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21. 发明申请

US20080228032A1 CARDIAC VISUALIZATION DEVICES AND METHODS 审中-公开
标题翻译： CARDIAC可视化设备和方法
公开(公告)号：US20080228032A1
公开(公告)日：2008-09-18
申请号：US12131831
申请日：2008-06-02
申请人： Niel F. Starksen , Nick Pliam , Rodolfo A. Morales , John To
发明人： Niel F. Starksen , Nick Pliam , Rodolfo A. Morales , John To
IPC分类号： A61B1/04 , A61B1/01 , A61M29/00
CPC分类号： A61B17/00234 , A61B17/1285 , A61B18/1492 , A61B2017/00243
摘要： Devices and methods for facilitating transvascular, minimally invasive and other “less invasive” surgical procedures generally include a sheath with an expandable balloon at the distal end, an inflation lumen for expanding the balloon, and a device passage lumen for allowing passage of one or more surgical instruments. The sheath is configured to house at least one visualization device such that an optical element of the device is positioned to view the surgical site. In some embodiments, instruments may be passed through the sheath, with the distal balloon partially or fully circumscribing or encircling the instruments. Any suitable instrument(s) may be passed through sheaths of the invention, such as a surgical clip applier for repairing a heart valve, an ablation member for treating atrial fibrillation, one or more pacemaker leads, a coronary sinus access device or the like.
摘要翻译：用于促进经血管，微创和其它“侵入性较小”外科手术的装置和方法通常包括在远端具有可膨胀气囊的护套，用于扩张气囊的充气腔，以及允许一个或多个手术器械。鞘被配置为容纳至少一个可视化装置，使得装置的光学元件被定位成观察手术部位。在一些实施例中，器械可以穿过护套，其中远端气囊部分或完全限定或环绕器械。任何合适的仪器可以通过本发明的护套，例如用于修复心脏瓣膜的手术夹具施放器，用于治疗房颤的消融构件，一个或多个起搏器引线，冠状窦入口装置等。

22. 发明申请

US20140155783A1 SYSTEMS AND METHODS FOR VARIABLE STIFFNESS TETHERS 审中-公开
标题翻译：系统和方法适用于变形刚度
公开(公告)号：US20140155783A1
公开(公告)日：2014-06-05
申请号：US14000177
申请日：2012-02-17
申请人： Niel F. Starksen , Joe Eder
发明人： Niel F. Starksen , Joe Eder
IPC分类号： A61B17/08 , A61M25/09
摘要： Described herein are devices and methods for guide elements configured with variable stiffness, with one or more flexible portions and one or more stiff portions. The flexible portion is be used as a tensioning element of a cinchable implant to tighten or compress tissues while the stiff portion is used to facilitate the insertion or withdrawal of portions of the implant or instruments acting on the implant. The guide element is further configured to be separated or severed between the flexible and stiff portions so that a flexible portion is left within the body as part of the implant, while the stiff portion is withdrawn from the body after implantation is completed.
摘要翻译：这里描述的是用于具有可变刚度的导向元件的装置和方法，具有一个或多个柔性部分和一个或多个刚性部分。柔性部分可用作可固定植入物的张紧元件，以紧固或压缩组织，而刚性部分用于促进植入物或作用在植入物上的器械的部分的插入或取出。引导元件进一步构造成在柔性部分和刚性部分之间被分离或切断，使得柔性部分作为植入物的一部分留在身体内部，而在植入完成之后刚性部分从身体中撤出。

23. 发明授权

US08641727B2 Devices and methods for heart valve repair 有权
标题翻译：心脏瓣膜修复的装置和方法
公开(公告)号：US08641727B2
公开(公告)日：2014-02-04
申请号：US12132161
申请日：2008-06-03
申请人： Niel F. Starksen , John To
发明人： Niel F. Starksen , John To
IPC分类号： A61B17/10 , A61F2/24
CPC分类号： A61F2/2466 , A61B17/00234 , A61B17/0401 , A61B17/064 , A61B17/0682 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61F2/2445
摘要： Devices and methods provide enhanced treatment of a cardiac valve annulus. Methods generally involve contacting an anchor delivery device with the valve annulus and releasing a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus. Anchors, which in some embodiments are super-elastic or shape memory self-securing anchors, are then drawn together to tighten the annulus. Devices generally include an elongate catheter having a housing at or near the distal end for releasably housing a plurality of coupled anchors. The housing may be flexible, may conform to a valve annulus, and in some embodiments may be coupled with an expandable member to enhance contact of the housing with annular tissue. In one embodiment, self-securing anchors lie approximately flat within the delivery device housing, allowing anchors with relatively large deployed shapes to be housed in and deployed from a relatively narrow delivery device.
摘要翻译：装置和方法提供对心脏瓣膜环的增强的治疗。方法通常包括使锚定器输送装置与阀环接触，并从锚定器输送装置释放多个联接的锚固件，以将锚固件固定到环形空间。然而，在一些实施例中，将超弹性或形状记忆自固定锚固件锚固在一起以紧固环。装置通常包括细长导管，其具有在远端处或附近的壳体，用于可释放地容纳多个联接的锚定件。壳体可以是柔性的，可以符合阀环，并且在一些实施例中可以与可扩张构件联接，以增强壳体与环形组织的接触。在一个实施例中，自固定锚定件大致平坦地位于输送装置壳体内，允许具有相对大的展开形状的锚定装置容纳在相对窄的输送装置中并从相对狭窄的输送装置展开。

24. 发明授权

US08287555B2 Devices and methods for heart valve repair 有权
标题翻译：心脏瓣膜修复的装置和方法
公开(公告)号：US08287555B2
公开(公告)日：2012-10-16
申请号：US10741130
申请日：2003-12-19
申请人： Niel F. Starksen , John To
发明人： Niel F. Starksen , John To
IPC分类号： A61B17/10 , A61F2/24
CPC分类号： A61B17/064 , A61B17/00234 , A61B17/0401 , A61B17/0682 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61F2/2445 , A61F2/2451 , A61F2/2466
摘要： Devices and methods provide enhanced treatment of a cardiac valve annulus. Methods generally involve contacting an anchor delivery device with the valve annulus and releasing a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus. Anchors, which in some embodiments are super-elastic or shape memory self-securing anchors, are then drawn together to tighten the annulus. Devices generally include an elongate catheter having a housing at or near the distal end for releasably housing a plurality of coupled anchors. The housing may be flexible, may conform to a valve annulus, and in some embodiments may be coupled with an expandable member to enhance contact of the housing with annular tissue. In one embodiment, self-securing anchors lie approximately flat within the delivery device housing, allowing anchors with relatively large deployed shapes to be housed in and deployed from a relatively narrow delivery device.
摘要翻译：装置和方法提供对心脏瓣膜环的增强的治疗。方法通常包括使锚定器输送装置与阀环接触，并从锚定器输送装置释放多个联接的锚固件，以将锚固件固定到环形空间。然而，在一些实施例中，将超弹性或形状记忆自固定锚固件锚固在一起以紧固环。装置通常包括细长导管，其具有在远端处或附近的壳体，用于可释放地容纳多个联接的锚定件。壳体可以是柔性的，可以符合阀环，并且在一些实施例中可以与可扩张构件联接，以增强壳体与环形组织的接触。在一个实施例中，自固定锚定件大致平坦地位于输送装置壳体内，允许具有相对大的展开形状的锚定装置容纳在相对窄的输送装置中并从相对狭窄的输送装置展开。

25. 发明申请

US20080294177A1 METHODS AND DEVICES FOR TERMINATION 有权
标题翻译：终止方法和设备
公开(公告)号：US20080294177A1
公开(公告)日：2008-11-27
申请号：US12187331
申请日：2008-08-06
申请人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
发明人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
IPC分类号： A61B17/138
CPC分类号： A61B17/0487 , A61B17/00234 , A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0485 , A61B17/064 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B17/1285 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0462 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61B2017/06176 , A61F2/2445
摘要： Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue. Various devices and methods for locking the tether in place and cutting excess tether are described.
摘要翻译：描述用于终止组织紧固程序的装置和方法。终止包括收紧系绳以收紧组织，锁定系绳以保持张力，并切割多余的系绳。在涉及固定到组织上的锚固件的过程中，系绳联接到锚固件上，并且组织通过紧固锚固件而被施加到锚固件上的张紧而被紧固。通常，这些装置和方法可用于微创外科手术，并可通过小切口或血管内应用。一种通过将第一锚定器固定地连接到系绳并将第二锚固件可滑动地联接到系绳来紧固组织的方法，将两个锚固件固定到组织上，将血管内的系绳施加张力，将系绳固定地连接到第二锚定器，并切割系绳被描述。待紧固的组织可以包括心脏组织，特别是心脏瓣膜环形组织。描述了将系绳锁定就位并切割多余系绳的各种装置和方法。

26. 发明授权

US08287557B2 Methods and devices for termination 有权
标题翻译：终止方法和设备
公开(公告)号：US08287557B2
公开(公告)日：2012-10-16
申请号：US11894401
申请日：2007-08-20
申请人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
发明人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
IPC分类号： A61B17/04
CPC分类号： A61B17/0487 , A61B17/00234 , A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0485 , A61B17/064 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B17/1285 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0462 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61B2017/06176 , A61F2/2445
摘要： Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue. Various devices and methods for locking the tether in place and cutting excess tether are described.
摘要翻译：描述用于终止组织紧固程序的装置和方法。终止包括收紧系绳以收紧组织，锁定系绳以保持张力，并切割多余的系绳。在涉及固定到组织上的锚固件的过程中，系绳联接到锚固件上，并且组织通过紧固锚固件而被施加到锚固件上的张紧而被紧固。通常，这些装置和方法可用于微创外科手术，并可通过小切口或血管内应用。一种通过将第一锚定器固定地连接到系绳并将第二锚固件可滑动地联接到系绳来紧固组织的方法，将两个锚固件固定到组织上，将血管内的系绳施加张力，将系绳固定地连接到第二锚定器，并切割系绳被描述。待紧固的组织可以包括心脏组织，特别是心脏瓣膜环形组织。描述了将系绳锁定就位并切割多余系绳的各种装置和方法。

27. 发明授权

US07883538B2 Methods and devices for termination 有权
公开(公告)号：US07883538B2
公开(公告)日：2011-02-08
申请号：US11232190
申请日：2005-09-20
申请人： John To , Niel F. Starksen , Tenny C. Calhoun
发明人： John To , Niel F. Starksen , Tenny C. Calhoun
IPC分类号： A61F2/24
CPC分类号： A61B17/064 , A61B17/00234 , A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0487 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B17/1285 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0462 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61F2/2445
摘要： Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue. Various devices and methods for locking the tether in place and cutting excess tether are described.

28. 发明授权

US07588582B2 Methods for remodeling cardiac tissue 有权
标题翻译：改造心脏组织的方法
公开(公告)号：US07588582B2
公开(公告)日：2009-09-15
申请号：US11255400
申请日：2005-10-20
申请人： Niel F. Starksen , John To , Rodolfo A. Morales
发明人： Niel F. Starksen , John To , Rodolfo A. Morales
IPC分类号： A61F2/24
CPC分类号： A61B17/064 , A61B17/00234 , A61B17/0401 , A61B17/0682 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61F2/2445
摘要： Described herein are methods of remodeling the base of a ventricle. In particular, methods of remodeling a valve annulus by forming a new fibrous annulus are described. These methods may result in a remodeled annulus that corrects valve leaflet function without substantially inhibiting the mobility of the leaflet. The methods of remodeling the base of the ventricle include the steps of securing a plurality of anchors to the valve annulus beneath one or more leaflets of the valve, constricting the valve annulus by cinching a tether connecting the anchors, and securing the anchors in the cinched conformation to allow the growth of fibrous tissue. The annulus may be cinched (e.g., while visualizing the annulus) so that the mobility of the valve leaflets is not significantly restricted. The remodeled annulus is typically constricted to shorten the diameter of the annulus to correct for valve dysfunction (e.g., regurgitation).
摘要翻译：本文描述了重建心室基部的方法。特别地，描述了通过形成新的纤维环重新形成瓣膜环的方法。这些方法可能导致改造的瓣环，其校正瓣膜小叶功能而基本上不抑制小叶的移动性。重建心室基部的方法包括以下步骤：将多个锚固件固定在阀的一个或多个小叶下方的瓣膜环上，通过收紧连接锚固件的系绳来收缩瓣膜环，并将锚固件固定在带状物允许纤维组织生长的构象。环可以被束缚（例如，同时可视化环），使得瓣膜小叶的移动性没有被显着限制。改造的环通常被收缩以缩短环的直径以纠正瓣膜功能障碍（例如，反流）。

29. 发明授权

US09072513B2 Methods and devices for termination 有权
标题翻译：终止方法和设备
公开(公告)号：US09072513B2
公开(公告)日：2015-07-07
申请号：US12187331
申请日：2008-08-06
申请人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
发明人： John To , Niel F. Starksen , Tenny C. Calhoun , Brian Tang
IPC分类号： A61B17/32 , A61B17/10 , A61B17/04 , A61B17/00 , A61B17/064 , A61B17/068 , A61B17/128 , A61B17/06 , A61F2/24
CPC分类号： A61B17/0487 , A61B17/00234 , A61B17/0401 , A61B17/0467 , A61B17/0469 , A61B17/0485 , A61B17/064 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B17/1285 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61B2017/0451 , A61B2017/0454 , A61B2017/0456 , A61B2017/0458 , A61B2017/0462 , A61B2017/0464 , A61B2017/0488 , A61B2017/0496 , A61B2017/06176 , A61F2/2445
摘要： Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue. Various devices and methods for locking the tether in place and cutting excess tether are described.
摘要翻译：描述用于终止组织紧固程序的装置和方法。终止包括收紧系绳以收紧组织，锁定系绳以保持张力，并切割多余的系绳。在涉及固定到组织上的锚固件的过程中，系绳联接到锚固件上，并且组织通过紧固锚固件而被施加到锚固件上的张紧而被紧固。通常，这些装置和方法可用于微创外科手术，并可通过小切口或血管内应用。一种通过将第一锚定器固定地连接到系绳并将第二锚固件可滑动地联接到系绳来紧固组织的方法，将两个锚固件固定到组织上，将血管内的系绳施加张力，将系绳固定地连接到第二锚定器，并切割系绳被描述。待紧固的组织可以包括心脏组织，特别是心脏瓣膜环形组织。描述了将系绳锁定就位并切割多余系绳的各种装置和方法。

30. 发明授权

US07922762B2 Devices and methods for cardiac annulus stabilization and treatment 有权
标题翻译：用于心脏瓣环稳定和治疗的装置和方法
公开(公告)号：US07922762B2
公开(公告)日：2011-04-12
申请号：US12132375
申请日：2008-06-03
申请人： Niel F. Starksen
发明人： Niel F. Starksen
IPC分类号： A61F2/24
CPC分类号： A61F2/2445 , A61F2/2451 , A61F2/2466
摘要： Devices and methods generally provide enhanced stabilization, exposure and/or treatment of a cardiac valve annulus. Methods generally involve introducing a stabilizing member beneath one or more leaflets of a heart valve to engage the annulus at an intersection between the leaflets and the interior ventricular wall of the heart. Force is then applied to the stabilizing member to stabilize and/or expose the valve annulus. In some embodiments, the stabilizing member may include a series of hydraulically driven tethered anchors, such as hooks or clips, for engaging and cinching valve annulus tissue to decrease the diameter of a regurgitant valve. Alternatively, other treatments may be delivered by a stabilizing member, such as radiofrequency energy, drugs, bulking agents or shape memory stents. A second stabilizing member may also be introduced above the leaflets for further stabilization.
摘要翻译：装置和方法通常提供增强的心脏瓣膜环的稳定，暴露和/或治疗。方法通常包括在心脏瓣膜的一个或多个小叶下方引入稳定构件，以在瓣膜和心脏的室内心室壁之间的交叉处接合环状物。然后将力施加到稳定构件以使阀环稳定和/或暴露。在一些实施例中，稳定构件可以包括一系列液压驱动的栓系锚，例如钩或夹子，用于接合和收紧瓣膜环组织以减小反流阀的直径。或者，其他治疗可以由稳定构件例如射频能量，药物，填充剂或形状记忆支架递送。还可以在传单上方引入第二稳定构件以进一步稳定。

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