In tunnel electrode for sealing intracardiac defects
The present invention provides methods and devices for sealing intracardiac defects, such as a patent foramen ovale (PFO) utilizing an electrode positioned in the lumen of the defect such as the tunnel of a PFO.
1 . A method for substantially sealing the tunnel of a PFO in the cardiac tissues of a patient, comprising:
introducing an apparatus into the heart comprising a catheter having an energy delivery element;
introducing the energy delivery element into the tunnel of the PFO;
applying energy from the energy delivery element to the tissues of the tunnel of the PFO while the energy delivery element is withdrawn from the tunnel.
2 . The method of claim 1 wherein the energy from the energy delivery element is intermittently applied as an energized and de-energized cycle as the energy delivery element is withdrawn.
3 . The method of claim 1 wherein the energy applied from the energy delivery element is continuously applied as the energy delivery element is withdrawn.
4 . The method of claim 2 wherein the intermittent application of energy to the tissues of the tunnel comprises more than one energized and de-energized cycle.
5 . The method of claim 1 wherein the energy delivering element delivers energy selected from the group consisting of radio frequency, cryogenic, laser, ultrasonic, resistive heat and microwave.
6 . The method of claim 1 further comprising abrading the tissues in the tunnel of the PFO.
7 . The method of claim 1 further comprising applying negative pressure from the catheter and stabilizing the end of the catheter on the tissues surrounding the opening of the PFO tunnel.
8 . An apparatus for closing the tunnel of a PFO in a patient's heart, comprising:
a catheter comprising a lumen and extending from a proximal end to a distal end;
an elongated member comprising an electrode and extending from a proximal end to a distal end, and slideably movable, and axially disposed in the lumen of the catheter, said elongated member comprising a plurality of filaments, each filament comprising a fixed end and a free end, said fixed end joined to a distal end portion of said elongated member; and,
at least one electrode disposed on said filament.
9 . The apparatus of claim 8 wherein said electrode is disposed on the free end of said filament.
10 . The apparatus of claim 8 wherein said plurality of filaments are disposed on the distal tip of said elongated member.
11 . The apparatus of claim 8 further comprising a vacuum cone disposed at the distal end of the catheter for applying a negative pressure to the patient's cardiac tissues surrounding the PFO.
12 . The apparatus of claim 8 further comprising an electrode disposed at the distal tip of said elongated member.
13 . The apparatus of claim 8 wherein said filaments are curvilinear.
14 . The apparatus of claim 8 wherein said filaments are flexible.
15 . The apparatus of claim 8 wherein said fixed end of each of said filaments is equidistant from the distal tip of said elongated member.
16 . The apparatus of claim 8 wherein said distal end portion comprises 30% of the length elongated member at the distal end of the elongated member.
17 . The apparatus of claim 8 wherein said distal end portion comprises 20% of the length elongated member at the distal end of the elongated member.
18 . The apparatus of claim 8 wherein said distal end portion comprises 15% of the length elongated member at the distal end of the elongated member.
19 . The apparatus of claim 8 wherein the fixed end of said filaments is joined to the distal tip of said elongated member.
20 . The apparatus of claim 8 wherein the fixed ends of one filament is disposed at a first distance from the distal tip of the elongated member and the fixed end of another filament is disposed at a second distance from the distal tip of the elongated member.
21 . The apparatus of claim 11 further comprising a vacuum source.
22 . The apparatus of claim 8 further comprising an energy source.
23 . The apparatus of claim 8 wherein said electrode delivers radio frequency energy.
24 . A method for substantially sealing the tissue of a patent foramen ovale, comprising:
introducing an apparatus into the heart via the percutaneous, transvascular route, the apparatus comprising a catheter comprising a lumen and extending from a proximal end to a distal end;
a vacuum cone disposed at the distal end of the catheter for applying a negative pressure to the patient's cardiac tissues surrounding the PFO; and,
an elongated member comprising an electrode and extending from a proximal end to a distal end, and slideably movable, and axially disposed in the lumen of the catheter;
contacting the cone with and applying a negative force to the patient's intracardiac tissues;
introducing at least the distal tip of the elongated member into the tunnel of the PFO;
applying energy to the tissues within the tunnel;
removing the apparatus from the patient