Trans-catheter ventricular reconstruction structures, methods, and systems for treatment of congestive heart failure and other conditions

摘要

Embodiments described include devices, systems, and methods for reducing the distance between two locations in tissue. An anchor may reside within the right ventricle in engagement with the septum. A tension member may extend from that anchor through the septum and an exterior wall of the left ventricle to a second anchor disposed along a surface of the heart. Perforating the exterior wall and the septum from an epicardial approach can provide control over the reshaping of the ventricular chamber. Guiding deployment of the implant from along the epicardial access path and another access path into and through the right ventricle provides control over movement of the anchor within the ventricle. The joined epicardial pathway and right atrial pathway allows the tension member to be advanced into the heart through the right atrium and pulled into engagement along the epicardial access path.

主权项

1. A system for treating a heart within a patient, the heart having first and second chambers with a septum therebetween, the second chamber having an exterior wall, the system comprising:
a first elongate shaft having a proximal end and a distal end, the distal end of the first shaft being configured to be advanced from outside the patient into the heart along a first path so that the distal end of the first shaft is disposed in the first chamber; a second elongate shaft having a proximal end and a distal end, the distal end of the second shaft being configured to be advanced along a second path from outside the heart, through the exterior wall and through the septum so that the distal end of the second shaft is disposed in the first chamber; a first elongate flexible body slidably coupled to one of the shafts, the first flexible body having a distal end portion configured for in situ coupling, within the first chamber of the heart, with a corresponding distal end portion extending from the other of the shafts so as to join the first path with the second path; an implant configured to be advanced along the joined paths, the implant including:
a first anchor having a low profile configuration for advancement of the first anchor along the joined paths;a second anchor; andan elongate tension member having a first end couplable with the first anchor and a second end coupleable with the second anchor, the first anchor configured to deploy laterally from the low-profile configuration within the first chamber, the tension member configured to extend from the first anchor in the first chamber, through the septum, through the second chamber, and through the exterior wall such that applying tension between the anchors with the tension member urges the septum and the external wall to engage.