Methods and apparatus for controlling the internal circumference of an anatomic orifice or lumen

Abstract

An implantable device is provided for controlling at least one of shape and size of an anatomical structure or lumen. An implantable device has an adjustable member configured to adjust the dimensions of the implantable device. An adjustment tool is configured to actuate the adjustable member and provide for adjustment before, during and after the anatomical structure or lumen resumes near normal to normal physiologic function.

1 . An adjustable prosthetic implant for controlling at least one of a shape and size of an anatomical structure or lumen, comprising:
 a ring shaped member having an opening;   a first draw string extending within the opening and having an end extending outwardly of the opening for engagement therewith;   a second draw string extending within the opening and having an end extending outwardly of the opening for engagement therewith; and
 a first plurality of wedge shaped shaping members disposed within the ring shaped member; 
 whereby tensioning of the first and second draw string by engagement of their ends causes the ring shaped member to assume a predetermined configuration. 
   
     
     
         2 . The adjustable prosthetic implant of  claim 1 , wherein the shaping members adjust the ring shaped member into a three-dimensional shape. 
     
     
         3 . The adjustable prosthetic implant of  claim 1 , wherein the plurality of shaping members include a right most shaping member and a left most shaping member; wherein the first draw string comprises a right draw string and the second draw string comprises a left draw string, and wherein the right draw string is attached to the left most shaping member and the left draw string is attached to the right most shaping member. 
     
     
         4 . The adjustable prosthetic implant of  claim 1 , further including a second plurality of shaping members disposed within the opening of the ring shaped member, wherein the first plurality of shaping members is spaced apart from the second plurality of shaping members. 
     
     
         5 . The adjustable prosthetic implant of  claim 4 , wherein the first and second draw strings are attached to the first plurality of shaping members, and further including third and fourth draw strings attached to the second plurality of shaping members. 
     
     
         6 . The adjustable prosthetic implant of  claim 5 , wherein the first and third draw strings extend clockwise through the opening in the ring shaped member and the second and fourth draw strings extend counter clockwise through opening. 
     
     
         7 . The adjustable prosthetic implant of  claim 1 , further including a third and fourth draw string, wherein the shaping members have a top and bottom, the top being narrower than at the bottom, whereby the ring shaped member has a saddle-shaped configuration upon tensioning the first, second, third and fourth draw strings. 
     
     
         8 . The adjustable prosthetic implant of  claim 1 , wherein the plurality of shaping members have a top and a bottom, wherein the shaping members are arranged in alternating groups of shaping members being narrower at their top than at their bottom and narrower at their bottom than at their top, whereby the ring shaped member has a three-dimensional configuration upon tensioning the first and second draw strings. 
     
     
         9 . The adjustable prosthetic implant of  claim 1 , wherein the ring shaped member is configured to lie in a common plane when the first and second draw strings are tensioned. 
     
     
         10 . The adjustable prosthetic implant of  claim 1 , wherein the ring shaped member has a circular shape, oval shape, polygonal shape, d-shape or c-shape. 
     
     
         11 . The adjustable prosthetic implant of  claim 1 , wherein the prosthetic implant comprises a prosthetic annuloplasty ring. 
     
     
         12 . The adjustable prosthetic implant of  claim 1 , wherein the predetermined configuration comprises a complex three dimensional configuration. 
     
     
         13 . An adjustable prosthetic implant for controlling at least one of a shape and size of an anatomical structure or lumen, comprising:
 a ring shaped member having a first plurality of wedge shaped shaping members arranged adjacent one another and configured to adjust the configuration of the ring shaped member between a first configuration and a second configuration; and   an adjustment member configured to actuate the plurality of wedge shaped shaping members between the first and second configurations, wherein the ring shaped member has a planar arrangement when the plurality of wedge shaped shaping members are arranged in the first configuration and have a three dimensional arrangement when the plurality of wedge shaped shaping members are arranged in the second configuration.   
     
     
         14 . The adjustable prosthetic implant of  claim 13 , wherein the ring shaped member comprises a prosthetic annuloplasty ring member. 
     
     
         15 . The adjustable prosthetic implant of  claim 13 , further including a first draw string coupled to one of the shaping members, and a second draw string coupled to another one of the shaping members, whereby tensioning of the first and second draw strings causes the ring shaped member to assume the second configuration. 
     
     
         16 . The adjustable prosthetic implant of  claim 15 , further including a third and fourth draw string, wherein the shaping members have a top and bottom, the top being narrower than at the bottom, whereby the ring shaped member has a saddle-shaped configuration upon tensioning the first, second, third and fourth draw strings. 
     
     
         17 . The adjustable prosthetic implant of  claim 13 , wherein the shaping members have a top and a bottom, wherein the shaping members are arranged in alternating groups of shaping members being narrower at their top than at their bottom and narrower at their bottom than at their top. 
     
     
         18 . The adjustable prosthetic implant of  claim 15 , further including a second plurality of shaping members spaced apart from the first plurality of shaping members. 
     
     
         19 . The adjustable prosthetic implant of  claim 18 , wherein the first and second draw strings are attached to the first plurality of shaping members, and further including third and fourth draw strings attached to the second plurality of shaping members. 
     
     
         20 . The adjustable prosthetic implant of  claim 19 , wherein the first and third draw strings extend clockwise about the ring shaped member and the second and fourth draw strings extend counter clockwise about the ring shaped member. 
     
     
         21 . The adjustable prosthetic implant of  claim 13 , wherein the plurality of wedge shaped shaping members lie in a single plane when in first configuration and lie in a plurality of planes when in the second configuration.