公开(公告)号：US08257351B2

公开(公告)日：2012-09-04

申请号：US12760807

申请日：2010-04-15

申请人： Mark T. Stewart ,  James R. Skarda

发明人： Mark T. Stewart ,  James R. Skarda

IPC分类号： A61B18/04

CPC分类号： A61B18/1492 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2018/00065 ,  A61B2018/00214 ,  A61B2018/00267 ,  A61B2018/00351 ,  A61B2018/00375 ,  A61B2018/00404 ,  A61B2018/00898 ,  A61B2018/1407 ,  A61B2018/1435 ,  A61B2018/1472

摘要： A catheter assembly for treatment of cardiac arrhythmia. The catheter assembly includes a catheter body and an ablative energy source. The catheter body includes a proximal portion, an intermediate portion, and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and includes an ablation section and a tip. The ablation section forms a loop defining a diameter greater than an outer dimension of a pulmonary vein ostium. The tip extends distally from the ablation section and is configured to locate a pulmonary vein. Finally, the ablative energy source is associated with the ablation section. With this configuration, upon activation of the energy source, the ablation section ablates a desired lesion pattern. In one preferred embodiment, the ablation section forms a distally decreasing radius helix, whereas the tip includes a relatively linear leader section. With this one preferred configuration, the tip readily locates a pulmonary vein and guides the ablation section to a seated relationship about a pulmonary vein ostium (or extra-ostial).

摘要翻译： 用于治疗心律失常的导管组件。 导管组件包括导管主体和消融能源。 导管主体包括近端部分，中间部分和远端部分。 中间部分从近端部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并且包括消融部分和尖端。 消融部分形成限定直径大于肺静脉口的外部尺寸的环。 尖端从消融部分向远端延伸并且被配置为定位肺静脉。 最后，烧蚀能源与消融部分相关联。 利用这种配置，在激活能量源时，消融部分消除所需的损伤模式。 在一个优选实施例中，消融部分形成远端减小的半径螺旋，而尖端包括相对线性的引导部分。 利用这一优选的构造，尖端容易地定位肺静脉，并将消融部分引导到关于肺静脉口（或口外）的就座关系。

公开(公告)号：US08096959B2

公开(公告)日：2012-01-17

申请号：US11923320

申请日：2007-10-24

申请人： Mark T. Stewart ,  David E. Francischelli ,  James R. Skarda

发明人： Mark T. Stewart ,  David E. Francischelli ,  James R. Skarda

IPC分类号： A61B17/88

CPC分类号： A61B17/00234 ,  A61B2017/00252 ,  A61M25/10

摘要： A trans-septal guide catheter for providing access through the septum separating a first heart chamber from a second heart chamber that includes an elongated guide catheter body extending between guide catheter proximal and distal ends. A distal segment of the guide catheter is adapted to be inserted through the septum to locate the distal segment of the guide catheter within one of the first heart chamber and the second heart chamber. The catheter body encloses a guide catheter lumen adapted to provide access into the one of the first heart chamber and the second heart chamber through a guide catheter lumen proximal end opening and a guide catheter lumen distal end opening. A retention mechanism engages the septum and maintains the distal segment of the guide catheter extending into the one of the first heart chamber and the second heart chamber.

摘要翻译： 一种反间隔导引导管，用于提供通过将第一心室与第二心室隔开的隔膜的通路，该第二心室包括在引导导管近端和远端之间延伸的细长引导导管主体。 引导导管的远侧部分适于插入穿过隔膜以将引导导管的远侧部分定位在第一心室和第二心室之一内。 导管主体包围引导导管内腔，其适于通过引导导管内腔近端开口和引导导管内腔远端开口提供通向第一心室和第二心室之一的通路。 保持机构接合隔膜并且保持引导导管的远端段延伸到第一心室和第二心室中的一个。

公开(公告)号：US20100204692A1

公开(公告)日：2010-08-12

申请号：US12760807

申请日：2010-04-15

申请人： Mark T. Stewart ,  James R. Skarda

发明人： Mark T. Stewart ,  James R. Skarda

IPC分类号： A61B18/14

CPC分类号： A61B18/1492 ,  A61B2017/00044 ,  A61B2017/00243 ,  A61B2017/00867 ,  A61B2018/00065 ,  A61B2018/00214 ,  A61B2018/00267 ,  A61B2018/00351 ,  A61B2018/00375 ,  A61B2018/00404 ,  A61B2018/00898 ,  A61B2018/1407 ,  A61B2018/1435 ,  A61B2018/1472

摘要： A catheter assembly for treatment of cardiac arrhythmia. The catheter assembly includes a catheter body and an ablative energy source. The catheter body includes a proximal portion, an intermediate portion, and a distal portion. The intermediate portion extends from the proximal portion and defines a longitudinal axis. The distal portion extends from the intermediate portion and includes an ablation section and a tip. The ablation section forms a loop defining a diameter greater than an outer dimension of a pulmonary vein ostium. The tip extends distally from the ablation section and is configured to locate a pulmonary vein. Finally, the ablative energy source is associated with the ablation section. With this configuration, upon activation of the energy source, the ablation section ablates a desired lesion pattern. In one preferred embodiment, the ablation section forms a distally decreasing radius helix, whereas the tip includes a relatively linear leader section. With this one preferred configuration, the tip readily locates a pulmonary vein and guides the ablation section to a seated relationship about a pulmonary vein ostium (or extra-ostial).

摘要翻译： 用于治疗心律失常的导管组件。 导管组件包括导管主体和消融能源。 导管主体包括近端部分，中间部分和远端部分。 中间部分从近端部分延伸并且限定纵向轴线。 远侧部分从中间部分延伸并且包括消融部分和尖端。 消融部分形成限定直径大于肺静脉口的外部尺寸的环。 尖端从消融部分向远端延伸并且被配置为定位肺静脉。 最后，烧蚀能源与消融部分相关联。 利用这种配置，在激活能量源时，消融部分消除所需的损伤模式。 在一个优选实施例中，消融部分形成远端减小的半径螺旋，而尖端包括相对线性的引导部分。 利用这一优选的构造，尖端容易地定位肺静脉，并将消融部分引导到关于肺静脉口（或口外）的就座关系。

公开(公告)号：US20100198346A1

公开(公告)日：2010-08-05

申请号：US12570888

申请日：2009-09-30

申请人： James R. Keogh ,  Timothy R. Ryan ,  Carol E. Eberhardt ,  Mark T. Stewart ,  James R. Skarda ,  Timothy G. Laske ,  Alexander J. Hill ,  Jack D. Lemmon ,  David E. Francischelli

发明人： James R. Keogh ,  Timothy R. Ryan ,  Carol E. Eberhardt ,  Mark T. Stewart ,  James R. Skarda ,  Timothy G. Laske ,  Alexander J. Hill ,  Jack D. Lemmon ,  David E. Francischelli

IPC分类号： A61F2/24

CPC分类号： A61F2/2496 ,  A61B5/0044 ,  A61B5/1076 ,  A61B5/6853 ,  A61B8/445 ,  A61B18/1442 ,  A61B34/20 ,  A61B90/37 ,  A61B90/39 ,  A61B2017/00243 ,  A61B2018/00291 ,  A61B2018/00351 ,  A61B2018/00577 ,  A61B2034/2051 ,  A61B2034/2063 ,  A61B2090/378 ,  A61B2090/397 ,  A61F2/2433 ,  A61F2210/009 ,  A61F2250/0096 ,  A61N7/02

摘要： A device and method for valve replacement or valve repair is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding a valve replacement delivery member or a valve repair delivery member within the patient while tracking the position of the delivery member in the patient, positioning the valve replacement member or valve repair member in a desired position to place a valve or repair valve and removing the delivery member from the patient. In one aspect of the invention, a delivery system is provided for percutaneous delivery of a heart valve to a predetermined position in the heart of a patient, where the delivery system itself includes features that allow it to be accurately positioned in the heart. In another aspect of the invention, a delivery system is provided for percutaneous repair of a heart valve in the heart of a patient, where the repair system itself includes features that allow it to be accurately positioned in the heart. In another aspect of the invention, a method and device are provided that involve imaging a native root using an interoperative technique, then introducing a device that is easily visualized in a chosen imaging modality.

摘要翻译： 公开了一种用于瓣膜置换或瓣膜修复的装置和方法，包括以下步骤：获取患者的解剖图像，将图像与患者相关联，在跟踪位置的同时引导患者内的瓣膜置换输送构件或瓣膜修复递送构件 的患者中的输送构件，将瓣膜置换构件或瓣膜修复构件定位在期望的位置以放置瓣膜或修复瓣膜并从患者移除输送构件。 在本发明的一个方面，提供一种用于将心脏瓣膜经皮递送到患者心脏中的预定位置的递送系统，其中递送系统本身包括允许其准确地定位在心脏中的特征。 在本发明的另一方面，提供一种用于经皮修复患者心脏中的心脏瓣膜的递送系统，其中所述修复系统本身包括允许其准确地定位在心脏中的特征。 在本发明的另一方面，提供了一种方法和装置，其涉及使用手术技术对本地根进行成像，然后引入在选择的成像模式中容易可视化的装置。

公开(公告)号：US07156843B2

公开(公告)日：2007-01-02

申请号：US10657377

申请日：2003-09-08

申请人： James R. Skarda

发明人： James R. Skarda

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B2018/00029 ,  A61B2018/1435

摘要： A helical ablation electrode extends from a distal end of the shaft and includes a first portion extending from a first end winding about a first diameter, a second portion extending from the first portion and winding about a second diameter smaller than the first diameter, and a second end terminating the second portion. The electrode further includes a fluid lumen extending from a location in proximity to the first end of the electrode to a location in proximity to the second end of the electrode and in fluid communication with a fluid delivery lumen of the catheter shaft. An irrigation fluid delivered through the fluid delivery lumen of the catheter shaft, from a fluid port, passes through the fluid lumen of the ablation electrode to cool the electrode.

摘要翻译： 螺旋消融电极从轴的远端延伸并且包括从第一端绕组围绕第一直径延伸的第一部分，从第一部分延伸的第二部分和围绕小于第一直径的第二直径缠绕的第二部分，以及 第二端终止第二部分。 电极还包括从接近电极第一端的位置延伸到靠近电极第二端的位置并与导管轴的流体输送腔流体连通的流体腔。 从流体端口通过导管轴的流体输送腔输送的冲洗液通过消融电极的流体腔以冷却电极。

公开(公告)号：US07331948B2

公开(公告)日：2008-02-19

申请号：US10871588

申请日：2004-06-18

申请人： James R. Skarda

发明人： James R. Skarda

IPC分类号： A61M25/00

CPC分类号： A61M25/0012 ,  A61M25/0045 ,  A61M25/0069 ,  A61M25/008 ,  A61M2025/0081

摘要： A catheter is fabricated by joining a first catheter body segment, the first segment including a braided or coiled filament reinforcing layer contained within an outer layer, to a second catheter body segment by thermal fusion in a zone including an interface between the first segment and the second segment and at a temperature causing ends of the filament reinforcing layer in the zone to extend outward within the outer layer. Following thermal fusion, the extending ends of the filament reinforcing layer are removed.

摘要翻译： 通过在包括第一段和第二段之间的界面的区域中通过热熔融将第一导管主体段（包括外层中包含的编织或卷绕的丝增强层）的第一段连接到第二导管主体段来制造导管， 第二段并且导致该区域中的细丝增强层的端部在外层内向外延伸的温度。 在热熔融之后，除去长丝增强层的延伸端。

公开(公告)号：US07104989B2

公开(公告)日：2006-09-12

申请号：US10656422

申请日：2003-09-05

申请人： James R. Skarda

发明人： James R. Skarda

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B2018/00065 ,  A61B2018/1472

摘要： A virtual ablation electrode assembly includes a non-conductive outer cap fitted over an inner electrode to form a fluid chamber between a cap inner surface and an exterior surface of the electrode. The inner electrode includes an interior fluid trunk and one or more fluid distribution branches extending from the fluid trunk to the exterior surface. A plurality of pores extends between the cap inner surface and a cap outer surface. When the electrode is energized and when fluid is delivered through the one or more fluid distribution branches from the trunk, the conductive fluid fills the fluid chamber and flows out from the chamber through the plurality of pores of the cap establishing ionic transport of ablation energy from the inner electrode to a target site in close proximity to the cap.

摘要翻译： 虚拟消融电极组件包括装配在内部电极上的非导电外盖，以在盖内表面和电极的外表面之间形成流体室。 内部电极包括内部流体主干和从流体主体延伸到外部表面的一个或多个流体分配分支。 多个孔在盖内表面和盖外表面之间延伸。 当电极通电并且当液体通过来自主干的一个或多个流体分配分支输送时，导电流体填充流体室并通过盖的多个孔从室中流出，从而形成消除能量的离子传输 内部电极到达靠近盖的目标位置。

公开(公告)号：US06945956B2

公开(公告)日：2005-09-20

申请号：US10328329

申请日：2002-12-23

申请人： Steven L. Waldhauser ,  James R. Skarda ,  Jeffrey B. Geske ,  Gregory P. Shipe ,  Eduard T. Teisanu

发明人： Steven L. Waldhauser ,  James R. Skarda ,  Jeffrey B. Geske ,  Gregory P. Shipe ,  Eduard T. Teisanu

IPC分类号： A61M25/00 ,  A61M37/00

CPC分类号： A61M25/0012 ,  A61M25/0029 ,  A61M25/005 ,  A61M25/0053 ,  A61M25/0054 ,  A61M25/0147 ,  A61M2025/0034 ,  A61M2025/0037 ,  A61M2025/0177 ,  A61M2025/018

摘要： A steerable catheter and methods of fabrication including a catheter body formed of a continuous wire braid formed of wires braided over a delivery lumen liner and a pull wire lumen liner distal to a pull wire jacket port, braided around the pull wire jacket port to form a braid port, and over at least a portion of the delivery lumen liner proximal to the pull wire jacket port. A pull wire extends from a pull wire proximal end through the pull wire lumen port and through the pull wire lumen to a pull wire distal end. A band is attached to the pull wire distal end and fitted over a distal segment of the wire braid proximal to the catheter body distal end to fix the pull wire distal end to the catheter body and restrain the wire distal end from flaring away from the delivery lumen liner.

摘要翻译： 一种可导向的导管和制造方法，其包括由连续导线编织物形成的导管主体，所述连续导线编织物由编织在输送内腔衬垫上的电线形成，并且拉线内腔衬套远离牵引线护套端口，围绕拉线护套端口编织以形成 编织端口，以及靠近拉线护套端口的至少一部分输送腔衬垫。 拉线从牵引线近端延伸穿过拉线管腔端口并且通过拉线内腔延伸到拉线远端。 带子连接到拉线远端并且装配在靠近导管主体远端的导线编织物的远侧部分上，以将拉线远端固定到导管主体并且限制线材远端远离输送 流明衬垫