Devices and methods for coronary sinus pressure relief
Inventors
Assignees
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Publication Number
US-10568751-B2
Publication Date
2020-02-25
Expiration Date
Abstract
A method and devices for relieving pressure in the left atrium of a patient's heart is disclosed. The method includes using an ablative catheter in a minimally invasive procedure to prepare an opening from the coronary sinus into a left atrium of the patient's heart. Once the opening is prepared, the opening may be enlarged by a technique such as expanding a balloon within the opening. A stent is then placed within the coronary sinus of the patient, with a transverse portion expanding within the opening, allowing blood to flow from the left atrium to the coronary sinus and then to the right atrium. Pressure within the left atrium is thus relieved.
Core Innovation
The disclosure relates to intracardial pressure-relief systems and methods for heart failure, where an opening is formed between a coronary sinus and a left atrium. A catheter is advanced into the coronary sinus, and a stent is delivered and deployed such that portions of the stent are placed in the left atrium, within the opening, and in the coronary sinus. Blood is permitted to flow from the left atrium into the coronary sinus, with the coronary sinus emptying into the right atrium.
The methods further include percutaneously placing a bending catheter inside the coronary sinus and penetrating a wall between the left atrium and the coronary sinus from inside the coronary sinus to create an opening. An expandable device is then delivered through a catheter and expanded to bear against the coronary sinus and hold the device in place. A second portion of the device is extended through the opening to provide a blood flow path from the left atrium into the coronary sinus, including a flange at a distal end that extends within the left atrium.
In additional embodiments, a stent includes a long portion and a crown portion, where the crown portion is strong enough to maintain the patency of the opening and allow blood flow therethrough. The crown portion and the long portion are joined around their circumference, and a flange engages a wall of the atrium. The long portion is deployed inside the coronary sinus both distal to and proximal to the opening while maintaining regular blood flow inside the coronary sinus.
Claims Coverage
The partial content includes three independent method claims that focus on creating or using an inter-atrial/coronary-sinus communication to relieve intracardiac pressure by maintaining patency of an opening and permitting blood flow from the left atrium into the coronary sinus. The inventive features center on catheter-based placement and delivery of a stent or expandable device, the use of a bending catheter to create the opening, and the structural portioning with crown or second portions and flange engagement.
Coronary-sinus stent deployment to permit la-to-coronary-sinus flow
advancing a catheter into a coronary sinus; delivering a stent through the catheter to an opening between the coronary sinus and a left atrium; deploying the stent through the opening to place a first portion of the stent in the left atrium, a second portion of the stent in the opening, and a third portion of the stent in the coronary sinus; and permitting blood to flow from the left atrium into the coronary sinus, with the coronary sinus emptying into the right atrium.
Bending catheter to create an opening and expandable device with flange extension
percutaneously placing a bending catheter inside a coronary sinus; penetrating the wall between the left atrium and the coronary sinus from inside the coronary sinus and thereby creating an opening; delivering an expandable device through a catheter to the coronary sinus; expanding a first portion of the device within the coronary sinus to bear against the coronary sinus and hold the device in place; extending a second portion of the device through the opening to provide a blood flow path from the left atrium into the coronary sinus; extending a flange within the left atrium; and maintaining regular blood flow inside the coronary sinus while allowing blood to flow from the left atrium into the coronary sinus.
Long-and-crown stent with crown patency and flange atrial engagement
percutaneously placing a bending catheter inside a coronary sinus; penetrating a wall between a left atrium and the coronary sinus and creating an opening; deploying a distal portion of a long portion of a stent inside the coronary sinus distal to the opening; deploying a crown portion of the stent at the opening, wherein the crown portion is strong enough to maintain the patency of the opening and allow blood flow therethrough, and an end of the crown portion is joined around its circumference to a portion of the long portion; engaging a wall of the atrium with a flange; and maintaining regular blood flow inside the coronary sinus through the long portion while allowing blood to flow from the left atrium into the coronary sinus.
Across the independent claims, the core claim coverage centers on percutaneous catheter-based formation and/or use of an opening between a coronary sinus and a left atrium, deployment of a stent or expandable device to maintain patency of that opening, and permitting blood flow from the left atrium into the coronary sinus while maintaining regular coronary-sinus flow and thereby relieving elevated or intracardial pressure.
Stated Advantages
Relieving intracardial pressure.
Relieving elevated pressure in a left atrium.
Allowing blood to flow from the left atrium into the coronary sinus while maintaining regular blood flow inside the coronary sinus.
Maintaining patency of an opening between the left atrium and the coronary sinus by using a crown portion or a second portion strong enough to maintain patency.
Documented Applications
Methods for relieving intracardial pressure by creating and/or using an opening between a coronary sinus and a left atrium in a patient's heart.
Methods for relieving elevated pressure in a patient's left atrium by percutaneously creating an opening between the left atrium and the coronary sinus and deploying an expandable device.
Heart failure intracardiac pressure relief via an inter-cardiac pressure vent/prosthesis that permits blood to flow from the left atrium into the coronary sinus, with the coronary sinus emptying into the right atrium.
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