Treatment for patient with congestive heart failure

Claim 2

1 . A minimally invasive method of treating a patient' heart having mitral valve regurgitation from a left ventricle, comprising: a. forming a small passageway in the patient's left ventricular wall defining in part the patient's left ventricle; b. seating a valve into the passageway formed in the left ventricular wall; c. advancing a grasping device through the valve into the left ventricle; d. advancing an expandable member through the valve, through the left ventricle, through the mitral valve into a left atrium distal to the mitral valve; e. expanding the expandable member within the left atrium and engaging leaflets of the mitral valve and guiding the leaflets to a grasping location; f. grasping the leaflets in the grasping location with the grasping device; and g. securing together free edges of the leaflets grasped with one or more connecting members.

Claim 3

2 . The method of claim 1 wherein the seated valve allows for passage of instrument into and out of the left ventricle and minimizes blood flow from the left ventricle.

Claim 4

3 . The method of claim 1 wherein a strand is secured to the by one end thereof to one or more of the connecting members and by a second end to the ventricular wall to hold the mitral valve in a desired position.

Claim 5

4 . The method of claim 1 wherein the strand is secured to the exterior of the ventricular wall.

Claim 6

5 . The method of claim 4 wherein the strand passes through the seated valve in the ventricular wall.

Claim 7

6 . The method of claim 3 wherein the strand is relatively non-compliant.

Claim 8

7 . The method of claim 5 wherein the strand is formed of a material selected from the group consisting of nylon, polyethylene terephthalate, polytetrafluoroethylene, and polyurethane.

Claim 9

8 . The method of claim 1 wherein the grasping device has an inner lumen and the expandable member passes through the inner lumen of the grasping device to advanced into the patient's heart.

Claim 10

9 . The method of claim 8 wherein the inner lumen tapers to smaller dimension in the distal direction within the grasping elements to close a leaflet clip when distally advanced therein.

Claim 11

10 A minimally invasive method of treating a patient's heart which has a left ventricle that provides insufficient output, comprising: a. exposing an exterior region of the patient's heart wall which defines in part the left ventricle; b. advancing a pacing lead with a penetrating electrode through the patient's chest cavity to an exposed region of the patient's heart wall; c. securing the pacing lead to the exposed region of the patient's heart wall with the penetrating electrode within the heart wall; and d. delivering electrical pulses to the pacing lead to control the contraction of the heart wall to which the pacing lead in secured.

Claim 12

10 A minimally invasive method of treating a patient's heart which has a left ventricle that provides insufficient output, comprising: a. exposing an exterior region of the patient's heart wall which defines in part the left ventricle; b. advancing a pacing lead with a penetrating electrode through the patient's chest cavity to an exposed region of the patient's heart wall; c. securing the pacing lead to the exposed region of the patient's heart wall with the penetrating electrode within the heart wall; and d. delivering electrical pulses to the pacing lead to control the contraction of the heart wall to which the pacing lead in secured.

Claim 13

11 . The method of claim 10 wherein a small opening is formed in the patient's chest to gain access to the patient's chest cavity.

Claim 14

12 . The method of claim 10 wherein the electrical pulses have a frequency, duration, current and voltage sufficient to control the contraction of the patient's left ventricle to increase the output thereof.

Claim 15

13 . The method of claim 11 wherein a trocar is seated within the small opening in the patient's chest.

Claim 16

14 . The method of claim 10 wherein a second pacing lead is disposed in the right ventricle of the patient' heart and electrical pulses are emitted from an electrode on a distal portion of the second pacing lead having a frequency, duration, current and voltage sufficient to control the contraction of the right ventricle to increase the output thereof.

Claim 17

15 . A method of treating a patient's heart with congestive heart failure due at least in part to regurgitation through a mitral valve and ventricular conduction delay with resulting disturbance of the synchronous ventricular contractility, comprising a. forming a small passageway in the patient's left ventricular wall defining in part the patient's left ventricle; b. seating a valve into the passageway formed in the left ventricular wall; c. advancing a grasping device through the valve into the left ventricle; d. advancing an expandable member through the valve, through the left ventricle, through the mitral valve into a left atrium distal to the mitral valve; e. expanding the expandable member within the left atrium and engaging leaflets of the mitral valve and guiding the leaflets to a grasping location; f. grasping the leaflets in the grasping location with the grasping device; and g. securing together free edges of the leaflets grasped with one or more connecting members; h. exposing an exterior region of the patient's heart wall which defines in part the left ventricle; i. advancing a pacing lead with a penetrating electrode through the patient's chest cavity to an exposed region of the patient's heart wall; j. securing the pacing lead to the exposed region of the patient's heart wall with the penetrating electrode within the heart wall; and k. delivering electrical pulses to the pacing lead to control the contraction of the heart wall to which the pacing lead in secured.

Claim 18

15 . A method of treating a patient's heart with congestive heart failure due at least in part to regurgitation through a mitral valve and ventricular conduction delay with resulting disturbance of the synchronous ventricular contractility, comprising a. forming a small passageway in the patient's left ventricular wall defining in part the patient's left ventricle; b. seating a valve into the passageway formed in the left ventricular wall; c. advancing a grasping device through the valve into the left ventricle; d. advancing an expandable member through the valve, through the left ventricle, through the mitral valve into a left atrium distal to the mitral valve; e. expanding the expandable member within the left atrium and engaging leaflets of the mitral valve and guiding the leaflets to a grasping location; f. grasping the leaflets in the grasping location with the grasping device; and g. securing together free edges of the leaflets grasped with one or more connecting members; h. exposing an exterior region of the patient's heart wall which defines in part the left ventricle; i. advancing a pacing lead with a penetrating electrode through the patient's chest cavity to an exposed region of the patient's heart wall; j. securing the pacing lead to the exposed region of the patient's heart wall with the penetrating electrode within the heart wall; and k. delivering electrical pulses to the pacing lead to control the contraction of the heart wall to which the pacing lead in secured.

Claim 19

16 . A minimally invasive system for treating a patient's heart having heart valve regurgitation, comprising: a. a valve configured to be secured within a passageway formed through the patient's heart wall to provide instrument passageway into a chamber of the patient's heart defined in part by the heart wall through which the passageway is formed; b. a tissue grasping device configured to extend through the valve secured within the passageway into the chamber of the patient's heart and having at least two grasping members configured to grasp valve leaflets; c. a tissue securing assembly to secure a tissue connecting member to at least one free edge of a valve leaflet.

Claim 20

16 . A minimally invasive system for treating a patient's heart having heart valve regurgitation, comprising: a. a valve configured to be secured within a passageway formed through the patient's heart wall to provide instrument passageway into a chamber of the patient's heart defined in part by the heart wall through which the passageway is formed; b. a tissue grasping device configured to extend through the valve secured within the passageway into the chamber of the patient's heart and having at least two grasping members configured to grasp valve leaflets; c. a tissue securing assembly to secure a tissue connecting member to at least one free edge of a valve leaflet.

Claim 21

17 . The minimally invasive system of claim 16 wherein the grasping aws of the grasping device grasp the valve leaflets with free edges exposed to facilitate securing the free edges together with the connecting member.

Claim 22

18 . A minimally invasive system for treating a patient's heart having a chamber providing insufficient output, comprising: a. a valve configured to be secured within a passageway formed through the patient's heart wall to provide an instrument passageway into a chamber of the patient's heart defined in part by the heart wall through which the passageway is formed; b. a tissue grasping device configured to extend through the valve into the chamber of the patient heart and to grasp free edges of valve leaflets; c. a tissue securing assembly advanceable through the valve to secure one or more connecting members to at least one free edge of a valve leaflet. d. a pacing lead configured to be advanced into the patient's chest cavity through a small opening in the patient's chest an to be secured to an exterior region of the patient's heart; and e. an elongated pulse transmitting member having one end secured to the pacing lead and another end configured to be connected to a source of energy pulses.

Claim 23

18 . A minimally invasive system for treating a patient's heart having a chamber providing insufficient output, comprising: a. a valve configured to be secured within a passageway formed through the patient's heart wall to provide an instrument passageway into a chamber of the patient's heart defined in part by the heart wall through which the passageway is formed; b. a tissue grasping device configured to extend through the valve into the chamber of the patient heart and to grasp free edges of valve leaflets; c. a tissue securing assembly advanceable through the valve to secure one or more connecting members to at least one free edge of a valve leaflet. d. a pacing lead configured to be advanced into the patient's chest cavity through a small opening in the patient's chest an to be secured to an exterior region of the patient's heart; and e. an elongated pulse transmitting member having one end secured to the pacing lead and another end configured to be connected to a source of energy pulses.

Claim 24

19 . A system for treating a patient with congestive heart failure including a regurgitating heart valve, comprising: a. at least one connecting member for securing together free edges of the patient's regurgitating heart valve; and b. at least one strand having one end secured to the at least one connecting member and one end configured to be secured to a heart wall.

Claim 25

19 . A system for treating a patient with congestive heart failure including a regurgitating heart valve, comprising: a. at least one connecting member for securing together free edges of the patient's regurgitating heart valve; and b. at least one strand having one end secured to the at least one connecting member and one end configured to be secured to a heart wall.

Claim 26

20 . A minimally invasive system for installing a pacing lead to an exterior region of a free wall of a patient's heart, comprising: a. a delivery tube having a proximal end, a port in the proximal end, a distal end, a port in the distal end, an inner lumen extending from the proximal end to the distal end and in fluid communication with the ports therein and a securing pod on the distal end to releasably secure the distal end of the delivery tube to the exterior region of the patient's free heart wall; b. a pacing lead slidably disposed within the inner lumen of the delivery tube with a distal electrode which is securable within the patient's heart wall of the exterior region and a collar on a distal portion of the lead proximal to the distal electrode; c. an expandable member at the distal end of the delivery tube configured for distal expansion to engage the collar on the distal portion of the lead and to drive the distal electrode into the heart wall of the exterior region. d. a driving member on the distal end of the delivery tube configured to engage the collar on the distal portion of the lead and drive the lead distally and drive the electrode of the lead into the heart wall of the exposed region of the patient's heart.

Claim 27

20 . A minimally invasive system for installing a pacing lead to an exterior region of a free wall of a patient's heart, comprising: a. a delivery tube having a proximal end, a port in the proximal end, a distal end, a port in the distal end, an inner lumen extending from the proximal end to the distal end and in fluid communication with the ports therein and a securing pod on the distal end to releasably secure the distal end of the delivery tube to the exterior region of the patient's free heart wall; b. a pacing lead slidably disposed within the inner lumen of the delivery tube with a distal electrode which is securable within the patient's heart wall of the exterior region and a collar on a distal portion of the lead proximal to the distal electrode; c. an expandable member at the distal end of the delivery tube configured for distal expansion to engage the collar on the distal portion of the lead and to drive the distal electrode into the heart wall of the exterior region. d. a driving member on the distal end of the delivery tube configured to engage the collar on the distal portion of the lead and drive the lead distally and drive the electrode of the lead into the heart wall of the exposed region of the patient's heart.

Claim 28

21 . A method of treating a patient having CHF, comprising: a. providing a pacing lead having a pulse emitting electrode on the distal end thereof; b. advancing the pacing lead through a small opening in the patient's chest; c. securing the pulse emitting electrode on the distal end of the pacing lead within a free wall of the patient's heart defining in part the patient's left ventricle; d. emitting electrical pulses from the electrode to pace the contractions of the patient's left ventricle to increase the blood flow out of the left ventricle.

Claim 29

21 . A method of treating a patient having CHF, comprising: a. providing a pacing lead having a pulse emitting electrode on the distal end thereof; b. advancing the pacing lead through a small opening in the patient's chest; c. securing the pulse emitting electrode on the distal end of the pacing lead within a free wall of the patient's heart defining in part the patient's left ventricle; d. emitting electrical pulses from the electrode to pace the contractions of the patient's left ventricle to increase the blood flow out of the left ventricle.

Claim 30

22 . A minimally invasive system for delivering a pacing lead to an exposed region of a patient's free ventricular wall defining in part the patient's left ventricle, comprising: a. an elongated pacing lead having a distal end with a ventricular wall penetrating electrode and a distal end configured to be connected to an electrical conducting relationship with a suitable pacing power source b. an elongated delivery tube having a proximal end, a distal end configured to pass through a small opening in the patient's chest, an inner lumen extending through the delivery tube configured to slidably receive the pacing lead and a pod on the distal end of the delivery tube to secure the distal end of the delivery tube to the exposed region of the patient heart wall. c. a driving member on a distal portion of the delivery tube configured to engage a distal portion of the pacing lead and drive the tissue penetrating electrode through the exposed surface of the patient's heart wall to secure the electrode within the heart wall.

Claim 31

22 . A minimally invasive system for delivering a pacing lead to an exposed region of a patient's free ventricular wall defining in part the patient's left ventricle, comprising: a. an elongated pacing lead having a distal end with a ventricular wall penetrating electrode and a distal end configured to be connected to an electrical conducting relationship with a suitable pacing power source b. an elongated delivery tube having a proximal end, a distal end configured to pass through a small opening in the patient's chest, an inner lumen extending through the delivery tube configured to slidably receive the pacing lead and a pod on the distal end of the delivery tube to secure the distal end of the delivery tube to the exposed region of the patient heart wall. c. a driving member on a distal portion of the delivery tube configured to engage a distal portion of the pacing lead and drive the tissue penetrating electrode through the exposed surface of the patient's heart wall to secure the electrode within the heart wall.

Claim 32

23 . The minimally invasive system of claim 22 wherein the delivery tube has an expanded distal end.

Claim 33

24 . The minimally invasive system of claim 23 wherein the driving member is an inflatable balloon which is disposed within the expanded distal end of the delivery tube.

Claim 34

25 . A minimally invasive system for treating a patient having CHF, comprising: a. means for accessing a CHF patient's left ventricle through a valved passageway in the free ventricular wall defining in part the patient's left ventricle; b. means for securing together free edges of the patient's mitral valve in a “Bow-Tie” configuration from within the patient's left ventricle; c. pacing means having an electrode secured within a region of the CHF patient's free heart wall defining in part the patient's left ventricle; and d. an electrical power source electrically connected to the pacing means to deliver electrical pulses to the patient's free wall suitable to pace the patient's left ventricle.

Claim 35

25 . A minimally invasive system for treating a patient having CHF, comprising: a. means for accessing a CHF patient's left ventricle through a valved passageway in the free ventricular wall defining in part the patient's left ventricle; b. means for securing together free edges of the patient's mitral valve in a “Bow-Tie” configuration from within the patient's left ventricle; c. pacing means having an electrode secured within a region of the CHF patient's free heart wall defining in part the patient's left ventricle; and d. an electrical power source electrically connected to the pacing means to deliver electrical pulses to the patient's free wall suitable to pace the patient's left ventricle.

Claim 36

26 . A minimally invasive method for treating a patient having CHF, comprising: a. accessing a CHF patient's left ventricle through a valved passageway in the free ventricular wall defining in part the patient's left ventricle; b. securing together free edges of the patient's mitral valve in a “Bow-Tie” configuration from within the patient's left ventricle; c. securing an electrode of a pacing lead within a region of the CHF patient's free heart wall defining in part the patient's left ventricle; and d. delivering electrical pulses from an electrical power source to the pacing lead to deliver electrical pulses to the patient's free wall suitable to pace the patient's left ventricle.

Claim 37

26 . A minimally invasive method for treating a patient having CHF, comprising: a. accessing a CHF patient's left ventricle through a valved passageway in the free ventricular wall defining in part the patient's left ventricle; b. securing together free edges of the patient's mitral valve in a “Bow-Tie” configuration from within the patient's left ventricle; c. securing an electrode of a pacing lead within a region of the CHF patient's free heart wall defining in part the patient's left ventricle; and d. delivering electrical pulses from an electrical power source to the pacing lead to deliver electrical pulses to the patient's free wall suitable to pace the patient's left ventricle.