Energy based devices and methods for treatment of patent foramen ovale
Methods and apparatus for treatment of patent foramen ovale (PFO) provide for applying energy to tissues adjacent the PFO with a catheter device to substantially close the PFO acutely. Apparatus generally includes a catheter device having at least one energy transmission member at or near its distal end configured to apply energy to PFO tissues to acutely, substantially close the PFO. Applied energy may be monopolar or bipolar radiofrequency energy or any other suitable energy, such as laser, microwave, ultrasound, resistive heating or the like. Some embodiments of a catheter device further include one or more tissue apposition members near the distal end for helping bring PFO tissues together, such as a PFO covering member, a vacuum applying member and/or the like. PFO closure via energy-based approaches of the invention may help prevent stroke, treat migraine headache, and possibly treat or prevent other medical conditions.
1 . A method of treating a patent foramen ovale (PFO) in a heart of a patient, the method comprising:
positioning a distal portion of an elongate catheter device proximate to tissues of a PFO as to extend through a PFO tunnel and bring the tissues at least partially together; and
applying energy to the tissues with the catheter device to substantially close the PFO, wherein the energy is monopolar energy applied from a right atrial side of the heart.
2 . The method of claim 1 , further comprising advancing the catheter device through the patient's vasculature to a position in the heart.
3 . The method of claim 2 , further comprising engaging a distal structure on the catheter device against tissues on a left atrial side of the patent foramen ovale to bring the tissues at least partially together.
4 . The method of claim 3 , wherein the tissues are brought together before applying the energy.
5 . The method of claim 3 , further comprising holding the tissues together while applying the energy.
6 . The method of claim 5 , further comprising holding the tissues together after the energy has been applied.
7 . The method of claim 1 , further comprising applying vacuum force to the tissues with a tissue covering member to bring the tissues at least partially together.
8 . The method of claim 1 , further comprising discontinuing application of energy while still holding the tissues at least partially together.
9 . The method of claim 1 , wherein applying energy comprises applying at least one of radiofrequency energy, cryogenic energy, heat energy, ultrasound energy, microwave energy and laser energy.
10 . The method of claim 9 , wherein applying energy comprises energizing multiple conductive members of the catheter device.
11 . The method of claim 1 , wherein applying energy comprises denaturing collagen in the tissues.
12 . The method of claim 1 , wherein applying energy comprises renaturing collagen in the tissues.
13 . The method of claim 3 , further comprising keeping the tissues in apposition to allow collagen in the tissues to denature, reorganize and bind together to form a stable tissue bridge.
14 . The method of claim 1 , further comprising withdrawing the distal portion of the elongate catheter through the PFO tunnel following energy application.
15 . A method of treating a patent foramen ovale (PFO) in a heart of a patient, the method comprising:
positioning a distal portion of an elongate catheter device proximate to tissues of a PFO as to extend through a PFO tunnel and bring the tissues at least partially together; and
applying energy to the tissues with the catheter device to substantially close the PFO, wherein the energy is monopolar energy applied from a left atrial side of the heart.
16 . The method of claim 15 , further comprising advancing the catheter device through the patient's vasculature to a position in the heart.
17 . The method of claim 16 , further comprising engaging a distal structure on the catheter device against tissues on a left atrial side of the patent foramen ovale to bring the tissues at least partially together.
18 . The method of claim 17 , wherein the tissues are brought together before applying the energy.
19 . The method of claim 17 , further comprising holding the tissues together while applying the energy.
20 . The method of claim 19 , further comprising holding the tissues together after the energy has been applied.
21 . The method of claim 15 , further comprising applying vacuum force to the tissues with a tissue covering member to bring the tissues at least partially together.
22 . The method of claim 15 , further comprising discontinuing application of energy while still holding the tissues at least partially together.
23 . The method of claim 15 , wherein applying energy comprises applying at least one of radiofrequency energy, cryogenic energy, heat energy, ultrasound energy, microwave energy and laser energy.
24 . The method of claim 23 , wherein applying energy comprises energizing multiple conductive members of the catheter device.
25 . The method of claim 15 , wherein applying energy comprises denaturing collagen in the tissues.
26 . The method of claim 15 , wherein applying energy comprises renaturing collagen in the tissues.
27 . The method of claim 17 , further comprising keeping the tissues in apposition to allow collagen in the tissues to denature, reorganize and bind together to form a stable tissue bridge.
28 . The method of claim 15 , further comprising withdrawing the distal portion of the elongate catheter through the PFO tunnel following energy application.
29 . A method of treating a patent foramen ovale (PFO) in a heart of a patient, the method comprising:
positioning a distal portion of an elongate catheter device proximate to tissues of a PFO as to extend through a PFO tunnel and bring the tissues at least partially together; and
applying energy to the tissues with the catheter device to substantially close the PFO, wherein the energy is bipolar energy applied from the either a right or left atrial side of the heart.