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    Transluminal mitral annuloplasty
    11.
    发明授权
    Transluminal mitral annuloplasty 有权
    二尖瓣成形术

    公开(公告)号：US06810882B2

    公开(公告)日：2004-11-02

    申请号：US09909101

    申请日：2001-07-19

    Applicant: Jonathan J. Langberg ,  Michael D. Lesh ,  Erik van der Burg

    Inventor： Jonathan J. Langberg ,  Michael D. Lesh ,  Erik van der Burg

    IPC: A61B1900

    CPC classification number: A61F2/2451 ,  A61F2/2466

    Abstract: A mitral annuloplasty and left ventricle restriction device is designed to be transvenously advanced and deployed within the coronary sinus and in some embodiments other coronary veins. The device places tension on adjacent structures, reducing the diameter and/or limiting expansion of the mitral annulus and/or limiting diastolic expansion of the left ventricle. These effects may be beneficial for patients with dilated cardiomyopathy.

    Abstract translation: 二尖瓣成形术和左心室限制装置被设计成在冠状窦内部和在一些实施例中是其他冠状静脉中经过递送和部署。 该装置在相邻结构上施加张力，减小二尖瓣环的直径和/或限制扩张和/或限制左心室的舒张期扩张。 这些影响可能对扩张型心肌病患者有益。

    QRST subtraction using an adaptive template for analysis of TU wave obscured atrial activity
    12.
    发明授权
    QRST subtraction using an adaptive template for analysis of TU wave obscured atrial activity 有权
    QRST减法使用自适应模板分析T波波模糊心房活动

    公开(公告)号：US06615075B2

    公开(公告)日：2003-09-02

    申请号：US09809719

    申请日：2001-03-14

    Applicant: Michael D. Mlynash ,  Arne Sippens Groenewegen ,  Michael D. Lesh

    Inventor： Michael D. Mlynash ,  Arne Sippens Groenewegen ,  Michael D. Lesh

    IPC: A61B50452

    CPC classification number: A61B5/061 ,  A61B5/04085 ,  A61B5/04525 ,  A61B5/6831 ,  A61B5/7232 ,  A61B5/7264

    Abstract: The present invention provides a noninvasive localization, characterization and classification apparatus and method for cardiac arrhythmias. The invention enables discrete isolation of the intricate spatial and temporal detail in morphology of the atrial activity of interest from superimposed ventricular activity of a preceding heartbeat in a particular arrhythmia. An adaptive QRST subtraction template is used that is modulated for discrepancies in voltage and rate between the QRST template and arrhythmia signal. The QRST template modulation is accomplished by using one or more fiducial points and windows that are annotated in both the QRST template and the arrhythmia signal. The invention includes, but is not limited to, the isolation of atrial activity that are commonly known as: (1) P waves in case of focal atrial fibrillation, atrial tachycardia, and orthodromic AV reentrant tachycardia; (2) fibrillation waves in case of chronic atrial fibrillation; and (3) flutter waves in case of atrial flutter.

    Abstract translation: 本发明提供了用于心律失常的非侵入性定位，表征和分类装置和方法。 本发明使得在特定心律不齐中的前一心跳的叠加心室活动的兴趣心房活动的形态学上的错综复杂的空间和时间细节的离散分离。 使用自适应QRST减法模板，其被调制为QRST模板和心律失常信号之间的电压和速率的差异。 QRST模板调制是通过使用在QRST模板和心律失常信号中注释的一个或多个基准点和窗口来实现的。 本发明包括但不限于通常所述的心房活动的分离：（1）在局灶性房颤，心房心动过速和正畸AV折返性心动过速的情况下的P波; （2）慢性心房颤动的原纤维颤动波; 和（3）在心房颤动的情况下的颤动波。

    Percutaneous mitral annuloplasty and cardiac reinforcement
    14.
    发明授权
    Percutaneous mitral annuloplasty and cardiac reinforcement 有权
    经皮二尖瓣成形术和心脏加强

    公开(公告)号：US06537314B2

    公开(公告)日：2003-03-25

    申请号：US09774869

    申请日：2001-01-30

    Applicant: Jonathan J. Langberg ,  Michael D. Lesh ,  Erik van der Burg

    Inventor： Jonathan J. Langberg ,  Michael D. Lesh ,  Erik van der Burg

    IPC: A61F206

    CPC classification number: A61F2/2451 ,  A61F2/2466 ,  A61N2001/0585

    Abstract: A mitral annuloplasty and left ventricle restriction device is designed to be transvenously advanced and deployed within the coronary sinus and in some embodiments other coronary veins. The device places tension on adjacent structures, reducing the diameter and/or limiting expansion of the mitral annulus and/or limiting diastolic expansion of the left ventricle. These effects may be beneficial for patients with dilated cardiomyopathy.

    Abstract translation: 二尖瓣成形术和左心室限制装置被设计成在冠状窦内部和在一些实施例中是其他冠状静脉中经过递送和部署。 该装置在相邻结构上施加张力，减小二尖瓣环的直径和/或限制扩张和/或限制左心室的舒张期扩张。 这些影响可能对扩张型心肌病患者有益。

    Tissue ablation device and method
    15.
    发明授权
    Tissue ablation device and method 有权
    组织消融装置及方法

    公开(公告)号：US06471697B1

    公开(公告)日：2002-10-29

    申请号：US09357184

    申请日：1999-07-19

    Applicant: Michael D. Lesh

    Inventor： Michael D. Lesh

    IPC: A61B1818

    CPC classification number: A61B18/1492 ,  A61B18/1815 ,  A61B2017/00243 ,  A61B2017/22038 ,  A61B2017/22054 ,  A61B2017/22067 ,  A61B2018/00011 ,  A61B2018/0016 ,  A61B2018/00214 ,  A61B2018/00273 ,  A61B2018/00285 ,  A61B2018/00291 ,  A61B2018/00369 ,  A61B2018/00375 ,  A61B2018/00797 ,  A61B2018/00815 ,  A61B2018/00821 ,  A61B2018/00839 ,  A61B2018/00898 ,  A61B2018/00994 ,  A61B2218/002

    Abstract: A tissue ablation device creates long linear lesions along a body space wall of an animal, and primarily between adjacent pulmonary vein ostia in a left atrial wall. An ablation element includes first and second ends that are bordered by first and second anchors. The anchors are adapted to secure the ablation element ends at predetermined first and second locations along the body space wall such that the ablation element is adapted to ablate an elongate region of tissue between those locations. The anchors may be guidewire tracking members, each including a bore adapted to receive and track over a guidewire, and may anchor within adjacent pulmonary vein ostia when the engaged guidewires are positioned within the respective veins. Stop members may be provided on the guidewires and may be adapted for positioning the relative anchors or for forcing the anchors to fit snugly within the vein ostia. A conduit passageway through the catheter houses a stiffening stylet which may be advanced into the region of the ablation element in order to impart a shape to that element to conform it to a predetermined region of anatomy, or to stiffen the underlying catheter in order to advance the assembly into remote anatomy.

    Abstract translation: 组织消融装置沿着动物的身体空间壁产生长的线性损伤，主要在左心房壁的相邻肺静脉口之间产生。 消融元件包括由第一和第二锚固件邻接的第一端和第二端。 锚固件适于将消融元件端部沿着身体空间壁固定在预定的第一和第二位置处，使得消融元件适于在这些位置之间消融组织的细长区域。 锚定器可以是导丝跟踪构件，每个构件包括适于在导丝上接收和跟踪的孔，并且当所接合的导丝定位在相应的静脉内时，锚固件可以锚定在相邻的肺静脉口内。 止动构件可以设置在导丝上，并且可以适于定位相对锚定件或迫使锚固件紧密地配合在静脉口内。 通过导管的管道通道容纳加强的心尖管，其可被推进到消融元件的区域中，以赋予该元件的形状以使其符合预定的解剖结构区域，或加强下面的导管，以便前进 组装成远程解剖。

    Circumferential ablation device assembly
    16.
    发明授权
    Circumferential ablation device assembly 有权
    周围消融装置组装

    公开(公告)号：US06245064B1

    公开(公告)日：2001-06-12

    申请号：US09481089

    申请日：2000-01-11

    Applicant: Michael D. Lesh ,  Michael Ronald Ross ,  Jonathan J. Langberg ,  James C. Peacock, III

    Inventor： Michael D. Lesh ,  Michael Ronald Ross ,  Jonathan J. Langberg ,  James C. Peacock, III

    IPC: A61B1804

    CPC classification number: A61B18/10 ,  A61B18/00 ,  A61B18/08 ,  A61B18/1492 ,  A61B18/1815 ,  A61B2017/00243 ,  A61B2017/22038 ,  A61B2018/00083 ,  A61B2018/00107 ,  A61B2018/00148 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00351 ,  A61B2018/00375 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61B2018/1407 ,  A61M25/1002 ,  A61M2025/1075 ,  A61M2210/125 ,  A61N7/02 ,  A61N7/022

    Abstract: This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. The equatorial band has a length relative to the longitudinal axis of the expandable member that is narrow relative to the working length, and is also substantially shorter than its circumference when the working length is in the radially expanded position. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described. The expandable member is also adapted to conform to the pulmonary vein in the region of its ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length which has a distally reducing outer diameter. A linear ablation element is provided adjacent to the circumferential ablation element in a combination assembly which is adapted for use in a less-invasive “maze”-type procedure in the region of the pulmonary vein ostia in the left ventricle.

    Abstract translation: 本发明是适于在肺静脉中形成圆周传导阻滞的周缘消融装置组件。 该组件包括圆周消融元件，其适于沿着围绕肺静脉管腔的肺静脉壁消融组织的周缘区域，从而横切肺静脉的导电性，以抵抗沿着其纵向轴线并进入左心房的传导。 周向消融元件包括可膨胀构件，其具有可从径向收缩位置到径向扩张位置的可调节的工作长度。 赤道带包围工作长度的外表面，并且适于在由消融致动器致动时消融邻近的组织。 赤道带相对于可扩展构件的纵向轴线具有相对于工作长度窄的长度，并且当工作长度处于径向扩张位置时也比其圆周短得多。 绝缘体的图案可以包括在消融元件上，否则将跨越工作长度以形成所描述的赤道带。 可膨胀构件还适于在其口部的区域中符合肺静脉，例如通过提供大量径向顺应性或通过沿具有远端减小外径的工作长度提供锥形。 在组合组件中邻近周缘消融元件提供线性消融元件，该组合组件适用于在左心室的肺静脉口区域中的侵入性较小的“迷宫”型手术。

    Circumferential ablation device assembly
    19.
    发明授权
    Circumferential ablation device assembly 有权

    公开(公告)号：US6117101A

    公开(公告)日：2000-09-12

    申请号：US199736

    申请日：1998-11-25

    Applicant: Chris J. Diederich ,  Michael D. Lesh ,  James C. Peacock, III ,  Michael R. Ross

    Inventor： Chris J. Diederich ,  Michael D. Lesh ,  James C. Peacock, III ,  Michael R. Ross

    IPC: A61B17/00 ,  A61B18/00 ,  A61B18/14 ,  A61F2/958 ,  A61N7/02 ,  A61B17/20

    CPC classification number: A61B18/1492 ,  A61B18/00 ,  A61M25/1002 ,  A61N7/02 ,  A61B2017/00243 ,  A61B2018/00083 ,  A61B2018/00148 ,  A61B2018/00214 ,  A61M2210/125 ,  A61N7/022

    Abstract: This invention is a circumferential ablation device assembly which is adapted to forming a circumferential conduction block in a pulmonary vein. The assembly includes a circumferential ablation element which is adapted to ablate a circumferential region of tissue along a pulmonary vein wall which circumscribes the pulmonary vein lumen, thereby transecting the electrical conductivity of the pulmonary vein against conduction along its longitudinal axis and into the left atrium. The circumferential ablation element includes an expandable member with a working length that is adjustable from a radially collapsed position to a radially expanded position. An equatorial band circumscribes the outer surface of the working length and is adapted to ablate tissue adjacent thereto when actuated by an ablation actuator. The equatorial band has a length relative to the longitudinal axis of the expandable member that is narrow relative to the working length, and is also substantially shorter than its circumference when the working length is in the radially expanded position. A pattern of insulators may be included over an ablation element which otherwise spans the working length in order to form the equatorial band described. The expandable member is also adapted to conform to the pulmonary vein in the region of its ostium, such as by providing a great deal of radial compliance or by providing a taper along the working length which has a distally reducing outer diameter. A linear ablation element is provided adjacent to the circumferential ablation element in a combination assembly which is adapted for use in a less-invasive "maze"-type procedure in the region of the pulmonary vein ostia in the left ventricle. A cylindrical ultrasound transducer is provided on an inner member within the balloon and forms the circumferential ablation member by emitting a radial ultrasound signal which is circumferential to the transducer and highly collimated to the transducer's length. The circumferential ultrasound signal sonically couples to the balloon's outer skin to form the circumferential ablation element that is adapted to ablate a circumferential path of tissue engaged to the balloon.

    COAPTATION ENHANCEMENT IMPLANT, SYSTEM, AND METHOD
    20.
    发明申请
    COAPTATION ENHANCEMENT IMPLANT, SYSTEM, AND METHOD 有权
    加工植入，系统和方法

    公开(公告)号：US20120197388A1

    公开(公告)日：2012-08-02

    申请号：US13099532

    申请日：2011-05-03

    Applicant: Alex Khairkhahan ,  Michael D. Lesh

    Inventor： Alex Khairkhahan ,  Michael D. Lesh

    IPC: A61F2/24

    CPC classification number: A61F2/246 ,  A61B17/0401 ,  A61B17/064 ,  A61B17/068 ,  A61B17/12122 ,  A61B17/12172 ,  A61B2017/00867 ,  A61B2017/0412 ,  A61B2017/0448 ,  A61B2017/0464 ,  A61B2017/048 ,  A61B2017/0649 ,  A61F2/2454 ,  A61F2/2457 ,  A61F2/2466 ,  A61F2250/0003

    Abstract: Implants, implant systems, and methods for treatment of mitral valve regurgitation and other valve diseases generally include a coaptation assist body which remains within the blood flow path as the leaflets of the valve move, the valve bodies often being relatively thin, elongate (along the blood flow path), and/or conformable structures which extend laterally from commissure to commissure, allowing the native leaflets to engage and seal against the large, opposed surfaces on either side of the valve body during the heart cycle phase when the ventricle contracts to empty that chamber of blood, and allows blood to pass around the valve body so that blood flows from the atrium to the ventricle during the filling phase of the heart cycle. Separate deployment of independent anchors near each of the commissures may facilitate positioning and support of an exemplary triangular valve body, with a third anchor being deployed in the ventricle. An outer surface of the valve body may accommodate tissue ingrowth or endothelialization, while a fluid-absorbing matrix can swell after introduction into the heart. The valve body shape may be selected after an anchor has been deployed, and catheter-based deployment systems may have a desirable low profile.

    Abstract translation: 植入物，植入物系统和治疗二尖瓣关闭不全的其它瓣膜疾病的方法通常包括接合辅助体，其保持在血流动路径内，因为瓣膜的小叶移动，瓣膜体通常相对较薄（沿着 血流路径）和/或适形结构，其从合缝延伸到合缝，允许天然小叶在心脏周期阶段期间在心脏周期阶段期间接合并密封在阀体两侧的大的相对表面上，当心室收缩为空 血液室，并允许血液在阀体周围通过，使得血液在心脏周期的充盈阶段期间从心房流向心室。 在每个连合处附近单独部署独立的锚杆可以促进示例性三角形阀体的定位和支撑，其中第三锚定部分在心室中。 阀体的外表面可以适应组织向内生长或内皮化，而吸入液体的基质可以在引入心脏后膨胀。 可以在锚定器部署之后选择阀体形状，并且基于导管的部署系统可以具有期望的低轮廓。

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