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:
Methods are provided for forming a coating of an immobilized biomolecule on a surface of a medical device to impart improved biocompatibility for contacting tissue and bodily fluids. A biomolecule such as a glycoprotein having an unsubstituted amide moiety is combined with an amine forming agent to form an amine-functional biomolecule. The amine-functional biomolecule is combined with a medical device surface having a chemical moiety such as aldehyde, epoxide, isocyanate, 1,2-dicarbonyl, phosphate, sulphate or carboxylate to form a chemical bond immobilizing the biomolecule on the surface. The chemical bond may be combined with a reducing agent or a stabilizing agent. The aldehyde moiety may be formed by combining a periodate with a 2-aminoalcohol moiety or a 1,2-dihydroxy moiety. Alternatively, an amine-functional medical device surface is combined with a biomolecule having a chemical moiety that reacts with an amine moiety. In another embodiment, the amine-functional biomolecule is converted to a guanidino-functional biomolecule and is combined with a medical device surface having a chemical moiety that reacts with a guanidino moiety. Alternatively, an amine-functional medical device surface is converted to a guanidino-functional surface and is combined with a biomolecule having the chemical moiety. Biomolecules may be crosslinked by combining the amine-functional or guanidino-functional biomolecule with a biomolecule having a chemical moiety that forms a chemical bond with an amine moiety or a guanidino moiety.
摘要:
An implantable medical device is provided which comprises a fixed tissue incorporating an amount of an albumin-binding dye effective to form a coating of endogenous albumin on said device when the device is in contact with a physiological fluid containing albumin. These albumin-binding dyes have been found to significantly reduce calcification when incorporated in tissue heart valves. A method of increasing the albumin-binding ability of an implantable medical device is also provided.
摘要:
A device and method for ablating tissue is disclosed comprising the steps of acquiring an anatomical image of a patient, correlating the image to the patient, guiding an ablating member within the patient while tracking the position of the ablating member in the patient, positioning the ablating member in a desired position to ablate tissue, emitting ablating energy from the ablating member to form an ablated tissue area and removing the ablating member from the patient.
摘要:
An ablation catheter including an inner tube having a length, a distal end and a longitudinal axis, a plurality of needles extending from the distal end of the inner tube and biased away from the longitudinal axis, an outer sheath slideably moveable relative to the inner tube to surround at least a portion of the length of the inner tube and its extending needles, and a radio frequency energy source electrically connected to the plurality of needles.
摘要:
Apparatus and methods for injecting biological agents into tissue. Devices are provided having elongate shafts and distal injection heads for driving needles into tissue and injecting medical agents into the tissue through the needles. A longitudinal force directed along the shaft can be translated to a needle driving force. Some devices provide controllably variable needle penetration depth. Devices include mechanical needle drivers utilizing four link pantographs, rack and pinions, and drive yokes for driving a first needle bearing body toward a second tissue contacting body. Other devices include inflatable members for driving and retracting needles. Still other devices include magnets for biasing the needles in extended and/or retracted positions. The invention includes minimally invasive methods for epicardially injecting cardiocyte precursor cells into infarct myocardial tissue.
摘要:
A tubular suction tool for accessing an anatomic surface or anatomic space and particularly the pericardium to access pericardial space and the epicardial surface of the heart to implant cardiac leads in a minimally invasive manner are disclosed. The suction tool incorporates a suction pad concave wall defining a suction cavity, a plurality of suction ports arrayed about the concave wall, and a suction lumen, to form a bleb of tissue into the suction cavity when suction is applied. The suction cavity extends along one side of the suction pad, so that the suction pad and suction cavity can be applied tangentially against a tissue site. The suction tool can incorporate light emission and video imaging of tissue adjacent the suction pad. A working lumen terminating in a working lumen port into the suction cavity enables introduction of tools, cardiac leads, and other instruments, cells, drugs or materials into or through the tissue bleb drawn into the suction cavity.
摘要:
Methods are provided for forming a coating of an immobilized biomolecule on a surface of a medical device to impart improved biocompatibility for contacting tissue and bodily fluids. A 2-aminoalcohol moiety of a biomolecule is oxidized with a periodate to an aldehyde moiety which is reacted with an amine moiety on the surface of a medical device to form an imine moiety, and the imine moiety is reduced to form an amine linkage immobilizing a coating of the biomolecule on the surface. In another method, a biomolecule coating containing an amine moiety and a 2-aminoalcohol moiety is immobilized on the surface of a medical device, the 2-aminoalcohol moiety is oxidized with a periodate to an aldehyde moiety which is reacted with the amine moiety to form an imine moiety, and the imine moiety is reduced to form a secondary amine and crosslink the coating. Each biomolecule may contain an amine moiety and a 2-aminoalcohol moiety, and the aldehyde moiety of one biomolecule resulting from periodate oxidation may react with the amine moiety of another biomolecule. In a further embodiment, a 2-aminoalcohol moiety on the surface of a medical device is oxidized with a periodate to an aldehyde moiety, and an amine moiety of a biomolecule is reacted with the aldehyde moiety to form an imine moiety which is reduced to form an amine linkage immobilizing the biomolecule on the surface.
摘要:
A method for making a medical device having at least one glycoprotein and/or glycopeptide immobilized on a substrate surface is provided. The method may include oxidizing 1,2 dihydroxy moieties with a periodate to form an aldehyde-functional material; combining the aldehyde-functional material with an amino-functional material to bond the two materials together through an imine moiety; and reacting the imine moiety with a reducing agent to form a secondary amine. Another method of the present invention may be employed to crosslink glycoproteins and/or glycopeptides immobilized on medical device surfaces. Additionally, one method of the present invention may be employed to crosslink glycoproteins and/or glycopeptides, thereby forming a crosslinked biomaterial or a crosslinked medical device coating.
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.