Compliant cardiac support device

Abstract

A jacket of biological compatible material has an internal volume dimensioned for an apex of the heart to be inserted into the volume and for the jacket to be slipped over the heart. The jacket has a longitudinal dimension between upper and lower ends sufficient for the jacket to surround a lower portion of the heart with the jacket surrounding a valvular annulus of the heart and further surrounding the lower portion to cover at least the ventricular lower extremities of the heart. The jacket is adapted to be secured to the heart with the jacket surrounding at least the valvular annulus and the ventricular lower extremities. The jacket is adjustable on the heart to snugly conform to an external geometry of the heart and assume a maximum adjusted volume for the jacket to constrain circumferential expansion of the heart beyond the maximum adjusted volume during diastole and to permit unimpeded contraction of the heart during systole.

1 . A device for treating a disease of a heart, the device comprising: a jacket of flexible material formed with a base end and an apex end and having an interior, said base end sized to be placed over an apex of said heart and moved toward a base of said heart for at least a portion of said heart to be received within said interior; said material compliant for said jacket to conform to an external geometry of said portion of said heart; said material adapted for said jacket to exert a maximum pressure on said heart less than 40 mm Hg. 
     
     
         2 . A device according to  claim 1  wherein said maximum pressure is a pressure on said heart at end diastole. 
     
     
         3 . A device according to  claim 1  wherein said maximum pressure is less than 20 mm Hg. 
     
     
         4 . A device according to  claim 3  wherein said maximum pressure is a pressure on said heart at end diastole. 
     
     
         5 . A device according to  claim 1  wherein said material is adapted for said jacket to exert a range of pressure on said heart of 2 mm Hg to 40 mm Hg. 
     
     
         6 . A device according to  claim 1  wherein said jacket is sized for said interior of said jacket to be smaller than an external geometry of said heart prior to application of said device. 
     
     
         7 . A device according to  claim 1  wherein said material has a compliance for said jacket to conform with an external shape of said portion of said heart without application of forces on said heart which would otherwise impair cardiac function. 
     
     
         8 . A device according to  claim 1  wherein said jacket is open at said apex end. 
     
     
         9 . A device according to  claim 1  wherein said jacket is closed at said apex end. 
     
     
         10 . A device according to  claim 1  wherein said material constructed of a plurality of flexible elongated members interconnected to form a jacket material. 
     
     
         11 . A device according to  claim 10  wherein said elongated members are fibers formed of multiple filaments. 
     
     
         12 . A device according to  claim 10  wherein said elongated members have a plurality of bends which straighten for said jacket to expand. 
     
     
         13 . A device according to  claim 10  wherein said elongated members are metal. 
     
     
         14 . A device according to  claim 13  wherein said metal is stainless steel. 
     
     
         15 . A device according to  claim 13  wherein said metal is titanium. 
     
     
         16 . A device according to  claim 10  wherein said elongated members are coated. 
     
     
         17 . The device according to  claim 1  wherein said jacket is adapted to constrain said heart from expanding beyond a maximum volume. 
     
     
         18 . The device according to  claim 1  wherein said jacket is collapsible for placement through a minimally invasive surgical instrument. 
     
     
         19 . A method for treating a disease of a heart, the method comprising: a. selecting a device including: i. a jacket of flexible material formed with a base end and an apex end and having an interior, said base end sized to be placed over an apex of said heart and moved toward a base of said heart for at least a portion of said heart to be received within said interior; ii. said material compliant for said jacket to conform to an external geometry of said portion of said heart; iii. said material adapted for said jacket to exert a maximum pressure on said heart less than 40 mm Hg. b. placing said jacket on said heart with said material surrounding at least the ventricles of said heart with said jacket exerting no more than said maximum pressure. 
     
     
         20 . A method according to  claim 19  wherein said step of placing a jacket includes covering a lower end of said heart. 
     
     
         21 . A method according to  claim 19  wherein said step of placing said jacket includes leaving a lower end of said heart exposed. 
     
     
         22 . A method according to  claim 19  wherein said maximum pressure is a pressure on said heart at end diastole. 
     
     
         23 . A method according to  claim 19  wherein said maximum pressure is less than 20 mm Hg. 
     
     
         24 . A method according to  claim 23  wherein said maximum pressure is a pressure on said heart at end diastole. 
     
     
         25 . A method according to  claim 19  wherein said placing includes placing said jacket on said heart for said jacket to exert a range of pressure on said heart of 2 mm Hg to 40 mm Hg. 
     
     
         26 . A method according to  claim 19  including sizing said jacket for said interior of said jacket to be smaller than an external geometry of said heart prior to application of said device. 
     
     
         27 . A method according to  claim 19  wherein said material has a compliance for said jacket to conform with an external shape of said portion of said heart without application of forces on said heart which would otherwise impair cardiac function. 
     
     
         28 . A method according to  claim 19  wherein said material constructed of a plurality of flexible elongated members interconnected to form a jacket material. 
     
     
         29 . A method according to  claim 28  wherein said elongated members are fibers formed of multiple filaments. 
     
     
         30 . A method according to  claim 28  wherein said elongated members have a plurality of bends which straighten for said jacket to expand. 
     
     
         31 . A method according to  claim 28  wherein said elongated members are metal. 
     
     
         32 . A method according to  claim 31  wherein said metal is stainless steel. 
     
     
         33 . A method according to  claim 31  wherein said metal is titanium. 
     
     
         34 . A method according to  claim 28  wherein said elongated members are coated. 
     
     
         35 . The method according to  claim 19  wherein said placing includes placing said jacket on said heart for said jacket to constrain said heart from expanding beyond a maximum volume. 
     
     
         36 . A method according to  claim 19  wherein said jacket is delivered minimally invasively to said heart by collapsing said jacket into a hollow minimally invasive surgical tool.