公开(公告)号：US07377941B2

公开(公告)日：2008-05-27

申请号：US11124405

申请日：2005-05-06

Applicant: Richard S. Rhee ,  Emanuel Shaoulian ,  Shahram Moaddeb ,  Samuel M. Shaolian

Inventor： Richard S. Rhee ,  Emanuel Shaoulian ,  Shahram Moaddeb ,  Samuel M. Shaolian

IPC: A61F2/24

CPC classification number: A61F2/2448 ,  A61F2/2445 ,  A61F2210/0014 ,  A61F2210/0023 ,  A61F2250/0001 ,  A61F2250/0004 ,  A61F2250/0082

Abstract: Methods and devices are provided for support of a body structure. The devices can be adjusted within the body of a patient in a minimally invasive or non-invasive manner. Thus, as the body structure changes size and/or shape, the size and/or shape of the annuloplasty rings can be adjusted to provide continued reinforcement. In certain embodiments, the devices include an anterior portion, a posterior portion and two lateral portions corresponding to intersections of the anterior portion and the posterior portion. The devices have a first shape in a first configuration and a second shape in a second configuration and are configured to transform from the first configuration to the second configuration in response to an activation energy applied thereto. The transformation is configured to reduce a distance between the anterior portion and the posterior portion without substantially decreasing a distance between the two lateral portions.

Abstract translation: 提供了用于支撑身体结构的方法和装置。 可以以微创或非侵入方式在装置体内调节装置。 因此，随着身体结构改变尺寸和/或形状，可以调节瓣膜成形术环的尺寸和/或形状以提供持续的加强。 在某些实施例中，装置包括前部，后部和对应于前部和后部的交叉点的两个侧部。 这些装置具有第一配置的第一形状和第二配置的第二形状，并且被配置为响应于施加到其上的激活能量而从第一配置变换到第二配置。 该变换被配置为减小前部和后部之间的距离，而基本上不减小两个侧部之间的距离。

公开(公告)号：US20080097487A1

公开(公告)日：2008-04-24

申请号：US11760482

申请日：2007-06-08

Applicant: Scott Pool ,  Blair Walker ,  Jay R. McCoy ,  Peter P. Tran ,  Richard L. Quick ,  Shahram Moaddeb ,  Arvin Chang

Inventor： Scott Pool ,  Blair Walker ,  Jay R. McCoy ,  Peter P. Tran ,  Richard L. Quick ,  Shahram Moaddeb ,  Arvin Chang

IPC: A61B17/08

CPC classification number: A61F5/0053 ,  A61F5/003 ,  A61F5/0059 ,  A61F5/0066 ,  A61F2005/002

Abstract: A gastrointestinal implant system includes an adjustable restriction device having a contact surface configured for at least partially engaging a surface of a gastrointestinal tract of a mammal. The implant system further includes an implantable interface including a first driving element, the first driving element being moveable and operatively coupled to the adjustable restriction device by an actuator configured to change the dimension or configuration of the contact surface in response to movement of the first driving element. The system also includes an external adjustment device having a second driving element configured to non-invasively engage the first driving element of the implantable interface from a location external to the mammal. In the system, actuation of the second driving element of the external adjustment device produces movement in the first driving element of the implantable interface and results in a change in the dimension or configuration of the contact surface.

Abstract translation: 消化道植入系统包括可调节限制装置，其具有构造成用于至少部分地接合哺乳动物的胃肠道表面的接触表面。 所述植入系统还包括可植入界面，其包括第一驱动元件，所述第一驱动元件可移动并通过构造成响应于所述第一驱动件的移动来改变所述接触表面的尺寸或构造而被可操作地联接到所述可调节限制装置 元件。 该系统还包括具有第二驱动元件的外部调整装置，该第二驱动元件构造成从哺乳动物外部的位置非侵入地接合可植入界面的第一驱动元件。 在该系统中，外部调节装置的第二驱动元件的致动在可植入界面的第一驱动元件中产生运动并且导致接触表面的尺寸或构型的变化。

公开(公告)号：US20080097249A1

公开(公告)日：2008-04-24

申请号：US11732431

申请日：2007-04-02

Applicant: Scott Pool ,  Jay R. McCoy ,  Richard L. Quick ,  Blair Walker ,  Shahram Moaddeb ,  David G. Davtyan

Inventor： Scott Pool ,  Jay R. McCoy ,  Richard L. Quick ,  Blair Walker ,  Shahram Moaddeb ,  David G. Davtyan

IPC: A61B5/103

CPC classification number: A61B5/05 ,  A61B5/03 ,  A61B5/411 ,  A61B17/1355 ,  A61B2017/00057 ,  A61B2017/00084 ,  A61B2090/063 ,  A61F5/0003 ,  A61F5/0053

Abstract: Methods and apparatus useful for monitoring fluid flow past a gastric restriction device using noninvasive means are described. Some methods involve the use of acoustic energy, e.g., Doppler ultrasound, to monitor the passage of fluid past the restriction device, and apparatus to detect the acoustic energy. In some embodiments the method detects a sound-producing fluid using a microphone, stethoscope, or ultrasound probe and detector combination. In some embodiments, there are described methods of using Doppler ultrasound to monitor the flow of a fluid through a stomal opening, allowing a flow condition, e.g., a flow rate, to be determined, so that a physician can accurately adjust the gastric restriction device.

Abstract translation: 描述了使用非侵入性手段监测通过胃限制装置的流体流动的方法和装置。 一些方法涉及使用诸如多普勒超声的声能来监测流经限制装置的流体，以及用于检测声能的装置。 在一些实施例中，该方法使用麦克风，听诊器或超声波探头和检测器组合来检测产生声音的流体。 在一些实施例中，描述了使用多普勒超声波来监测通过造口开口的流体的流动的方法，允许确定流量条件，例如流速，使得医师可以精确地调整胃限制装置 。

公开(公告)号：US07361190B2

公开(公告)日：2008-04-22

申请号：US11123851

申请日：2005-05-06

Applicant: Emanuel Shaoulian ,  Samuel M. Shaolian ,  Shahram Moaddeb

Inventor： Emanuel Shaoulian ,  Samuel M. Shaolian ,  Shahram Moaddeb

IPC: A61F2/24

CPC classification number: A61F2/2448 ,  A61F2/2445 ,  A61F2210/0014 ,  A61F2210/0023 ,  A61F2250/0001 ,  A61F2250/0004 ,  A61F2250/0082

Abstract: Methods and devices are provided for support of a body structure. The devices can be adjusted within the body of a patient in a minimally invasive or non-invasive manner such as by applying energy percutaneously or external to the patient's body. The energy may include, for example, acoustic energy, radio frequency energy, light energy and magnetic energy. Thus, as the body structure changes size and/or shape, the size and/or shape of the annuloplasty rings can be adjusted to provide continued reinforcement. In certain embodiments, the devices include a tubular member configured to be attached to or near a cardiac valve annulus. The tubular member includes a receptacle end and an insert end configured to couple with the receptacle end of the tubular member such that the tubular member substantially forms a shape of a ring. The insert end is configured to move with respect to the receptacle end to change a circumference of the ring.

Abstract translation: 提供了用于支撑身体结构的方法和装置。 可以以微创或非侵入性方式在患者体内调节装置，例如通过经皮或外部给患者的身体施加能量。 能量可以包括例如声能，射频能量，光能和磁能。 因此，随着身体结构改变尺寸和/或形状，可以调节瓣膜成形术环的尺寸和/或形状以提供持续的加强。 在某些实施例中，这些装置包括构造成附接到心脏瓣膜环上或附近的管状构件。 管状构件包括容置端和插入端，所述插入端构造成与管状构件的容置端相连，使得管状构件基本上形成环的形状。 插入端构造成相对于插座端移动以改变环的圆周。

公开(公告)号：US20080051840A1

公开(公告)日：2008-02-28

申请号：US11773311

申请日：2007-07-03

Applicant: Shahram Moaddeb ,  Samuel Shaolian ,  Emanuel Shaoulian

Inventor： Shahram Moaddeb ,  Samuel Shaolian ,  Emanuel Shaoulian

IPC: A61N1/368

CPC classification number: A61N1/3627

Abstract: Systems, methods and devices are provided for improving the hemodynamic efficiency of a patient's heart by implanting one or more reinforcement elements on or with the heart and providing electrical stimulation to the heart. The reinforcement elements may include magnetic and/or shape memory material and are configured to reshape the heart so as to boost the heart's mechanical energy during a response to the electrical stimulation. In some embodiments, at least one reinforcement element includes an electrode configured to sense electrocardiogram signals within the heart. An electrical stimulation device such as an implantable or external pacemaker/defibrillator may be configured to control delivery of electrical pulses to the heart based on the sensed electrocardiogram signals. In addition, or in other embodiments, at least one reinforcement element includes an electrode configured to deliver the electrical pulses to the heart.

Abstract translation: 提供了系统，方法和装置，用于通过在心脏上或与心脏一起植入一个或多个增强元件并向心脏提供电刺激来改善患者心脏的血液动力学效率。 加强元件可以包括磁性和/或形状的记忆材料，并且被配置成重塑心脏，以便在对电刺激的响应期间增强心脏的机械能。 在一些实施例中，至少一个加强元件包括被配置为感测心脏内的心电图信号的电极。 诸如植入式或外部起搏器/除颤器之类的电刺激装置可以被配置成基于感测到的心电图信号来控制向心脏的电脉冲的传递。 另外或在其它实施例中，至少一个加强元件包括被配置为将电脉冲传送到心脏的电极。

公开(公告)号：US07285087B2

公开(公告)日：2007-10-23

申请号：US11142078

申请日：2005-05-31

Applicant: Shahram Moaddeb ,  Samuel M. Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven C. Anderson

Inventor： Shahram Moaddeb ,  Samuel M. Shaolian ,  Emanuel Shaoulian ,  Richard Rhee ,  Steven C. Anderson

IPC: A61F2/00

CPC classification number: A61B17/00234 ,  A61B17/06166 ,  A61B17/0644 ,  A61B17/068 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2017/06052

Abstract: Systems, methods and devices are provided for treating heart failure patients suffering from various levels of heart dilation. Such heart dilation is treated by reshaping the heart anatomy with the use of shape memory elements. Such reshaping changes the geometry of portions of the heart, particularly the right or left ventricles, to increase contractibility of the ventricles thereby increasing the stroke volume which in turn increases the cardiac output of the heart. The shape memory elements have an original shape and at least one memory shape. The elements are implanted within the heart tissue or attached externally and/or internally to a surface of the heart when in the original shape. The elements are then activated to transition from the original shape to one of the at least one memory shapes. Transitioning of the elements cause the associated heart tissue areas to readjust position, such as to decrease the width of the ventricles. Such repositioning is maintained over time by the elements, allowing the damaging effects of heart dilation to slow in progression or reverse.

Abstract translation: 提供了用于治疗患有各种心脏扩张水平的心力衰竭患者的系统，方法和装置。 通过使用形状记忆元件重建心脏解剖结构来治疗这种心脏扩张。 这种重塑改变了心脏的部分的几何形状，特别是右心室或左心室，以增加心室的收缩性，从而增加了行程体积，从而增加了心脏的心输出量。 形状记忆元件具有原始形状和至少一种存储器形状。 当原始形状时，将元件植入心脏组织内或外部和/或内部附着到心脏的表面。 元件然后被激活以从原始形状转换到至少一个存储器形状之一。 元件的过渡导致相关的心脏组织区域重新调整位置，例如减小心室的宽度。 这种重新定位由元素随时间推移而维持，从而允许心脏扩张的破坏性影响进展缓慢或逆转。

公开(公告)号：US20070239154A1

公开(公告)日：2007-10-11

申请号：US11728010

申请日：2007-03-22

Applicant: Samuel Shaolian ,  Shahram Moaddeb ,  Maurice Buchbinder ,  David Zarbatany ,  Jason Tran

Inventor： Samuel Shaolian ,  Shahram Moaddeb ,  Maurice Buchbinder ,  David Zarbatany ,  Jason Tran

IPC: A61F2/24 ,  A61B18/18

CPC classification number: A61F2/2445 ,  A61F2/2466 ,  A61F2250/0001

Abstract: An activation device for applying energy to an implanted annuloplasty ring is described. In some embodiments, the activation device includes an outer elongate member having an outer elongate member distal end and an outer elongate member proximal end, and a lumen therebetween. In some embodiments, the activation device further includes an inner elongate member having a inner elongate member distal end and a inner elongate member proximal end, and a lumen therebetween, wherein the inner elongate member is slidably insertable through the lumen of the outer elongate member. In some embodiments, the activation device further includes at least one adjustable spline having spline proximal and spline distal ends, the spline distal end connected to the inner tubular member distal end and the spline proximal end connected to the outer tubular member distal end, wherein the adjustable spline is configured to flex as the inner tubular member distal end is drawn proximally toward the outer tubular member distal end while the inner elongate member resides in the lumen of the outer elongate member. In some embodiments, the activation device further includes at least one energy-transfer element coupled to the adjustable spline.

Abstract translation: 描述了一种用于向植入的瓣膜成形术环施加能量的激活装置。 在一些实施例中，激活装置包括具有外部细长构件远端和外部细长构件近端的外部细长构件和其间的内腔。 在一些实施例中，激活装置还包括具有内部细长构件远端和内部细长构件近端的内部细长构件和其间的内腔，其中内部细长构件可滑动地插入穿过外部细长构件的内腔。 在一些实施例中，激活装置还包括具有花键近端和花键远端的至少一个可调节花键，花键远端连接到内部管状构件远端，花键近端连接到外部管状构件远端，其中， 当内部细长构件驻留在外部细长构件的内腔中时，可调节花键构造成随着内部管状构件远端朝向外部管状构件远端被拉近而弯曲。 在一些实施例中，激活装置还包括耦合到可调节花键的至少一个能量传递元件。

公开(公告)号：US20060241747A1

公开(公告)日：2006-10-26

申请号：US11123874

申请日：2005-05-06

Applicant: Emanuel Shaoulian ,  Shahram Moaddeb ,  Samuel Shaolian

Inventor： Emanuel Shaoulian ,  Shahram Moaddeb ,  Samuel Shaolian

IPC: A61F2/24 ,  A61F2/86

CPC classification number: A61F2/2451 ,  A61F2250/0001 ,  A61F2250/0039

Abstract: Tissue shaping methods and devices are provided. The devices can be adjusted within the body of a patient in a less invasive or non-invasive manner, such as by applying energy percutaneously or external to the patient's body. In one example, the device is positioned within the coronary sinus of the patient so as to effect changes in at least one dimension of the mitral valve annulus. The device may also advantageously include a shape memory material that is responsive to changes in temperature and/or exposure to a magnetic field. In one example, the shape memory material is responsive to energy, such as electromagnetic or acoustic energy, applied from an energy source located outside the coronary sinus. A material having enhanced absorption characteristics with respect to the desired heating energy may also be used to facilitate heating and adjustment of the tissue shaping device.

Abstract translation: 提供组织成形方法和装置。 可以以侵入性或非侵入性方式在患者体内调节装置，例如通过经皮或外部给予患者身体的能量。 在一个示例中，装置定位在患者的冠状窦内，以便实现二尖瓣环的至少一个维度的变化。 该装置还可以有利地包括响应温度变化和/或暴露于磁场的形状记忆材料。 在一个示例中，形状记忆材料响应于从位于冠状窦外侧的能量源施加的能量，例如电磁或声能。 相对于期望的加热能量具有增强的吸收特性的材料也可用于促进组织整形装置的加热和调节。

公开(公告)号：US06980858B2

公开(公告)日：2005-12-27

申请号：US10040977

申请日：2001-12-31

Applicant: Kristine B. Fuimaono ,  Shahram Moaddeb

Inventor： Kristine B. Fuimaono ,  Shahram Moaddeb

IPC: A61N1/39 ,  A61N1/05 ,  A61N1/365

CPC classification number: A61N1/0563

Abstract: A method and system for atrial defibrillation in a patient are provided. The method comprises introducing into the patient a catheter comprising an elongated catheter body having proximal and distal ends and at least one lumen therethrough, and a basket-shaped electrode assembly at the distal end of the catheter body. The electrode assembly has proximal and distal ends and comprises a plurality of spines connected at their proximal and distal ends, each spine comprising an elongated spine electrode along its length. The electrode assembly has an expanded arrangement wherein the spines bow radially outwardly and a collapsed arrangement wherein the spines are arranged generally along the axis of the catheter body. The method further comprises introducing the electrode assembly into the heart of the patient and applying defibrillation energy to the tissue through one or more of the elongated electrodes. The system comprises a catheter as described above in combination with an external defibrillator electrically connected to the catheter.

Abstract translation: 提供了一种患者心房除颤的方法和系统。 所述方法包括向患者引入导管，该导管包括具有近端和远端以及穿过其中的至少一个腔的细长导管本体，以及位于导管主体远侧的筐形电极组件。 电极组件具有近端和远端，并且包括在其近端和远端连接的多个脊，每个脊沿其长度包括细长的脊柱电极。 电极组件具有扩展的布置，其中脊柱径向向外弯曲并且具有塌缩的布置，其中脊通常沿着导管主体的轴线布置。 该方法还包括将电极组件引入患者的心脏中，并通过一个或多个细长电极向组织施加除颤能量。 该系统包括如上所述的导管和与导管电连接的外部除颤器。

公开(公告)号：US06402719B1

公开(公告)日：2002-06-11

申请号：US08924342

申请日：1997-09-05

Applicant: Dean M. Ponzi ,  Shahram Moaddeb

Inventor： Dean M. Ponzi ,  Shahram Moaddeb

IPC: A61M3700

CPC classification number: A61B18/24 ,  A61B5/0422 ,  A61B18/1492 ,  A61B2017/00247 ,  A61B2017/003 ,  A61B2018/00392 ,  A61M1/1072

Abstract: A steerable, direct myocardial revascularization catheter comprises a catheter body, a control handle, a tip section, and a means for deflecting the tip section by manipulation of the control handle. The catheter body has an outer wall, proximal and distal ends and at least one lumen extending therethrough. The control handle is situated at the proximal end of the catheter body. The tip section comprises a flexible tubing having proximal and distal ends and at least one lumen therethrough. The proximal end of the tip section is fixedly attached to the distal end of the catheter body. The catheter also comprises an optic fiber having proximal and distal ends. The optic fiber extends through a lumen in a catheter body and tip section. The distal end of the optic fiber is substantially flush with the distal end of the tip section. The catheter further comprises an infusion tube having proximal and distal ends. The infusion tube extends through a lumen in the catheter body and tip section. The distal end of the infusion tube is fixedly situated within the tip section, and the proximal end of the infusion tube extends outside of the catheter body for receiving fluids. A method for inducing revascularization in the heart tissue comprises providing a catheter as described above, inserting the catheter into a heart chamber, transmitting sufficient laser energy through the optic fiber to create a channel in the heart wall, and administering at least one drug to the channel through the infusion tube.

Abstract translation: 可引导的直接心肌血运重建导管包括导管主体，控制手柄，尖端部分和用于通过操纵控制手柄偏转尖端部分的装置。 导管主体具有外壁，近端和远端以及延伸穿过其中的至少一个内腔。 控制手柄位于导管主体的近端。 尖端部分包括柔性管，其具有近端和远端以及穿过其中的至少一个腔。 尖端部分的近端固定地附接到导管主体的远端。导管还包括具有近端和远端的光纤。 光纤延伸穿过导管主体和尖端部分的内腔。 光纤的远端基本与尖端部分的远端齐平。 导管还包括具有近端和远端的输液管。 输液管延伸穿过导管主体和尖端部分的内腔。 输液管的远端固定地位于尖端部分内，并且输液管的近端延伸到导管主体的外部以便接收流体。1.一种用于诱导心脏组织血运重建的方法，包括提供如上所述的导管， 将导管插入心室中，通过光纤透射足够的激光能量以在心脏壁中产生通道，以及通过输注管给予通道至少一种药物。