Cardiac support with metallic structure
A jacket of biological compatible material has an internal volume dimensioned for an apex of the heart to be inserted into the volume and for the jacket to be slipped over the heart. The jacket has a longitudinal dimension between upper and lower ends sufficient for the jacket to surround a lower portion of the heart with the jacket surrounding a valvular annulus of the heart and further surrounding the lower portion to cover at least the ventricular lower extremities of the heart. The jacket is adapted to be secured to the heart with the jacket surrounding at least the valvular annulus and the ventricular lower extremities. The jacket is adjustable on the heart to snugly conform to an external geometry of the heart and assume a maximum adjusted volume for the jacket to constrain circumferential expansion of the heart beyond the maximum adjusted volume during diastole and to permit unimpeded contraction of the heart during systole.
1. A method for treating a disease of a heart, the method comprising:
(a) selecting a jacket adapted to conform to an external geometry of said heart to constrain circumferential expansion of said heart during diastole and permit substantially unimpeded contraction of said heart during systole, and wherein said jacket includes elongated members, wherein said elongated members are metal, and wherein said elongated members are interconnected for said jacket to be expandable;
(b) placing said jacket on a heart of a patient with said jacket surrounding at least the ventricles of said heart to constrain circumferential expansion of said heart during diastole and permit substantially unimpeded contraction of said heart during systole.
2. A method according to claim 1 , wherein said metal is metal alloy.
3. A method according to claim 2 , wherein said metal alloy is stainless steel.
4. A method according to claim 1 , wherein said jacket is placed over an epicardial surface of said heart.
5. A method according to claim 1 , wherein said jacket is placed over a pericardium.
6. A method according to claim 1 further comprising placing said jacket on said heart with a snugness selected to avoid impairment of cardiac function.
7. A method according to claim 6 further comprising placing said jacket on said heart with a snugness selected to avoid substantial resistance to diastolic filling of said heart.
8. A method according to claim 1 wherein said jacket is delivered minimally invasively to said heart by collapsing said jacket into a hollow minimally invasive surgical tool.
9. A method according to claim 1 , wherein said jacket is placed surrounding a valvular annulus of said heart.
10. A method according to claim 1 , wherein said jacket is placed in the surrounding ventricles of said heart.
11. A method according to claim 1 , wherein said jacket is placed surrounding atria of said heart.
12. A method according to claim 1 , wherein said elongated members include bends, said bends at least partially straighten as said jacket expands.
13. A method according to claim 1 further comprising affixing said jacket to said heart at a plurality of locations.
14. A method according to claim 1 wherein said jacket is placed on said heart with a snugness selected to constrain said heart from expanding beyond a maximum volume.
15. A method according to claim 1 wherein selecting a jacket includes selecting a jacket including interwoven elongated members.
16. A method according to claim 15 wherein selecting a jacket includes selecting a jacket including elongated members defining a plurality of open areas between opposing elongated members.
17. A method according to claim 16 wherein selecting a jacket includes selecting a jacket having a first axis and a second axis with the jacket stretching in a direction of the first axis by a different amount than in a direction of the second axis in response to a given force.
18. A method according to claim 17 wherein selecting a jacket includes selecting a jacket having an open apex.
19. A method according to claim 18 wherein selecting a jacket includes selecting a jacket having a coating on the elongated members.
20. A method according to claim 1 wherein selecting a jacket includes selecting a jacket including elongated members defining a plurality of open areas between opposing elongated members.
21. A method according to claim 20 wherein selecting a jacket includes selecting a jacket having an open apex.
22. A method according to claim 21 wherein selecting a jacket includes selecting a jacket having a first axis and a second axis with the jacket stretching in a direction of the first axis by a different amount than in a direction of the second axis in response to a given force.
23. A method according to claim 1 wherein selecting a jacket includes selecting a jacket having a coating on the elongated members.
24. A method according to claim 1 wherein selecting a jacket includes selecting a jacket having an open apex.