Energy based devices and methods for treatment of anatomic tissue defects
Methods for treating anatomic tissue defects such as patent foramen ovale (PFO) generally involve positioning a distal end of an elongate catheter device at the site of the anatomic defect, exposing an expandable housing and energy transmission member out of the distal end of the catheter device, engaging the housing with tissues at the site of the anatomic defect, applying suction to the tissues via the housing to bring the tissues together; and applying energy to the tissues with the energy transmission member to substantially close the anatomic defect acutely. Apparatus generally include an elongate catheter body, a housing extending from a distal end of the catheter body for engaging tissues at the site of the anatomic defect, and an energy transmission member adjacent a distal end of the housing, the energy transmission member having at least one substantially planar surface.
1. An apparatus for treating an anatomic defect in a heart, the apparatus comprising:
an elongate catheter body having a proximal end and a distal end;
a housing extending from the distal end of the catheter body for engaging tissues at a site of the anatomic defect;
an energy transmission member adjacent to a distal end of the housing, the energy transmission member having at least one substantially planar surface, the housing being adapted to apply vacuum to the tissues to bring them together and position them against the energy transmission member; and
a plurality of struts formed in a pattern, the struts being coupled to the housing,
wherein the energy transmission member comprises an outer rim extending at least partially around an outer circumference thereof, and
wherein at least some of the plurality of struts are attached to other struts as well as to the outer rim.
2. An apparatus as in claim 1 , wherein the plurality of struts and the energy transmission member are of unitary construction.
3. An apparatus as in claim 1 , wherein the struts comprise a metal.
4. An apparatus as in claim 1 , wherein the plurality of struts comprise one or more markers to facilitate visual orientation of the energy transmission member relative to the anatomic defect.
5. An apparatus as in claim 4 , wherein the markers comprise a radiopaque marker.
6. An apparatus as in claim 1 , wherein the rim is discontinuous.
7. An apparatus as in claim 1 , wherein the rim includes one or more inward bends directed toward the plurality of struts, the inward bends adapted to promote collapsibility of an electrode.
8. An apparatus as in claim 1 , wherein the pattern in the plurality of struts includes at least one area of thicker struts relative to another area of thinner struts, such that different areas of the energy transmission member provide different amounts of energy transmission to the tissues.
9. An apparatus as in claim 1 , wherein the pattern in the plurality of struts includes at least one fold line along which the energy transmission member folds to allow the energy transmission member to collapse.
10. An apparatus as in claim 1 , wherein the struts are attached asymmetrically to the outer rim such that a first half of the housing and the energy transmission member fold into a second half of the housing and the energy transmission member when the housing and the energy transmission member assume collapsed configurations.
11. An apparatus as in claim 1 , further comprising a plurality of metallic attachment members extending from the outer rim for attaching the energy transmission member to the housing.
12. An apparatus as in claim 11 , wherein the plurality of metallic attachment members comprise:
an inferior attachment member for attaching proximally to an inferior portion of the housing; and
multiple superior attachment members for attaching proximally to a superior portion of the housing.
13. An apparatus as in claim 12 , wherein the inferior attachment member extends onto an inferior portion of the catheter body, and the multiple superior attachment members extend onto a superior portion of the catheter body.
14. An apparatus as in claim 12 , wherein the inferior attachment member divides before attaching to the outer rim at two attachment points.
15. An apparatus as in claim 12 , wherein the inferior attachment member curves asymmetrically before attaching to the outer rim.
16. An apparatus as in claim 11 , wherein the plurality of struts are attached to the outer rim at locations apart from attachment points of the attachment members to the outer rim.
17. An apparatus as in claim 11 , wherein the plurality of struts are attached to the outer rim at attachment points of the attachment members to the outer rim.
18. An apparatus as in claim 1 , wherein the anatomic defect comprises a defect selected from the group consisting of a patent foramen ovale, a ventricular septal defect, an atrial septal defect, a left atrial appendage, and a patent ductus arteriosus.
19. An apparatus for treating an anatomic defect in a heart, the apparatus comprising:
an elongate catheter body having a proximal end and a distal end;
a housing extending from the distal end of the catheter body for engaging tissues at a site of the anatomic defect;
an energy transmission member adjacent to a distal end of the housing, the energy transmission member having at least one substantially planar surface, the housing being adapted to apply vacuum to the tissues to bring them together and position them against the energy transmission member; and
a plurality of struts formed in a pattern, the struts being coupled to the housing,
wherein the pattern in the plurality of struts includes at least one area of more closely positioned struts relative to another area of less closely positioned struts, such that different areas of the energy transmission member provide different amounts of energy transmission to the tissues.
20. An apparatus as in claim 19 , wherein the energy transmission member comprises an outer rim extending at least partially around an outer circumference thereof, and
wherein the plurality of struts are attached only to the outer rim and not to one another.
21. An apparatus for treating an anatomic defect in a heart, the apparatus comprising:
an elongate catheter body having a proximal end and a distal end;
a housing extending from the distal end of the catheter body for engaging tissues at a site of the anatomic defect;
an energy transmission member adjacent to a distal end of the housing, the energy transmission member having at least one substantially planar surface, the housing being adapted to apply vacuum to the tissues to bring them together and position them against the energy transmission member; and
a plurality of struts formed in a pattern, the struts being coupled to the housing,
wherein the energy transmission member includes an outer rim extending at least partially around an outer circumference thereof, and
wherein the plurality of struts are attached to the outer rim at between 8 and 16 attachment points to enhance collapsibility of the energy transmission member.
22. An apparatus as in claim 21 , wherein the plurality of struts are attached only to the outer rim and not to one another.