Energy Assisted Tissue Piercing Device and Method of Use Thereof
An energy assisted tissue piercing device that enables a tissue piercing wire to puncture heart tissue percutaneouly. The energy assisted tissue piercing device includes an outer delivery catheter, an inner tissue piercing wire, and an energy source. The inner tissue piercing wire is disposed longitudinally through the lumen of the outer delivery catheter during delivery. The inner needle has a flexible portion that allows the wire to bend when it is free from the constraint of the outer delivery catheter. The inner tissue piercing wire is conductive and connected to an energy source and the piercing of the heart tissue is done with the aid of the energy from the energy source.
1 . A device for piercing heart tissue percutaneously, comprising:
an outer catheter with a proximal end, a distal end and a lumen longitudinally disposed therethrough;
an inner tissue piercing wire with a conductive inner wire and an insulation outer layer, the inner tissue piercing wire being slidably disposed within the lumen of the outer catheter;
an energy source operatively coupled to the second inner tissue piercing wire; and
wherein the conductive inner wire of the inner tissue piercing wire has a proximal portion, a distal portion, and an intermediate portion, and wherein the intermediate portion is narrower than the proximal portion and distal portion of the conductive inner wire.
2 . The device of claim 1 , wherein the tissue piercing wire is rotatably movable within the lumen of the outer catheter.
3 . The device of claim 1 , wherein the insulation outer layer has an open distal end through which the conductive inner wire passes such that that a distal end of the conductive inner wire extends distal to the open distal end of the insulation outer layer.
4 . The device of claim 1 , wherein the insulation outer layer comprises a coating disposed over the conductive inner wire.
5 . The device of claim 1 , wherein the insulation outer layer comprises a sleeve.
6 . The device of claim 1 , further including a coil spring disposed between the conductive inner wire and the insulation outer layer.
7 . The device of claim 6 , wherein the coil spring covers less than an entire length of the conductive inner wire and is at least disposed along a length of the conductive inner wire that is covered by the insulation outer layer.
8 . The device of claim 1 , wherein the conductive inner wire is formed of a material selected from the group consisting of; a straight stainless steel wire, a coiled stainless steel wire, a glass fiber, a nitinol material and a polymeric material.
9 . The device of claim 1 , wherein the energy source is selected from the group consisting of: microwave, infrared, visible light, ultraviolet rays, x-rays, gamma rays, cosmic rays, acoustic energy, thermal energy and radio frequency energy.
10 . The device of claim 1 , wherein there is a first tapered region between intermediate portion and the proximal portion and there is a second tapered region between the intermediate portion and the distal portion.
11 . The device of claim 1 , wherein the distal portion has a length between about 5 mm to about 30 mm and the intermediate portion has a length between about 5 mm to about 15 mm.
12 . The device of claim 1 , wherein the distal portion has a diameter between about 0.1 mm to about 0.3 mm and a diameter of the intermediate portion is between 5-70% of the diameter of the distal portion.
13 . The device of claim 1 , wherein the distal portion is bent at an angle up to 270 degrees relative to the intermediate portion.
14 . The device of claim 13 , wherein the bent distal portion is disposed outside of a distal end of the insulation outer layer.
15 . A device for piercing heart tissue percutaneously, comprising:
an energy source,
an outer catheter with a proximal end, a distal end and a lumen longitudinally disposed therethrough,
an inner tissue piercing wire with a proximal portion, a distal portion and a intermediate portion between the proximal and distal portions,
wherein the inner tissue piercing wire is configured to transition from a delivery profile, wherein the distal portion of the inner tissue piercing wire is disposed within the lumen of the outer catheter, and substantially aligns with the proximal portion of the inner tissue piercing wire, to a deployed profile, wherein the distal portion of the inner tissue piercing wire is exposed outside of the lumen of the outer catheter, and pivots from the proximal portion of inner tissue piercing wire, and
wherein the energy source is operative coupled to the inner tissue piercing wire.
16 . A method for piercing heart valve tissue comprising the steps of:
delivering a delivery catheter to a tissue treatment site by passing the delivery catheter into an aorta through an aortic valve into a left ventricle between cordae tendonae;
delivering a tissue piercing device through a lumen of the delivery catheter to the tissue treatment site, wherein the tissue piercing device comprises:
an outer catheter with a proximal end, a distal end and a lumen longitudinally disposed therethrough;
an inner tissue piercing wire with a conductive inner wire and an insulation outer layer, the inner tissue piercing wire being slidably disposed within the lumen of the outer catheter;
an energy source operatively coupled to the second inner tissue piercing wire; and
wherein the conductive inner wire of the inner tissue piercing wire has a proximal portion, a distal portion, and an intermediate portion, and wherein the intermediate portion is narrower than the proximal portion and distal portion of the conductive inner wire; and
activating the energy source and directing the distal portion against the tissue at the treatment site to cause a piercing thereof.
17 . The method of claim 16 , wherein the tissue treatment site comprises a mitral annulus.
18 . The method of claim 17 , wherein the energy source comprises radio frequency energy and a distal tip of the distal portion of the tissue piercing wire is advanced through the annuls and reaches a left atrium.