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1. 发明授权

US09226825B2 Delivery devices and methods for heart valve repair 有权
公开(公告)号：US09226825B2
公开(公告)日：2016-01-05
申请号：US10901554
申请日：2004-07-27
申请人： Niel F. Starksen , John To , Mariel Fabro , Michael F. Wei , Rodolfo A. Morales
发明人： Niel F. Starksen , John To , Mariel Fabro , Michael F. Wei , Rodolfo A. Morales
IPC分类号： A61F2/24 , A61B17/00 , A61B17/04 , A61B17/064 , A61B17/068 , A61B17/29
CPC分类号： A61F2/2436 , A61B17/00234 , A61B17/0401 , A61B17/064 , A61B17/0643 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0443 , A61B2017/0496 , A61B2017/2905 , A61F2/2427 , A61F2/2442 , A61F2/2445 , A61F2/2454 , A61F2/2466
摘要： Devices, systems and methods facilitate positioning of a cardiac valve annulus treatment device, thus enhancing treatment of the annulus. Methods generally involve advancing an anchor delivery device through vasculature of the patient to a location in the heart for treating the valve annulus, contacting the anchor delivery device with a length of the valve annulus, delivering a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus, and drawing the anchors together to circumferentially tighten the valve annulus. Devices generally include an elongate catheter having at least one tensioning member and at least one tensioning actuator for deforming a distal portion of the catheter to help it conform to a valve annulus. The catheter device may be used to navigate a subannular space below a mitral valve to facilitate positioning of an anchor delivery device.

2. 发明授权

US08066766B2 Methods and devices for termination 有权
标题翻译：终止方法和设备
公开(公告)号：US08066766B2
公开(公告)日：2011-11-29
申请号：US11894530
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： 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。

3. 发明申请

US20100023056A1 TETHER-ANCHOR ASSEMBLIES 审中-公开
公开(公告)号：US20100023056A1
公开(公告)日：2010-01-28
申请号：US12505332
申请日：2009-07-17
申请人： Peter K. JOHANSSON , Marshall TSURUDA
发明人： Peter K. JOHANSSON , Marshall TSURUDA
IPC分类号： A61B17/04
CPC分类号： A61B17/0401 , A61B17/00234 , A61B17/06166 , A61B17/064 , A61B17/068 , A61B17/0682 , A61B17/072 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0437 , A61B2017/0464 , A61B2017/07221 , A61F2/2445 , Y10T29/49826
摘要： Anchors, tethers, knot configurations and other coupling mechanisms used to secure tethers to anchors or other implants are described. The knot configurations described may provide enhanced knot security and/or tensile strength, while also occupying relatively little volume. In some variations, the surfaces of a tether and/or an anchor or other implant may be at least partially coated with one or more agents and/or may be at least partially textured.
摘要翻译：描述了用于将系绳固定到锚固器或其他植入物的锚固件，系绳，结结构和其它联接机构。所描述的结结构可以提供增强的结安全性和/或拉伸强度，同时也占据相对较小的体积。在一些变型中，系链和/或锚固体或其它植入物的表面可以至少部分地涂覆有一种或多种药剂和/或可以至少部分地被纹理化。

4. 发明申请

US20090209950A1 ELECTROPHYSIOLOGY CATHETER SYSTEM 审中-公开
标题翻译：电生理导管系统
公开(公告)号：US20090209950A1
公开(公告)日：2009-08-20
申请号：US12390326
申请日：2009-02-20
申请人： Niel F. STARKSEN
发明人： Niel F. STARKSEN
IPC分类号： A61B18/18 , A61B18/02 , A61N7/00 , A61B18/14 , A61B5/04
CPC分类号： A61B18/1492 , A61B5/0215 , A61B5/0535 , A61B18/02 , A61B2018/00011 , A61B2018/00577 , A61B2018/00702 , A61B2018/00744 , A61B2018/00791 , A61B2018/00994 , A61B2018/0212
摘要： Described herein are devices and methods for treating tissue, comprising a catheter with a plurality of access sites and a plurality of sensors associated with the access sites. The catheter may be positioned along a tissue surface and the sensors may be used to identify a target site along the tissue surface using the plurality of sensors. Analysis of the tissue surface by the sensors is performed without requiring repositioning of the catheter. In some examples, the access sites of the catheter are side openings along a length of the catheter and the plurality of sensors are electrodes configured to measure electrophysiology parameters. In these examples, the catheter may comprise an internal lumen which permits a treatment device, such as an ablation catheter, to be slidably positioned at the desired target site without requiring displacement of the catheter. In other examples, the catheter may comprise a plurality of fixed ablation elements associated with the plurality of access sites.
摘要翻译：本文描述了用于治疗组织的装置和方法，包括具有多个接入位置的导管和与接入部位相关联的多个传感器。导管可以沿着组织表面定位，并且传感器可以用于使用多个传感器来识别沿着组织表面的目标部位。通过传感器对组织表面进行分析，而无需重新定位导管。在一些示例中，导管的进入位置是沿着导管的长度的侧开口，并且多个传感器是被配置为测量电生理参数的电极。在这些示例中，导管可以包括允许诸如消融导管的治疗装置可滑动地定位在期望的目标位置而不需要导管移位的内腔。在其他示例中，导管可以包括与多个接入部位相关联的多个固定消融元件。

5. 发明授权

US07534204B2 Cardiac visualization devices and methods 有权
标题翻译：心脏可视化装置和方法
公开(公告)号：US07534204B2
公开(公告)日：2009-05-19
申请号：US10927784
申请日：2004-08-27
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： A61B1/00
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。

6. 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。

7. 发明申请

US20060058817A1 Delivery devices and methods for heart valve repair 失效
公开(公告)号：US20060058817A1
公开(公告)日：2006-03-16
申请号：US10901555
申请日：2004-07-27
申请人： Niel Starksen , John To , Mariel Fabro , Michael Wei , Rodolfo Morales
发明人： Niel Starksen , John To , Mariel Fabro , Michael Wei , Rodolfo Morales
IPC分类号： A61B17/10
CPC分类号： A61B17/00234 , A61B17/0401 , A61B17/064 , A61B17/0643 , A61B17/0644 , A61B17/068 , A61B17/0682 , A61B2017/00243 , A61B2017/00783 , A61B2017/00867 , A61B2017/0409 , A61B2017/0414 , A61B2017/0496 , A61B2017/2905 , A61F2/2445 , A61F2/2451 , A61F2/2466 , A61M2025/0096
摘要： Devices, systems and methods facilitate positioning of a cardiac valve annulus treatment device, thus enhancing treatment of the annulus. Methods generally involve advancing an anchor delivery device through vasculature of the patient to a location in the heart for treating the valve annulus, contacting the anchor delivery device with a length of the valve annulus, delivering a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus, and drawing the anchors together to circumferentially tighten the valve annulus. Devices generally include an elongate catheter having at least one tensioning member and at least one tensioning actuator for deforming a distal portion of the catheter to help it conform to a valve annulus. The catheter device may be used to navigate a subannular space below a mitral valve to facilitate positioning of an anchor delivery device.

8. 发明授权

US09173646B2 Diagnostic catheters, guide catheters, visualization devices and chord manipulation devices, and related kits and methods 有权
标题翻译：诊断导管，引导导管，可视化装置和和弦操纵装置，以及相关工具包和方法
公开(公告)号：US09173646B2
公开(公告)日：2015-11-03
申请号：US13619331
申请日：2012-09-14
申请人： Mariel Fabro
发明人： Mariel Fabro
IPC分类号： A61M25/00 , A61B17/00 , A61B1/00 , A61B6/12 , A61B8/12 , A61B1/313 , A61B17/32 , A61B17/72 , A61M25/04
CPC分类号： A61M25/0043 , A61B1/00078 , A61B1/3137 , A61B6/12 , A61B6/481 , A61B6/485 , A61B8/12 , A61B17/00234 , A61B17/0057 , A61B17/320016 , A61B17/7208 , A61B2017/00243 , A61M25/0041 , A61M25/04 , A61M2210/127
摘要： Described herein are devices, methods and kits for assessing and/or enhancing the accessibility of a subvalvular space of a heart, accessing the subvalvular space of the heart (e.g., to provide access for one or more other devices), and/or positioning one or more devices in the subvalvular space of the heart. The devices described herein may, for example, comprise catheters that may be used to manipulate one or more chordae tendineae, diagnostic catheters having different sizes and/or shapes (e.g., different curvatures), guide catheters having different sizes and/or shapes (e.g., different curvatures), and visualization catheters. In some variations, the devices, methods, and/or kits may be used to visualize a target site, such as a subannular groove of a heart valve. In certain variations, the devices, methods, and/or kits may be used to manipulate chordae tendineae to provide additional space in a ventricle of a heart (e.g., enhancing the accessibility of the ventricle).
摘要翻译：这里描述的是用于评估和/或增强心脏的亚阀瓣空间的可达性的装置，方法和试剂盒，其进入心脏的瓣膜下空间（例如，为一个或多个其它装置提供通路）和/或定位一个或更多的设备在心脏的小脑空间。本文描述的装置可以例如包括可用于操纵一个或多个腱索腱的导管，具有不同尺寸和/或形状（例如不同曲率）的诊断导管，具有不同尺寸和/或形状的导向导管（例如，，不同的曲率）和可视化导管。在一些变型中，可以使用装置，方法和/或试剂盒来可视化目标部位，例如心脏瓣膜的子宫沟槽。在某些变型中，装置，方法和/或试剂盒可用于操纵腱索腱索以在心脏的心室中提供额外的空间（例如，增强心室的可及性）。

9. 发明授权

US08795298B2 Tether tensioning devices and related methods 有权
标题翻译：系绳张力装置及相关方法
公开(公告)号：US08795298B2
公开(公告)日：2014-08-05
申请号：US12576955
申请日：2009-10-09
申请人： Jonathan D. Hernlund , Tenny C. Calhoun , Brian Tang , John To , Clyde Henry Booth, III
发明人： Jonathan D. Hernlund , Tenny C. Calhoun , Brian Tang , John To , Clyde Henry Booth, III
IPC分类号： A61B17/10
CPC分类号： A61B17/0487 , A61B17/0467 , A61B17/0485 , A61B2017/00243 , A61B2017/00783 , A61B2017/045 , A61B2017/0451 , A61B2017/048 , A61B2017/0488 , A61B2017/0496 , A61B2017/320052 , A61F2/2487
摘要： Devices, methods, and kits for tensioning tethers during a tissue modification procedure are described. In some variations, a tether coupled to anchors embedded in tissue may be tensioned to provide a cinching effect that tightens or compresses the tissue by bringing two pieces or sections of the tissue together. In certain variations, the tether may then be locked (e.g., to maintain the tension), and/or excess tether may be severed. The devices, methods, and/or kits may be used, for example, in minimally invasive procedures.
摘要翻译：描述了在组织修饰过程中张紧系链的装置，方法和试剂盒。在一些变型中，连接到嵌入在组织中的锚固件的系绳可以被张紧以提供通过将组织的两个或多个部分组合在一起而收紧或压缩组织的收紧效果。在某些变型中，系绳可以被锁定（例如，以维持张力），和/或可能切断多余的系绳。装置，方法和/或试剂盒可以用于例如微创手术。

10. 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。

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