Adjustable cardiac valve implant with coupling mechanism

Abstract

Methods and devices are provided for support of a body structure. The devices can be adjusted within the body of a patient in a minimally invasive or non-invasive manner such as by applying energy percutaneously or external to the patient's body. The energy may include, for example, acoustic energy, radio frequency energy, light energy and magnetic energy. Thus, as the body structure changes size and/or shape, the size and/or shape of the annuloplasty rings can be adjusted to provide continued reinforcement. In certain embodiments, the devices include a tubular member configured to be attached to or near a cardiac valve annulus. The tubular member includes a receptacle end and an insert end configured to couple with the receptacle end of the tubular member such that the tubular member substantially forms a shape of a ring. The insert end is configured to move with respect to the receptacle end to change a circumference of the ring.

1 . An adjustable annuloplasty ring, comprising:
 an arcuate member configured to be attached to or near a cardiac valve annulus, said arcuate member comprising:   a first end;   a second end configured to couple with said first end of said arcuate member such that said arcuate member substantially forms a shape of a ring;   wherein said arcuate member is configured to change, after implantation in a patient's body, from a first shape to a second, asymmetric shape in response to an activation energy;   wherein said activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy; and   wherein said change from said first shape to said second shape comprises movement of said second end with respect to said first end to change a circumference of said ring.   
     
     
         2 . The adjustable annuloplasty ring of  claim 1 , wherein said arcuate member further comprises a shape memory material configured to change, after implantation in said patient's body, from said first shape to said second, asymmetric shape in response to said activation energy, wherein said shape change causes said change in the circumference of said ring. 
     
     
         3 . The adjustable annuloplasty ring of  claim 2 , wherein said arcuate member further comprises an energy conducting material disposed within said arcuate member, said energy conducting material facilitating transfer of heat to said shape memory material. 
     
     
         4 . The adjustable annuloplasty ring of  claim 3 , wherein said energy conducting material is further disposed in or on an outer surface of said arcuate member. 
     
     
         5 . The adjustable annuloplasty ring of  claim 1 , wherein said arcuate member further comprises a ratchet member configured to allow said second end to move predominantly in a first direction with respect to said first end, and to resist movement in a second, opposite direction. 
     
     
         6 . The adjustable annuloplasty ring of  claim 1 , wherein said annuloplasty ring is ring shaped. 
     
     
         7 . The adjustable annuloplasty ring of  claim 1 , wherein said annuloplasty ring is C-shaped. 
     
     
         8 . The adjustable annuloplasty ring of  claim 1 , wherein said annuloplasty ring is D-shaped. 
     
     
         9 . An adjustable annuloplasty ring, comprising:
 a body member configured to be attached to or near a cardiac valve annulus, said body member comprising:
 a first end; 
 a second end configured to couple with said first end of said body member such that said body member substantially forms a shape of a ring; 
 wherein said body member is configured to change, after implantation in a patient's body, from a first shape to a second, asymmetric shape in response to an activation energy; 
 wherein said activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy; and 
 wherein said change from said first shape to said second shape comprises movement of said second end with respect to said first end to change a circumference of said ring. 
   
     
     
         10 . The adjustable annuloplasty ring of  claim 9 , wherein said body member further comprises a shape memory material configured to change, after implantation in said patient's body, from said first shape to said second, asymmetric shape in response to said activation energy, wherein said shape change causes said change in the circumference of said ring. 
     
     
         11 . The adjustable annuloplasty ring of  claim 10 , wherein said body member further comprises an energy conducting material, said energy conducting material facilitating transfer of heat to said shape memory material. 
     
     
         12 . The adjustable annuloplasty ring of  claim 9 , wherein said body member further comprises a ratchet member configured to allow said second end to move predominantly in a first direction with respect to said first end, and to resist movement in a second, opposite direction. 
     
     
         13 . The adjustable annuloplasty ring of  claim 9 , wherein said annuloplasty ring is ring shaped. 
     
     
         14 . The adjustable annuloplasty ring of  claim 9 , wherein said annuloplasty ring is C-shaped. 
     
     
         15 . The adjustable annuloplasty ring of  claim 9 , wherein said annuloplasty ring is D-shaped. 
     
     
         16 . A method for treating a heart valve, said method comprising:
 providing an adjustable annuloplasty ring comprising:
 an arcuate member configured to be attached to or near a cardiac valve annulus, said arcuate member comprising:
 a first end; 
 a second end configured to couple with said first end of said arcuate member such that said arcuate member substantially forms a shape of a ring; 
 wherein said arcuate member is configured to change, after implantation in a patient's body, from a first shape to a second, asymmetric shape in response to an activation energy; 
 wherein said activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy; 
 
 wherein said shape change results in said second end moving with respect to said first end to change a circumference of said ring; and 
   implanting said annuloplasty ring on or near a patient's cardiac valve annulus.   
     
     
         17 . An adjustable annuloplasty ring, comprising:
 a body member configured to be attached to or near a cardiac valve annulus, said body member comprising means for coupling a first end of said body member to a second end of said body member such that said body member substantially forms a shape of a ring;   wherein said body member is configured to change, after implantation in a patient's body, from a first shape to a second, asymmetric shape in response to an activation energy; and   wherein said activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy   wherein said means allows said second end to move with respect to said first end to change a circumference of said ring.   
     
     
         18 . The annuloplasty ring of  claim 17 , wherein said means comprises a ratchet member configured to allow said second end to move predominantly in a first direction with respect to said first end, and to resist movement in a second, opposite direction. 
     
     
         19 . The adjustable annuloplasty ring of  claim 1 , wherein said activation energy comprises electromagnetic energy. 
     
     
         20 . The adjustable annuloplasty ring of  claim 1 , wherein said activation energy comprises acoustic energy. 
     
     
         21 . The adjustable annuloplasty ring of  claim 1 , wherein said activation energy comprises catheter-based energy. 
     
     
         22 . The adjustable annuloplasty ring of  claim 21 , wherein said catheter-based energy comprises movement of a wire inserted though a catheter, said wire configured to move said second end with respect to said first end. 
     
     
         23 . The method of  claim 16 , further comprising moving an elongate member through a catheter, said elongate member configured to move said second end with respect to said first end. 
     
     
         24 . An adjustable annuloplasty ring, comprising:
 an arcuate member configured to be attached to or near a cardiac valve annulus, said arcuate member comprising:
 a first end; 
 a second end configured to engage said first end of said arcuate member such that said arcuate member substantially forms a shape of a ring;
 wherein said arcuate member is configured to change, after implantation in a patient's body, from a first shape to a second, asymmetric shape in response to an activation energy; 
 wherein said activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy; and 
 
   wherein said activation energy is a first activation energy, and the arcuate member further comprising:
 a first section, located between said second end and said first end, said first section comprising a first shape memory material and being configured to change said arcuate member, in response to said first activation energy, after implantation in said patient's body, from said first shape having a first circumference to said second, asymmetric shape having a second circumference, by movement of said second end with respect to said first end; and 
 a second section, located between said second end and said first end and separated from said first section by a boundary, comprising a second shape memory material and being configured to change said arcuate member, in response to a second activation energy, after implantation in said patient's body, from said second circumference to a third circumference, by movement of said second end with respect to said first end; 
 wherein said second activation energy is selected from the group consisting of electromagnetic energy, acoustic energy, and catheter-based energy; and 
 wherein said change from said first shape to said second shape comprises movement of said second end with respect to said first end to change a circumference of said ring. 
   
     
     
         25 . The adjustable annuloplasty ring of  claim 24 , wherein said first shape memory material and said second shape memory material are the same material. 
     
     
         26 . The adjustable annuloplasty ring of  claim 24 , wherein said first shape memory material and said second shape memory material comprise different materials. 
     
     
         27 . The adjustable annuloplasty ring of  claim 24 , wherein said arcuate member comprises a tubular member. 
     
     
         28 . The adjustable annuloplasty ring of  claim 24 , wherein said first shape and said third shape are substantially similar. 
     
     
         29 . The adjustable annuloplasty ring of  claim 24 , wherein said first circumference is greater than said second circumference. 
     
     
         30 . The adjustable annuloplasty ring of  claim 24 , wherein said first circumference is less than said second circumference. 
     
     
         31 . The adjustable annuloplasty ring of  claim 24 , wherein said first circumference is greater than said third circumference. 
     
     
         32 . The adjustable annuloplasty ring of  claim 24 , wherein said first circumference is less than said third circumference. 
     
     
         33 . The adjustable annuloplasty ring of  claim 24 , wherein said second circumference is greater than said third circumference. 
     
     
         34 . The adjustable annuloplasty ring of  claim 24 , wherein said second circumference is less than said third circumference. 
     
     
         35 . The adjustable annuloplasty ring of  claim 24 , wherein said first circumference is not substantially different than said third circumference. 
     
     
         36 . The adjustable annuloplasty ring of  claim 24 , wherein said first activation energy is different in magnitude than said second activation energy. 
     
     
         37 . The adjustable annuloplasty ring of  claim 24 , wherein said first activation energy is less than said second activation energy. 
     
     
         38 . The adjustable annuloplasty ring of  claim 24 , wherein said first activation energy is greater than said second activation energy. 
     
     
         39 . The adjustable annuloplasty ring of  claim 24 , wherein said first shape memory material is configured to receive said first activation energy independently of said second shape memory material receiving said second activation energy. 
     
     
         40 . The adjustable annuloplasty ring of  claim 24 , wherein at least one of said first activation energy and said second activation energy produces a temperature in said first shape memory material and said second shape memory material, respectively, in a range between approximately 39 degrees Celsius and approximately 48 degrees Celsius. 
     
     
         41 . The adjustable annuloplasty ring of  claim 24 , wherein at least one of said first activation energy and said second activation energy produces a temperature in said first shape memory material and said second shape memory material, respectively, in a range between approximately 50 degrees Celsius and approximately 60 degrees Celsius. 
     
     
         42 . The adjustable annuloplasty ring of  claim 24 , wherein said first activation energy produces a first temperature in the first shape memory material and said second activation energy produces a second temperature in the second shape memory material, wherein said first temperature is different from said second temperature. 
     
     
         43 . The adjustable annuloplasty ring of  claim 24 , further comprising an energy conducting material disposed in or on said arcuate member, said energy conducting material facilitating transfer of heat to at least one of said first shape memory material and said second shape memory material. 
     
     
         44 . The adjustable annuloplasty ring of  claim 24 , wherein said arcuate member further comprises a ratchet member configured to allow said second end to move predominantly in a first direction with respect to said first end, and to resist movement in a second, opposite direction. 
     
     
         45 . The adjustable annuloplasty ring of  claim 24 , wherein said first activation energy is different in type than said second activation energy.