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

Abstract

An implantable device is provided for controlling shape and/or size of an anatomical structure or lumen. The implantable device has an adjustable member configured to adjust the dimensions of the implantable device. The implantable device is housed in a catheter and insertable from a minimally invasive surgical entry. An adjustment tool actuates the adjustable member and provide for adjustment before, during or after the anatomical structure or lumen resumes near normal to normal physiologic function.

1 . An implantable prosthetic device delivery system, comprising:
 a housing sheath;   a catheter assembly including an actuating catheter disposed within the housing sheath and a core catheter disposed within the actuating catheter, the actuating catheter including at least one longitudinally extending slot, and a retention tab having an attachment tab slideably received within the slot;   a deployment umbrella including a plurality of support struts, at least one of the support struts attached to the attachment tab; and   an implantable device including an adjustable member configured to adjust a dimension of the implantable device, the implantable device configured to be releasably attached to the deployment umbrella and for being received in the housing sheath.   
     
     
         2 . The system of  claim 1 , wherein the core catheter is coaxially arranged within the actuating catheter forming an annular lumen therebetween. 
     
     
         3 . The system of  claim 2 , wherein the retention tab is slideably received within the lumen. 
     
     
         4 . The system of  claim 1 , wherein the actuating catheter includes a plurality of longitudinally extending slots, and a corresponding number of retention tabs each having an attachment tab slideably received within a corresponding slot. 
     
     
         5 . The system of  claim 1 , wherein the deployment umbrella further includes a plurality of support arms attached to the plurality of support struts and to the core catheter. 
     
     
         6 . The system of  claim 5 , wherein the implantable device is configured to be releasably attached to a distal end of the plurality of support arms. 
     
     
         7 . The system of  claim 1 , wherein the actuating catheter is coaxially arranged within the housing sheath. 
     
     
         8 . The system of  claim 2 , wherein the actuating catheter and the core catheter are configured to be slidable relative to each other and the housing sheath. 
     
     
         9 . The system of  claim 1 , wherein an expansion of the implantable device is achieved by sliding movement of the housing sheath, the actuating catheter and the core catheter. 
     
     
         10 . The system of  claim 1 , wherein the core catheter includes one or more lumens receiving release elements for releasing the implantable device from the deployment umbrella and adjustment elements for adjusting the size or shape of the implantable device. 
     
     
         11 . The system of  claim 1 , wherein the implantable device comprises an annuloplasty ring. 
     
     
         12 . An implantable prosthetic device delivery system, comprising:
 a housing sheath;   an activating catheter slideably received within the housing sheath, the activating catheter including a plurality of longitudinally extending slots and a retention tab having an attachment tab slideably received within a corresponding slot;   a core catheter slideably received in coaxial arrangement within the activating catheter forming an annular lumen therebetween, the retention tab received with the lumen;   a deployment umbrella including a plurality of support struts and a plurality of support arms, at least one of the support struts pivotally attached to the attachment tab, the plurality of support arms having a portion thereof attached to the support struts and to the core catheter; and   an implantable device including an adjustable member configured to adjust a dimension of the implantable device, the implantable device configured to be releasably attached to a distal end of the support arms for being received within the housing sheath.   
     
     
         13 . The system of  claim 12 , wherein an expansion of the implantable device is achieved by sliding movement of the housing sheath, the actuating catheter and the core catheter 
     
     
         14 . The system of  claim 12 , wherein the core catheter includes one or more lumens receiving release elements for releasing the implantable device from the deployment umbrella and adjustment elements for adjusting the size or shape of the implantable device. 
     
     
         15 . The system of  claim 12 , wherein the implantable device comprises an annuloplasty ring. 
     
     
         16 . An implantable prosthetic device delivery system, comprising:
 a housing sheath;   an activating catheter slideably received within the housing sheath, the activating catheter having a distal end;   a core catheter slideably received within the activating catheter;   a deployment umbrella including a plurality of support arms having a proximal end and a distal end, the proximal ends of the deployment umbrella coupled to the distal end of the actuating catheter; and   an implantable device including an adjustable member configured to adjust a dimension of the implantable device, the implantable device configured to be releasably attached to the distal ends of the support arms and for being received in the housing sheath.   
     
     
         17 . The system of  claim 16 , wherein the implantable device comprises an annuloplasty ring. 
     
     
         18 . The system of  claim 16 , further including a plurality of support struts connected between the plurality of support arms and the actuating catheter. 
     
     
         19 . The system of  claim 16 , wherein the core catheter includes one or more lumens receiving release elements for releasing the implantable device from the deployment umbrella and adjustment elements for adjusting the size or shape of the implantable device. 
     
     
         20 . The system of  claim 16 , wherein the core catheter is coaxially arranged within the actuating catheter forming an annular lumen therebetween. 
     
     
         21 . The system of  claim 20 , further including a retention tab received within the lumen. 
     
     
         22 . An implantable device adapted for use as an annuloplasty ring, comprising:
 an adjustable implantable ring having an exterior;   an elongated track member arranged encircling the exterior of the implantable ring; and   a coil configured to fasten the implantable ring to anatomical tissue, the coil arranged encircling the track member along a spiral path about the exterior of the implantable ring, wherein the coil is adapted to penetrate the anatomical tissue when spiraling the coil over the track member around the implantable ring adjacent the anatomical tissue.   
     
     
         23 . The device of  claim 22 , wherein the track member is supported concentrically around the exterior of the implantable ring. 
     
     
         24 . The device of  claim 23 , wherein the track member is supported by track carriers. 
     
     
         25 . The device of  claim 22 , further including an adjustment tool adapted for adjusting the implantable ring. 
     
     
         26 . An implantable device adapted for use as an annuloplasty ring, comprising:
 an adjustable implantable ring having an interior formed by an incomplete tubular body providing a closure gap in communication with the interior;   an elongated track member extending through the interior of the tubular body; and   a coil configured to fasten the implantable ring to anatomical tissue, the coil arranged encircling the track member within the interior along a spiral path, wherein the coil is adapted to penetrate the anatomical tissue when spiraling the coil over the track member around the implantable ring adjacent the anatomical tissue by a portion of the coil extending through the closure gap.   
     
     
         27 . The device of  claim 26 , further including an adjustment tool adapted for adjusting the implantable ring.