US 8,740,918 B2Grant
Surgical device for connecting soft tissue
Issue Date:2014-06-03
•7 Claims
•5 Drawing Sheets
Abstract
Provided is a surgical instrument including an external tube (2) and two elongated members (4) positioned in the tube (2), each of which includes a distal end (10a) for capturing one of the two tissue zones (M1, M2) to be attached. The instrument (1) may further include a catching member (22, 25) for each tissue (M1, M2) to be attached; a rod (15, 16) linked to each catching member (22, 25) enabling tension to move axially, the rod (15, 16) being separable from said catching member (22, 25) when a tension is exerted on it beyond a certain threshold; and a member (17a) forming a stop for locking axially each catching member (22, 25) during the tensioning.
Metadata
Assignee
- Evalve, Inc.
Inventor
- Jacques Seguin
Application Information
Application Number:US 13/156,760
Filing Date:2011-06-09
Priority Date:1997-09-12
Art Unit:3731
Classifications
IPC:
A61B17/00
Patent Drawings (5 sheets)
Description
Cross-References to Related Applications
[0001] The present application is a divisional of U.S. patent application Ser. No. 12/699,768 now U.S. Pat. No. 7,981,123, filed Feb. 3, 2010, which is a continuation of U.S. patent application Ser. No. 11/354,612 now U.S. Pat. No. 7,682,369, filed on Feb. 14, 2006, which is a continuation U.S. patent application Ser. No. 10/877,279 now U.S. Pat. No. 7,288,097, filed on Jun. 24, 2004, which is a divisional of U.S. patent application Ser. No. 10/202,599 now U.S. Pat. No. 6,770,083, filed Jul. 24, 2002, which is a divisional of U.S. patent application Ser. No. 09/523,018 now U.S. Pat. No. 6,461,366, filed Mar. 10, 2000, which is a continuation of PCT/FR98/01960, which designated the United States, filed Sep. 12, 1997, the full disclosure of which is incorporated herein by reference.
Background of the Invention
[0002] This invention provides a surgical device allowing the percutaneous connection of two soft tissue areas that are ordinarily separate. This device is particularly intended for reconstruction of heart valves, especially the mitral valve, and for the treatment of any malformation of a heart septum.
[0003] In a condition known as mitral insufficiency, the mitral valve does not completely shut, and does not prevent the back-flow of blood to the left atrium from the left ventricle. Surgical repair is then necessary. In a current procedure, a sternotomy is performed. The patient is then placed under extra-corporal blood circulation while the heart is stopped, and the heart chambers are opened to gain access to the mitral valve, usually through the left atrium. Once the mitral valve is accessed, repair procedures include annuloplasty and, more recently, suturing of the free edge of the anterior leaflet to the free edge of the back leaflet where the mitral insufficiency occurs.
[0004] These procedures are complicated and require general anesthesia, sternotomy and extra-corporal blood circulation. They also require high doses of anti-coagulant therapy adding to the operative risk of a myocardial infarction and hemorrhage.
Summary of the Invention
[0005] The methods of the present invention are performed percutaneously, diminishing considerably these risks. A surgical device allows the connection of two zones of soft tissue that are usually separate. In a particular embodiment, a connection is formed between a free edge area of an anterior mitral leaflet and a free edge area of a back mitral leaflet. Suitable surgical devices for performing tissue connection are described for example in EP 558 031 and WO 94/18893, and may comprise:
[0006] (a) a tube which may be inserted percutaneously until its distal extremity reaches the area around the tissues to be connected; and
[0007] (b) two elongated elements inside that tube, each of which comprises a distal extremity having a device that grasps one of the two tissues to be connected;
[0008] (c) wherein the distal extremities of these elongated elements may be opened and closed in order to permit introduction into the desired area, allow the procedure.
[0009] Particular devices according to the present invention may further comprise:
[0010] (a) a grasping element, optionally having two parts for capturing each of the tissues to be connected, wherein the grasping or hooking element effects the connection of the two zones of tissue when brought close thereto by shifting of the portions of distal extremities to a position where they meet;
[0011] (b) a rod connected to each of the grasping or hooking elements and operated from the proximal end of the tube in order to axially shift the elongated element, wherein the rod can be separated from the grasping or hooking element upon pulling beyond a given threshold; and
[0012] (c) a wedge inside the tube, allowing the axial immobilization of each grasping or hooking element while pulling on them.
[0013] The rod positions the insertion of the hooking element up to the level of the tissue edges to be connected. The rod also engages the hooking element against the wedge in order to open the two hooking parts.
[0014] According to the present invention, the device may be used to remotely grasp through a percutaneous passage, to draw together, and to connect the two zones of tissue by a simple external manipulation.
[0015] Preferably, the tube, the elongated elements, and the rod are flexible enough to be inserted percutaneously and through a patient's vasculature for the treatment of the leaflets of a cardiac valve, in particular the mitral valve. Each of the elongated elements is made out of an elastically flexible material, and one of these elongated elements diverges from the longitudinal axis of the other. The two elongated elements can move axially in relation to the tube between (a) a retracted position within the tube where the ends of the elongated elements are flexibly bent and closed together, and (b) a position where the ends of the elongated elements spring open and diverge from each other in a way that permits those ends to capture the soft tissues in order to grasp them.
[0016] The elongated elements may be deployed to allow their distal extremities to grasp the tissue areas or may be retracted in order to make the insertion, shifting or removal of the apparatus easier. Each elongated element may comprise a rod made of elastic material, with a curved distal extremity and/or a harpoon shape, and a sheath able to slide axially in a forward position to cover the distal extremity and slide back to uncover it.
[0017] According to a variation, each elongated element can be composed of a tube linked to a system that contracts its internal volume in order to grasp the corresponding tissue area, and expands to release the tissue with no lesion. In this case, the wide-mouthed shape of the elongated element's distal extremity will insure a large enough grasping surface.
[0018] Preferably, the device includes two hooking elements. One is operated on the distal side of the tissues, and the other, to be operated on the proximal side of the tissues, is situated between the first hooking element and the wedge element. This way the two hooking elements can be operated on both sides of the tissues and can be pressed together for a perfect attachment of those tissues.
Brief Description of the Drawings
[0019] For greater clarity, the invention is described again in reference to the enclosed Figures representing two unrestricted examples of the invention in its optimal capacity.
[0020] FIG. 1 shows a longitudinal section of a heart with a mitral valve that does not shut properly and has to be treated with this device.
[0021] FIG. 2 shows the mitral valve before treatment.
[0022] FIG. 3 shows a mitral valve similar to FIG. 2 after treatment by suture according to the usual procedure.
[0023] FIG. 4 is a view similar to that of FIG. 1 , with the device of the present invention inserted into a heart.
[0024] FIG. 5 is an enlarged view of a longitudinal section of the distal extremity of the device.
[0025] FIG. 6 shows a view of this distal extremity according to the line VI-VI of FIG. 5 .
[0026] FIG. 7 and FIG. 8 are similar views to FIG. 5 at different stages of the procedure.
[0027] FIG. 9 is a similar view to FIG. 2 of the mitral valve after treatment with the device.
[0028] FIG. 10 is a view of this valve according to line X-X of FIG. 9 .
[0029] FIG. 11 illustrates an alternative embodiment of the device of the present invention.
Description of the Specific Embodiments
[0030] FIG. 1 shows a heart C with a mitral valve M having poorly opposed leaflets (M1, M2). Thus, the valve M does not shut tightly and no longer performs its back-flow function between the left atrium O and the left ventricle V. According to conventional procedures, after sternotomy, the patient is placed under extra-corporal blood circulation. The heart is stopped and the heart chambers are opened to directly reach to the valve M and stitch together the free opposite edges of both leaflets (M1, M2) as shown on FIGS. 2 and 3 . Connecting leaflets M1 to M2 restores a good attachment between them and restores the imperviousness of valve M.
[0031] FIGS. 4 to 5 show a device (1) according to the present invention which enables the percutaneous connection of leaflet M1 to leaflet M2. This device (1) comprises an external tube (2), guidewire (3), two elongated elements (4), and a clipping system (5). The apparatus is sufficiently flexible to be percutaneously inserted into the heart C, through the patient's vascular, e.g., the Vena Cava Ve and the intra-atrial septum S. Guidewire (3) is inserted through valve M and so the distal extremity of external tube (2) is located in the left atrium O, with its distal opening facing mitral valve M.
[0032] Each of the elongated elements (4) has a distal extremity (4a) that is normally curved to diverge outwardly. A rod (10) is made out of a relatively rigid but still elastic material, more particularly in metal, with a sheath (11) of synthetic material. The distal extremity (10a) of the rod (10) is sharp and more or less harpoon-shaped. The sheath (11) fits on the rod (10) and can slide axially to a forward position (as shown on left side of FIG. 5 ) in order to cover the distal extremity of the rod, and can slide back (as shown on the right side of FIG. 5 ) in order to uncover that same distal extremity (10a). The elongated elements (4) extend from the end of the tube (2). Because of this, they can be shifted axially in relation to the tube (2) between a retracted position where the extremities (10a) close together (FIGS. 7 and 8 ) and an extended position where these same extremities (10a) diverge from each other (FIG. 5 ). The clipping system (5) comprises three concentric tubular rods (15, 16, 17) that can be slidably introduced over the guidewire (3). Each rod can also slide axially in relation to the others. The internal rod (15) is linked to a disk (20) through a frangible area (21). The rod and disk (15 and 20) are made of molded synthetic material. The disk (20) is axially pierced in order to let the guidewire (3) pass through, and carries a clip (22). Side prongs (22a) of that clip extend from the proximal face (20a) of the disk (20). A central portion (22b) of the clip (22) having a central ring for receiving the guidewire (3) is embedded into the material of the disk (24).
[0033] The intermediate rod (16) is also connected by a frangible area (23) to a disk (24) with two clips (25). Side prongs (25a) of these clips extend from the distal face (24a) of this disk (24), and central portions of the prongs are embedded into the material of the disk (24). On each side, the disk (24) has two diametrically opposed notches (26, FIG. 6 ) to allow the passage of the elongated elements (4). The external rod (17) has an expanded distal extremity (17a) which engages the proximal face of the disk (24). Each of these rods (15, 16, 17) can be extended beyond the proximal extremity of tube (2) so they can be shifted by the operator.
[0034] A handle or other structure for manipulating the rods (15, 16, 17) will usually be provided at a proximal end of the device. The handle will permit deployment rod (15) while rod (17) is held in a desired position in relation to tube (2), and then deployment rod (16), while rod (17) is also held in the desired position in relation to tube (2).
[0035] In practice, under X-ray or echography control, the guidewire (3) is first inserted through Vena Cava Ve, the intra-atrial septum S, and mitral valve M. Then tube (2) and its internal parts are inserted into the Vena Cava Ve and through the septum S until the distal extremity of tube (2) is directed at mitral valve M (FIG. 4 ). At this stage, disk (20) should be held at the opening of tube 2 (FIG. 5 ), while elongate elements (4) are retracted so that their distal extremities are retracted into slots (26).
[0036] When the distal extremity of tube (2) is in the proper position, rod (15) is shifted to advance disk (20) beyond leaflets M1 and M2 and into the left ventricle V. Elongate elements (4) are then advanced to their extended positions, as shown in FIG. 5 . As the elongate elements (4) are advanced, their distal extremities diverge. After the elements (4) are advanced, distal extremities (10a) of rods (10) are positioned close to leaflets (M1, M2). The sheaths (11) of elements (4) are then retracted in relation to the rods (10) in order to uncover the extremities (10a), each of which can then pierce and capture the adjacent leaflet M1 or M2. Tube (2) is then advanced over the elongate elements (4), drawing the distal extremities (4a) closer, as shown on FIG. 7 . This action draws the free edges of leaflets M1 and M2 together.
[0037] Rod (17) is advanced distally in relation to tube (2), and rod (15) is pulled proximally in relation to tube (2) in order to insert the prongs (22a and 25a) of clips (22 and 25) into the leaflets M1 and M2. The tension on rod (15) forces the prongs (22a and 25a) against the opposed walls (20a, 24a) of the disks (20, 24) and breaks frangible area (21). This break gives the prongs of the clips enough freedom of movement to ensure a good connection between leaflets M1 and M2. The sheaths (11) are then advanced distally in relation to the rods (10) to engage leaflets (M1, M2). This facilitates the extremities (10a) of the rods from the leaflets (M1, M2). Rod (16) is then pulled while holding rod (17) in position to break frangible area (25). Leaflets (M1, M2) have thus been clipped to each other by their free edges, as shown in FIGS. 9 and 10 .
[0038] FIG. 11 shows a variation of the apparatus where rods (10) and sheaths (11) have been replaced by two catheters (40) having trumpeted distal extremities (40a). These catheters (40) project beyond the proximal end of tube (2) and may be attached to syringes that permit the creation of negative pressure. The grasping or releasing of leaflets (M1, M2) is then achieved by controlling the internal pressure within catheters (40). The trumpeted ends (40a) ensure a sufficient grip on leaflets (M1, M2). Those ends (40a) are preferably sufficiently flexible enough to bend slightly when they are drawn between the wall of tube (2) and two lateral slots (26) of disk (20). The other parts of this alternative device are the same as already described and bear the same record numbers.
[0039] It goes without saying that the invention is not limited to the above example and is opened to different variations. For instance, the unstressed shape of the extremities (10a) that hook the tissues could be of a curved J which is straightened when drawn into the sheaths (11). The elongated parts (4) and the connecting system could also be placed in separate tubes. The device (1) could be inserted arterially as well as veinously.
Claims
What is claimed is:
1. A method for percutaneously attaching valve leaflets, said method comprising:
percutaneously introducing a device through a patient's vasculature into a heart chamber;
capturing a first valve leaflet by applying a vacuum to the device;
capturing a second valve leaflet by applying a vacuum to the device, wherein the second valve leaflet is captured separately from the first valve leaflet;
drawing the first and second captured leaflets together; and
attaching the first valve leaflet to the second valve leaflet.
2. The method of claim 1, wherein the valve leaflets comprise mitral valve leaflets.
3. The method of claim 1, wherein percutaneously introducing the device comprises advancing the device across the intra-atrial septum into the left atrium.
4. The method of claim 1, wherein capturing the first valve leaflet or the second valve leaflet comprises advancing an elongate member from the device and securing the first valve leaflet or the second valve leaflet thereto.
5. The method of claim 1, wherein drawing the first and second captured leaflets together comprises drawing a first elongate member and a second elongate member together, wherein the first elongate member and the second elongate member extend from the device.
6. The method of claim 5, wherein drawing the first elongate member and the second elongate member together comprises advancing a sheath over the first and the second elongate members.
7. A system for repairing a cardiac valve, said system comprising:
a tube suitable for introduction through a patient's vasculature and into a chamber of a heart;
a clipping system comprising a first element adapted to be brought up beneath a pair of valve leaflets from the ventricular side and a second element adapted to be brought down over the pair of valve leaflets from the atrial side, wherein the first element engages the ventricular side of both leaflets and the second element engages the atrial side of both the leaflets to capture both leaflets therebetween and wherein the first and second elements may be left to attach the free edges of the leaflets together; and
a pair of elongate elements each having trumpeted distal extremities, the pair of elongate elements extensible from a distal end of the tube, wherein each trumpeted distal extremity is adapted to grasp a valve leaflet when vacuum is applied thereto, wherein attaching comprises clipping the leaflets together.
Patent Citations (583)
| Patent | Date | Inventor | Cited By |
|---|---|---|---|
| US2108206(A) | 1938-02-01 | Meeker | Applicant |
| US3296668(A) | 1967-01-01 | Aiken | Applicant |
| US3378010(A) | 1968-04-01 | Codling | Applicant |
| US3557780(A) | 1971-01-01 | Sato | Applicant |
| US3671979(A) | 1972-06-01 | Moulopouslos | Applicant |
| US3874388(A) | 1975-04-01 | King et al. | Applicant |
| US4007743(A) | 1977-02-01 | Blake | Applicant |
| US4056854(A) | 1977-11-01 | Boretos et al. | Applicant |
| US4064881(A) | 1977-12-01 | Meredith | Applicant |
| US4112951(A) | 1978-09-01 | Hulka et al. | Applicant |
| US4235238(A) | 1980-11-01 | Ogiu et al. | Applicant |
| US4297749(A) | 1981-11-01 | Davis et al. | Applicant |
| US4425908(A) | 1984-01-01 | Simon | Applicant |
| US4458682(A) | 1984-07-01 | Cerwin | Applicant |
| US4484579(A) | 1984-11-01 | Meno et al. | Applicant |
| US4487205(A) | 1984-12-01 | Di Giovanni et al. | Applicant |
| US4498476(A) | 1985-02-01 | Cerwin et al. | Applicant |
| US4510934(A) | 1985-04-01 | Batra | Applicant |
| US4531522(A) | 1985-07-01 | Bedi et al. | Applicant |
| US4578061(A) | 1986-03-01 | Lemelson | Applicant |
| US4641366(A) | 1987-02-01 | Yokoyama et al. | Applicant |
| US4686965(A) | 1987-08-01 | Bonnet et al. | Applicant |
| US4777951(A) | 1988-10-01 | Cribier et al. | Applicant |
| US4809695(A) | 1989-03-01 | Gwathmey et al. | Applicant |
| US4917089(A) | 1990-04-01 | Sideris | Applicant |
| US4944295(A) | 1990-07-01 | Gwathmey et al. | Applicant |
| US4969890(A) | 1990-11-01 | Sugita et al. | Applicant |
| US4994077(A) | 1991-02-01 | Dobben | Applicant |
| US5015249(A) | 1991-05-01 | Nakao et al. | Applicant |
| US5019096(A) | 1991-05-01 | Fox, Jr. et al. | Applicant |
| US5042707(A) | 1991-08-01 | Taheri | Applicant |
| US5047041(A) | 1991-09-01 | Samuels | Applicant |
| US5049153(A) | 1991-09-01 | Nakao et al. | Applicant |
| US5061277(A) | 1991-10-01 | Carpentier et al. | Applicant |
| US5069679(A) | 1991-12-01 | Taheri | Applicant |
| US5108368(A) | 1992-04-01 | Hammerslag et al. | Applicant |
| US5125758(A) | 1992-06-01 | DeWan | Applicant |
| US5171252(A) | 1992-12-01 | Friedland | Applicant |
| US5171259(A) | 1992-12-01 | Inoue | Applicant |
| US5190554(A) | 1993-03-01 | Coddington et al. | Applicant |
| US5195968(A) | 1993-03-01 | Lundquist et al. | Applicant |
| US5209756(A) | 1993-05-01 | Seedhom et al. | Applicant |
| US5226429(A) | 1993-07-01 | Kuzmak | Applicant |
| US5226911(A) | 1993-07-01 | Chee et al. | Applicant |
| US5234437(A) | 1993-08-01 | Sepetka | Applicant |
| US5242456(A) | 1993-09-01 | Nash et al. | Applicant |
| US5250071(A) | 1993-10-01 | Palermo | Applicant |
| US5251611(A) | 1993-10-01 | Zehel et al. | Applicant |
| US5254130(A) | 1993-10-01 | Poncet et al. | Applicant |
| US5261916(A) | 1993-11-01 | Engelson | Applicant |
| US5271381(A) | 1993-12-01 | Ailinger et al. | Applicant |
| US5275578(A) | 1994-01-01 | Adams | Applicant |
| US5282845(A) | 1994-02-01 | Bush et al. | Applicant |
| US5304131(A) | 1994-04-01 | Paskar | Applicant |
| US5306283(A) | 1994-04-01 | Conners | Applicant |
| US5306286(A) | 1994-04-01 | Stack et al. | Applicant |
| US5312415(A) | 1994-05-01 | Palermo | Applicant |
| US5314424(A) | 1994-05-01 | Nicholas | Applicant |
| US5318525(A) | 1994-06-01 | West et al. | Applicant |
| US5320632(A) | 1994-06-01 | Heidmueller | Applicant |
| US5325845(A) | 1994-07-01 | Adair | Applicant |
| US5330442(A) | 1994-07-01 | Green et al. | Applicant |
| US5332402(A) | 1994-07-01 | Teitelbaum | Applicant |
| US5350397(A) | 1994-09-01 | Palermo et al. | Applicant |
| US5350399(A) | 1994-09-01 | Erlebacher et al. | Applicant |
| US5359994(A) | 1994-11-01 | Kreuter et al. | Applicant |
| US5368564(A) | 1994-11-01 | Savage | Applicant |
| US5368601(A) | 1994-11-01 | Sauer et al. | Applicant |
| US5383886(A) | 1995-01-01 | Kensey et al. | Applicant |
| US5403312(A) | 1995-04-01 | Yates et al. | Applicant |
| US5403326(A) | 1995-04-01 | Harrison et al. | Applicant |
| US5411552(A) | 1995-05-01 | Andersen et al. | Applicant |
| US5417699(A) | 1995-05-01 | Klein et al. | Applicant |
| US5417700(A) | 1995-05-01 | Egan | Applicant |
| US5423857(A) | 1995-06-01 | Rosenman et al. | Applicant |
| US5423858(A) | 1995-06-01 | Bolanos et al. | Applicant |
| US5423882(A) | 1995-06-01 | Jackman et al. | Applicant |
| US5431666(A) | 1995-07-01 | Sauer et al. | Applicant |
| US5437551(A) | 1995-08-01 | Chalifoux | Applicant |
| US5437681(A) | 1995-08-01 | Meade et al. | Applicant |
| US5447966(A) | 1995-09-01 | Hermes et al. | Applicant |
| US5450860(A) | 1995-09-01 | O'Connor | Applicant |
| US5456400(A) | 1995-10-01 | Shichman et al. | Applicant |
| US5456684(A) | 1995-10-01 | Schmidt et al. | Applicant |
| US5462527(A) | 1995-10-01 | Stevens-Wright et al. | Applicant |
| US5472044(A) | 1995-12-01 | Hall et al. | Applicant |
| US5476470(A) | 1995-12-01 | Fitzgibbons, Jr. | Applicant |
| US5477856(A) | 1995-12-01 | Lundquist | Applicant |
| US5478309(A) | 1995-12-01 | Sweezer et al. | Applicant |
| US5478353(A) | 1995-12-01 | Yoon | Applicant |
| US5487746(A) | 1996-01-01 | Yu et al. | Applicant |
| US5507725(A) | 1996-04-01 | Savage et al. | Applicant |
| US5507757(A) | 1996-04-01 | Sauer et al. | Applicant |
| US5520701(A) | 1996-05-01 | Lerch | Applicant |
| US5522873(A) | 1996-06-01 | Jackman et al. | Applicant |
| US5527313(A) | 1996-06-01 | Scott et al. | Applicant |
| US5527321(A) | 1996-06-01 | Hinchliffe | Applicant |
| US5527322(A) | 1996-06-01 | Klein et al. | Applicant |
| US5536251(A) | 1996-07-01 | Evard et al. | Applicant |
| US5540705(A) | 1996-07-01 | Meade et al. | Applicant |
| US5542949(A) | 1996-08-01 | Yoon | Applicant |
| US5554185(A) | 1996-09-01 | Block et al. | Applicant |
| US5569274(A) | 1996-10-01 | Rapacki et al. | Applicant |
| US5571085(A) | 1996-11-01 | Accisano, III | Applicant |
| US5571137(A) | 1996-11-01 | Marlow et al. | Applicant |
| US5571215(A) | 1996-11-01 | Sterman et al. | Applicant |
| US5575802(A) | 1996-11-01 | McQuilkin et al. | Applicant |
| US5582611(A) | 1996-12-01 | Tsuruta et al. | Applicant |
| US5593424(A) | 1997-01-01 | Northrup, III | Applicant |
| US5593435(A) | 1997-01-01 | Carpentier et al. | Applicant |
| US5609598(A) | 1997-03-01 | Laufer et al. | Applicant |
| US5618306(A) | 1997-04-01 | Roth et al. | Applicant |
| US5620452(A) | 1997-04-01 | Yoon | Applicant |
| US5626588(A) | 1997-05-01 | Sauer et al. | Applicant |
| US5634932(A) | 1997-06-01 | Schmidt | Applicant |
| US5636634(A) | 1997-06-01 | Kordis et al. | Applicant |
| US5639277(A) | 1997-06-01 | Mariant et al. | Applicant |
| US5640955(A) | 1997-06-01 | Ockuly et al. | Applicant |
| US5649937(A) | 1997-07-01 | Bito et al. | Applicant |
| US5662681(A) | 1997-09-01 | Nash et al. | Applicant |
| US5669917(A) | 1997-09-01 | Sauer et al. | Applicant |
| US2097018(A) | 1997-10-01 | Chamberlain | Applicant |
| US5690671(A) | 1997-11-01 | McGurk et al. | Applicant |
| US5695504(A) | 1997-12-01 | Gifford, III et al. | Applicant |
| US5695505(A) | 1997-12-01 | Yoon | Applicant |
| US5702825(A) | 1997-12-01 | Keital et al. | Applicant |
| US5706824(A) | 1998-01-01 | Whittier | Applicant |
| US5709707(A) | 1998-01-01 | Lock et al. | Applicant |
| US5713910(A) | 1998-02-01 | Gordon et al. | Applicant |
| US5713911(A) | 1998-02-01 | Racene et al. | Applicant |
| US5715817(A) | 1998-02-01 | Stevens-Wright et al. | Applicant |
| US5716367(A) | 1998-02-01 | Koike et al. | Applicant |
| US5718725(A) | 1998-02-01 | Sterman et al. | Applicant |
| US5719725(A) | 1998-02-01 | Nakao | Applicant |
| US5722421(A) | 1998-03-01 | Francese et al. | Applicant |
| US5725542(A) | 1998-03-01 | Yoon | Applicant |
| US5725556(A) | 1998-03-01 | Moser et al. | Applicant |
| US5738649(A) | 1998-04-01 | Macoviak | Applicant |
| US5741280(A) | 1998-04-01 | Fleenor | Applicant |
| US5749828(A) | 1998-05-01 | Solomon et al. | Applicant |
| US5769812(A) | 1998-06-01 | Stevens et al. | Applicant |
| US5769863(A) | 1998-06-01 | Garrison | Applicant |
| US5772578(A) | 1998-06-01 | Heimberger et al. | Applicant |
| US5782845(A) | 1998-07-01 | Shewchuk | Applicant |
| US5797927(A) | 1998-08-01 | Yoon | Applicant |
| US5797960(A) | 1998-08-01 | Stevens et al. | Applicant |
| US5810847(A) | 1998-09-01 | Laufer et al. | Applicant |
| US5810849(A) | 1998-09-01 | Kontos | Applicant |
| US5810853(A) | 1998-09-01 | Yoon | Applicant |
| US5810876(A) | 1998-09-01 | Kelleher | Applicant |
| US5814029(A) | 1998-09-01 | Hassett | Applicant |
| US5820592(A) | 1998-10-01 | Hammerslag | Applicant |
| US5820631(A) | 1998-10-01 | Nobles | Applicant |
| US5823955(A) | 1998-10-01 | Kuck et al. | Applicant |
| US5823956(A) | 1998-10-01 | Roth et al. | Applicant |
| US5824065(A) | 1998-10-01 | Gross | Applicant |
| US5827237(A) | 1998-10-01 | Macoviak et al. | Applicant |
| US5829447(A) | 1998-11-01 | Stevens et al. | Applicant |
| US5833671(A) | 1998-11-01 | Macoviak et al. | Applicant |
| US5836955(A) | 1998-11-01 | Buelna et al. | Applicant |
| US5840081(A) | 1998-11-01 | Andersen et al. | Applicant |
| US5843031(A) | 1998-12-01 | Hermann et al. | Applicant |
| US5849019(A) | 1998-12-01 | Yoon | Applicant |
| US5853422(A) | 1998-12-01 | Huebsch et al. | Applicant |
| US5855271(A) | 1999-01-01 | Eubanks et al. | Applicant |
| US5855614(A) | 1999-01-01 | Stevens et al. | Applicant |
| US5860990(A) | 1999-01-01 | Nobles et al. | Applicant |
| US5868733(A) | 1999-02-01 | Ockuly et al. | Applicant |
| US5876399(A) | 1999-03-01 | Chia et al. | Applicant |
| US5879307(A) | 1999-03-01 | Chio et al. | Applicant |
| US5885271(A) | 1999-03-01 | Hamilton et al. | Applicant |
| US5891160(A) | 1999-04-01 | Williamson, IV et al. | Applicant |
| US5916147(A) | 1999-06-01 | Boury | Applicant |
| US5928224(A) | 1999-07-01 | Laufer | Applicant |
| US5944733(A) | 1999-08-01 | Engelson | Applicant |
| US5947363(A) | 1999-09-01 | Bolduc et al. | Applicant |
| US5954732(A) | 1999-09-01 | Hart et al. | Applicant |
| US5957949(A) | 1999-09-01 | Leonhard et al. | Applicant |
| US5972020(A) | 1999-10-01 | Carpentier et al. | Applicant |
| US5972030(A) | 1999-10-01 | Garrison et al. | Applicant |
| US5980455(A) | 1999-11-01 | Daniel et al. | Applicant |
| US5989284(A) | 1999-11-01 | Laufer | Applicant |
| US6015417(A) | 2000-01-01 | Reynolds, Jr. | Applicant |
| US6019722(A) | 2000-02-01 | Spence et al. | Applicant |
| US6022360(A) | 2000-02-01 | Reimels et al. | Applicant |
| US6033378(A) | 2000-03-01 | Lundquist et al. | Applicant |
| US6036699(A) | 2000-03-01 | Andreas et al. | Applicant |
| US6048351(A) | 2000-04-01 | Gordon et al. | Applicant |
| US6056769(A) | 2000-05-01 | Epstein et al. | Applicant |
| US6059757(A) | 2000-05-01 | Macoviak et al. | Applicant |
| US6060628(A) | 2000-05-01 | Aoyama et al. | Applicant |
| US6060629(A) | 2000-05-01 | Pham et al. | Applicant |
| US6063106(A) | 2000-05-01 | Gibson | Applicant |
| US6066146(A) | 2000-05-01 | Carroll et al. | Applicant |
| US6068628(A) | 2000-05-01 | Fanton et al. | Applicant |
| US6068629(A) | 2000-05-01 | Haissaguerre et al. | Applicant |
| US6077214(A) | 2000-06-01 | Mortier et al. | Applicant |
| US6086600(A) | 2000-07-01 | Kortenbach | Applicant |
| US6088889(A) | 2000-07-01 | Luther et al. | Applicant |
| US6099505(A) | 2000-08-01 | Ryan et al. | Applicant |
| US6099553(A) | 2000-08-01 | Hart et al. | Applicant |
| US6110145(A) | 2000-08-01 | Macoviak | Applicant |
| US6117144(A) | 2000-09-01 | Nobles et al. | Applicant |
| US6117159(A) | 2000-09-01 | Huebsch et al. | Applicant |
| US6123699(A) | 2000-09-01 | Webster, Jr. | Applicant |
| US6126658(A) | 2000-10-01 | Baker | Applicant |
| US6132447(A) | 2000-10-01 | Dorsey | Applicant |
| US6136010(A) | 2000-10-01 | Modesitt et al. | Applicant |
| US6143024(A) | 2000-11-01 | Campbell et al. | Applicant |
| US6159240(A) | 2000-12-01 | Sparer et al. | Applicant |
| US6162233(A) | 2000-12-01 | Williamson, IV et al. | Applicant |
| US6165164(A) | 2000-12-01 | Hill et al. | Applicant |
| US6165183(A) | 2000-12-01 | Kuehn et al. | Applicant |
| US6165204(A) | 2000-12-01 | Levinson et al. | Applicant |
| US6168614(B1) | 2001-01-01 | Andersen et al. | Applicant |
| US6171320(B1) | 2001-01-01 | Monassevitch | Applicant |
| US6182664(B1) | 2001-02-01 | Cosgrove | Applicant |
| US6187003(B1) | 2001-02-01 | Buysse et al. | Applicant |
| US6190408(B1) | 2001-02-01 | Melvin | Applicant |
| US6203531(B1) | 2001-03-01 | Ockuly et al. | Applicant |
| US6203553(B1) | 2001-03-01 | Robertson et al. | Applicant |
| US6206893(B1) | 2001-03-01 | Klein et al. | Applicant |
| US6206907(B1) | 2001-03-01 | Marino et al. | Applicant |
| US6210419(B1) | 2001-04-01 | Mayenberger et al. | Applicant |
| US6210432(B1) | 2001-04-01 | Solem et al. | Applicant |
| US6245079(B1) | 2001-06-01 | Nobles et al. | Applicant |
| US6267746(B1) | 2001-07-01 | Bumbalough | Applicant |
| US6267781(B1) | 2001-07-01 | Tu | Applicant |
| US6269819(B1) | 2001-08-01 | Oz et al. | Applicant |
| US6277555(B1) | 2001-08-01 | Duran et al. | Applicant |
| US6283127(B1) | 2001-09-01 | Sterman et al. | Applicant |
| US6283962(B1) | 2001-09-01 | Tu et al. | Applicant |
| US6299637(B1) | 2001-10-01 | Shaolian et al. | Applicant |
| US6306133(B1) | 2001-10-01 | Tu et al. | Applicant |
| US6312447(B1) | 2001-11-01 | Grimes | Applicant |
| US6319250(B1) | 2001-11-01 | Falwell et al. | Applicant |
| US6322559(B1) | 2001-11-01 | Daulton et al. | Applicant |
| US6332893(B1) | 2001-12-01 | Mortier et al. | Applicant |
| US6352708(B1) | 2002-03-01 | Duran et al. | Applicant |
| US6355030(B1) | 2002-03-01 | Aldrich et al. | Applicant |
| US6358277(B1) | 2002-03-01 | Duran | Applicant |
| US6368326(B1) | 2002-04-01 | Dakin et al. | Applicant |
| US6402780(B2) | 2002-06-01 | Williamson et al. | Applicant |
| US6402781(B1) | 2002-06-01 | Langberg et al. | Applicant |
| US6406420(B1) | 2002-06-01 | McCarthy et al. | Applicant |
| US6419669(B1) | 2002-07-01 | Frazier et al. | Applicant |
| US6461366(B1) | 2002-10-01 | Seguin | Applicant |
| US6464707(B1) | 2002-10-01 | Bjerken | Applicant |
| US6482224(B1) | 2002-11-01 | Michler et al. | Applicant |
| US6485489(B2) | 2002-11-01 | Teirstein et al. | Applicant |
| US6508828(B1) | 2003-01-01 | Akerfeldt et al. | Applicant |
| US6533796(B1) | 2003-03-01 | Sauer et al. | Applicant |
| US6537314(B2) | 2003-03-01 | Langberg et al. | Applicant |
| US6540755(B2) | 2003-04-01 | Ockuly et al. | Applicant |
| US6551331(B2) | 2003-04-01 | Nobles et al. | Applicant |
| US6562037(B2) | 2003-05-01 | Paton et al. | Applicant |
| US6562052(B2) | 2003-05-01 | Nobles et al. | Applicant |
| US6575971(B2) | 2003-06-01 | Hauck et al. | Applicant |
| US6585761(B2) | 2003-07-01 | Taheri | Applicant |
| US6599311(B1) | 2003-07-01 | Biggs et al. | Applicant |
| US6616684(B1) | 2003-09-01 | Vidlund et al. | Applicant |
| US6619291(B2) | 2003-09-01 | Hlavka et al. | Applicant |
| US6626899(B2) | 2003-09-01 | Houser et al. | Applicant |
| US6626930(B1) | 2003-09-01 | Allen et al. | Applicant |
| US6629534(B1) | 2003-10-01 | St. Goar et al. | Applicant |
| US6641592(B1) | 2003-11-01 | Sauer et al. | Applicant |
| US6656221(B2) | 2003-12-01 | Taylor et al. | Applicant |
| US6669687(B1) | 2003-12-01 | Saadat | Applicant |
| US6685648(B2) | 2004-02-01 | Flaherty et al. | Applicant |
| US6689164(B1) | 2004-02-01 | Seguin | Applicant |
| US6695866(B1) | 2004-02-01 | Kuehn et al. | Applicant |
| US6701929(B2) | 2004-03-01 | Hussein | Applicant |
| US6702825(B2) | 2004-03-01 | Frazier et al. | Applicant |
| US6702826(B2) | 2004-03-01 | Liddicoat et al. | Applicant |
| US6709382(B1) | 2004-03-01 | Homer | Applicant |
| US6709456(B2) | 2004-03-01 | Langberg et al. | Applicant |
| US6718985(B2) | 2004-04-01 | Hlavka et al. | Applicant |
| US6719767(B1) | 2004-04-01 | Kimblad | Applicant |
| US6723038(B1) | 2004-04-01 | Schroeder et al. | Applicant |
| US6726716(B2) | 2004-04-01 | Marquez | Applicant |
| US6740107(B2) | 2004-05-01 | Loeb et al. | Applicant |
| US6746471(B2) | 2004-06-01 | Mortier et al. | Applicant |
| US6752813(B2) | 2004-06-01 | Goldfarb et al. | Applicant |
| US6755777(B2) | 2004-06-01 | Schweich et al. | Applicant |
| US6764510(B2) | 2004-07-01 | Vidlund et al. | Applicant |
| US6767349(B2) | 2004-07-01 | Ouchi | Applicant |
| US6770083(B2) | 2004-08-01 | Seguin | Applicant |
| US6797001(B2) | 2004-09-01 | Mathis et al. | Applicant |
| US6797002(B2) | 2004-09-01 | Spence et al. | Applicant |
| US6860179(B2) | 2005-03-01 | Hopper et al. | Applicant |
| US6875224(B2) | 2005-04-01 | Grimes | Applicant |
| US6926715(B1) | 2005-08-01 | Hauck et al. | Applicant |
| US6945978(B1) | 2005-09-01 | Hyde | Applicant |
| US6949122(B2) | 2005-09-01 | Adams et al. | Applicant |
| US6966914(B2) | 2005-11-01 | Abe | Applicant |
| US6986775(B2) | 2006-01-01 | Morales et al. | Applicant |
| US7004970(B2) | 2006-02-01 | Cauthen, III et al. | Applicant |
| US7011669(B2) | 2006-03-01 | Kimblad | Applicant |
| US7048754(B2) | 2006-05-01 | Martin et al. | Applicant |
| US7112207(B2) | 2006-09-01 | Allen et al. | Applicant |
| US7226467(B2) | 2007-06-01 | Lucatero et al. | Applicant |
| US7288097(B2) | 2007-10-01 | Seguin | Applicant |
| US7341584(B1) | 2008-03-01 | Starkey | Applicant |
| US7381210(B2) | 2008-06-01 | Zarbatany et al. | Applicant |
| US7464712(B2) | 2008-12-01 | Oz et al. | Applicant |
| US7497822(B1) | 2009-03-01 | Kugler et al. | Applicant |
| US7533790(B1) | 2009-05-01 | Knodel et al. | Applicant |
| US7563267(B2) | 2009-07-01 | Goldfarb et al. | Applicant |
| US7563273(B2) | 2009-07-01 | Goldfarb et al. | Applicant |
| US7604646(B2) | 2009-10-01 | Goldfarb et al. | Applicant |
| US7608091(B2) | 2009-10-01 | Goldfarb et al. | Applicant |
| US7635329(B2) | 2009-12-01 | Goldfarb et al. | Applicant |
| US7635386(B1) | 2009-12-01 | Gammie | Applicant |
| US7651502(B2) | 2010-01-01 | Jackson | Applicant |
| US7682319(B2) | 2010-03-01 | Martin et al. | Applicant |
| US7682369(B2) | 2010-03-01 | Seguin | Applicant |
| US2001/0004715(A1) | 2001-06-01 | Duran et al. | Applicant |
| US2001/0005787(A1) | 2001-06-01 | Oz et al. | Applicant |
| US2001/0010005(A1) | 2001-07-01 | Kammerer et al. | Applicant |
| US2001/0018611(A1) | 2001-08-01 | Solem et al. | Applicant |
| US2001/0022872(A1) | 2001-09-01 | Marui | Applicant |
| US2001/0037084(A1) | 2001-11-01 | Nardeo | Applicant |
| US2001/0039411(A1) | 2001-11-01 | Johansson et al. | Applicant |
| US2001/0044568(A1) | 2001-11-01 | Langberg et al. | Applicant |
| US2002/0013571(A1) | 2002-01-01 | Goldfarb et al. | Applicant |
| US2002/0022848(A1) | 2002-02-01 | Garrison et al. | Applicant |
| US2002/0026233(A1) | 2002-02-01 | Shaknovich | Applicant |
| US2002/0035361(A1) | 2002-03-01 | Houser et al. | Applicant |
| US2002/0035381(A1) | 2002-03-01 | Bardy et al. | Applicant |
| US2002/0042651(A1) | 2002-04-01 | Liddicoat et al. | Applicant |
| US2002/0055774(A1) | 2002-05-01 | Liddicoat | Applicant |
| US2002/0055775(A1) | 2002-05-01 | Carpentier et al. | Applicant |
| US2002/0058910(A1) | 2002-05-01 | Hermann | Applicant |
| US2002/0058995(A1) | 2002-05-01 | Stevens | Applicant |
| US2002/0077687(A1) | 2002-06-01 | Ahn | Applicant |
| US2002/0087148(A1) | 2002-07-01 | Brock et al. | Applicant |
| US2002/0087169(A1) | 2002-07-01 | Brock et al. | Applicant |
| US2002/0087173(A1) | 2002-07-01 | Alferness et al. | Applicant |
| US2002/0103532(A1) | 2002-08-01 | Langberg et al. | Applicant |
| US2002/0107534(A1) | 2002-08-01 | Schaefer et al. | Applicant |
| US2002/0147456(A1) | 2002-10-01 | Diduch et al. | Applicant |
| US2002/0156526(A1) | 2002-10-01 | Hilavka et al. | Applicant |
| US2002/0158528(A1) | 2002-10-01 | Tsuzaki et al. | Applicant |
| US2002/0161378(A1) | 2002-10-01 | Downing | Applicant |
| US2002/0169360(A1) | 2002-11-01 | Taylor et al. | Applicant |
| US2002/0183766(A1) | 2002-12-01 | Seguin | Applicant |
| US2002/0183835(A1) | 2002-12-01 | Taylor et al. | Applicant |
| US2003/0050693(A1) | 2003-03-01 | Quijano et al. | Applicant |
| US2003/0069570(A1) | 2003-04-01 | Witzel et al. | Applicant |
| US2003/0069593(A1) | 2003-04-01 | Tremulis et al. | Applicant |
| US2003/0069636(A1) | 2003-04-01 | Solem et al. | Applicant |
| US2003/0074012(A1) | 2003-04-01 | Nguyen et al. | Applicant |
| US2003/0078654(A1) | 2003-04-01 | Taylor et al. | Applicant |
| US2003/0083742(A1) | 2003-05-01 | Spence et al. | Applicant |
| US2003/0105519(A1) | 2003-06-01 | Fasol et al. | Applicant |
| US2003/0105520(A1) | 2003-06-01 | Alferness et al. | Applicant |
| US2003/0120340(A1) | 2003-06-01 | Lisk et al. | Applicant |
| US2003/0120341(A1) | 2003-06-01 | Shennib et al. | Applicant |
| US2003/0130669(A1) | 2003-07-01 | Damarati | Applicant |
| US2003/0130730(A1) | 2003-07-01 | Cohn et al. | Applicant |
| US2003/0144697(A1) | 2003-07-01 | Mathis et al. | Applicant |
| US2003/0167071(A1) | 2003-09-01 | Martin et al. | Applicant |
| US2003/0171776(A1) | 2003-09-01 | Adams et al. | Applicant |
| US2003/0187467(A1) | 2003-10-01 | Schreck | Applicant |
| US2003/0195562(A1) | 2003-10-01 | Collier et al. | Applicant |
| US2003/0208231(A1) | 2003-11-01 | Williamson, IV et al. | Applicant |
| US2003/0229395(A1) | 2003-12-01 | Cox | Applicant |
| US2003/0233038(A1) | 2003-12-01 | Hassett | Applicant |
| US2004/0002719(A1) | 2004-01-01 | Oz et al. | Applicant |
| US2004/0019377(A1) | 2004-01-01 | Taylor et al. | Applicant |
| US2004/0019378(A1) | 2004-01-01 | Hlavka et al. | Applicant |
| US2004/0024414(A1) | 2004-02-01 | Downing | Applicant |
| US2004/0030382(A1) | 2004-02-01 | St. Goar et al. | Applicant |
| US2004/0039442(A1) | 2004-02-01 | St. Goar et al. | Applicant |
| US2004/0039443(A1) | 2004-02-01 | Solem et al. | Applicant |
| US2004/0044350(A1) | 2004-03-01 | Martin et al. | Applicant |
| US2004/0044365(A1) | 2004-03-01 | Bachman | Applicant |
| US2004/0049207(A1) | 2004-03-01 | Goldfarb et al. | Applicant |
| US2004/0049211(A1) | 2004-03-01 | Tremulis et al. | Applicant |
| US2004/0073302(A1) | 2004-04-01 | Rourke et al. | Applicant |
| US2004/0078053(A1) | 2004-04-01 | Berg et al. | Applicant |
| US2004/0088047(A1) | 2004-05-01 | Spence et al. | Applicant |
| US2004/0092962(A1) | 2004-05-01 | Thornton et al. | Applicant |
| US2004/0097878(A1) | 2004-05-01 | Anderson et al. | Applicant |
| US2004/0097979(A1) | 2004-05-01 | Svanidze et al. | Applicant |
| US2004/0106989(A1) | 2004-06-01 | Wilson et al. | Applicant |
| US2004/0111099(A1) | 2004-06-01 | Nguyen et al. | Applicant |
| US2004/0122448(A1) | 2004-06-01 | Levine | Applicant |
| US2004/0127981(A1) | 2004-07-01 | Randert et al. | Applicant |
| US2004/0127982(A1) | 2004-07-01 | Machold et al. | Applicant |
| US2004/0127983(A1) | 2004-07-01 | Mortier et al. | Applicant |
| US2004/0133062(A1) | 2004-07-01 | Pai et al. | Applicant |
| US2004/0133063(A1) | 2004-07-01 | McCarthy et al. | Applicant |
| US2004/0133082(A1) | 2004-07-01 | Abraham-Fuchs et al. | Applicant |
| US2004/0133192(A1) | 2004-07-01 | Houser et al. | Applicant |
| US2004/0133220(A1) | 2004-07-01 | Lashinski et al. | Applicant |
| US2004/0133240(A1) | 2004-07-01 | Adams et al. | Applicant |
| US2004/0133273(A1) | 2004-07-01 | Cox | Applicant |
| US2004/0138744(A1) | 2004-07-01 | Lashinski et al. | Applicant |
| US2004/0138745(A1) | 2004-07-01 | Macoviak et al. | Applicant |
| US2004/0148021(A1) | 2004-07-01 | Cartledge et al. | Applicant |
| US2004/0152847(A1) | 2004-08-01 | Emri et al. | Applicant |
| US2004/0152947(A1) | 2004-08-01 | Schroeder et al. | Applicant |
| US2004/0153144(A1) | 2004-08-01 | Seguin | Applicant |
| US2004/0158123(A1) | 2004-08-01 | Jayaraman | Applicant |
| US2004/0162610(A1) | 2004-08-01 | Laiska et al. | Applicant |
| US2004/0167539(A1) | 2004-08-01 | Kuehn et al. | Applicant |
| US2004/0186486(A1) | 2004-09-01 | Roue et al. | Applicant |
| US2004/0186566(A1) | 2004-09-01 | Hindrichs et al. | Applicant |
| US2004/0193191(A1) | 2004-09-01 | Starksen et al. | Applicant |
| US2004/0215339(A1) | 2004-10-01 | Drasler et al. | Applicant |
| US2004/0220593(A1) | 2004-11-01 | Greenhalgh | Applicant |
| US2004/0220657(A1) | 2004-11-01 | Nieminen et al. | Applicant |
| US2004/0225300(A1) | 2004-11-01 | Goldfarb et al. | Applicant |
| US2004/0236354(A1) | 2004-11-01 | Seguin | Applicant |
| US2004/0243229(A1) | 2004-12-01 | Vidlund et al. | Applicant |
| US2004/0249452(A1) | 2004-12-01 | Adams et al. | Applicant |
| US2004/0249453(A1) | 2004-12-01 | Cartledge et al. | Applicant |
| US2005/0004583(A1) | 2005-01-01 | Oz et al. | Applicant |
| US2005/0004665(A1) | 2005-01-01 | Aklog | Applicant |
| US2005/0004668(A1) | 2005-01-01 | Aklog et al. | Applicant |
| US2005/0021056(A1) | 2005-01-01 | St. Goer et al. | Applicant |
| US2005/0021057(A1) | 2005-01-01 | St. Goer et al. | Applicant |
| US2005/0021058(A1) | 2005-01-01 | Negro | Applicant |
| US2005/0033446(A1) | 2005-02-01 | Deem et al. | Applicant |
| US2005/0038508(A1) | 2005-02-01 | Gabbay | Applicant |
| US2005/0049698(A1) | 2005-03-01 | Bolling et al. | Applicant |
| US2005/0055089(A1) | 2005-03-01 | Macoviak et al. | Applicant |
| US2005/0059351(A1) | 2005-03-01 | Cauwels et al. | Applicant |
| US2005/0149014(A1) | 2005-07-01 | Hauck et al. | Applicant |
| US2005/0159810(A1) | 2005-07-01 | Filsoufi | Applicant |
| US2005/0197694(A1) | 2005-09-01 | Pai et al. | Applicant |
| US2005/0197695(A1) | 2005-09-01 | Stacchino et al. | Applicant |
| US2005/0216039(A1) | 2005-09-01 | Lederman | Applicant |
| US2005/0228422(A1) | 2005-10-01 | Machold et al. | Applicant |
| US2005/0228495(A1) | 2005-10-01 | Macoviak | Applicant |
| US2005/0251001(A1) | 2005-11-01 | Hassett | Applicant |
| US2005/0267493(A1) | 2005-12-01 | Schreck et al. | Applicant |
| US2005/0273160(A1) | 2005-12-01 | Lashinski et al. | Applicant |
| US2005/0287493(A1) | 2005-12-01 | Novak et al. | Applicant |
| US2006/0004247(A1) | 2006-01-01 | Kute et al. | Applicant |
| US2006/0015003(A1) | 2006-01-01 | Moaddes et al. | Applicant |
| US2006/0030866(A1) | 2006-02-01 | Schreck | Applicant |
| US2006/0030867(A1) | 2006-02-01 | Zadno | Applicant |
| US2006/0030885(A1) | 2006-02-01 | Hyde | Applicant |
| US2006/0058871(A1) | 2006-03-01 | Zakay et al. | Applicant |
| US2006/0064115(A1) | 2006-03-01 | Allen et al. | Applicant |
| US2006/0064116(A1) | 2006-03-01 | Allen et al. | Applicant |
| US2006/0064118(A1) | 2006-03-01 | Kimblad | Applicant |
| US2006/0089671(A1) | 2006-04-01 | Goldfarb et al. | Applicant |
| US2006/0089711(A1) | 2006-04-01 | Dolan | Applicant |
| US2006/0184203(A1) | 2006-08-01 | Martin et al. | Applicant |
| US2006/0195012(A1) | 2006-08-01 | Mortier et al. | Applicant |
| US2006/0229708(A1) | 2006-10-01 | Powell et al. | Applicant |
| US2006/0252984(A1) | 2006-11-01 | Randert et al. | Applicant |
| US2007/0038293(A1) | 2007-02-01 | St.Goar et al. | Applicant |
| US2007/0100356(A1) | 2007-05-01 | Lucatero et al. | Applicant |
| US2007/0118155(A1) | 2007-05-01 | Goldfarb et al. | Applicant |
| US2007/0129737(A1) | 2007-06-01 | Goldfarb et al. | Applicant |
| US2007/0198082(A1) | 2007-08-01 | Kapadia et al. | Applicant |
| US2008/0039935(A1) | 2008-02-01 | Buch et al. | Applicant |
| US2008/0051703(A1) | 2008-02-01 | Thornton et al. | Applicant |
| US2008/0051807(A1) | 2008-02-01 | St. Goar et al. | Applicant |
| US2008/0097489(A1) | 2008-04-01 | Goldfarb et al. | Applicant |
| US2008/0167714(A1) | 2008-07-01 | St. Goer et al. | Applicant |
| US2008/0183194(A1) | 2008-07-01 | Goldfarb et al. | Applicant |
| US2009/0163934(A1) | 2009-06-01 | Raschdorf, Jr. et al. | Applicant |
| US2009/0177266(A1) | 2009-07-01 | Powell et al. | Applicant |
| US2009/0198322(A1) | 2009-08-01 | Deem et al. | Applicant |
| US2009/0270858(A1) | 2009-10-01 | Hauck et al. | Applicant |
| US2009/0326567(A1) | 2009-12-01 | Goldfarb et al. | Applicant |
| US2010/0016958(A1) | 2010-01-01 | St. Goar et al. | Applicant |
| US2010/0022823(A1) | 2010-01-01 | Goldfarb et al. | Applicant |
| DE3504292 | 1986-07-01 | Applicant | |
| EP179562 | 1986-04-01 | Applicant | |
| EP179562(B1) | 1989-07-01 | Applicant | |
| EP558031 | 1993-02-01 | Applicant | |
| EP684012 | 1995-11-01 | Applicant | |
| EP727239 | 1996-08-01 | Applicant | |
| EP1674040 | 2006-06-01 | Applicant | |
| FR2768324 | 1999-03-01 | Applicant | |
| GB1598111 | 1981-09-01 | Applicant | |
| GB2151142 | 1985-07-01 | Applicant | |
| JP59-85653(A) | 1984-05-01 | Applicant | |
| JP11-089937 | 1999-04-01 | Applicant | |
| JP2000-283130(A) | 2000-10-01 | Applicant | |
| WO81/00668 | 1981-03-01 | Applicant | |
| WO91/01689 | 1991-02-01 | Applicant | |
| WO92/12690 | 1992-08-01 | Applicant | |
| WO94/18881 | 1994-09-01 | Applicant | |
| WO94/18893 | 1994-09-01 | Applicant | |
| WO95/15715(A1) | 1995-06-01 | Applicant | |
| WO96/14032(A1) | 1996-05-01 | Applicant | |
| WO96/22735 | 1996-08-01 | Applicant | |
| WO96/30072(A1) | 1996-10-01 | Applicant | |
| WO97/18746(A2) | 1997-05-01 | Applicant | |
| WO97/25927(A1) | 1997-07-01 | Applicant | |
| WO97/26034(A1) | 1997-07-01 | Applicant | |
| WO97/38748(A2) | 1997-10-01 | Applicant | |
| WO97/39688 | 1997-10-01 | Applicant | |
| WO97/48436(A2) | 1997-12-01 | Applicant | |
| WO98/07375 | 1998-02-01 | Applicant | |
| WO98/24372 | 1998-06-01 | Applicant | |
| WO98/30153 | 1998-07-01 | Applicant | |
| WO98/32382 | 1998-07-01 | Applicant | |
| WO98/35638 | 1998-08-01 | Applicant | |
| WO99/00059 | 1999-01-01 | Applicant | |
| WO99/07354 | 1999-02-01 | Applicant | |
| WO99/13777(A1) | 1999-03-01 | Applicant | |
| WO99/66967(A1) | 1999-12-01 | Applicant | |
| WO/02489 | 2000-01-01 | Applicant | |
| WO/03651(A1) | 2000-01-01 | Applicant | |
| WO/03759 | 2000-01-01 | Applicant | |
| WO/12168(A1) | 2000-03-01 | Applicant | |
| WO/44313(A1) | 2000-08-01 | Applicant | |
| WO/59382 | 2000-10-01 | Applicant | |
| WO/60995 | 2000-10-01 | Applicant | |
| WO1/00111 | 2001-01-01 | Applicant | |
| WO1/00114(A1) | 2001-01-01 | Applicant | |
| WO1/03651(A2) | 2001-01-01 | Applicant | |
| WO1/26557 | 2001-04-01 | Applicant | |
| WO1/26586 | 2001-04-01 | Applicant | |
| WO1/26587(A1) | 2001-04-01 | Applicant | |
| WO1/26588(A2) | 2001-04-01 | Applicant | |
| WO1/26703(A1) | 2001-04-01 | Applicant | |
| WO1/28432 | 2001-04-01 | Applicant | |
| WO1/28455 | 2001-04-01 | Applicant | |
| WO1/47438(A1) | 2001-07-01 | Applicant | |
| WO1/49213(A2) | 2001-07-01 | Applicant | |
| WO1/50985(A1) | 2001-07-01 | Applicant | |
| WO1/54618 | 2001-08-01 | Applicant | |
| WO1/56512(A1) | 2001-08-01 | Applicant | |
| WO1/66001 | 2001-09-01 | Applicant | |
| WO1/70320(A1) | 2001-09-01 | Applicant | |
| WO1/89440(A2) | 2001-11-01 | Applicant | |
| WO1/95831(A2) | 2001-12-01 | Applicant | |
| WO1/95832(A2) | 2001-12-01 | Applicant | |
| WO1/97741(A2) | 2001-12-01 | Applicant | |
| WO2/00099(A2) | 2002-01-01 | Applicant | |
| WO2/01999(A2) | 2002-01-01 | Applicant | |
| WO2/03892 | 2002-01-01 | Applicant | |
| WO2/34167(A2) | 2002-05-01 | Applicant | |
| WO2/060352(A1) | 2002-08-01 | Applicant | |
| WO2/062263(A2) | 2002-08-01 | Applicant | |
| WO2/062270(A1) | 2002-08-01 | Applicant | |
| WO2/062408(A2) | 2002-08-01 | Applicant | |
| WO3/001893 | 2003-01-01 | Applicant | |
| WO3/003930(A1) | 2003-01-01 | Applicant | |
| WO3/020179 | 2003-03-01 | Applicant | |
| WO3/028558 | 2003-04-01 | Applicant | |
| WO3/037171 | 2003-05-01 | Applicant | |
| WO3/047467 | 2003-06-01 | Applicant | |
| WO3/049619 | 2003-06-01 | Applicant | |
| WO3/073910 | 2003-09-01 | Applicant | |
| WO3/073913 | 2003-09-01 | Applicant | |
| WO3/105667 | 2003-12-01 | Applicant | |
| WO2004/004607 | 2004-01-01 | Applicant | |
| WO2004/012583 | 2004-02-01 | Applicant | |
| WO2004/012789(A2) | 2004-02-01 | Applicant | |
| WO2004/014282(A2) | 2004-02-01 | Applicant | |
| WO2004/019811 | 2004-03-01 | Applicant | |
| WO2004/030570 | 2004-04-01 | Applicant | |
| WO2004/037317 | 2004-05-01 | Applicant | |
| WO2004/045370 | 2004-06-01 | Applicant | |
| WO2004/045378 | 2004-06-01 | Applicant | |
| WO2004/045463 | 2004-06-01 | Applicant | |
| WO2004/047679 | 2004-06-01 | Applicant | |
| WO2004/062725 | 2004-07-01 | Applicant | |
| WO2004/082523 | 2004-09-01 | Applicant | |
| WO2004/082538 | 2004-09-01 | Applicant | |
| WO2004/093730 | 2004-11-01 | Applicant | |
| WO2004/112585 | 2004-12-01 | Applicant | |
| WO2004/112651 | 2004-12-01 | Applicant | |
| WO2005/002424 | 2005-01-01 | Applicant | |
| WO2005/018507 | 2005-03-01 | Applicant | |
| WO2005/027797 | 2005-03-01 | Applicant | |
| WO2005/032421 | 2005-04-01 | Applicant | |
| WO2005/062931 | 2005-07-01 | Applicant | |
| WO2005/112792 | 2005-12-01 | Applicant | |
| WO2006/105008 | 2006-10-01 | Applicant | |
| WO2006/105009 | 2006-10-01 | Applicant | |
| WO2006/115875 | 2006-11-01 | Applicant | |
| WO2006/115876 | 2006-11-01 | Applicant |
Non-Patent Literature (78)
- Kavarna et al., “Transaortic repair of mitral regurgitation,” Presented at the third annualNew Era Cardiac Care conference, San Diego, CA, Jan. 13-16, 2000,http://www.hsforum.com/vol3/issue1/2000-2389print.html.Applicant
- Lorusso et al., The double-orifice technique for mitral valve construction: predictors ofpostoperative outcome, Eur J. Cardiothorac Surg, May 23, 2001; 20(3):583-589.Applicant
- Osawa et al., “Partial left ventriculectomy in a 3 year old boy with dilated cardiomyopathy,” Japanese Journal of Thoracic and Cardiovascular Surg, Sep. 2000, 48(9):590-593.Applicant
- Timek et al., “Edge-to-edge mitral repair: gradients and three-dimensional annular dynamics in vivo during inotropic stimulation,” Eur J. of Cardiothoracic Surg., Jan. 9, 2001; 19:431-437.Applicant
- Alvarez et al., “Repairing the Degenerative Mitral Valve: Ten- to Fifteen-Year Follow-up,” J. Thorac. Cardiovasc. Surg. (Aug. 1996) 112:238-247.Applicant
- Abe et al., “De Vega's annuloplasty for acquired tricuspid disease: Early and late results in 110 patients” Ann. Thorac. Surg. (Nov. 1989) 48:670-676.Applicant
- Arisi et al., “Mitral valve repair with Alfieri technique in mitral regurgitation of diverse etiology: early echocardiographic results,” Circulation Supplement II, (Oct. 2001) 104(17):3240.Applicant
- Abe et al., “Updated: De Vega's annuloplasty for acqiuried tricuspiddisease: Early and late results in 110 patients” Ann. Thorac. Surg. (Dec. 1996) 62:1876-1877.Applicant
- Bach et al., “Early improvement in congestive heart failure after correction of secondary mitral regurgitation in end-stagecardiomyopathy,” Am. Heart J., (Jun. 1995) 129:1165-1170.Applicant
- Alfieri et al., “Novel suture device for beating heart mitral leafle tapproximation,” Annals of Thoracic Surgery, (Nov. 2002) 74: 1488-1493.Applicant
- Alfieri et al., “The double orifice technique in mitral valve repair: a simple solution for complex problems,” Journal of Thoracic CardiovascularSurgery, (Oct. 2001) 122: 674-681.Applicant
- Alfieri et al., “An effective technique to correct anterior mitral leaflet prolapse,” J. Card. Surg., (Nov./Dec. 1999) 14(6): 468-470.Applicant
- Agricola et al., “Mitral valve reserve in double orifice technique: an exercise echocardiographic study,” Journal of Heart Valve Disease, (Sep. 2002) 11(5):637-643.Applicant
- Alfieri et al., “The edge to edge technique,” The European Association for Cardio-Thoracic Surgery 14th Annual Meeting, Oct. 7-11, 2000, Book of Proceedings.Applicant
- Alfieri, “The edge to edge repair of the mitral valve,” [Abstract] 6th Annual New Era Cardiac Care: Innovation & Technology,Heart Surgery Forum, (Jan. 2003) pp. 103.Applicant
- Bach et al., “Improvement following correction of secondary mitral regurgitation in end-stage cardiomyopathy with mitral annuloplasty,” Am. J. Cardiol., (Oct. 1996) 78:966-969.Applicant
- Bailey, “Surgery of the Heart,” Chapter 20, (1995) pp. 686-737.Applicant
- Bernal et al., “The ‘Valve Racket’: a new and different concept of atrioventricular valve repair,” Eur. J. Cardio-thoracic Surgery 29:1026-29 (Jun. 2006).Applicant
- Bhudia et al., “Edge-to-edge (Alfieri) mitral repair: results in diverse clinical settings,” Ann Thorac Surg, 77: 1598-1606, (2004).Applicant
- Bhudia, #58 Edge-to-edge mitral repair: a versatile mitral repair technique, 2003 STS Presentation, [Abstract Only].Applicant
- Bolling et al., “Surgery for acquired heart disease” (Apr. 1995) 109:676-683.Applicant
- Borghetti et al., “Preliminary observations on haemodynamics during physiological stress conditions following ‘double-orifice’ mitral valve repair,” European Journal of Cardio-thoracic Surgery, Apr. 18, 2001 20: 262-269.Applicant
- Castedo, “Edge-to-edge tricuspid repair for redeveloped valve incompetence after DeVega's annuloplasty,” Ann Thora Surg., (Feb. 2003) 75:605-606.Applicant
- Dec et al., “Idiopathic dilated cardiomyopathy,” N. Engl. J.Med. (Dec. 1994) 331:1564-1575.Applicant
- Dottori et al., “Echocardiographic imaging of the Alfieri type mitral valve repair,” Ital. Heart J., (Apr. 2001) 2(4): 319-320.Applicant
- Downing et al., “Beating heart mitral valve surgery: Preliminary model and methodology,” Journal of Thoracic and Cardiovascular Surgery, (Jun. 2002) 123(6):1141-1146.Applicant
- Falk et al., “Computer-enhanced mitral valve surgery: toward a total endoscopic procedure,” Seminars in thoracic and cardiovascular surgery, (Jul. 1999) 11(3): 224-249.Applicant
- Filsoufi et al., “Restoring Optimal Surface of Coaptation With a Mini Leaflet Prosthesis: A New Surgical Concept for the Correction of Mitral Valve Prolapse,” Intl. Soc. For Minimally Invasive Cardiothoracic Surgery (Sep. 2006) 1(4):186-87.Applicant
- Frazier et al., #62 Early Clinical Experience With an Implantable, Intracardiac Circulatory Support Device: Operative Considerations and Physiologic Implications, 2003 STS Presentation, 1 page total. [Abstract Only].Applicant
- Fucci et al., “Improved results with mitral valve repair using new surgical techniques”, Eur. J. Cardiothorac. Surg. (Nov. 1995) 9:621-627.Applicant
- Fundaro et al., “Chordal placation and free edge remodeling for mitral anterior leaflet prolapse repair: 8-year follow-up,” Annals of ThoracicSurgery, (Nov. 2001) 72:1515-1519.Applicant
- Garcia-Rinaldi et al., “Left ventricular volume reduction and reconstruction is ischemic cardiomyopathy,” Journal of Cardiac Surgery, (May/Jun. 1999) 14:199-210.Applicant
- Gateliene, “Early and postoperative results results of metal and tricuspid valve insufficiency surgical treatment using edge-to-edge central coaptation procedure,” (Oct. 2002) 38 (Suppl 2):172-175.Applicant
- Gatti et al., “The edge to edge technique as a trick to rescue an imperfect mitral valve repair,” Eur. J. Cardiothorac Surg, (Nov. 2002) 22(5): 817-20.Applicant
- Gillinov et al., “Is minimally invasive heart valve surgery a paradigm for the future?,” Current Cardiology Reports, (Nov. 1999) 1:318-322.Applicant
- Gundry, “Facile mitral valve repair utilizing leaflet edge approximation: midterm results of the Alfieri figure of eight repair,” Presented at the Meeting of the Western Thoracic Surgical Association, (1999).Applicant
- Gupta et al., #61 Influence of Older Donor Grafts on Heart Transplant Survival: Lack of Recipient Effects, 2003 STS Presentation, [Abstract Only].Applicant
- Ikeda et al., “Batista's operation with coronary artery bypass grafting and mitral valve plasty for ischemic dilated cardiomyopathy,” The Japanese Journal of Thoracic and Cardiovascular Surgery, (Nov. 2000) 48:746-749.Applicant
- Izzat et al., “Early experience with partial left ventriculectomy in the Asis-Pacific Region,” Annuals of Thoracic Surgery, (Jun. 1999) 67: 1703-1707.Applicant
- Kallner et al., “Transaortic approach for the Alfieri Stitch,” Ann Thorac Surg, (Jan. 2001) 71: 378-380.Applicant
- Kameda et al., “Annuloplasty for severe mitral regurgitation due to dilated cardiomyopathy,” Am. Thorac. Surg. (Jun. 1996) 61:1829-1832.Applicant
- Kaza et al., “Ventricular reconstruction results in improved left ventricular function and amelioration of mitral insufficiency,” Annals of Surgery, (Jun. 2002) 235(6): 828-832.Applicant
- Khan et al. “Blade atrial septostomy: Experience with the first 50 procedures” Cathet. Cardiovasc. Diagn. (Aug. 1991) 23: 257-262.Applicant
- Kherani et al., “The edge-to-edge mitral valve repair: the Columbia Presbyterian experience,” Ann. Thorac. Surg., (Jul. 2004) 78: 73-76.Applicant
- Konertz et al., “Results after partial left venticulectomy in a European heart failure population,” Journal of Cardiac Surgery, (Mar./Apr. 1999) 14(2): 129-135.Applicant
- Kron et al., “Surgical relocation of the posterior papillary muscle in chronic ischemic mitral regurgitation,” Annals. of Thoracic Surgery, (Aug. 2002) 74:600-601.Applicant
- Kruger et al., “Edge to edge technique in complex mitral valve repair,” Thorac Cardiovasc Surg., (Feb. 2000), Thema: Poster, http://www.thieme.de/thoracic/abstracts/abstracts/p—73.html.Applicant
- Langer et al., “Posterier mitral leaflet extensions: An adjunctive repair option for ischemic mitral regurgitation?,” J Thorac Cardiovasc Surg, (Apr. 2006) 131:868-77.Applicant
- Lorusso et al., “‘Double-Orifice’ technique to repair extensive mitral valve excision following acute endocarditis,” J. Card Surg, (Jan. 1998) 13:24-26.Applicant
- Maisano et al., “The double orifice repair for Barlow Disease: a simple solution for a complex repair,” Supplement I Circulation, (Nov. 1999); 100(18):1-94.Applicant
- Maisano et al., “The double orifice technique as a standardized approach to treat mitral regurgitation due to severe myxomatous disease: surgical technique,” European Journal of Cardiothoracic Surgery, Jan. 18, 2000; 17:201-215.Applicant
- Maisano et al., “The edge-to-edge technique: A simplified method to correct mitral insufficiency” Eur. J. Cardiothorac. Surg., (Mar. 1998) 13:240-246.Applicant
- Maisano et al., “The hemodynamic effects of double-orifice valve repair for mitral regurgitation: a 3D computational model,” European Journal of Cardio-thoracic Surgery, (Apr. 1999); 15: 419-425.Applicant
- Maisano et al., “Valve repair for traumatic tricuspid regurgitation,” Eur. J. Cardio-thorac Surg, (Oct. 1996) 10: 867-873.Applicant
- Mantovani et al., “Edge-to-edge repair of congenital familiar tricuspid regurgitation: case report,” J. Heart Valve Dis., (Sep. 2000) 9(5):641-643.Applicant
- McCarthy et al., “Partial left ventriculectony and mitral valve repair for end-stage congestive heart failure,” European Journal of Cardio-thoracicSurgery, (Apr. 1998) 13:337-343.Applicant
- McCarthy et al., “Tricuspid Valve Reapir with the Cosgrove-Edwards Annuloplasty System,” Ann. Thorac. Surg., (Jul. 1997) 64:267-268.Applicant
- Moainie et al., “Correction of traumatic tricuspid regurgitation using the double orifice technique, ” Annals of Thoracic Surgery, (Mar. 2002) 73: 963-965.Applicant
- Morales et al., “Development of an off bypass mitral valve repair,” The Heart Surgery Forum #1999-4693, (Apr. 1999) 2(2):115-120.Applicant
- Nakanishi et al., “Early outcome with the Alfieri mitral valve repair,” J.Cardiol., (May 2001); 37(5): 263-266, [Abstract in English; Article in Japanese].Applicant
- Nielsen et al., “The edge-to-edge mitral repair: tension of the approximating suture and leaflet deformation during acute ischemic mitral regurgitation in the ovine heart,” Circulation, (Sep. 2001); 104(Suppl I):I-29-I-35.Applicant
- Noera et al., “Tricuspid Valve Incompetence Caused by Nonpenetrating Thoracic Trauma”, Annals of Thoracic Surger, 1991, 51 (2), 320-322.Applicant
- Park et al., “Clinical use of a blade atrial septostomy” Circulation (Oct. 1978) 58:600-608.Applicant
- Patel et al., #57 Epicardial Atrial Defibrillation: Novel Treatment of Postoperative Atrial Fibrillation, 2003 STS Presentation, [Abstract Only].Applicant
- Privitera et al., “Alfieri Mitral Valve Repair: Clinical Outcome and Pathology,” Circulation, (Nov. 2002) 106:173.Applicant
- Redaelli et al., “A computational study of the hemodynamics after ‘edge-to-edge’ mitral valve repair,” Journal of Biomechanical Engineering, (Dec. 2001) 123:565-570.Applicant
- Reul et al., “Mitral valve reconstruction for mitral insufficiency,” Progress in Cardiovascular Diseases, (May/Jun. 1997) vol. XXXIX, No. 6, pp. 567-599.Applicant
- Ricchi et al., “Linear segmental annuloplasty for mitral valve repair” Ann. Thorac. Surg., (Jun. 1997) 63:1805-1806.Applicant
- Robicsek et al., #60 The Bicuspid Aortic Valve: How Does It Function? Why Does It Fail?, 2003 STS Presentaion, [Abstract Only].Applicant
- Tager et al., “Long-term follow-up of rheumatic patients undergoing left-sided valve replacement with tricuspid annuloplasty-Validity of preoperative echocardiographic criteria in the decision to perform tricuspid annuloplasty,” Am. J. Cardiol., (Apr. 1998) 81:1013-1016.Applicant
- Tamura et al., “Edge to edge repair for mitral regurgitation on a patient with chronic hemodialysis: report of a case,” Kyobu Geka, (Aug. 2001) 54(9):788-790.Applicant
- Tibayan et al., #59 Annular Geometric Remodeling in Chronic Ischemic Mitral Regurgitation, 2003 STS Presentation, [Abstract Only].Applicant
- Timek, “Edge-to-edge mitral valve repair without annuloplasty ring in acute ischemic mitral regurgitation,” [Abstract] Clinical Science, Abstracts from Scientific Sessions, (2002) II-461.Applicant
- Totaro, “Mitral valve repair for isolated prolapse of the anterior leaflet: an 11-year follow-up,” European Journal of Cardio-thoracic Surgery, (Feb. 1999) 15: 119-126.Applicant
- Uchida et al., “Percutaneous cardiomyotomy and valvulotomy with angioscopic guidance,” Am. Heart J., (Apr. 1991) 121:1221-1224.Applicant
- Umana et al., “‘Bow-tie’ mitral valve repair successfully addresses subvalvular dysfunction in ischemic mitral regurgitation,” (Oct. 1997) Surgical Forum, pp. 279-280.Applicant
- Umana et al., “‘Bow-tie’ mitral valve repair: An Adjuvant technique for ischemic regurgitation” Ann. Thorac. Surg., (Nov. 1998) 66:1640-1646.Applicant
- Votta et al., “3-D computational analysis of the stress distribution on the leaflets after edge-to-edge repair of mitral regurgitation,” Journal of Heart Valve Disease, (Nov. 2002) 11: 810-822.Applicant