backwards through the closed lock 150. In some embodiments, the projection elements 140 may comprise rigid spheres located within the range 110 , track 110 being a tube. Band 110 can be pierced between rigid spheres by a ring, wire, or rope around the outside of band 110, so that rigid spheres cannot move within band 110. Any number of protrusions can be made at the second end 130 of the strip 110, and the lock 150 can lock closed between any of the projection elements 140 or by the last projection element 140, thereby locking any one of several locations along the strip 110.
[0067] [0067] In some embodiments of the present invention, the closure 150 can connect to a distal end 160 of an administration device 190 so that when the closure 150 is actuated, the closure 150 is automatically disconnected from the administration device 190. An inside and outside diameter of the distal end 160 of the delivery device 190 can be similar to the inside and outside diameter of the closure 150. In addition, the distal end 160 of the delivery device 190 can be cut with a cutting pattern which is complementary to the shape of the flap of the closure 150 so that when the closure 150 is in the open configuration with the flaps angled into the cylindrical shape of the tube, the flaps of the closure 150 can lock into the cutting pattern of the distal end 160 of the delivery device 190, as shown in Figure 1A. When lock 150 is allowed to return to the closed configuration, the tabs can send in, thus disconnecting from the cut pattern at the distal end 160 of the delivery device 190. Certainly, lock 150 and band 110 can disconnect from the administration device 190, as shown in Figure 1B.
[0068] [0068] As illustrated by way of example in Figures 1A and 1B, device 100 may further comprise a lock actuator 180 and / or a pull cable 170. Pull cable 170 can be attached to the lock retainer ring 165 which is located inside the lock 150 and inside the distal end 160 of the delivery device 190 so that under actuation of the lock by the lock actuator 180, the lock retainer ring 165 can retract from the lock 150. Certain specifically, under actuation by the actuator of the lock 180, the lock 150 can move in the closed configuration, in which the lock 150 closes between the projection elements 140 at the second end 130 of the track 110. Thus, the lock 150 and the track 110 it can disconnect from the administration device 190, thus forming a circuit.
[0069] [0069] According to another embodiment of the present invention, the band 110 can be configured to be passed through the spaces between the trabeculae between the papillary muscles and the ventricle wall. Figure 3, for example, illustrates a device 300 comprising a strip 310 having a lock 320. The strip 310 can be configured to be passed through the spaces between trabeculae 330 between the papillary muscles 340 and the ventricle wall 350. In some embodiments of the present invention, two locations along the strip can be attached together after the strip passes around one, two, or more, papillary muscles in order to form a circuit. In some modalities, the fixation is configured so that the band or circuit pulls the papillary muscles towards each other.
[0070] [0070] In some embodiments of the present invention, the band can be configured so that it does not come into contact with the opposite faces of the papillary muscles. For example, the band can only come into contact with the sides of the non-opposing surfaces of the papillary muscles. Figure 3, for example, illustrates the band 310 coming into contact only with the sides of the non-opposing surfaces of the papillary muscles 340. Alternatively, the band can be configured to come into contact with the non-opposing sides of the papillary muscles and to pull the papillary muscles towards each other.
[0071] [0071] In another embodiment of the present invention, the band can be configured to come into contact with the papillary muscles so that the opposite faces of the papillary muscles do not have material from the band interposed between them. In Figure 3, for example, the band 310 loops around the papillary muscles 340 so that there is no material from the band interposed between the papillary muscles 340.
[0072] [0072] In some embodiments of the present invention, the two locations of the fastening that forms the strip in a circuit can be at the first end and the second end of the strip. The term "fixation" can refer to a fastener or any material used to hold the ends of the strip together to form a circuit. With reference again to Figure 1 A, for example, the two locations of the attachment that forms the strip 110 may be at the first end 120 and at the second end 130 of the strip 110. In some embodiments of the present invention, the two locations of the attachment that forms track 110 on a circuit can be close to the first end 120 and the second end 130 of track 110. Alternatively, the fixation that forms track 110 on a circuit can be closer to the first end 120 than to the second end 130. In other embodiments, the fixation that forms the strip 110 in a circuit may be in a fixed position with respect to the first end 120 of the strip 110, and its position with respect to the second end 130 range 110 can be varied to adjust the size of the range
[0073] [0073] Figure 2, for example, illustrates a device 200 comprising a strip 210. The strip 210 comprises a first end 230, a second end 220, and a lock 240. The lock 240 can be located in a fixed position with respect to the first end 230 of the track 210. The position of the lock 240 with respect to the second end 220 of the track 210 can be varied in order to adjust the size of the circuit formed by the track 210. Optionally, the fixation that forms the strip can fix one end of the strip at any location along the strip. In yet another modality, the fixation that forms the strip can fix any of the two locations along the strip together.
[0074] [0074] According to the modalities of the present invention, the band can also comprise a closure. Figures 1A-1C, for example, illustrate a strip 110 comprising a closure 150 that forms the attachment between the first end 120 and the second end 130 along the strip 110 in order to form a circuit. In some embodiments, lock 150 can be provided with strip 110 and attached to strip 110. In other embodiments, lock 150 can be attached to or near the first end 120 of strip 110. In other embodiments, lock 150 may not be attached to track 110 until lock 150 is engaged. When the lock 150 is actuated, the lock 150 can attach to the first end 120 and the second end 130 of the band 110 to form a circuit (an example which is shown in Figure 2). In some embodiments of the present invention, device 100 may further comprise a lock actuator (not shown) that can be used to drive lock 150. The position of lock 150 with respect to the second end 130 of the strip can be varied from in order to adjust the size of the circuit formed by the range 110 until the lock actuator (not shown) activates the lock 150. For example, once activated, the lock 150 can move from an open configuration (an example that is shown in Figure 1A) to a closed configuration (an example that is shown in Figures 1B and 1C). Alternatively, the length of the circuit formed by the band 110 can be adjusted over a band of at least 5 mm, at least 8 mm, or at least 10 mm.
[0075] [0075] In some embodiments, the closure can be attached to a wall of the strip near one end of the strip. Figure 2, for example, illustrates the closure 240 attached to a wall of the band 210 near the first end 230. The closure 240 can be attached to the band 210 at the first end 230, for example, before implantation in the heart. The second end of the strip can pass through or through the lock 240. For example, with reference to Figure 2, the second end 220 of the strip 210 can pass through or through the lock 240. Upon activation of the lock 240 after implantation in the heart, the actuation can cause the lock 240 to grab a portion of the track 210 that has passed through or the lock 240, thus locking the second end 220 of the track 210 in a fixed position with respect to the first end 230 of track 210. Certainly, a circuit can be formed.
[0076] [0076] The width or diameter of the strip can be between about 2 mm and about 5 mm. For example, the width or diameter of the strip can be between about 3 mm and about 4 mm. The strip width can be constant along the strip length. Alternatively, the width of the strip may vary along its length and may be larger at one end than at the other end. For example, the end of the strip to which the clasp is attached may be wider than the end of the strip that is inserted into the clasp. Certainly, the end of the strip inserted into the clasp may have a smaller width.
[0077] [0077] In some embodiments, the strip may comprise a tube. In some embodiments, the closure may be located within a first end of the strip and / or may be attached to the wall of the strip near the first end. Figure 2, for example, illustrates the fastener 240 attached to a wall of the band 210 near the first end 230. The second end of the band can pass through or through the fastener within the inner lumen of the band. For example, the second end 220 of the band 210 can pass through or through the lock 240 within the inner lumen of the band 110. Under actuation of the lock 240 after implantation in the heart, the actuation can cause the lock 240 to grab a portion of the track 210 that has passed through or through the lock 240, thus locking the second end 220 of the track 210 in a fixed position with respect to the first end 230 of the track 210. Certainly, a circuit can be formed. In some embodiments, the closure can be positioned within the band so that the band prevents the closure from coming into contact with the heart tissue. Figure 3, for example, illustrates the device 300 comprising a band 310 and a closure 320 located within the band 310. The band 310 can prevent the closure 320 from contacting the surrounding tissue in the ventricle 350 of the heart.
[0078] [0078] According to the exemplary modalities of the present invention, the closure can be configured to fix a length of the circuit to match the unique anatomy of the patient. In addition, the closure can be configured to trigger within the patient's heart. Certainly, the closure can be configured to be selectively actionable to fix a length of the circuit formed by the band so that the circuit corresponds to the patient's unique anatomy. As discussed above, the closure can have multiple mechanical configurations. For example, during insertion and positioning of the band within the patient's heart, the closure may be in an open configuration (an example that is shown in Figure 1A). In the open configuration, for example, an insertion cable (not shown) and a second end of the strip can move freely through or through the lock. Once the strip is properly positioned and adjusted, a lock actuator can be used to trigger the lock, reconfiguring to a closed configuration (an example that is shown
[0079] [0079] The clasp can be a clamp, clamp, hook, fastener, clasp, or any other type of clasp that is capable of fixing a location on the strip to another location on the strip. Figure 4 illustrates several exemplary methods of closing in the open and closed configurations. For example, as seen in Figure 4, the clasp can be a bear trap 410 clasp, a clamp type clasp 420, a clamp type 430 clasp, a self-locking zip tie clasp 440, a clasp clasp 450, a fastener of type 460, or any other type of fastener capable of fixing a location of the strip to another location of the strip.
[0080] [0080] In some embodiments, the closure may be made of a metal, for example, spring steel, stainless steel and / or nitinol. In other embodiments, the closure may be made of a polymer material, or any other material with the necessary mechanical properties to provide an open configuration and a closed configuration. In some embodiments, the closure may be polarized towards a closed configuration and may be elastically deformed in an open configuration until activated by the closure actuator. For example, the lock actuator can allow the lock to return to the closed configuration. A second end of the strip can be passed through or through the lock in the open configuration. Certainly, when the second end of the band is properly positioned, the actuator of the closure can allow the closure to return elasticly to the closed configuration so that the closure can tighten the band and lock the band in place, thus forming a circuit.
[0081] [0081] In other modalities, the closure can be polarized towards an open configuration and can be deformed in a closed configuration when activated by the closure actuator. For example, the closing actuator can force the closing in the closed configuration. In such embodiments, the second end of the strip may pass through or through the closure in the open configuration. When the second end of the strip is properly positioned, the lock actuator can force the lock in the closed configuration so that the lock can hold the strip and lock the strip in place, thus forming a circuit.
[0082] [0082] According to another embodiment of the present invention, the closure may be a cylinder with elastic elements that extend inwardly inside the cylinder. In the open configuration, the elastic elements of the lock can be kept out or close to the cylinder wall. Figure 5, for example, illustrates various modes of closure that can be a cylinder. For example, a closure 510 can be manufactured from a cutting tube in which the elastic elements are cut from the wall of the tube and then angled inward. Closure 510 can be configured to secure a portion of the strip at any location along the strip or closure 510 may be configured to secure a component or grip feature located at a given location along the strip. Lock 510 can be held in the open configuration by a tube (not shown) positioned inside lock 510. Lock 510 can be operated to return to its closed position by removing the tube from within the lock
[0083] [0083] Alternatively, a lock 520 can be made on an inclined wire, such as a helical spring, and the elastic elements can be portions of the inclined wire that are configured to extend inwardly inside the cylinder. Latches 510 and 520 can be flexible so that the band in the region of latches 510 and 520 remains
[0084] [0084] In another embodiment, the closure may be a disc with a plurality of cuts that forms a plurality of leaves. The plurality of sheets can rotate from the plane of the disc. Figure 6, for example, illustrates the closure 610 with a plurality of cuts 620 forming a plurality of leaves 630. The perimeter of the closure 610 can remain intact and the leaves 620 can be connected to the closure 610 close to the perimeter so that when the leaves 620 rotate from the plane of the closure 610, the leaves 620 can leave an open channel 640 through the middle of the closure 610. The leaves 620 can be configured so that when an object (not shown) passes in one direction through the open channel 640 through the middle of the lock 610, the sheets 620 can press against the object and prevent or reduce the likelihood of the object passing back in the opposite direction through the open channel 610. In another embodiment, the sheets 620 can comprise at least , a clamp 650 in the region that comes into contact with the object (not shown) that is passing through the open channel 640. Certainly, if the object passes, it is capable of being penetrated, the clamp 650 can penetrate the object and increase cap the ability of lock 610 to secure the object by passing through lock 610.
[0085] [0085] While only one clasp 610 is illustrated in Figure 6, multiple clasps 610 can be used together in order to increase the resistance with which clasps 610 can hold an object passing through them. Alternatively, a single closure 610 can comprise multiple layers of sheets 630, thereby increasing the resistance with which closure 610 can hold an object through it. Such a multilayer closure may be flexible so that a portion of a strip, to which the closure is connected, may remain flexible. The closure 610 can be manufactured by cutting or sealing the shape of the closure 610 out of a flat blade or by cutting the shape of the closure 610 out of a tube and tilting the leaves 630 inward.
[0086] [0086] In some embodiments, the closure can be made from a plurality of panels. Figures 7A-7B, for example, illustrate the lock 710 comprising a plurality of panels 720. The panels 720 can comprise a plurality of clips 730 projecting from the panels 720. The clips 730 can press together to secure a strip, for example. example, passing between panels 720. Panels 720 can be connected at their edges by elastic components that induce panels 720 to press against each other. The panels 720 can be flexible so that they naturally press against each other, but they can be elastically deformed in a curved shape, as shown in the example in Figures 7A-7B.
[0087] [0087] The closure 710 can be cut from a tube with the panels 720, and the elastic components that hold the panels 720 together at their edges can also be cut from the same tube. Staples 730 projecting from panels 720 can be cut from the wall of panels 720 and angled inward to form projection staples 730. Staples 730 and / or panels 720 can be elastically deformed outward in an open configuration closure 710 by placing an inner tube (not shown) between panels 720. Upon removal of the inner tube, clips 730 and panels 720 can return to a closed configuration, in which clips 730 can project perpendicularly to panels 720, and the 720 panels can press against each other.
[0088] [0088] In other embodiments, the closure may consist of a ring with clips projecting from the ring. Figures 7C-7D, for example,
[0089] [0089] As discussed above, the lock can be locked in a closed configuration under activation by a lock actuator. In some embodiments of the present invention, the closure actuator can be configured to allow the closure to be triggered remotely, such as from the outside of the heart. In other embodiments, the lock actuator can be configured to allow the lock to be activated from outside the patient's body. Certainly, the lock actuator can be configured to allow the user to trigger the lock from a location away from the lock.
[0090] [0090] Figure 8, for example, illustrates a lock actuator 800 that can allow the user to engage lock 840 on the outside of the body 830. The lock actuator 800 can include pull cables, rotary shafts, rotating tubes, movable shafts, movable tubes, electric actuators, pneumatic actuators, hydraulic actuators, or any other means of providing the drive remotely in order to activate a lock located inside the heart of the outside of the body. For example, lock actuator 800 can be configured to allow lock actuation 840 through a flexible catheter 820 on the outside of body 830. In some embodiments, lock actuator 800 may also include a trigger 810 located outside of the body 830 that can be used to activate the closure 840 located inside the heart.
[0091] [0091] In some embodiments of the present invention, the first end of the band can be mounted on an administration device in order to surround the band around the papillary muscles. The administration device can incorporate part or all of the lock actuator into the device. In addition, the delivery device may include a rigid or flexible tube. Alternatively, the delivery device may comprise a tube having rigid and flexible portions. The delivery device may include a tube or conduit that passes through a sidewall of the configured band to form a circuit around the papillary muscles.
[0092] [0092] As an example, Figure 9 illustrates an exemplary delivery device 910 connected near the first end 980 of lane 970. Lane 970 may comprise an opening 930 in a side wall of lane 970, through which the removable administration device 910 can pass. The delivery device 910 can pass through the wall of the strip 970 near the first end 980 so that a portion of the delivery device 910 is within a portion of the strip 970 near the first end 980. The portion of the strip 970 that comprises the delivery device 910 within the range 970, for example, distance from the first end 980 of the range 970 to the location where the delivery device 910 passes through the opening 930 of the range 970, may be in the range of about 5 mm about 25 mm. For example, the distance can be in the range of about 10 mm to about 15 mm. In some embodiments, lock 940 may be located within 25 mm, 15 mm, 10 mm, or 5 mm from the first end 980 of strip 970. Lock 940 may be located within the portion of strip 970 that has the administration device 910 within it. In some embodiments, the components of the locking drive mechanism, for example, pull cables or a snap ring, which engage the lock may be located in the portion of the administration device 910 which is within the 970 range Lock 940 may be located at one end of the delivery device 910. The other end of the delivery device 910 may be located outside the patient's body. In other embodiments, the lock actuation mechanism may include an elongated member that can pass through the delivery device 910.
[0093] [0093] The administration device 910 may also include a region close to the location where the administration device 910 passes through an opening 930 of the strip 970 which can be flexible and / or actively detachable. The deviation of the detachable region 920 can be controllable between at least 0 degree and 90 degrees. In some instances, the delivery device 910 may further include an insertion cable loop 960 projecting from both ends of the delivery device 910. One end of the passer 960 projecting from one end of the delivery device tion 910 may comprise a clamp 950 configured to hold an insertion cable (not shown) attached to the 970 strip.
[0094] [0094] In some embodiments, an insertion cable attached to a band can be provided in order to help insert the band into the heart. As an example, Figure 10 illustrates a device 1000 comprising an insertion cable 1050 coupled to a strip
[0095] [0095] According to the modalities of the present invention, a distal end of the insertion cable 1050 can be removably connected to the second end 1030 of the range 1010. The insertion cable 1050 can be configured to adjust the size of a circuit formed by the 1010 strip surrounding the papillary muscles. The insertion cable 1050 can be flexible, so that the insertion cable 1050 can help guide the strip 1010 around the papillary muscles to form a circuit. The proximal end of the insertion cable 1050 can be configured to pass through the spaces between the trabeculae between the papillary muscles and the wall of the ventricle. In addition, the insertion cable 1050 can fit in the first end 1020 of the strip 1010 and through or through the lock 1040 when the lock 1040 is in an open configuration. Alternatively, the insertion cable 1050 can fit on a distal end of a delivery device (an example which is illustrated in Figure 9) which can be located within the first end 1020 of the 1010 range.
[0096] [0096] In an alternative embodiment, the insertion cable 1050 may further comprise an insertion cable release trigger (not shown) located at or near the proximal end of the insertion cable 1050. The distal end of the insertion cable 1050 can be configured to separate from the second end 1030 of the range 1010 under activation of the release cable release trigger. In some embodiments, the inlet cable release trigger may be the proximal end of a wire or tube (not shown) extending through the lumen of the 1050 insertion cable that is pulled, pushed, rotated or, if otherwise, manipulated to trigger the release of the 1050 insertion cable.
[0097] [0097] The 1010 strip can be releasably connected to the 1050 insertion cable. For example, the insertion cable can be releasably connected to the 1010 strip in the form of a 1060 insertion cable adapter. The insertion cable adapter 1060 can be attached to the second end 1030 of the 1010 range. In other ways, the adapter of the insertion cable 1060 can be permanently attached to the second end 1030 of the 1010 range, and the insert 1050 can be removably attached to the insert cable adapter 1060.
[0098] [0098] In some embodiments, at least a portion of the band can be pre-loaded into a tube. As an example, Figure 11 illustrates at least a portion of a strip 1110 pre-loaded in a tube 1120. Alternatively, at least a portion of strip 1110, at least a portion of the cable insert 1170 attached to it and at least a portion of a fixed administration device 1180 can be preloaded into a tube 1120.
[0099] [0099] Referring again to Figure 10, strip 1010, an administration device (not shown), and insertion cable 1050 can be configured for insertion into the heart using a transthoracic approach, transarterial approach, transverse approach, transarterial / transaortic approach, transvenous / transseptal / transmral approach, or any other surgical or minimally invasive approach to the heart.
[00100] [00100] In some embodiments, a lock 1040 can be attached to or near the first end 1020 of the 1010 strip and can be configured to secure the 1010 strip in a location where strip 1010 passes through or through the 1040 lock. , the amount of band adjustment required to form a circuit of a desired circumference can be independent of the length of the closure
[00101] [00101] As discussed above, lock 1040 can be attached to or near the first end 1020 of the 1010 range and can be configured to attach a gripping component or feature located at or near the second end 1030 of the 1010 range. , or at any location along the 1010 range. In other modes, multiple components or gripping features can be located at multiple locations along the 1010 range. The 1040 lock can be configured to hold a component or gripping feature. hold in multiple locations or at any location along the length of the 1040 lock. In some embodiments, the amount of adjustment range required to form a circuit of a desired circumference may be dependent on the length of the lock 1040 and the number of component locations or gripping features since a gripping component or feature may need to be inside the clasp to be attached (an example that is shown o in Figures 1A-1C).
[00102] [00102] In some embodiments, the closure 1040 can interact with the material in the range 1010 to reach the grip. In other modalities, there may be a component or feature in a location or in the range 1010 that the lock 1040 can hold. The gripping component or feature that lock 1040 can hold can be movable with respect to the position of the second end 1030 of strip 1010.
[00103] [00103] Closure 1040 can be fixed to the wall of strip 1010 at or near the first end 1020 of strip 1010 using glue or adhesive. In addition or alternatively, lock 1040 can be fixed using fusion or thermal bonding to the wall of strip 1010, using suturing, stitches or stitching to the wall of strip 1010, using fastening elements that couple lock 1040 to the wall of strip 1010 , or any other fastening method or combination of fastening methods that can secure fastener 1040 to the wall of strip 1010.
[00104] [00104] As an example, Figure 11 illustrates a strip 11 10 comprising a plurality of gripping components 1130 at or near the second end 1150 of strip 1110. Gripping elements 1130 can be objects, soft or rigid spheres - those made of plastic, metal, and / or polymer, protrusions, clamps, or any material that is capable of being fastened by a fastener. At or near the first end 1160 of strip 11 10, a lock 1140 can be provided which is configured to secure at least one of the gripping components 1130. The second end 1150 of strip 1110 can be pulled through the first end 1160 of the range 1110. Then, lock 1140 can be configured to move from an open configuration to a closed configuration under actuation by a lock actuator to hold at least one of the 1130 gripping components in order to form a circuit of a desired circumference, preferably based on the patient's unique anatomy.
[00105] [00105] Referring again to Figure 1A-1B, in some embodiments, the distal end of the delivery device 190 may include a locking retainer ring 165 within an outer tube of the delivery device 190. The distal end of the tube extends The suit can be located close to the closure 150 and have a diameter so that the closure 150 cannot fit to the outer tube. Closure ring 165 can extend distally beyond the distal end of the outer tube and be positioned within closure 150, following closure 150 in an open configuration (an example that is illustrated in Figure 1A). Certainly, lock 150 can be polarized towards a closed configuration and can be kept in the open configuration by lock retainer ring 165 located within lock 160. Activation of lock 150 may include pulling the locking ring 165 close to the outer tube so that the retaining ring 165 is retracted from within the lock 150 to the outer tube, thus allowing the lock 150 to return to a closed configuration (an example that is illustrated in Figure 1B) . In addition or alternatively, the pull cables or a pull tube can be connected to the locking ring 165, and can travel through the delivery device 190 to the proximal end of the delivery device 190. At the proximal end of the delivery device 190, the pull cables or pull tube can be connected to a trigger that can pull the pull cables close to the delivery device 190 in order to retract the retaining ring 165 from the outer tube. After actuation of lock 150, delivery device 190 can be removed from the strip
[00106] [00106] In some aspects, the insertion cable (an example that is shown in Figure 10) can comprise a tube with a wire located inside the tube. The distal end of the tube can have longitudinal slits dividing the tube wall into multiple flaps. The flaps may have thick walls at their distal ends so that when the wire is inside the tube, the distal end of the tube may be unable to fit through a hole whose diameter is the same as the outside diameter of the tube. However, when the wire is removed from the distal end of the tube, the distal end of the tube may be able to fit through a hole whose diameter is the same as the outside diameter of the tube. In other embodiments, the distal region of the wire that holds the flaps out may have a larger diameter than the rest of the wire. In some respects, the tube may be a coil with a solid tubular region at the distal end. The bobbin can be wound tightly to avoid compression and have a thread or ribbon running through the bobbin connected at both ends to prevent stretching.
[00107] [00107] According to an embodiment of the present invention, the flaps can be formed by cutting through the pipe wall close to the distal end. The thickening of the walls of the distal ends of the flaps can be formed by tilting the distal tips of the flaps back on themselves one or more times. The distal portion of the tube of the insertion cable where the flaps are formed can be made of metal, polymer, or plastic or any other material capable of being formed into flaps with thickened walls.
[00108] [00108] In other respects, the flaps may have a radially outward step before the thickened portion. Therefore, the insertion cable cannot pass through a hole whose diameter is the same as the outside diameter of the tube without applying excessive force to the wire holding the flaps out. Additionally or alternatively, the flaps can be polarized inwardly, so that when the wire is not located in the region of the tube containing the flaps, the flaps can bend inward and the tube can pass freely through a hole whose diameter is the same as the outside diameter of the tube.
[00109] [00109] “With reference again to Figure 10, an insertion cable adapter 1060 can be connected to the second end 1030 of band 1010. The insertion cable adapter, for example, can have a channel (not shown) through it with a diameter equal to or slightly larger than the outer diameter of the 1050 inlet cable tube. A region of the channel may be large enough to fit the distal end of the tube with the wire inside it. The tube diameters, the thickened tabs at the distal end of the tube and the narrow and wide regions of the channel in the adapter can be configured so that when the outer tube is inside the channel in the adapter and the wire is in the distal end of the tube - bo, the tube can be locked in the adapter because its distal end cannot pass through the narrow region of the channel. Thus, when the wire is removed from the distal end of the tube, the tube can be removed from the adapter. The wire can extend through the tube, extending further or alternatively beyond the proximal end of the tube, so that the wire can be pulled from the proximal end to retract the wire from the distal end of the tube, in order to disconnect the adapter insertion cable. In addition or alternatively, the proximal end of the wire can be attached to an extractor, which can be removably attached to the proximal end of the tube. Therefore, when the extractor is removed and pulled out of the tube, the extractor can pull the wire along with it, retracting the wire from the distal end of the tube. In some aspects, the extractor can be fixedly removed at the proximal end of the tube, being screwed or screwed at the distal end of the tube. Alternatively, the extractor may not be at the distal end of the tube, but may be located in the middle of the tube, close to the distal end.
[00110] [00110] In some aspects, the insertion cable can be connected
[00111] [00111] According to another embodiment of the present invention, a cardiac implant is provided. The cardiac implant may comprise a papillary band formed of a tube with an opening in a side wall of the tube and a removable conduit passing through the opening. The cardiac implant may additionally comprise a closure associated with the band. The closure can be configured to be actuated by an elongated member, which passes through the removable conduit. Under activation, the lock can fix two locations along the strip to each other forming the strip in a circuit. The closure may be located at a distal end of the conduit, and the proximal end of the conduit may be located outside the patient's body. The removable conduit can be configured to be removed from the tube after closing.
[00112] [00112] As discussed above, the band can be configured to come into contact with the non-opposite surfaces of the papillary muscles. The band can be configured to involve a plurality or group of papillary muscles, thus pulling the papillary muscles towards each other without a portion of the band being interposed between the papillary muscles (an example that is shown in Figure 3).
[00113] [00113] According to another embodiment of the present invention, a cardiac implant is provided. The cardiac implant can comprise a papillary band having a first end and a second end and being selectively configurable between an elongated configuration where the first end is disconnected from the second end, and a circuit configuration where the band is formed in a circuit. The cardiac implant can also comprise a socket fixed to the band, closer to the first end of the band than to the second end of the band. The implant can also comprise an elongated insertion cable, removably connected to the second end of the band. The papillary band can be configured to form a circuit simultaneously surrounding a group of papillary muscles, and the elongated insertion cable can be configured to adjust the size of the circuit. The band can be configured to contact non-opposing portions of the papillae muscles. The band can be configured to involve a plurality of papillary muscles, thus pulling the plurality of papillary muscles towards each other without a portion of the band being interposed between the papillary muscles. In some embodiments, the closure can be selectively configurable between two configurations - an open configuration and a closed configuration. In the open configuration, the insertion cable and the second end of the strip can pass through the latch. In the closed configuration, the region of the strip that passes through the lock can be held in place so that the strip cannot move with respect to the lock.
[00114] [00114] The modalities of the present invention are further described by the following paragraphs:
[00115] [00115] A. Device for repositioning the papillary muscles, comprising:
[00116] [00116] a band configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band, wherein the band comprises a first end and a second end; and
[00117] [00117] an adjustable latch coupled to a location close to the first end of the strip, where a latch is configured to move from an open configuration to a closed configuration to connect the second end of the strip to the first end of the strip, thus forming a circuit .
[00118] [00118] B.The device, in accordance with paragraph A, in which:
[00119] [00119] the adjustable latch includes a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the strip between them.
[00120] [00120] C.The device, in accordance with paragraph A, in which:
[00121] [00121] the adjustable lock is configured to be kept in an open configuration by a lock retaining ring located inside the lock; and
[00122] [00122] the adjustable lock is configured to return to a setting
[00123] [00123] D.The device, according to paragraph A, in which the adjustable closure includes metal.
[00124] [00124] E. .The device, according to paragraph A, in which:
[00125] [00125] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit; and
[00126] [00126] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[00127] [00127] F.The device, in accordance with paragraph A, in which:
[00128] [00128] the band is further configured to pull the papillary muscles towards each other, thus reducing a distance between opposing surfaces of the papillary muscles; and
[00129] [00129] the lock is selectively operable to adjust a length of the circuit.
[00130] [00130] G.The device, according to paragraph A, in which the adjustable closure is further configured to fix a length of the loop so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference.
[00131] [00131] H.The device, according to paragraph A, in which a length of the circuit is adjustable over a range of at least 8 mm.
[00132] [00132] |. The device, according to paragraph A, in which:
[00133] [00133] At least a portion of the strip includes a tube; and
[00134] [00134] the adjustable end is coupled within the portion of the strip that includes the tube.
[00135] [00135] J.The device, according to paragraph A, in which a strip width varies over different portions of a strip length.
[00136] [00136] K. The device, according to paragraph A, in which the adjustable closure is further configured to be activated within a heart.
[00137] [00137] L. The device, according to paragraph A, in which the adjustable closure is further configured to be activated, by a catheter, from the outside of a body.
[00138] [00138] M. The device, according to paragraph A, in which the group of papillary muscles includes two or more papillary muscles within a ventricle of a heart.
[00139] [00139] IN the device, according to paragraph A, in which the band is still configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle.
[00140] [00140] O. A device for repositioning papillary muscles, comprising:
[00141] [00141] a band configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band, wherein the band comprises a first end and a second end; and
[00142] [00142] an adjustable latch coupled to a location close to the first end of the strip, where:
[00143] [00143] the lock is configured to move from an open configuration to a closed configuration to connect the second end of the strip to the first end of the strip, thus forming a circuit; and
[00144] [00144] the lock is selectively operable to adjust a length of the circuit.
[00145] [00145] P.The device, according to paragraph O, in which the length of the circuit is adjustable over a range of at least 8 mm.
[00146] [00146] OQ. The device, in accordance with paragraph O, where:
[00147] [00147] the adjustable lock includes a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the strip between them.
[00148] [00148] R.The device, in accordance with paragraph O, in which:
[00149] [00149] the adjustable lock is configured to be kept in an open configuration by a lock retainer ring located inside the lock; and
[00150] [00150] the adjustable closure is configured to return to a closed configuration upon retraction of the closure retainer ring from within the closure.
[00151] [00151] S.The device, in accordance with paragraph O, in which:
[00152] [00152] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit;
[00153] [00153] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[00154] [00154] T.The device, according to paragraph O, in which the band is still configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and the wall of a ventricle.
[00155] [00155] The modalities of the present invention are further described by the following paragraphs:
[00156] [00156] AA. A transcatheter system to surround a plurality of papillary muscles, comprising:
[00157] [00157] a band comprising a first end, a second end, and an opening in a side wall of the band, where the band is configured to surround a group of pillar muscles, the group having an external peripheral limit defined by the band surrounding;
[00158] [00158] an administration device configured to be inserted at the opening of the strip; and an actionable lock coupled to a second end of the strip, in which the administration device is configured to activate the lock.
[00159] [00159] BB.The system, according to paragraph AA, in which:
[00160] [00160] the administration device also includes an external tube and an internal tube extending distally beyond a distal end of the external tube;
[00161] [00161] the internal tube is positioned inside the actionable lock, thus retaining the lock in an open configuration; and
[00162] [00162] a retraction of the inner tube from inside the closure to the outer tube is configured to allow the closure to return to a closed configuration.
[00163] [00163] CC.The system, according to paragraph AA, in which:
[00164] [00164] the actionable lock includes a plurality of clamps projecting radially inwards so that, in the closed configuration, the clamps are configured to tighten a first end of the strip between them.
[00165] [00165] DD.The system, according to paragraph AA, in which the actionable lock includes metal.
[00166] [00166] EE. The system, according to paragraph AA, in which:
[00167] [00167] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit; and
[00168] [00168] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the small limit
[00169] [00169] FF.The system, according to paragraph AA, in which:
[00170] [00170] the band is still configured to pull the papillary muscles towards each other, thus reducing a distance between opposing surfaces of the papillary muscles; and
[00171] [00171] the lock is selectively operable to adjust a length of a circuit formed by the surrounding band.
[00172] [00172] GG.The system, according to paragraph FF, in which the actionable closure is further configured to fix a length of the loop so that the outer peripheral limit of the papillary muscle group reaches a predefined circumference.
[00173] [00173] HH.The system, according to paragraph AA, in which:
[00174] [00174] the band is configured to form a circuit around the group of papillary muscles; and
[00175] [00175] a length of the circuit is adjustable over a range of at least 8 mm.
[00176] [00176] 11.The system, according to paragraph AA, in which:
[00177] [00177] At least a portion of the strip includes a tube; and
[00178] [00178] - actionable closure is coupled within the portion of the strip that includes the tube.
[00179] [00179] JJ. The system, according to paragraph AA, in which a strip width varies over different portions of a strip length.
[00180] [00180] KK. The system, according to paragraph AA, in which the actionable lock is further configured to be activated within a heart.
[00181] [00181] LL. The system, according to paragraph AA, in which the actionable closure is further configured to be activated, through a catheter, from the outside of a body.
[00182] [00182] MM.The system, according to paragraph AA, in which the group of papillary muscles includes two or more papillary muscles within a ventricle of a heart.
[00183] [00183] NN.The system, according to paragraph AA, in which the band is still configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle.
[00184] [00184] OO. A transcatheter system to surround a plurality of papillary muscles, comprising:
[00185] [00185] a band comprising a first end, a second end, and an opening in a side wall of the band, where the band is configured to surround a group of pillar muscles, the group having an external peripheral limit defined by the band surrounding;
[00186] [00186] an administration device configured to be inserted at the opening of the strip; and an actionable lock coupled to a second end of the strip, where:
[00187] [00187] the administration device is configured to activate the closure to form a circuit; and
[00188] [00188] the lock is selectively operable to adjust a length of the circuit. PP. The system, according to paragraph OO, in which:
[00189] [00189] the delivery device further includes an outer tube and an inner tube extending distally beyond the distal end of the outer tube;
[00190] [00190] the inner tube is positioned inside the actionable closure, thus retaining the closure in an open configuration; and
[00191] [00191] a retraction of the inner tube from inside the closure to the outer tube is configured to allow the closure to return to a configuration
[00192] [00192] QQ.The system, according to paragraph OO, in which:
[00193] [00193] the actionable lock includes a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten a first end of the strip between them.
[00194] [00194] RR.The system, according to paragraph OO, in which the length of the circuit is adjustable over a range of at least 8 mm.
[00195] [00195] SS.The system, according to paragraph OO, in which the actionable closure is further configured to fix a length of the loop so that the outer peripheral limit of the papillary muscle group reaches the predefined circumference.
[00196] [00196] TT.The system, according to paragraph OO, in which:
[00197] [00197] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit;
[00198] [00198] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[00199] [00199] The modalities of the present invention are further described by the following paragraphs:
[00200] [00200] AAA. A transcatheter device to surround a plurality of papillary muscles, comprising:
[00201] [00201] an adjustable band configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band;
[00202] [00202] a spring lock coupled to a location close to the first end of the adjustable band;
[00203] [00203] “an elongated positioner coupled to a location close to a second end of the adjustable range, where the positioner is configured to selectively position the second end of the adjustable range adjacent to the spring lock; and
[00204] [00204] a closure retainer ring disposed, at least partially, within the spring lock, in which the retainer is configured to withstand the bias of the spring lock.
[00205] [00205] BBB. The device, according to paragraph AAA, in which a retraction of the retainer from inside the spring lock is configured to return the spring lock to a closed configuration, thus forming a circuit around the group of papillary muscles.
[00206] [00206] CCC. The device, according to paragraph AAA, in which:
[00207] [00207] the spring lock includes a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the adjustable band between them.
[00208] [00208] DDD. The device, according to paragraph AAA, in which the spring lock includes metal.
[00209] [00209] EEA. The device, according to paragraph AAA, in which:
[00210] [00210] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit; and
[00211] [00211] the adjustable band is configured to pull the pillar muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the internal region and so that the region internal area is stripped of any portion of the strip.
[00212] [00212] FFF. The device, according to paragraph AAA, in which:
[00213] [00213] the adjustable band is further configured to pull the papillary muscles towards each other, thus reducing the distance between opposite surfaces of the papillary muscles.
[00214] [00214] GGG.The device, according to the BBB paragraph, in which the spring lock is still configured to fix a length of the circuit so that the outer peripheral limit of the group of papillary muscles reaches the predefined circumference.
[00215] [00215] HHH. The device, according to paragraph GGG, in which a circuit length is adjustable over a range of at least 8 mm.
[00216] [00216] Ill. The device, according to paragraph AAA, in which at least the portion of the adjustable band includes a tube.
[00217] [00217] JJJ. The device, according to paragraph III, in which the spring lock is further configured to be coupled within the portion of the tube close to the first end of the adjustable band.
[00218] [00218] KKK. The device, according to paragraph AAA, in which the spring lock is further configured to be activated within a heart.
[00219] [00219] LLL.The device, according to paragraph AAA, in which the spring lock is still configured to be activated, through a catheter, from the outside of a body.
[00220] [00220] MMM. The device, according to paragraph AAA, in which the group of papillary muscles includes two or more papillary muscles within a ventricle of a heart.
[00221] [00221] NNN. The device, according to paragraph AAA, in which the adjustable range is further configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and a wall of a ventricle.
[00222] [00222] —OOO. A transcatheter device to surround a plurality of papillary muscles, comprising:
[00223] [00223] an adjustable band configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band;
[00224] [00224] a spring lock coupled within the adjustable range at the location near the first end of the adjustable range;
[00225] [00225] “an elongated positioner coupled to a location close to a second end of the adjustable range, where the positioner is configured to selectively position the second end of the adjustable range adjacent to the spring lock; and
[00226] [00226] a locking ring disposed, at least partially, inside the spring lock, in which the retainer is configured to resist the bias of the spring lock.
[00227] [00227] PPP. The device, according to paragraph OOO, in which the retraction of the retainer from inside the spring lock is configured to return the spring lock to a closed configuration, thus forming a circuit around the group of papillary muscles.
[00228] [00228] QQOQ. The device, according to paragraph OOO, where:
[00229] [00229] the spring lock includes a plurality of clamps projecting radially inward so that, in the closed configuration, the clamps are configured to tighten the second end of the adjustable band between them.
[00230] [00230] RRR. The device, according to paragraph PPP, in which a circuit length is adjustable over a range of at least 8 mm.
[00231] [00231] SSS. The device, according to the PPP paragraph, in which:
[00232] [00232] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit;
[00233] [00233] The adjustable band is configured to pull the muscles
[00234] [00234] TTT. The device, according to paragraph OOO, in which the adjustable range is further configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and the wall of a ventricle.
[00235] [00235] The modalities of the present invention are further described by the following paragraphs:
[00236] [00236] YYYY. A transcatheter device to surround a plurality of papillary muscles, comprising:
[00237] [00237] a strip comprising a first end and a second end;
[00238] [00238] a first connector coupled to the first end of the strip;
[00239] [00239] an administration device comprising a second connector, in which the second connector is initially connected to the first connector and configured to be remotely operable to disconnect from the first connector to allow the removal of the administration device from a body; and
[00240] [00240] a lock at the second end of the strip, in which the lock is configured to be remotely operable to permanently connect the lock to a portion of the strip close to the first end, thus forming a circuit.
[00241] [00241] BBBB.The device, according to paragraph AAAA, in which the band is configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band.
[00242] [00242] —CCCC. The device according to paragraph AAAA, in which the closure is a spring closure comprising a movable retainer arranged, at least partially, within the closure to resist the skew of the spring closure.
[00243] [00243] - “DDDD.The device, according to the BBBB paragraph, in which:
[00244] [00244] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit; and
[00245] [00245] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[00246] [00246] EEEE.The device, according to paragraph AAAA, in which:
[00247] [00247] the band is still configured to pull the papillary muscles towards each other, thus reducing a distance between opposing surfaces of the papillary muscles; and
[00248] [00248] the lock is selectively operable to adjust a length of the circuit.
[00249] [00249] FFFF.The device, according to the BBBB paragraph, in which the group of papillary muscles includes two or more papillary muscles within a ventricle of a heart.
[00250] [00250] GGGG. The device, according to paragraph AAAA, in which the band is still configured to be passed through a plurality of spaces between the trabeculae between the papillary muscles and a wall of a ventricle.
[00251] [00251] HHHH. The device, in accordance with paragraph AAAA, in which:
[00252] [00252] - the closure includes a plurality of clamps projecting radially inwards so that, in a closed configuration, the clamps are configured to tighten the first end of the strip between them.
[00253] [00253] Il. The device, according to the BBBB paragraph, in which the closure is further configured to fix a length of the circuit so that the outer peripheral limit of the papillary muscle group reaches the predefined circumference.
[00254] [00254] JJJJ. The device, according to paragraph AAAA, in which a length of the circuit is adjustable over a range of at least 8 mm.
[00255] [00255] - KKKK. The device, according to paragraph AAAA, in which the lock is still configured to be activated within a heart.
[00256] [00256] LLLL. The device, according to paragraph AAAA, in which the lock is still configured to be activated, through the catheter, from the outside of a body.
[00257] [00257] MMMM. A transcatheter device to surround a plurality of papillary muscles, comprising:
[00258] [00258] lowering comprising the first end and the second end;
[00259] [00259] a first connector coupled to the first end of the strip;
[00260] [00260] an administration device comprising a second connector, in which the second connector is initially connected to the first connector and configured to be remotely operable to disconnect from the first connector to allow the removal of the administration device from a body; and
[00261] [00261] a spring lock at the second end of the strip, where the spring lock is configured to be remotely operable to permanently connect the spring lock to a portion of the strip close to the first end, thus forming a circuit.
[00262] [00262] NNNN. The device, according to the MMMM paragraph, in which the band is configured to involve a group of pillar muscles, the group having an external peripheral limit defined by the surrounding band.
[00263] [00263] —OOOO. The device, according to the MMMM paragraph, in which the spring lock still includes a movable retainer arranged, at least partially, within the spring lock to resist the spring lock being bent.
[00264] [00264] PPPP. The device, according to paragraph MMMM, in which the length of the circuit is adjustable over a range of at least 8 mm.
[00265] [00265] —QQQOQA. The device, according to paragraph NNNN, in which:
[00266] [00266] the group includes an internal region on the sides of the papillary muscles opposite the external peripheral limit; and
[00267] [00267] the band is configured to pull the papillary muscles towards each other so that the band comes in contact with the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[00268] [00268] RRRR. The device, according to the MMMM paragraph, in which:
[00269] [00269] the band is still configured to pull the papillary muscles towards each other, thus reducing the distance between opposite surfaces of the papillary muscles; and
[00270] [00270] the spring clip is selectively operable to adjust a circuit length.
[00271] [00271] SSSS. The device, according to paragraph NNNN, in which the group of papillary muscles includes two or more papillary muscles within the ventricle of a heart.
[00272] [00272] TTTT. The device, according to the MMMM paragraph, in which the band is still configured to be passed through a plurality of spaces between trabeculae between the papillary muscles and the wall of a ventricle.
[00273] [00273] Although the present invention is described here with reference to illustrative modalities of catheters, bands and guidewires used for particular applications, such as to reposition the papillary muscle and improve cardiac function, it should be understood that the modes described here are not limited to them. Those versed in the technique and access to the teachings provided here will recognize additional modifications, applications, modalities and substitution of equivalents that fall within the scope of the disclosed modalities. Therefore, the disclosed modalities should not be considered limited by the previous or following descriptions.
[00274] [00274] The many features and advantages of the present invention are evident in the detailed specification and, therefore, the attached claims are intended to cover all of these features and advantages of the present invention that fall within the true spirit and scope of the present invention. In addition, since numerous modifications and variations will take place readily for those skilled in the art, it is not desirable to limit the present invention to the exact construction and operation illustrated and described and, therefore, all suitable modifications and equivalents can be used, covering the scope of the present invention.
[00275] [00275] Furthermore, those skilled in the art will appreciate that the design upon which this description is based can easily be used as a basis for designing other structures, methods and systems to accomplish the various purposes of the present invention. Consequently, the claims are not to be considered limited by the foregoing description.

权利要求:
Claims (19)
[1]
1. Cardiac device, characterized by the fact that it comprises: a band configured to form a loop within a heart, the band defining a lumen extending, at least partially, through it along an elongated axis of the band , wherein the strip includes a first end, a second end configured to be received into the lumen by a first opening at the first end, and a side wall opening between the first end and the second end, the opening of the side wall providing lumen access; and an actionable closure configured to move from an open configuration to a closed configuration to form a loop of fixed length after the second end is inserted into the first end, and where the closure is configured to actuate by a catheter passing through the opening of the side wall, in which the actionable lock is configured to be kept in the open configuration by a lock retainer associated with the lock; and in which the actionable lock is configured so that the retraction of the lock retainer of the lock results in the lock returning to its closed configuration.
[2]
2. Cardiac device according to claim 1, characterized by the fact that: the actionable closure includes a plurality of buckles projecting radially inward so that, in the closed configuration, the buckles are configured to secure the band between them .
[3]
3. Cardiac device according to claim 2, characterized by the fact that the actionable closure is formed of a cut nitinol tube, and the buckles of the closure are tilted radially inwards towards the closed configuration.
[4]
4. Cardiac device according to claim 1, characterized by the fact that the actionable closure includes metal.
[5]
5. Cardiac device, according to claim 1, characterized by the fact that: the loop is configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding band, and an internal region on the sides of the muscles papillaries opposite the outer peripheral limit; and the band is configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[6]
6. Cardiac device, according to claim 5, characterized by the fact that: the band is also configured to pull the papillary muscles towards each other, thus reducing a distance between opposing surfaces of the papillary muscles; and the closure is selectively operable to adjust a length of the loop.
[7]
7. Cardiac device according to claim 5, characterized by the fact that the group of papillary muscles includes two or more papillary muscles within a ventricle of the heart.
[8]
8. Cardiac device according to claim 1, characterized by the fact that a loop length is adjustable over a range of at least 8 mm.
[9]
9. Cardiac device, according to claim 1, characterized by the fact that: the band includes a plurality of gripping elements near the second end of the band, forming protrusions between which the clasp is configured to lock when in its configuration - closed section, the gripping elements being configured to pass through the lock in a first direction and a second direction opposite to the first direction when the lock is in its open configuration, and being configured to prevent passage through of the lock in the second direction when the lock is in its closed configuration.
[10]
10. Cardiac device according to claim 1, characterized by the fact that a band width varies over different portions of a band length.
[11]
11. Cardiac device, according to claim 1, characterized by the fact that the actionable closure is further configured to be activated inside a heart, by a catheter, from outside a body.
[12]
12. Cardiac device, according to claim 1, characterized by the fact that the band is further configured to be passed through a plurality of spaces between the trabeculae between the papillary muscles and a wall of a ventricle.
[13]
13. Cardiac device, according to claim 1, characterized by the fact that the actionable closure is located inside the lumen.
[14]
14. Cardiac device, characterized by the fact that it comprises: a band configured to form a loop within a heart, the band defining a lumen extending, at least partially, through it along an elongated axis of the band, in that the strip includes a first end, a second end configured to be received into the lumen by a first opening at the first end, and a side wall opening between the first end and the second end, the side wall opening providing access to the lumen; and an actionable closure configured to move from an open configuration to a closed configuration to form a fixed length loop after the second end is inserted into the first end, and the closure is configured to actuate by a catheter that it passes through the side wall opening, in which the lock is selectively operable to allow the adjustment of a loop length, in which the actionable lock is configured to be maintained in the open configuration by a lock retainer associated with the lock; and where the closure is configured so that the retraction of the closure retainer of the closure results in the closure returning to its closed configuration.
[15]
15. Cardiac device according to claim 14, characterized by the fact that the length of the loop is adjustable over a range of at least 8 mm.
[16]
16. Cardiac device, according to claim 14, characterized by the fact that: the actionable closure includes a plurality of buckles projecting radially inward so that, in the closed configuration, the buckles are configured to secure the band between them .
[17]
17. Cardiac device, according to claim 14, characterized by the fact that: the loop is configured to involve a group of papillary muscles, the group having an external peripheral limit defined by the surrounding loop, and an internal region on the sides of the muscles papillaries opposite the outer peripheral limit; and the band is configured to pull the papillary muscles towards each other so that the band contacts the outer peripheral limit of the papillary muscles without coming into contact with the inner region and so that the inner region is devoid of any portion of the track.
[18]
18. Cardiac device, according to claim 14, characterized by the fact that the band is further configured to be passed through a plurality of spaces between the trabeculae between the papillary muscles and a wall of a ventricle.
[19]
19. Cardiac device, characterized by the fact that it comprises a band configured to form a loop within a heart, the band defining a lumen extending, at least partially, through it along an elongated axis of the band, in which the strip includes a first end, a second end configured to be received into the lumen by a first opening at the first end, and a side wall opening between the first end and the second end, the side wall opening providing access to the lumen; and an actionable closure configured to move from an open configuration to a closed configuration to form a fixed length loop after the second end is inserted into the first end, and the closure is configured to actuate by a catheter that it passes through the opening of the side wall, in which the strip includes a plurality of pressing elements near the second end of the strip, forming protrusions between which the lock is configured to lock when in its closed configuration, the elements of grip being configured to pass through the lock in a first direction and a second direction opposite to the first direction when the lock is in its open configuration, and being configured to prevent passage through the lock in the second direction when the lock is in its closed configuration.

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法律状态:
2020-11-03| B15I| Others concerning applications: loss of priority|Free format text: PERDA DA PRIORIDADE DE 23/10/2017 US 62/575,538 REIVINDICADA DEVIDO A NAO APRESENTACAO DO CONTEUDO DO DOCUMENTO DE PRIORIDADE JUNTO AO REQUERIMENTO DE ENTRADA NA FASE NACIONAL E O MESMO TAMBEM NAO ESTAR DISPONIVEL NA BIBLIOTECA DIGITAL DA OMPI (DAS) OU NO PATENTSCOPE , CONFORME AS DISPOSICOES PREVISTAS NA LEI 9.279 DE 14/05/1996 (LPI) ART. 164O E NO ART. 26 DA RESOLUCAO INPI-PR 77/2013. |

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2020-11-17| B10A| Cessation: cessation confirmed|

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2021-12-07| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US201762575538P| true| 2017-10-23|2017-10-23|

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PCT/IB2018/001370|WO2019081985A2|2017-10-23|2018-10-22|Adjustable self-locking papillary muscle band|

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