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 . A method of mitral valve treatment using a coronary sinus, the method comprising: 
 positioning an elongate member in the coronary sinus,    anchoring proximal and distal ends of the member, and    applying tension to the elongate member to apply force on the mitral valve to improve valve function.    
   
   
       52 . The method of  claim 51 , wherein tension of the elongate member is adjusted intraoperatively.  
   
   
       53 . The method of  claim 51 , wherein tension of the elongate member is adjusted postoperatively.  
   
   
       54 . The method of  claim 51 , wherein tension is applied to the elongate member before anchoring.  
   
   
       55 . The method of  claim 51 , wherein tension is applied to the elongate member after anchoring.  
   
   
       56 . The method of  claim 51 , wherein loops of material are used to preload to the elongate member.  
   
   
       57 . The method of  claim 51 , wherein removal of at least some of the loops at least partially release the elongate member from tension.  
   
   
       58 . The method of  claim 51 , wherein the elongate member is tightened by retracting the proximal anchor.  
   
   
       59 . The method of  claim 51 , wherein the elongate member is tightened by retracting the elongate member relative to the proximal anchor.  
   
   
       60 . The method of  claim 59 , wherein the tightening is in steps secured by a locking mechanism.  
   
   
       61 . The method of  claim 59 , wherein the tightening is secured by a one-way locking mechanism.  
   
   
       62 . A method of treating a heart, said method comprising: providing a tensioning device comprising a proximal anchor, a distal anchor, and an elongate member adapted to be engaged in tension between said anchors, positioning and securing said distal anchor in a vessel adjacent said heart, positioning and securing said proximal anchor at a location selected from a vessel adjacent the heart, an ostium of the heart and a valve, wherein tension is applied between said anchors by said elongate member.  
   
   
       63 . The method of  claim 62 , wherein said elongate member is tightened after securing said anchors.  
   
   
       64 . The method of  claim 63 , wherein said vessel said distal anchor is secured in is the coronary sinus of said heart.  
   
   
       65 . The method of  claim 64 , performed percutaneously.