US20020077524A1 - Heart wall tension reduction apparatus - Google Patents
Heart wall tension reduction apparatus Download PDFInfo
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- US20020077524A1 US20020077524A1 US10/073,968 US7396802A US2002077524A1 US 20020077524 A1 US20020077524 A1 US 20020077524A1 US 7396802 A US7396802 A US 7396802A US 2002077524 A1 US2002077524 A1 US 2002077524A1
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- heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2487—Devices within the heart chamber, e.g. splints
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/122—Clamps or clips, e.g. for the umbilical cord
- A61B17/1227—Spring clips
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0404—Buttons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0429—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being expanded by a mechanical mechanism which also locks them in the expanded state
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0435—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being separate elements mechanically linked to the anchor, e.g. by pivots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0446—Means for attaching and blocking the suture in the suture anchor
- A61B2017/0461—Means for attaching and blocking the suture in the suture anchor with features cooperating with special features on the suture, e.g. protrusions on the suture
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
- A61B2017/048—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery for reducing heart wall tension, e.g. sutures with a pad on each extremity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
-
- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/909—Method or apparatus for assembling prosthetic
- Y10S623/91—Heart
Abstract
Description
- The present invention pertains to the field of apparatus for treatment of a failing heart. In particular, the apparatus of the present invention is directed toward reducing the wall stress in the failing heart.
- The syndrome of heart failure is a common course for the progression of many forms of heart disease. Heart failure may be considered to be the condition in which an abnormality of cardiac function is responsible for the inability of the heart to pump blood at a rate commensurate with the requirements of the metabolizing tissues, or can do so only at an abnormally elevated filling pressure. There are many specific disease processes that can lead to heart failure with a resulting difference in pathophysiology of the failing heart, such as the dilatation of the left ventricular chamber. Etiologies that can lead to this form of failure include idiopathic cardiomyopathy, viral cardiomyopathy, and ischemic cardiomyopathy.
- The process of ventricular dilatation is generally the result of chronic volume overload or specific damage to the myocardium. In a normal heart that is exposed to long term increased cardiac output requirements, for example, that of an athlete, there is an adaptive process of slight ventricular dilation and muscle myocyte hypertrophy. In this way, the heart fully compensates for the increased cardiac output requirements. With damage to the myocardium or chronic volume overload, however, there are increased requirements put on the contracting myocardium to such a level that this compensated state is never achieved and the heart continues to dilate.
- The basic problem with a large dilated left ventricle is that there is a significant increase in wall tension and/or stress both during diastolic filling and during systolic contraction. In a normal heart, the adaptation of muscle hypertrophy (thickening) and ventricular dilatation maintain a fairly constant wall tension for systolic contraction. However, in a failing heart, the ongoing dilatation is greater than the hypertrophy and the result is a rising wall tension requirement for systolic contraction. This is felt to be an ongoing insult to the muscle myocyte resulting in further muscle damage. The increase in wall stress is' also true for diastolic filling. Additionally, because of the lack of cardiac output, there is generally a rise in ventricular filling pressure from several physiologic mechanisms. Moreover, in diastole there is both a diameter increase and a pressure increase over normal, both contributing to higher wall stress levels. The increase in diastolic wall stress is felt to be the primary contributor to ongoing dilatation of the chamber.
- Prior art treatments for heart failure fall into three generally categories. The first being pharmacological, for example, diuretics. The second being assist systems, for example, pumps. Finally, surgical treatments have been experimented with, which are described in more detail below.
- With respect to pharmacological treatments, diuretics have been used to reduce the workload of the heart by reducing blood volume and preload. Clinically, preload is defined in several ways including left ventricular end diastolic pressure (LVEDP), or left ventricular end diastolic volume (LVEDV). Physiologically, the preferred definition is the length of stretch of the sarcomere at end diastole. Diuretics reduce extra cellular fluid which builds in congestive heart failure patients increasing preload conditions. Nitrates, arteriolar vasodilators, angiotensin converting enzyme inhibitors have been used to treat heart failure through the reduction of cardiac workload through the reduction of afterload. Afterload may be defined as the tension or stress required in the wall of the ventricle during ejection. Inotropes like digoxin are cardiac glycosides and function to increase cardiac output by increasing the force and speed of cardiac muscle contraction. These drug therapies offer some beneficial effects but do not stop the progression of the disease.
- Assist devices include mechanical pumps and electrical stimulators. Mechanical pumps reduce the load on the heart by performing all or part of the pumping function normally done by the heart. Currently, mechanical pumps are used to sustain the patient while a donor heart for transplantation becomes available for the patient. Electrical stimulation such as bi-ventricular pacing have been investigated for the treatment of patients with dilated cardiomyopathy.
- There are at least three surgical procedures for treatment of heart failure: 1) heart transplant; 2) dynamic cardiomyoplasty; and 3) the Batista partial left ventriculectomy. Heart transplantation has serious limitations including restricted availability of organs and adverse effects of immunosuppressive therapies required following heart transplantation. Cardiomyoplasty includes wrapping the heart with skeletal muscle and electrically stimulating the muscle to contract synchronously with the heart in order to help the pumping function of the heart. The Batista partial left ventriculectomy includes surgically remodeling the left ventricle by removing a segment of the muscular wall. This procedure reduces the diameter of the dilated heart, which in turn reduces the loading of the heart. However, this extremely invasive procedure reduces muscle mass of the heart.
- The present invention pertains to a non-pharmacological, passive apparatus for the treatment of a failing heart. The device is configured to reduce the tension in the heart wall. It is believed to reverse, stop or slow the disease process of a failing heart as it reduces the energy consumption of the failing heart, decrease in isovolumetric contraction, increases sarcomere shortening during contraction and an increase in isotonic shortening in turn increases stroke volume. The device reduces wall tension during diastole (preload) and systole.
- In one embodiment, the apparatus includes a tension member for drawing at least two walls of the heart chamber toward each other to reduce the radius or area of the heart chamber in at least one cross sectional plane. The tension member has anchoring member disposed at opposite ends for engagement with the heart or chamber wall.
- In another embodiment, the apparatus includes a compression member for drawing at least two walls of a heart chamber toward each other. In one embodiment, the compression member includes a balloon. In another embodiment of the apparatus, a frame is provided for supporting. the compression member.
- Yet another embodiment of the invention includes a clamp having two ends biased toward one another for drawing at least two walls of a heart chamber toward each other. The clamp includes at least two ends having atraumatic anchoring member disposed thereon for engagement with the heart or chamber wall.
- FIG. 1 is a transverse cross-section of the left and right ventricles of a human heart showing the placement of a splint in accordance with the present invention;
- FIG. 2 is a transverse cross-section of the left and right ventricles of a human heart showing the placement of a balloon device in accordance with the present invention;
- FIG. 3 is a transverse cross-section of the left and right ventricles of a human heart showing the placement of an external compression frame structure in accordance with the present invention;
- FIG. 4 is a transverse cross-section of the left and right ventricles of a human heart showing a clamp in accordance with the present invention;
- FIG. 5 is a transverse cross-section of the left and right ventricles of a human heart showing a three tension member version of the splint of FIG. 1;
- FIG. 6 is a transverse cross-section of the left and right ventricles of a human heart showing a four tension member version of the splint shown in FIG. 1;
- FIG. 7 is a vertical cross-section of the left ventricle and atrium, the left ventricle having scar tissue;
- FIG. 8 is a vertical cross-section of the heart of FIG. 7 showing the splint of FIG. 1 drawing the scar tissue toward the opposite wall of the left ventricle;
- FIG. 9 is a vertical cross-section of the left ventricle and atrium of a human heart showing a version of the splint of FIG. 1 having an elongate anchor bar;
- FIG. 10 is a side view of an undeployed hinged anchor member;
- FIG. 11 is a side view of a deployed hinged anchor member of FIG. 10;
- FIG. 12 is a cross-sectional view of an captured ball anchor member;
- FIG. 13 is a perspective view of a cross bar anchor member;
- FIG. 14 is a idealized cylindrical model of a left ventricle of a human heart;
- FIG. 15 is a splinted model of the left ventricle of FIG. 14;
- FIG. 16 is a transverse cross-sectional view of FIG. 15 showing various modeling parameters;
- FIG. 17 is a transverse cross-section of the splinted left ventricle of FIG. 15 showing a hypothetical force distribution; and
- FIG. 18 is a second transverse cross-sectional view of the model left ventricle of FIG. 15 showing a hypothetical force distribution.
- Referring now to the drawings wherein like reference numerals refer to like elements throughout the several views, FIG. 1 shows a transverse cross-section of a
left ventricle 10 and aright ventricle 12 of ahuman heart 14. Extending through the left ventricle is asplint 16 including atension member 18 and oppositely disposed anchors 20.Splint 16 as shown in FIG. 1 has been positioned to draw opposite walls ofleft ventricle 10 toward each other to reduce the “radius” of the left ventricular cross-section or the cross-sectional area thereof to reduce left ventricular wall stresses. It should be understood that although thesplint 16 and the alternative devices disclosed herein are described in relation to the left ventricle of a human heart, these devices could also be used to reduce the radius or cross-sectional area of the other chambers of a human heart in transverse or vertical directions, or at an angle between the transverse and vertical. - FIG. 2 discloses an alternate embodiment of the present invention, wherein a
balloon 200 is deployed adjacent the left ventricle. The size and degree of inflation of the balloon can be varied to reduce the radius or cross-sectional area ofleft ventricle 10 ofheart 14. - FIG. 3 shows yet another alternative embodiment of the present invention deployed with respect to
left ventricle 10 ofhuman heart 14. Here acompression frame structure 300 is engaged withheart 14 atatraumatic anchor pads 310. Acompression member 312 having anatraumatic surface 314 presses against a wall ofleft ventricle 10 to reduce the radius or cross-sectional area thereof. - FIG. 4 is a transverse cross-sectional view of
human heart 14 showing yet another embodiment of the present invention. In this case aclamp 400 havingatraumatic anchor pads 410 biased toward each other is shown disposed on a wall ofleft ventricle 10. Here the radius or cross-sectional area ofleft ventricle 10 is reduced by clamping off the portion of the wall betweenpads 410.Pads 410 can be biased toward each other and/or can be held together by a locking device. - Each of the various embodiments of the present invention disclosed in FIGS.1-4 can be made from materials which can remain implanted in the human body indefinitely. Such biocompatible materials are well-known to those skilled in the art of clinical medical devices.
- FIG. 5 shows an alternate embodiment of the splint of FIG. 1 referred to in FIG. 5 by the numeral116. The
embodiment 116 shown in FIG. 5 includes three tension members 119 as opposed to asingle tension member 18 as shown in FIG. 1. FIG. 6 shows yet another embodiment of thesplint 216 having fourtension members 218. It is anticipated that in some patients, the disease process of the failing heart may be so advanced that three, four or more tension members may be desirable to reduce the heart wall stresses more substantially than possible with a single tension member as shown in FIG. 1. - FIG. 7 is a partial vertical cross-section of
human heart 14 showingleft ventricle 10 and leftatrium 22. As shown in FIG. 7,heart 14 includes a region ofscar tissue 24 associated with an aneurysm or ischemia. As shown in FIG. 7, thescar tissue 24 increases the radius or cross-sectional area ofleft ventricle 10 in the region affected by the scar tissue. Such an increase in the radius or cross-sectional area of the left ventricle will result in greater wall stresses on the walls of the left ventricle. - FIG. 8 is a vertical cross-sectional view of the
heart 14 as shown in FIG. 7, wherein asplint 16 has been placed to draw thescar tissue 24 toward an opposite wall ofleft ventricle 10. As a consequence of placingsplint 16, the radius or cross-sectional area of the left ventricle affected by thescar tissue 24 is reduced. The reduction of this radius or cross-sectional area results in reduction in the wall stress in the left ventricular wall and thus improves heart pumping efficiency. - FIG. 9 is a vertical cross-sectional view of
left ventricle 10 and leftatrium 22 ofheart 14 in which asplint 16 has been placed. As shown in FIG. 9,splint 16 includes analternative anchor 26. Theanchor 26 is preferably an elongate member having a length as shown in FIG. 9 substantially greater than its width (not shown).Anchor bar 26 might be used to reduce the radius or cross-sectional area of the left ventricle in an instance where there is generalized enlargement ofleft ventricle 10 such as in idiopathic dilated cardiomyopathy. In such an instance,bar anchor 26 can distribute forces more widely thananchor 20. - FIGS. 10 and 11 are side views of a hinged
anchor 28 which could be substituted foranchors 20 in undeployed and deployed positions respectively.Anchor 28 as shown in FIG. 10 includes two legs similar to baranchor 26. Hingedanchor 28 could include additional legs and the length of those legs could be varied to distribute the force over the surface of the heart wall. In addition there could be webbing between each of the legs to giveanchor 28 an umbrella-like appearance. Preferably the webbing would be disposed on the surface of the legs which would be in contact with the heart wall. - FIG. 12 is a cross-sectional view of a
capture ball anchor 30.Capture ball anchor 30 can be used in place ofanchor 20.Capture ball anchor 30 includes adisk portion 32 to distribute the force of the anchor on the heart wall, and arecess 34 for receiving aball 36 affixed to an end oftension member 18.Disk 32 andrecess 34 include a side groove which allowstension member 38 to be passed from an outside edge ofdisk 32 intorecess 34.Ball 36 can then be advanced intorecess 34 by drawingtension member 18 through anopening 38 inrecess 34opposite disk 32. - FIG. 13 is a perspective view of a
cross bar anchor 40. Thecross bar anchor 40 can be used in place ofanchors 20. Theanchor 40 preferably includes a disk orpad portion 42 having across bar 44 extending over anopening 46 inpad 42.Tension member 18 can be extended throughopening 46 and tied to crossbar 42 as shown. - In use, the various embodiments of the present invention are placed in or adjacent the human heart to reduce the radius or cross-section area of at least one chamber of the heart. This is done to reduce wall stress or tension in the heart or chamber wall to slow, stop or reverse failure of the heart. In the case of the
splint 16 shown in FIG. 1, a canula can be used to pierce both walls of the heart and one end of the splint can be advanced through the canula from one side of the heart to the opposite side where an anchor can be affixed or deployed. Likewise, an anchor is affixed or deployed at the opposite end ofsplint 16. - FIG. 14 is a view of a cylinder or
idealized heart chamber 48 which is used to illustrate the reduction of wall stress in a heart chamber as a result of deployment of the splint in accordance with the present invention. The model used herein and the calculations related to this model are intended merely to illustrate the mechanism by which wall stress is reduced in the heart chamber. No effort is made herein to quantify the actual reduction which would be realized in any particular in vivo application. - FIG. 15 is a view of the
idealized heart chamber 48 of FIG. 14 wherein the chamber has been splinted along its length L such that a “figure eight” cross-section has been formed along the length thereof. It should be noted that the perimeter of the circular transverse cross-section of the chamber in FIG. 14 is equal to the perimeter of the figure eight transverse cross-section of FIG. 15. For purposes of this model, opposite lobes of the figure in cross-section are assumed to be mirror images. - FIG. 16 shows various parameters of the FIG. 8 cross-section of the splinted idealized heart chamber of FIG. 15. Where l is the length of the splint between opposite walls of the chamber, R2 is the radius of each lobe, θ is the angle between the two radii of one lobe which extends to opposite ends of the portion of the splint within
chamber 48 and h is the height of the triangle formed by the two radii and the portion of the splint within the chamber 48 (R1 is the radius of the cylinder of FIG. 14). These various parameters are related as follows: - h<R2 COS (θ/2)
- l=R2 SIN (θ/2)
- R2=R1π/(2π−θ)
- From these relationships, the area of the figure eight cross-section can be calculated by:
- A 2−2π(R 2)2(1−θ/2π)+hl
- Where
chamber 48 is unsplinted as shown in FIG. 14 A1, the original cross-sectional area of the cylinder is equal to A2 where θ=180°, h=0 and l=2R2. Volume equals A2 times length L and circumferential wall tension equals pressure within the chamber times R2 times the length L of the chamber. - Thus, for example, with an original cylindrical radius of four centimeters and a pressure within the chamber of 140 mm of mercury, the wall tension T in the walls of the cylinder is 104.4 newtons. When a 3.84 cm splint is placed as shown in FIGS. 15 and 16 such that l=3.84 cm, the wall tension T is 77.33 newtons.
- FIGS. 17 and 18 show a hypothetical distribution of wall tension T and pressure P for the figure eight cross-section. As θ goes from 180° to 0°, tension Ts in the splint goes from 0 to a 2T load where the chamber walls carry a T load.
- It will be understood that this disclosure, in many respects, is only illustrative. Changes may be made in details, particularly in matters of shape, size, material, and arrangement of parts without exceeding the scope of the invention. Accordingly, the scope of the invention is as defined in the language of the appended claims.
Claims (14)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
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US10/073,968 US20020077524A1 (en) | 1997-01-02 | 2002-02-14 | Heart wall tension reduction apparatus |
US12/314,004 US20090137863A1 (en) | 1997-01-02 | 2008-12-02 | Heart wall tension reduction apparatus |
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US08/778,277 US6050936A (en) | 1997-01-02 | 1997-01-02 | Heart wall tension reduction apparatus |
US09/492,777 US6162168A (en) | 1997-01-02 | 2000-01-28 | Heart wall tension reduction apparatus |
US09/697,597 US6332864B1 (en) | 1997-01-02 | 2000-10-27 | Heart wall tension reduction apparatus |
US09/985,361 US20020068849A1 (en) | 1997-01-02 | 2002-01-23 | Heart wall tension reduction apparatus |
US10/073,968 US20020077524A1 (en) | 1997-01-02 | 2002-02-14 | Heart wall tension reduction apparatus |
Related Parent Applications (2)
Application Number | Title | Priority Date | Filing Date |
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US09/985,361 Continuation US6589160B2 (en) | 1997-01-02 | 2001-11-02 | Heart wall tension reduction apparatus |
US09/985,361 Continuation US20020068849A1 (en) | 1997-01-02 | 2002-01-23 | Heart wall tension reduction apparatus |
Related Child Applications (1)
Application Number | Title | Priority Date | Filing Date |
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US12/314,004 Continuation US20090137863A1 (en) | 1997-01-02 | 2008-12-02 | Heart wall tension reduction apparatus |
Publications (1)
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US20020077524A1 true US20020077524A1 (en) | 2002-06-20 |
Family
ID=25112816
Family Applications (15)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US08/778,277 Expired - Lifetime US6050936A (en) | 1997-01-02 | 1997-01-02 | Heart wall tension reduction apparatus |
US09/224,349 Expired - Lifetime US6165119A (en) | 1997-01-02 | 1999-01-04 | Heart wall tension reduction apparatus and method |
US09/224,348 Expired - Lifetime US6059715A (en) | 1997-01-02 | 1999-01-04 | Heart wall tension reduction apparatus |
US09/492,777 Expired - Lifetime US6162168A (en) | 1997-01-02 | 2000-01-28 | Heart wall tension reduction apparatus |
US09/543,155 Expired - Lifetime US6165120A (en) | 1997-01-02 | 2000-04-04 | Heart wall tension reduction apparatus and method |
US09/697,596 Expired - Lifetime US6332863B1 (en) | 1997-01-02 | 2000-10-27 | Heart wall tension reduction kit |
US09/697,597 Expired - Lifetime US6332864B1 (en) | 1997-01-02 | 2000-10-27 | Heart wall tension reduction apparatus |
US09/985,361 Expired - Lifetime US6589160B2 (en) | 1997-01-02 | 2001-11-02 | Heart wall tension reduction apparatus |
US09/985,362 Expired - Lifetime US6514194B2 (en) | 1997-01-02 | 2001-11-02 | Heart wall tension reduction apparatus and method |
US09/985,361 Granted US20020068849A1 (en) | 1997-01-02 | 2002-01-23 | Heart wall tension reduction apparatus |
US10/073,968 Abandoned US20020077524A1 (en) | 1997-01-02 | 2002-02-14 | Heart wall tension reduction apparatus |
US10/326,595 Expired - Lifetime US6793618B2 (en) | 1997-01-02 | 2002-12-20 | Heart wall tension reduction apparatus |
US10/326,585 Expired - Lifetime US6755777B2 (en) | 1997-01-02 | 2002-12-20 | Heart wall tension reduction apparatus and method |
US10/778,176 Expired - Fee Related US7695425B2 (en) | 1997-01-02 | 2004-02-17 | Heart wall tension reduction apparatus and method |
US12/314,004 Abandoned US20090137863A1 (en) | 1997-01-02 | 2008-12-02 | Heart wall tension reduction apparatus |
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US09/224,349 Expired - Lifetime US6165119A (en) | 1997-01-02 | 1999-01-04 | Heart wall tension reduction apparatus and method |
US09/224,348 Expired - Lifetime US6059715A (en) | 1997-01-02 | 1999-01-04 | Heart wall tension reduction apparatus |
US09/492,777 Expired - Lifetime US6162168A (en) | 1997-01-02 | 2000-01-28 | Heart wall tension reduction apparatus |
US09/543,155 Expired - Lifetime US6165120A (en) | 1997-01-02 | 2000-04-04 | Heart wall tension reduction apparatus and method |
US09/697,596 Expired - Lifetime US6332863B1 (en) | 1997-01-02 | 2000-10-27 | Heart wall tension reduction kit |
US09/697,597 Expired - Lifetime US6332864B1 (en) | 1997-01-02 | 2000-10-27 | Heart wall tension reduction apparatus |
US09/985,361 Expired - Lifetime US6589160B2 (en) | 1997-01-02 | 2001-11-02 | Heart wall tension reduction apparatus |
US09/985,362 Expired - Lifetime US6514194B2 (en) | 1997-01-02 | 2001-11-02 | Heart wall tension reduction apparatus and method |
US09/985,361 Granted US20020068849A1 (en) | 1997-01-02 | 2002-01-23 | Heart wall tension reduction apparatus |
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US10/778,176 Expired - Fee Related US7695425B2 (en) | 1997-01-02 | 2004-02-17 | Heart wall tension reduction apparatus and method |
US12/314,004 Abandoned US20090137863A1 (en) | 1997-01-02 | 2008-12-02 | Heart wall tension reduction apparatus |
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