Delivery of cardiac constraint jacket

Abstract

A cardiac constraint jacket is formed of flexible material defining a volume between an open upper end and a lower end. The jacket is dimensioned for an apex of a patient's heart to be inserted into the volume through the open upper end and for the jacket to be slipped over the heart. A delivery device is used to place the jacket on the heart. The delivery device includes a plurality of attachment locations. Each of the attachment locations is releasably secured to separate positions surrounding a periphery of the open upper end of the jacket. The delivery device also includes a control arrangement which is selectively movable between an open position and a closed position. The control arrangement is connected to the attachment locations such that the attachment locations are in a compact array urging the open upper end of the jacket into a collapsed configuration when the control member is in the closed position. When the control arrangement is in the open position, the attachment locations are in an open array. The attachment locations urge the open upper end of the jacket into an open configuration sufficient for the heart to be inserted into the jacket volume through the open upper end and for the jacket to be slipped over said heart.

1 . An apparatus for delivering a cardiac harness, comprising:
 a support member, said cardiac harness being preloaded on said support member and attached to said support member by a line, said line comprised of a series of interconnected loops which form a releasable stitch.   
     
     
         2 . The apparatus of  claim 1 , wherein an end one of said interconnected loops of said stitch is retained by an anchoring member which prevents unravelment of said series of loops, and wherein the release of said loop from said anchoring member allows unravelment of said series of interconnected loops. 
     
     
         3 . An apparatus for delivering a cardiac harness, comprising:
 an elongate body having a proximal portion and a distal portion;   a plurality of push rods longitudinally movable with respect to said body, said cardiac harness releasably connected to each of the push rods such that movement of said push rods in a distal direction advances said harness onto said heart, said harness being releasable from the push rods such that the push rods may be withdrawn from said harness proximally along a withdrawal path while said harness remains on said heart, said distal portion of said push rods having an inward facing surface which presses against said harness during said withdrawal, said inward facing surface configured such that non-frictional force components parallel to said path and attributable to forces exerted by said inner surface on said harness are directed distally, without substantial non-frictional force components directed proximally.   
     
     
         4 . The apparatus of  claim 3 , wherein the distal portions of the push rods splay outwardly during advancement. 
     
     
         5 . The apparatus of  claim 3 , wherein the distal portions of the push rods are canted outwardly. 
     
     
         6 . A method of delivering a cardiac harness, comprising:
 providing a cardiac harness that is preloaded on a support member, said harness attached to said support member by a line forming a releasable stitch;   positioning said harness so that said harness surrounds a portion of a heart of a patient;   disconnecting said harness from said support member by releasing said releasable stitch without cutting said line.   
     
     
         7 . The method of  claim 6 , wherein said line comprises a series of interconnected loops, including a retention loop, said releasing comprising releasing said retention loop and unraveling said series of loops. 
     
     
         8 . The method of  claim 6 , wherein said positioning comprises positioning said harness to apply a compressive force to said portion of the heart. 
     
     
         9 . The method of  claim 6 , wherein said positioning comprises orienting said harness in a predetermined orientation with respect to said heart. 
     
     
         10 . The method of  claim 6 , wherein said positioning comprises forming an incision in the patient and inserting the harness through the incision in a compacted configuration. 
     
     
         11 . The method of  claim 10 , comprising expanding said harness into an expanded configuration after inserting said harness through said incision. 
     
     
         12 . The method of  claim 11 , comprising moving a releasing member outside the patient's body to release said stitch. 
     
     
         13 . The method of  claim 12 , comprising using said releasing member to pull the line through the incision and out of the patients body.