Belt for applying pressure to a bodily organ

Patent metadata

Field	Value
Publication number	US-11213392-B2
Application number	US-201816174779-A
Country	US
Kind code	B2
Filing date	Oct 30, 2018
Priority date	Nov 1, 2017
Publication date	Jan 4, 2022
Grant date	Jan 4, 2022

Abstract

Among other things, there are disclosed embodiments of belts or bands that can be used in treatments for tricuspid valve regurgitation. In some embodiments, such belts may be heat-set in a particular configuration to effectively decrease tricuspid annulus when deployed around the atrioventricular groove. Embodiments include one or more tensioning sutures for applying cinching or tightening to belts when deployed, and structure for effectively distributing force during such tightening.

First claim

What is claimed is:

1. A belt for placement along the atrioventricular groove of the heart, comprising:
a mesh tube having a first open end, a second open end and a lumen passing through the tube from the first open end to the second open end along a longitudinal axis of the tube, the tube configured longitudinally in a loop so as to be placed around the heart and along the atrioventricular groove;
a first suture portion within the tube, the first suture portion fixed to the tube at a first location adjacent the first open end and extending through the lumen toward the second open end, the first suture portion connected to the tube within the lumen by a first plurality of holding elements so that the first suture portion is longitudinally movable through the first plurality of holding elements with respect to the tube;
a second suture portion within the tube and spaced from the first suture portion, the second suture portion fixed to the tube at a second location adjacent the first open end and extending through the lumen toward the second open end, the second location spaced from the first location, the second suture portion connected to the tube within the lumen by a second plurality of holding elements so that the second suture portion is longitudinally movable through the second plurality of holding elements with respect to the tube;
wherein pulling the first and second suture portions moves the first and second suture portions through the first plurality of holding elements and the second plurality of holding elements, respectively, and cinches the tube to reduce an area of the loop so that the tube compress longitudinally in at least selected locations along the tube.

2. The belt of claim 1 , wherein the first suture portion and second suture portion each extend through the second open end of the tube to provide respective parts of the first and second suture portions that are outside the tube and able to be pulled to cinch the tube.

3. The belt of claim 1 , wherein the mesh is nitinol.

4. The belt of claim 1 , wherein the mesh is heat-set so that when the tube reaches body temperature, a cross section of the tube assumes a barbell shape.

5. The belt of claim 1 , wherein the mesh is heat-set so that when the tube reaches body temperature, a cross section of the tube assumes an elliptical or oval shape.

6. The belt of claim 1 , wherein the mesh is heat-set so that when the tube reaches body temperature, the tube assumes a flat ribbon shape.

7. The belt of claim 1 , wherein the mesh is heat-set so that when the tube reaches body temperature, the tube assumes a shape with a first region having a first hoop diameter and first cross sectional dimension, and a second region having a second hoop diameter and second cross sectional dimension, and wherein the first hoop diameter is greater than the second hoop diameter, and the first cross sectional dimension is greater than the second cross sectional dimension.

8. The belt of claim 7 , wherein a medial portion between the first and second regions includes a contour adapted to conform to at least part of the atrioventricular groove.

9. The belt of claim 1 , wherein the mesh is heat-set so that when the tube reaches body temperature, the tube assumes a saddle shape having one or more lower rounded contoured regions, and wherein at least one of the lower rounded contoured regions is adapted to fit closely within the atrioventricular groove.

10. The belt of claim 1 , wherein the first and second suture portions are each part of a respective separate suture.

11. The belt of claim 1 , wherein the first and second suture portions are connected to form a loop.

12. The belt of claim 11 , wherein the loop is connected to an elongated element at least partially exterior to the belt, the elongated element being one of a locking suture and a delivery filament.

13. The belt of claim 1 , wherein the second suture portion within the tube is parallel to the first suture portion.

14. The belt of claim 1 , wherein the mesh tube is comprised of braided nitinol wires, wherein the mesh tube is configured to stretch lengthwise under tension to thereby decrease a diameter of the mesh tube in an area of the mesh tube that is stretched, and wherein the mesh tube is configured to be compressed lengthwise under compression or relaxation of tension to thereby increase a diameter of the mesh tube in an area of the meshed tube that is compressed.

15. A belt for placement along the atrioventricular groove of the heart, comprising:
a mesh tube having a first open end, a second open end and a lumen passing through the tube from the first open end to the second open end along a longitudinal axis of the tube, the tube configured longitudinally in a loop so as to be placed around the heart and along the atrioventricular groove;
a first suture portion within the tube, the first suture portion fixed to the tube adjacent the first open end and extending through the lumen toward the second open end, the first suture portion connected to the tube within the lumen by a first plurality of holding elements so that the first suture portion is longitudinally movable through the first plurality of holding elements with respect to the tube;
a second suture portion within the tube, the second suture portion being parallel to and spaced from the first suture portion, the second suture portion fixed to the tube adjacent the first open end and extending through the lumen toward the second open end, the second suture portion connected to the tube within the lumen by a second plurality of holding elements so that the second suture portion is longitudinally movable through the second plurality of holding elements with respect to the tube;
wherein pulling the first and second suture portions cinches the tube to reduce an area of the loop so that the tube compress longitudinally in at least selected locations along the tube; and wherein the first suture portion and second suture portion are parts of a single tensioning suture having a middle portion between the first suture portion and second suture portion, and further comprising a locking suture attached to the middle portion of the tensioning suture.

16. The belt of claim 15 , further comprising a ring within the tube and adjacent the second open end, wherein the tensioning suture folds over and through the ring, wherein the first and second suture portions are on one side of the ring and the middle portion is on the other side of the ring.

17. The belt of claim 16 , wherein the ring includes a rounded engagement portion around which the tensioning suture is folded.

18. The belt of claim 16 , wherein the ring includes first and second linear sides that parallel the tube adjacent the second open end, the first linear side connected to the tube by at least one holding element, and the second linear side connected to the tube by at least one holding element.

19. The belt of claim 15 , wherein the locking suture includes a plurality of protrusions for use in holding tension applied to the locking suture and transmitted to the first and second suture portions.

20. The belt of claim 19 , wherein the locking suture has a length within the tube and a portion exiting the tube through the first open end, and wherein the protrusions are on up to the full length of the locking suture within the tube and next to the first open end, and are not otherwise on the length of the locking suture within the tube.

Assignees

• Muffin Inc

Inventors

• Gittard Shaun Davis
• Sigmon Jr John C
• Hardy Gregory James
• Newkirk Jeremy T
• Fearnot Neal E
• Havel William J
• Hadley Rita
• Zhou Yun

Classifications

• A61B17/0487

  Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks (suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122) · CPC title

• A61F2230/0065

  toroidal, e.g. ring-shaped, doughnut-shaped · CPC title

• A61F2250/001

  for adjusting a diameter · CPC title

• A61F2220/0075

  sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable · CPC title

• A61F2/2481 Primary

  Devices outside the heart wall, e.g. bags, strips or bands · CPC title