Systems for heart treatment

Abstract

Described are devices and methods for treating degenerative, congestive heart disease and related valvular dysfunction. Percutaneous and minimally invasive surgical tensioning structures offer devices that mitigate changes in the ventricular structure (i.e., remodeling) and deterioration of global left ventricular performance related to tissue damage precipitating from ischemia, acute myocardial infarction (AMI) or other abnormalities. These tensioning structures can be implanted within various major coronary blood-carrying conduit structures (arteries, veins and branching vessels), into or through myocardium, or into engagement with other anatomic structures that impact cardiac output to provide tensile support to the heart muscle wall which resists diastolic filling pressure while simultaneously providing a compressive force to the muscle wall to limit, compensate or provide therapeutic treatment for congestive heart failure and/or to reverse the remodeling that produces an enlarged heart.

1 .- 50 . (canceled)  
   
   
       51 . An intravascular mitral valve support device comprising: 
 a proximal anchor, a distal anchor and an elongate member secured between the proximal and distal anchors,    wherein at least the distal anchor is adapted to hold within a coronary sinus vessel, and    wherein the elongate member is adapted to apply force on the mitral valve when the elongate member is tensioned.    
   
   
       52 . The device of  claim 51 , wherein the elongate member comprises a wire.  
   
   
       53 . The device of  claim 51 , wherein the wire is selected from stainless steel, NiTi and titanium alloy.  
   
   
       54 . The device of  claim 51 , wherein both anchors are adapted to hold within the coronary sinus.  
   
   
       55 . The device of  claim 51 , wherein the elongate member is integral with the anchors.  
   
   
       56 . The device of  claim 51 , wherein the anchors are attached to the elongate member.  
   
   
       57 . The device of  claim 51 , wherein the at least one of the anchors is adapted to be delivered in a collapses state and expanded to contact and hold against tissue.  
   
   
       58 . The device of  claim 51 , wherein at least one of the anchors comprises superelastic material to self-expand from the collapsed state to the expanded state.  
   
   
       59 . The device of  claim 51 , wherein at least one of the anchors comprises deformable material for deforming the anchors from the collapsed state to the expanded shape.  
   
   
       60 . The device of  claim 51 , wherein at least the distal anchor comprises a loop.  
   
   
       61 . The device of  claim 60 , wherein the loop is circular.  
   
   
       62 . The device of  claim 61 , wherein the device is adapted so that at lest the distal anchor holds the elongate member in position with the elongate member and the distal anchor positioned at an acute angle relative to one another.  
   
   
       63 . The device of  claim 51 , wherein at least the distal anchor comprises a hook.  
   
   
       64 . The device of  claim 63 , wherein the hook is J-shaped.  
   
   
       65 . The device of  claim 64 , wherein the hook is adapted to hold against a coronary sinus vessel lumen.  
   
   
       66 . The device of  claim 64 , wherein the hook is adapted to hold by passing through a wall of he coronary sinus vessel.  
   
   
       67 . The device of  claim 51 , wherein at least one of the anchors comprises a plurality of tissue interface member to distribute anchor load.  
   
   
       68 . The device of  claim 67 , wherein the plurality of members comprise hook portions.  
   
   
       69 . The device of  claim 67 , wherein the plurality of members are portions of a stent.  
   
   
       70 . The device of  claim 51 , wherein at least the distal anchor comprises a stent.  
   
   
       71 . The device of  claim 70 , wherein the stent is formed from strands of material.  
   
   
       72 . The device of  claim 71 , wherein at least some of the strands overlap.  
   
   
       73 . The device of  claim 70 , wherein the stent comprises a mesh or braid.  
   
   
       74 . The device of  claim 70 , wherein the stent comprises a cell pattern.  
   
   
       75 . The device of  claim 74 , wherein the stent is produced from cut tubing.  
   
   
       76 . The device of  claim 51 , wherein the anchors are substantially the same in shape.  
   
   
       77 . The device of  claim 51 , wherein the proximal anchor is adapted to hold at an annulus of the mitral valve.  
   
   
       78 . The device of  claim 51 , wherein the proximal anchor is adapted to hold at an ostium of the coronary sinus.  
   
   
       79 . The device of  claim 51 , wherein the proximal anchor is located at least partly outside of the coronary sinus.  
   
   
       80 . The device of  claim 79 , wherein the proximal anchor comprises a form selected from a loop, a hook and a stent.