Source: http://www.docstoc.com/docs/51410388/Anterior-And-Inferior-Segment-Ventricular-Restoration-Apparatus-And-Method---Patent-6450171
Timestamp: 2014-07-25 00:14:37
Document Index: 484904091

Matched Legal Cases: ['art.\n2', 'art.\n3', 'art.\n6', 'art.\n7', 'art 12', 'art 12', 'art\n1', 'art.2']

United States Patent: 6450171
6,450,171
09/689,254
235664Jan., 19996221104
128/898  ; 600/16; 600/37; 623/3.1; 623/3.3
128/898 623/3.1,3.3 600/16,37
Dor. V., &quot;Reconstructive Left Ventricular Surgery for Post-Ischemic Akinetic Dilatation&quot;, 139-145; 1997.
Author Unknown, Date Unknown (Videotape given to one of the applicants after Dec. 24, 1997), Rocontrucao da geometria ventricular esquerda com protege semi-rigida de pericardio de bovino (A videotape by the Institue De Molestias Cardiovasculares in
09/235,664, filed Jan. 22, 1999, entitled ANTERIOR AND INFERIOR SEGMENT
VENTRICULAR RESTORATION APPARATUS AND METHOD, now U.S. Pat. No. 6,221,104
09/071,817, filed May 1, 1998, U.S. Pat. No. 6,024,096, entitled ANTERIOR
SEGMENT VENTRICULAR RESTORATION APPARATUS AND METHOD
1.  A method for restoring the ventricular architecture of a heart having an anterior wall and an inferior wall, comprising the steps of: creating an incision in the inferior
wall of the heart to expose an inner surface of the ventricle of the heart;  forming a suture line around the inner surface of the inferior wall;  providing a ventricular patch having a sheet of biocompatible material and a continuous ring;  and sewing
at least the continuous ring of the ventricular patch to the inner surface of the inferor wall along the suture line to restore the ventricular architecture of the heart.
2.  The method recited in claim 1, wherein the inferior wall includes a contracting region and a non-contracting region separated by a zone of separation, and the creating step includes the steps of creating the incision in the non-contacting
region of the inferior wall;  and opening the incision to expose an inner surface of the heart.
3.  The method recited in claim 2, wherein the forming step includes the step of forming the suture line generally along the line of separation.
4.  The method of claim 1, wherein the ring defines a central area of the patch inwardly of the ring and an outer rim of the patch outwardly of the ring.
5.  The method of claim 4, wherein sewing at least the continuous ring of the ventricular patch to the inner surface of the inferior wall includes: sewing the continuous ring to the inner surface of the ventricle so that the central area of the
patch defines a portion of the ventricle of the heart;  and sewing the outer rim to the inner surface of the ventricle outward of the ventricle of the heart.
6.  The method recited in claim 2, wherein the opening step includes the step of spreading the incision to create a triangular opening extending into the ventricle of the heart.
7.  The method of claim 6, wherein the sheet of biocompatible material and the continuous ring are in the shape of a triangle.
8.  A method for restoring the ventricular architecture of a heart having an anterior wall and an inferior wall, comprising the steps of: providing a patch including a sheet of biocompatible material in the shape of a first triangle with a ring
fixed to the sheet in the shape of a second triangle;  restoring the ventricular architecture of the heart using the patch in the inferior wall.
9.  A method for restoring the ventricular architecture of a heart having an anterior wall and an inferior wall, comprising the steps of: creating an incision in the inferior wall of the heart to expose an inner surface of the ventricle of the
heart;  providing a ventricular patch including a central area and an outer rim;  sewing the ventricular patch to the inner surface of the ventricle so that the central area of the patch defines a portion of the ventricle of the heart;  and sewing the
outer rim to the inner surface of the venticle outward of the ventricle of the heart inhibit blood from leaking from the ventricle.
10.  The method of claim 9, wherein the ventricular patch includes a sheet of biocompatible material and a continuous ring, and the continuous ring defines the central area of the patch inwardly of the continuous ring and the outer rim of the
patch outwardly of the continuous ring.
11.  The method of claim 10, wherein the sheet of biocompatible material and the continuous ring are in the shape of a triangle.  Description
A certain percentage of the blood in the left ventricle is pumped during each stroke of the heart.  This pumped percentage, commonly referred to as the ejection fraction, is normally about sixt percent.  It can be seen that in a heart having a
going to the cardiac apex.  As the triangle becomes widened, due to loss of contracting muscle after infraction, the same form of ventricular dilatation occurs.
However, instead of making the oval ventricle into a sphere in the anterior segment, with subsequent enlargement (dilatation) of the non-infarcted remaining contracting muscle, there is an increase in the triangle inferiorly.  As a result, there
is an increase in both the transverse diameter as well as the longitudinal dimension.  Thus, inferior coronary involvement results in dilatation of the entire inferior segment.
FIG. 12B is a crowsection view taken along lines 12B--12B of FIG. 12A and illustrating the sheet material in a concave configuration;
FIG. 14 is a circumferentional cross section taken along lines 14--14 of FIG. 13;
septum walll next to the patch;
conical or apical in shape in that it is longer than it is wide and descends from a base 35 with a decreasing cross-sectional circumference, to a point or apex 37.  The left ventricle is further defined by a lateral ventricle wall 38, and a septum 41
The body&#39;s reaction to ischemic infarction is of particular interest.  The body seems to realize that with a reduced pumping capacity, the ejection fraction of the heart is automatically reduced.  For example, the ejection fraction may drop from
a normal sixty percent to perhaps twenty percent.  Realizing that the body still requires the same volume of blood for oxygen and nutrition, the body causes its heart to dilate or enlarge in size so that the smaller ejection fraction pumps about the same
amount of blood.  As noted, a normal heart with a blood capacity of seventy milliliters and an ejection fraction of sixty percent would pump approximately 42 milliliters per beat.  The body seems to appreciate that this same volume per beat can be
shape.  The heart 12 becomes greatly enlarged and the left ventricle 25 becomes more spherical in shape losing its apex 37 as illustrated in FIG. 3.  In this view, the stippled area of cross section shows the ischernic or infracted region of the
As noted, successfull acute reprefision by thrombolysis, percutaneous angioplasty, or urgent surgery can decrease early mortality by reducing arrhythmia and cardiogenic shock.  These procedures applied in the early stages of ischemia can also aid
With a primary purpose of reducing the left ventricle volume, the intent of the procedure initially is to remove that portion of the wall-which is not capable of contracting.  This, of course, includes the scarred dyskinetic segments, which are
The sheet material 81 may be formed, for example, from Dacron (Hemoshield), or polytetrafluroethylene (Gortex).  However in a preferred embodiment, the sheet material 81 is formed of autologous pericardium,or some other fixed mammalium tissue
The sheet material 81 can have a generally fiat planar configuration, or can be shaped as a section of a sphere.  The spherical shape can be achieved as illustrated in FIG. 12B by fixing the pericardium while it is stretched over a spherical die
The ring 87 can be attached to the material 81 by adhesive or by stitches 97 passing over with reference to FIG. 19 the ring 87 and through the material 81.  Alternatively, the ring 87 can be sandwiched between two pieces of the sheet material.
Another method for placement of the interrupted patch suture is illustrated in FIG. 22A.  In this view, which is similar to FIG. 21, interrupted sutures 111 are directed through with reference to FIG. 18, the entire ventricular wall 38 and exit
the wall 38 in proximity to the protrusion 76 which forms the Fontan neck 78.  These sutures 111 can also be anchored in a pledged strip 113 disposed on the outer surface of the heart 12 to further enhance the anchoring of these sutures 111.
wall 41, over the ventricular wall 38.  Alternatively, the lateral wall 38 can be disposed interiorly of the septum wall 41 so a majority of the force on the patch 72 is diverted to the lateral wall 38.  These walls 38 and 41 can be overlapped in close
where P is blodd pressure; R is radius of the heart wall; and h is wall thickness.
Anterior and inferior segment ventricular restoration apparatus and method, Buckberg, et al., Gerald D. Buckberg, Constantine L. Athanasuleas, Application number 09 689-254, Surgery, Prosthesis (I.E. Artificial Body Members) Parts Thereof Or Aids And Accessories Therefor, left ventricle, patent search, tension reduction, delivery system, new patent, search terms, present invention provides, patent application, congenital heart failure, beating heart
1. Field of the InventionThis invention relates generally to surgical methods and apparatus for addressing ischemic cardiomyopathy, and more specifically to methods and apparatus for restoring the architecture and normal function of a mammalian heart.2. Discussion of the Prior ArtThe function of a heart in an animal is primarily to deliver life-supporting oxygenated blood to tissue throughout the body. This function is accomplished in four stages, each relating to a particular chamber of the heart. Initiallydeoxygenated blood is received in the right auricle of the heart. This deoxygenated blood is pumped by the right ventricle of the heart to the lungs where the blood is oxygenated. The oxygenated blood is initially received in the left auricle of theheart and ultimately pumped by the left ventricle of the heart throughout the body. It can be seen that the left ventricular chamber of the heart is of particular importance in this process as it is relied upon to pump the oxygenated blood initiallythrough a mitral valve into and ultimately throughout the entire vascular system.A certain percentage of the blood in the left ventricle is pumped during each stroke of the heart. This pumped percentage, commonly referred to as the ejection fraction, is normally about sixt percent. It can be seen that in a heart having aleft ventricular volume such as seventy milliliters, an ejection fraction of sixty percent would deliver approximately 42 milliliters of blood into the aorta. A heart with reduced left ventricular volume might have an ejection fraction of only 40% andprovide a stroke volume of only 28 millimeters.Realizing that the heart is part of the body tissue, and the heart muscle also requires oxygenated blood, it can be appreciated that the normal function of the heart is greatly upset by clotting or closure of the coronary arteries. When thecoronary arteries are blocked, an associate portion of the heart muscle becomes oxygen-starved and begins to die. Thi
Strabismus for the anterior segment surgeon Sensory exotropia What
ANTERIOR TRANSPOSITION VERSUS MYECTOMY OF THE INFERIOR OBLIQUE Arrhythmia and Conduction Disorders in Acute Inferior Myocardial
Anterior Segment Issues - PowerPoint
Catheter Ablation of Repetitive Ventricular Tachycardia VENTRICULAR ECTOPY
A_O alert and oriented A_P anterior and posterior auscultation and OTHER DOCS BY Patents-186