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Publication number | US7390293 B2 |
Publication type | Grant |
Application number | US 10/770,266 |
Publication date | Jun 24, 2008 |
Filing date | Feb 2, 2004 |
Priority date | Oct 9, 1998 |
Fee status | Lapsed |
Also published as | US6685627, US20020056461, US20040158123, WO2003043507A2, WO2003043507A3 |
Publication number | 10770266, 770266, US 7390293 B2, US 7390293B2, US-B2-7390293, US7390293 B2, US7390293B2 |
Inventors | Swaminathan Jayaraman |
Original Assignee | Swaminathan Jayaraman |
Export Citation | BiBTeX, EndNote, RefMan |
Patent Citations (60), Non-Patent Citations (2), Referenced by (16), Classifications (49), Legal Events (4) | |
External Links: USPTO, USPTO Assignment, Espacenet | |
This application is a continuation of U.S. application Ser. No. 09/988,293 filed Nov. 19, 2001 now U.S. Pat. No. 6,685,627, which is a continuation-in-part of U.S. application Ser. No. 09/414,708 filed Oct. 8, 1999, now U.S. Pat. No. 6,360,749, and claims the benefit of U.S. Provisional application No. 60/103,824 filed Oct. 9, 1998, the contents of which are expressly incorporated herein by reference thereto.
This invention relates to treatment of heart failure and more particularly, treatment of heart failure by reducing the internal volume of a dilated and diseased left ventricle.
Congestive heart failure is a chronic, degenerative condition that impairs the heart's ability to pump blood at normal filling pressures to adequately meet the energy requirements of the body. It is estimated that 4.9 million Americans suffer from various degrees of congestive heart failure (CHF), with about 400,000 new cases identified each year. Heart failure is the most common diagnosis in hospital patients over the age of 65, and it carries a mortality rate higher than that for malignant tumors. One in five CHF patients dies within one year of diagnosis and only 15% survive more than 10 years.
There is no cure for CHF short of a heart transplant. However, advances in pharmacology have provided improved treatment programs. Multidrug treatment regimens that include diuretics, vasodilators and inotropic agents such as angiotensin-converting enzyme (ACE) inhibitors, can slow the progression of CHF and reduce the number of acute episodes. However, treatment remains directed at symptoms and is most effective in the early stages of CHF.
In later stages of the disease, mechanical devices can play an important role. Speciality left ventricular pacemakers can improve the heart's function as a pump, while cardiac assist devices may be used to help support the failing heart. These devices primarily address the needs of approximately 25% of CHF patients.
The increase in CHF has inspired researchers to look for new ways to treat this disease, leading to the development of drugs, surgical procedures and mechanical pumps to assist heart function, which either prevent or at least delay progression of the condition. One such approach involves implantation of an artificial heart, comprising, a diaphragm pump, an example of which is described in U.S. Pat. No. 4,468,177. The pump disclosed in this patent comprises two chambers which are driven in a "push-pull" manner so that the volumes of each of the two chambers are alternatively enlarged and reduced and, further, both chambers are in the path of fluid through the pump. However the use of this, or a similar, pump arrangement for total heart replacement or heart assistance would require an extremely reliable, durable and portable power supply. Although mechanical pumps have been constructed and tested, they have not been found to be adequate for long-term treatment of heart failure.
Chronic heart failure is characterized by changes in the biochemical composition of the ventricular wall, the orientation of cardiac muscle fibers, and the geometry of the ventricular chamber. Remodeling is the term commonly used to describe these facets of cardiac adaptation in disease. While some aspects of the remodeling process may be beneficial to overall heart function to this disease, other aspects are likely to be maladaptive over extended periods. One notable maladaptive aspect of remodeling is left ventricular dilatation, which is characterized not only by an increase in ventricular end diastolic volume but also by shifts of the end diastolic pressure volume relation toward larger volumes. Ventricular dilation increases wall stress and imparts mechanical disadvantage to the myofibrils; therefore, it is a critical event in the disease process.
A decrease in the internal volume of the damaged left ventricle will increase its efficiency because the amount of oxygen consumed by the myocardial muscle as it pumps is related to the wall tension developed during ventricular contraction. The wall tension, in turn, is proportional to the fourth power of the diameter of the ventricular cavity. Therefore, at a given smaller diameter, less work will be used by the muscle to pump a given volume of blood against a given pressure.
Cardiac output has been improved surgically by reducing the volume of a diseased left ventricle. Removal of the non-functioning aneurysmatic segment of the heart muscle has improved the hemodynamic situation by changing the geometry of the left ventricle, leading to enhanced cardiac output. However, this procedure, generally referred to as the Batista technique, is associated with considerable operative risk.
An improvement upon this operation is disclosed in U.S. Pat. No. 5,738,626. In this modified surgical procedure, which includes elements of the other approaches as well, the dilated left ventricle is first reduced in size via myocardial resection and then the heart is supported and assisted by the attachment of a cardiomyoplasty muscle wrap. Cardiomyoplasty is a term used to describe a procedure in which the sheetlike latissimus dorsi muscle is mobilized (while maintaining its vascular supply) and inserted into the mediastinum through a lateral thoracotomy. After pericardiectomy, the muscle is wrapped around both the left and right ventricles. Several weeks are provided for surgical recovery and electrical muscle conditioning, and thereafter the muscle is paced by burst stimulation synchronized to every other cardiac systole. Chronic repetitive stimulation induces biochemical and physiological transformations in the muscle, altering its characteristics toward those of cardiac muscle. These changes include fatigue resistance, prolonged contraction duration, diminution in size, and reduced maximal power.
The principal mechanism by which cardiomyoplasty has been assumed to assist the failing heart is augmentation of systolic ejection by active squeezing of the ventricles. While human studies have reported improvement in the clinical symptoms of patients undergoing this therapy, evidence for active systolic assist has been inconsistent. The results have led some to speculate that more passive external constraining effects of the muscle wrap maybe a source of benefit.
Surgical modes of intervention for the treatment of heart failure include: stiffening zones of acute infarction, for example by directly injecting glutaraldehyde into the affected tissue; wrapping a skeletal muscle (stimulated electrically) around the heart to augment ventricular contractility; and applying an epicardial marlex mesh to support the weakened and distended left ventricle.
A disadvantage common to cardiomyoplasty procedures, which is a consequence of the use of skeletal muscle as the ventricular wrap, is that the tissue wrap fatigues upon repeated stimulation at normal heart rates. Therefore, a period of time exceeding several weeks is required after this operation to condition the skeletal muscle, transforming it into a different tissue, rich in mitochondria and adapted to withstand the repeated stimulation with much less fatigue. During this period a ventricular assist pump may be implanted within a hole cut in the ventricle. Eventually, this assist pump will be removed.
Today, ventricular assist devices (VAD) designed to support a failing heart, represents the most important device technology for treating CHF. These devices are manufactured by Thermocardiosystems (TCS: Woburn, USA), Thoratec (Berkeley, USA), Abiomed (Danvers, USA), and Novacor (Santa Ana, USA).
Some heart remodeling techniques are also under development. Cardio Technologies (Pine Brook, N.J.) is developing a cardiosupport system, that acts via direct mechanical ventricular activation which mimics open chest resuscitation. The device squeezes the heart by applying pressure to a cup-like component placed around the heart.
Acorn Cardiovascular (New Brighton, Minn., USA) envisions a completely new technology for the treatment of CHF. The company is developing a passive device made of biocompatible materials that is placed around the heart via minimally invasive surgical techniques. The device is able to reduce the size, preventing the heart from enlarging further. Unlike surgical reduction techniques (Batista techniques), the product does not require the removal of any heart muscle.
Additional developments are illustrated in the following patents.
U.S. Pat. No. 5,749,855 issued to Reitan et al. describes implantable catheter pump including a drive cable, with one end of the drive cable being connectable to a drive source, a collapsible drive propeller being adjustable between a closed configuration in which the collapsible drive propeller is expanded so as to be operative as an impeller, and a sleeve extending between one side of the collapsible drive propeller and the other side of the collapsible drive propeller.
U.S. Pat. No. 5,908,378 issued to Kovacs et al. describes a cardiac assist device comprising of an outer shell and a diaphragm, formed of polyurethane copolymer.
U.S. Pat. No. 5,824,071 describes an apparatus for treatment of ischemic heart disease by providing transvenous myocardial perfusion.
U.S. Pat. No. 5,798,102 describes a method of treating cardiomyoplasty with a composition comprising beta-amyloid, streptolysin O and growth hormone.
U.S. Pat. No. 5,702,343 describes a cardiac reinforcement device and method of treatment of cardiomyopathy. This device provides for reinforcement of the walls of the heart by constraining cardiac expansion, beyond a predetermined limit, during diastolic expansion of the heart. This device is applied to the external wall of the heart and surrounds the complete cardiac wall.
U.S. Pat. No. 5,738,626 discloses a cardiomyoplasty procedure comprising excision of the tissue of the myocardium and replacing it with a muscle wrap. This muscle is conditioned with a support device.
U.S. Pat. No. 5,848,962 issued to Feindt et al. describes a half shell which is placed against the ventricle and an external filling unit which compresses the shell synchronously with cardiac activity, enhancing the ejection fraction of the ventricle.
U.S. Pat. No. 5,800,528 describes a passive girdle which is wrapped around a heart muscle which constrains the dilatation during diastole. The girdle is formed of a material and structure that does not expand away from the heart but may, over an extended period of time be decreased in size as dilatation decreases.
U.S. Pat. No. 5,282,849 issued to Kolff et al. describes a ventricle assist device with volume displacement chamber.
U.S. Pat. No. 4,902,291 issued to Kolff et al. describes a collapsible artificial ventricle and pumping shell.
Nevertheless, none of the above approaches is wholly satisfactory for the treatment of congestive heart failure. Therefore, there is a need for additional or alternative methods for treatment heart pump failure.
This present invention relates to devices, materials and methods and is directed toward treatment of heart failure by physically modifying the diseased or damaged heart tissue in such a manner that the internal volume of the damaged left ventricle is reduced, thereby improving the pumping efficiency of the diseased heart and ameliorating the symptoms of heart failure.
One embodiment of this invention comprises a catheter-based, minimally invasive procedure that will introduce biocompatible materials into the left ventricle of the heart. Part of the left ventricular cavity will be filled with biocompatible material which will be applied and attached to the left ventricle using catheter-guided techniques and equipment rather than conventional cardiosurgical procedures. The biocompatible filling materials introduced will decrease the volume of the left ventricle and improve the hemodynamics of the heart, thereby alleviating the symptoms of heart failure.
A second embodiment, which may be used either alone or in combination with the first embodiment, comprises direct injection of suitable, substantially non-compressible biocompatible materials into the wall of the left ventricle. This procedure will increase the bulk of the wall and thereby diminish the interior volume of the left ventricle. These materials may also strengthen and reinforce the wall as well, diminishing the risk that the ventricle might rupture.
The biocompatible filler materials to be used in both embodiments of this invention will exist in a substantially liquid state while they are delivered to the heart. They will then be converted to a second, substantially rigid state when they are attached to or injected within the wall of the left ventricle. Also contemplated in this invention are filler materials which will expand to a predetermined volume as they undergo the transition from the first, substantially liquid state to the second, substantially rigid state. These could also be foam-like materials which increase or decrease in size depending on the desired mechanism of action. The filler materials may include at least one of genetically modified therapeutic agents and growth factors, for example, genetically-engineered muscle cells and muscle fibers.
A third embodiment of the method relates to a method for treating heart failure comprising attaching at least one band to the surface of a human heart comprising a left atrium, a right atrium, a left ventricle and a right ventricle, thereby compressing the heart, whereby cardiac performance is improved. The internal volume of at least one of the left atrium, right atrium, left ventricle, and right ventricle can be decreased by this method, preferably by attaching a plurality of elastic bands to the surface of the heart. If desired, cross-links between a plurality of circular elastic bands attached to the surface of the heart can be provided. If desired, the circular elastic bands can be substantially horizontally positioned and substantially parallel to one another, wherein the bands are of varying diameter arranged in order of descending size from the atria toward the ventricles in order to form a conical structure on the outer surface of the heart.
The at least one attached band may preferably be made of wire and be adjustable in diameter, and wherein the diameter is adjusted according to monitored action of the heart. If desired, the at least one band can include other monitoring or diagnosis features, such as means for conductance of electrical signals to and from cardiac tissue, or means for delivery of drugs to the heart. The drugs may include at least one of genetically modified therapeutic agents and growth factors, for example, genetically-engineered muscle cells and muscle fibers. The at least one band can be attached to the surface of the heart by an attaching means selected from the group consisting of sutures, clamps, bio-compatible adhesives, or combinations thereof. The method can be used to decrease the internal volume of any one or all of the left atrium, right atrium, left ventricle, and right ventricle.
The invention also relates to a device for the treatment of congestive heart failure, in the form of a band configured and dimensioned to apply force to the outer surface of a human heart and made of at least one biocompatible elastic component selected from the group consisting of metallic materials, synthetic elastomeric materials, rubber materials, biological materials, stent graft materials and combinations thereof. Advantageously, additional features can be built into the biocompatible elastic components. For example, at least one of the biocompatible components can be electrically conductive. Preferably, the device is constructed in the form of a stent, optionally covered with a biocompatible elastomeric synthetic material such as muscle or other biological tissue. Also, the device may be constructed in the form of a cup-shaped stent, which stent is adjustable in size.
Other embodiments of this device include a band which is adjustable in diameter, which is introduced in a compact state and is released in vivo for placement around at least the left ventricle of the heart. The device can include elastic bands which are stretched before placement around the heart, and which include cross-links therebetween, wherein the elastic bands are substantially horizontally positioned and substantially parallel to one another, are of varying diameter arranged in order of descending size from the atria toward the ventricles, whereby a conical structure is formed on the outer surface of the heart. The band may alternatively be made of a resilient synthetic biocompatible material which overcomes flexing movements of heart muscles and which does not fracture upon long term flexing.
The present invention also is related to an apparatus for application around a heart with an apex. The apparatus includes a first portion having an anchor that is configured and dimensioned to be disposed proximate the apex, and a second portion having a plurality of petals and a retaining region, with the petals being resiliently biased. The anchor is retained in the retaining region and at least one of the petals is biased to provide compressive force against at least a portion of the heart.
In some embodiments, a tensioning band is included and is secured to at least one of the petals. The tensioning band may permit selective tightening of at least one of the petals. Also, two or more of the first portion, the second portion, and the tensioning band may be integrally formed. A screw mechanism may be provided for increasing or decreasing the compressive force applied by at least one of the petals. The first portion may be disposed about at least a portion of a ventricle. The anchor may be retained in the retaining region at least in part by a male-female interlock, and the petals may extend from the second portion proximate the retaining region. The petals may be uniformly spaced with respect to each other.
This invention describes approaches to be taken for the treatment of heart failure which avoid resection of diseased heart muscle. Various novel treatment methods, materials and devices are disclosed.
In one embodiment of this method, part of the diseased, expanded left ventricle will be partially filled with biocompatible materials which either will be attached to the wall directly or to a stabilizing skeleton attached to the wall. This will modify the geometry of the heart due to the introduction of the biocompatible material to decrease the internal volume of the left ventricle and thereby improve its geometry and hemodynamics. In a second embodiment, which may be used independently or in conjunction with the first embodiment, appropriate, biocompatible materials may be injected directly into the diseased tissue thereby thickening, reinforcing and strengthening or revitalizing the cardiac wall and, simultaneously, decreasing the internal volume of the left ventricle, thereby increasing cardiac efficiency. In a third embodiment of the method, at least one elastic band is placed around the outer surface of a human heart to compress one or more of the left atrium, right atrium, left ventricle and right ventricle to improve cardiac performance.
Damaged regions of the left ventricular cardiac wall may be defined and mapped by procedures well known in the art including both computer imaging and ventricular wall motion analyzers. Once this has been done, either or both embodiments of this invention may be utilized to treat heart failure resulting from the damage to the wall of the left ventricle.
The first embodiment of this invention comprises the use of a catheter for the introduction of biocompatible materials into the left ventricle. These materials may be coated upon or within a supporting skeleton within the heart. This embodiment also encompasses the delivery of filler materials into a container that may either be attached directly to the cardiac wall within the left ventricle or it may be attached to a stabilizing skeleton that will be fixed to the wall of the ventricle.
This embodiment also encompasses application of suitable biocompatible materials directly to the surface of the wall of the left ventricle. These filler materials may be used to increase the bulk of that part of the cardiac wall, decreasing the volume of the left ventricle. These materials may also be used to induce the retraction of the wall to which they are attached. Here the filler materials on the wall would shrink, condense or retract as a result of a physical or chemical change, causing a corresponding retraction of the wall of the ventricle. In addition, the state or phase of the material can be converted as it is introduced into the heart to cause expansion of the material and reduction of the volume of the heart. The filler materials may include at least one of genetically modified therapeutic agents and growth factors, for example, genetically-engineered muscle cells and muscle fibers.
Another embodiment of this invention comprises direct injection of biocompatible materials into the diseased tissue of the left ventricle to revitalize it or to increase its bulk and, consequently, improve the properties of the wall and to decrease the internal volume of the left ventricle. Suitable materials for this purpose would include, but not be limited to, angiogenic agents, collagen, fibrinogen, foams or hydrogels which are well known in the art. More generally, this invention contemplates the use of the group of substances referred to in the art as "polymeric endoluminal paving system" materials as biocompatible filler materials. Heart failure could be treated with such injections, either alone or in conjunction with the decrease in the volume of the left ventricle that would be obtained through the first embodiment of this invention.
These embodiments of this invention will generally employ a steerable application catheter which will be introduced into the left ventricle either by direct percutaneous access or by transluminal vascular access by retrograde passage of the aortic valve. The application catheter will be capable of being reversibly attached to the cardiac wall. Attachment of the steerable application catheter to the wall of the ventricle will allow the precise and accurate delivery of biocompatible filler materials, stabilizing skeletons, cutting means and tissue removal means to predetermined locations within the heart.
Furthermore, the application catheter will transport a stabilizing skeleton attached to the catheter by a reversible release mechanism. The application catheter may carry the stabilizing skeleton either internally or externally. The release mechanism, deploying the stabilizing skeleton, will be reversible to allow the retrieval of the stabilizing skeleton.
The application catheter may also be attached by a first reversible attachment means to a stabilizing skeleton which, in turn has a second reversible attachment means by which it may be attached to the wall of the ventricle. The catheter is attached only indirectly to the wall of the ventricle through the stabilizing skeleton. Furthermore, in this instance, the delivery means for the biocompatible filler material would be located at a point on the stabilizing skeleton proximal to the second attachment means and distal to the junction between the catheter and the stabilizing skeleton defined by the first attachment means.
The first attachment means may be any joining member or procedure which reversibly connects the catheter to the skeleton. The second attachment means can be any attachment member, such as an anchoring, screw or other fastener for fixing the stabilizing skeleton to the wall of the left ventricle at one or more points. The stabilizing skeleton may comprise arrangements of flexible filaments or elastic wires comprising suitable, biocompatible materials. The stabilizing skeleton may also comprise a network or mesh of such filaments and, if desired, a flexible, expandable container.
The application catheter of this invention may also have cutting and retrieval elements. These will allow removal of part of the cardiac wall as needed, for example, for attachment of the application catheter, attachment of the stabilizing skeleton, application of suitable materials to the surface of the cardiac muscle, and injection of the filler material into the wall. The cutting and retrieval elements of the application catheter may also be used to remove the filler material from the heart, prior to the extraction of the support skeleton if that were to become desirable or necessary.
The application catheter of this invention will also comprise means by which the biocompatible filler material will be coated upon or inserted within the wall of the ventricle. These means can include any tube or conduit which can direct the filler material to the heart. In addition, filler material distribution elements can be used to direct the filler material to the proper location. In this embodiment, the elements can be used to directly apply substantially liquid filler material upon the surface of the ventricular wall. The catheter may also carry suitable means to initiate the physical and chemical changes that would be necessary to allow the biocompatible filler material to adhere to the surface of the wall. Alternatively, the catheter can include components for the injection of biocompatible filler material directly into the wall. These components are preferably needles or include needle-like tubular elements for injection of materials, which elements are advantageously positioned substantially perpendicular to the site of injection. The injection component may also be composed of a plurality of needles or needle-like elements placed at the proximal end of the catheter and oriented at an angle to the longitudinal axis of the catheter to allow a wider area of the wall of the ventricle to be treated at one time. Preferably, this angle would be between 20 and 60 degrees and is preferably about 30 degrees. Also contemplated are needle means in the form of elongated tubular members projecting radially from the application catheter. Here the catheter may be placed within the heart wall, using for example a void or pit constructed with the cutting and retrieval elements described above. The filler material would then be injected in a direction substantially perpendicular to the long axis of the catheter and substantially parallel to the surface of the cardiac wall. This embodiment of the invention contemplates multiple, retractable needles allowing a radial dispersion of the biocompatible filler material within the cardiac muscle.
The biocompatible filler materials generally are in a fluid, substantially liquid state before they are introduced into the ventricle. Once in place these materials undergo a phase transition into a substantially non-compressible form, essentially rigid state, as they are attached to or injected within the wall of the ventricle. The biocompatible filler may also be a material that is both compressible and expandable. In this instance, the filler material would first be compressed while it is delivered to the heart and then allowed to expand to a pre-determined volume within the heart. The filler material will be extruded from the application catheter onto a supporting skeleton which supports a flexible, expandable container. The filler will be firmly attached to or confined within the supporting skeleton in order to avoid embolization caused by the flow of the blood stream and the dynamics of the heart.
The expandable, flexible container contemplated by this invention may be attached directly to the cardiac wall or to a stabilizing skeleton or support that is fixed to the wall. In this approach, the filler material or materials will be injected into the skeleton or container until it expands to a pre-determined final volume. Once filled, the container will then be sealed. Materials which can be used to fill the container would include not only the biocompatible materials applied directly to or injected within the wall of the ventricle but they could also include, for example, colloidal suspensions, contrast mixtures and conventional pharmaceutical solutions such as saline.
Expansion of the biocompatible filler may be driven by any one of a number of mechanisms. The filler material may expand upon release as a result of its inherent mechanical properties. One type material is a foam material that increases its volume upon deployment. Typical foam materials include polyurethane foams such as IVALON™ or hydrogel plugs as these materials are well known biocompatible fillers that are used in other medical applications. Another would be a spring or flexible mechanical structure based on a memory material such as nitinol wire. The expansion could also be the result of an interaction between the filler material and blood or between the filler material and the tissue surface. The expansion may also be the result of the temperature and/or pressure differences between those within the heart compared to the comparable conditions found in the catheter or other delivery apparatus.
This invention also contemplates the expansion or phase transition of filler material by the injection of liquids into a fluid-tight, sealable compartment containing the filler material. Suitable liquids, again, include colloids, saline solutions, contrast mixtures, or mixtures thereof.
It is also contemplated that a substantially non-compressible substantially rigid filler material is generated through a chemical reaction in situ in the compartment. Reagents and catalysts, if appropriate, could be provided through independent lumina of a multi-channel catheter. The reagents would be mixed and allowed to react within a sealable, fluid tight, flexible container held within the stabilizing skeleton attached to the wall of the left ventricle. The product of this reaction would have a pre-determined volume and a shape that could be constrained by a container, a stabilizing skeleton, or an expandable container held within the stabilizing skeleton. For example, reversible hydrogels may be constituted using self-assembling artificial proteins. Such protein solutions, adjusted to a first pH level could be used to fill and expand a fluid-tight container held by the support skeleton within the diseased left ventricle. Subsequent adjustment to a second pH would then induce a reversible transition of the protein solution to a substantially non-compressible, substantially rigid gel. Suitable hydrogels, with properties that would present specific advantages for application in this invention could be designed and produced by recombinant DNA methods known in the art. (Petka et al., "Reversible Hydrogels form Self-Assembling Artificial Proteins, (1998) Science 281 (Jul. 17, 1998), 389-392).
This invention further contemplates biocompatible filler materials which could be expanded to a pre-determined volume by the application of an external influence. Examples would include the expansion of suitable biocompatible fillers mediated by exposure to ultraviolet, ionizing or other radiation of an appropriate wavelength.
Still further, this invention contemplates direct attachment of the biocompatible filler material to the wall of the left ventricle. Contraction, shrinkage or compaction of a layer of filler material directly attached to the wall of the ventricle would result in a parallel contraction of that wall, thereby decreasing the internal volume of the left ventricle. Contraction of the filler material directly attached to the wall could occur over a period of time as a consequence of the nature of that material within the cardiac environment. Contraction might also occur only after a certain time period and could be mediated by the application of external factors. Such factors might include exposure to radiation of a suitable wavelength and intensity, electricity or other physical influences, injection of other interacting materials, and application of a localized source of heat or suction applied to the biocompatible filler attached to the wall of the left ventricle.
The stabilizing skeleton may be made up of biocompatible, flexible mesh-like materials, flexible filaments or from an arrangement of biocompatible elastic wires. As noted above, the stabilizing skeleton generally includes means for reversible attachment to both the application catheter and the cardiac wall. It will also be capable of collapsing into a compact structure that may transported, either upon or within the attachment catheter, to, or from, the site of its attachment within the body. Once set in place within the body the stabilizing skeleton will be expanded to the shape and size with which it will be used for the attachment of filler materials. The stabilizing skeleton may also contain within it, or have attached to it, an expandable container into which filler material can be injected.
The stabilizing skeleton may also be used for the mechanical support of a predetermined section of the wall of the left ventricle. This structure could be applied to the internal surface of the left ventricle prior to the injection of biocompatible filler materials within the wall.
In another embodiment, the biocompatible filler may be added by injection directly through the diseased heart wall. A variety of suitable syringes are useful for this purpose, with the biocompatible material carried by the syringe body and then injected through the needle into the heart. One of ordinary skill in the art can select an appropriately sized needle to deliver the selected biocompatible material via this pericardial access.
In addition, the biocompatible material can be, or include, a genetic material that operates on the heart tissue over time to enhance its mass or performance. Typical genetic materials include angiogenic factor or growth factor, and these are preferably added with a biocompatible material so that the biocompatible material initially reduces the volume of the heart followed by the action of the genetic material on the heart wall over time. For example, genetically-engineered muscle cells and muscle fibers can be introduced along with one or more filler materials. Genetically-modified cells and growth factors suitable for injection according to the present invention include those described, for example, in "Gene Therapy in Heart Studies Shows Promise," The Wall Street Journal, Nov. 14, 2001, p. B7, the content of which is incorporated herein by reference. These genetically-engineered cells and fibers, referred to as muscle growth factors, facilitate the growth of new cells and capillaries in the myocardium. Therefore, in this instance, not only is the volume of the ventricle reduced, but perfusion of the myocardium is also increased as well. Therefore, biocompatible filler materials may be selected from the group consisting of a self-expanding foam, a hydrogel, gelatin, collagen, fibrinogen, elastin, water-absorbing microspheres, muscle growth factors, and combinations thereof.
The amount of biocompatible material filler to be introduced is that which will reduce heart volume to levels that control the diastolic ("D") and systolic ("S") levels to desired ranges. Typically, the heart ejection function ("F") can be calculated by the following equation:
Values of 60 to 75% and particularly 65% are desired. Thus the optimum volume of biocompatible material to be introduced into the heart is that which can increase the F value to 65%. Example 1 illustrates how this is done.
An additional method for reduction of the volume of the ventricle, which can be used either alone or in combination with the other procedures and compositions of the present invention, is designated Ventricular Geometry Reduction. In this method an elastic strap or band is attached to the external surface of the heart and thereby compresses the heart in such a manner as to decrease the effective internal volume of one or more cardiac chambers. Consequently, cardiac systolic and diastolic cycles are performed with substantially decreased blood volumes, thereby increasing the efficiency of the pumping action of the CHF-afflicted heart.
In one embodiment of this procedure, one or more bands formed from a metal or a combination of metal and a synthetic material, are attached to the external wall of the ventricle. This band, or these bands, may be sutured onto the ventricular wall such that the ventricular wall is pulled closer together thus reducing the volume of the ventricle. That is, since the left ventricle is dilated considerably in CHF, the walls of the ventricle may be pulled together whereby an overlap of the wall tissue is formed and held in this physically constricted state, thus causing a significant reduction in the volume of the ventricle. This decrease in the effective volume of the left ventricle decreases the contractile force required to expel blood from that ventricle.
In another embodiment of this procedure, one or more bands may be attached to the outer wall of the heart to reduce the radius of the ventricle. These bands may comprise a set of bands of decreasing diameters, which can be attached to the exterior surface of the heart, and which may be crosslinked to one another to form a conical structure surrounding and supporting the heart, whereby the radius of the ventricle is reduced.
Bands can be placed through minimally invasive surgery, using, as a non-limiting example, fluoroscopy procedures to guide their positioning and placement. In addition, other imaging techniques, including the use of a Noga catheter for example, can be used to monitor ventricular function, and to identify and map those regions of the wall that are functioning poorly or not at all. Evaluation of the mapping information obtained is used to guide placement of the band or bands on the wall of the heart. Similar imaging procedures can be used after application of the bands of the present invention, to verify an improvement in cardiac function.
In further embodiments of this procedure, the bands attached to the heart are capable of transmitting an applied electrical impulse to stimulate contraction of the heart. Here, the band may be temporarily, or permanently, connected to electrical leads, which could be used to pace the heart by either increasing or decreasing the frequency of contraction. Similarly, in another embodiment, the cardiac bands are constructed to allow the delivery of one or more drugs to the heart in a programmable manner. Drug delivery can be provided as a continuous infusion or through intermittent doses. In both instances, the timing and rate of delivery of the drug can be regulated by means of an external, programmable interface. These applications are in contrast to muscle wraps, which have been used to support the heart, that have, essentially, failed because the muscle fibers by themselves have no contracting motion and, therefore, simply lie over nonfunctioning or only poorly-functioning cardiac tissue.
Once one or more bands are attached to the heart, cardiac improvement methods, including, but not limited to transmyocardial revascularization or percutaneous myocardial revascularization may be carried out using laser, ultrasound, or RF ablation or other, appropriate, mechanical processes.
The bands may be attached to one or more regions of the heart. For example a band may be positioned so that it surrounds the ventricle in such a manner that it reduces both the systole and diastole. In this instance, the band exerts a constrictive force on the ventricle and thereby remodels the geometry of the heart, and improves the functioning of the heart. In one example, the band or bands may be placed around the ventricles in order to improve the injection fraction of the heart. When appropriate, the band or bands may be placed only around the left ventricle. Here the band can be one formed in the shape of an arc, similar to, but more elastic than, conventional annuluplasty rings that are placed around the mitral valve. In this instance, the diameter of the semicircular band encompasses the left ventricle, while the arms of the arc are placed around the ventricular chamber, and adhered thereto by suitable means. In another embodiment of the present invention, both the systole and diastole of a failing heart can also be improved by attaching one or more bands around the entire heart in such a manner that both the atria and the ventricles are enveloped.
The bands may be constructed as stents which may be formed of any of a number of suitable, biocompatible materials. For example, the bands may be constructed of one or more metals, or appropriate synthetic materials, and may have one or more openings within the band. These bands can also be made from stent graft material, which may be applied to either the inside or the outside of the stent or on both sides of the stent. The band, formed as a stent, may be manufactured employing processes comprising one or more of laser cutting, chemical etching, photomachining techniques, and metal injection molding.
The bands can also be constructed as adjustable rings, which may comprise a metallic component, that can be placed over the top of the left ventricle only. Such an adjustable ring, which has been positioned over the top of the left ventricle, may be clipped or sutured onto that ventricle, or otherwise attached using materials and procedures know to those in the art. The bands may also be shaped as a cusp having one or more stent-like elements with an adjustable diameter.
The band may also comprise a cover of a synthetic material and it may be formed between two layers of synthetic material, which may conduct electricity. The bands may also be covered with a biological material, including, but not limited to, muscle tissue or elastic tissue, which may be capable of conducting electricity. Where the band is coated with muscle tissue, the band can have three functions: volume reduction of the left ventricle, an electrical function and stimulation of the electrical function of the heart. In one embodiment of the present invention, electrical stimulation can be used to control movement of one or more bands attached to the heart, in such a manner as to mimic normal heart function.
The bands are preferably designed to be contractible or collapsible to a compact configuration to facilitate introduction into the patient. A small incision can be made with the compact band inserted within an introducing catheter in a manner similar to that used for introducing stents into the vascular system. The bands are then deployed and expanded or otherwise allowed to change into their final configuration and location in place around the outer surface of the heart.
The methods and means by which this invention leads to a reduction in heart volume may be understood more clearly by reference to
In one embodiment of this invention, depicted in
In some prior art embodiments, a jacket or cusp is placed around the heart or the left ventricle. This has the potential to compress some of the arteries that supply blood to the heart muscle.
As shown in
As shown in
In one embodiment, as many as twelve petals (82) are provided about the periphery of heart (76) with its various chambers. The petals may be uniformly spaced, or alternatively spaced in non-uniform fashion about the periphery. In one exemplary embodiment, petals (82) are formed from a metal or polymer. Petals (82) may be clip-like, and may be resiliently biased to apply a compressive force around at least a portion of heart (76), for example, to decrease the volume of a ventricle. In some exemplary embodiments, a tensioning band (84) may be secured to one or more of petals (82) to permit selective tightening using a tightening force remote from retaining region (80) and apex (74). The petals (82) connected by tensioning band (84) may be adjacent one another, or more remotely located from one another. In general, the structure of tensioning band (84) is like or comparable to the structure of the bands previously described, and accordingly is not repeated. Further, biocompatible materials introduced into the heart, as previously described, may be used in combination with jacket (70), petal-like structure (78), and tensioning band (84) to effect the desired volume reduction in at least a portion of the heart. In some exemplary embodiments, tensioning band (84), for example, may be attached to multiple petals (82), and provided with means to permit petals (82) to be selectively tightened or loosened so that a desired compressive force is applied to heart (76).
In some embodiments, jacket (70), petal-like structure (78), and tensioning band (84) are provided as separate components, while in other embodiments two or more of jacket (70), petal-like structure (78), and tensioning band (84) may be integrally provided.
The following examples illustrate the most preferred features of the invention.
An angiogram is used to determine the heart rate of a subject, and it is found that D=180, S=100, and F is 44.4%. Computer modeling of the heart is used to image the heart and determine where dead or non-functioning tissue is located.
A biocompatible filler material of a hydrogel is placed in the heart in the area of the non-functioning tissue. After the material is placed, another angiogram is taken to find that D=170, S=100 and F is 42%. The preceding steps are repeated until F is increased into the range of 60 to 75% and preferably, as close to 65% as possible. The final values of D=150, S=60 and F=60% are acceptable and the procedure is terminated.
A left ventricular angiogram was done with a LV catheter and the ejection fraction was determined using the dye outflow technique. Later, a Noga catheter was used to map the ventricular wall motion to determine the areas of the ventricular wall where the tissues are ischemic.
A biocompatible filler material was introduced in the areas of the ventricular wall where the tissues were found to be ischemic. The ventricular wall mapping was repeated to notice any changes in wall motion. The wall mapping was repeated after 4 weeks, one month and six months to monitor any changes.
The experiment of Example 3 was repeated after a filling material consisting of a biological material and a filler material was introduced inside the ventricular wall.
After LV angiogram and LV wall mapping techniques, a filler material that contained a genetic material which enhances angiogenesis was injected into the ventricular wall. Following this, an elastic band was placed around the ventricle and the angiogram and mapping was repeated.
After the steps described in Example 4 were completed a second band was placed parallel to the first band and around the ventricle.
For all examples, the methods described therein resulted in improved heart pumping efficiency.
While various descriptions of the present invention are described above, it should be understood that the various features can be used singly or in any combination thereof. Therefore, this invention is not to be limited to only the specifically preferred embodiments depicted herein.
Further, it should be understood that variations and modifications within the spirit and scope of the invention may occur to those skilled in the art to which the invention pertains. Accordingly, all expedient modifications readily attainable by one versed in the art from the disclosure set forth herein that are within the scope and spirit of the present invention are to be included as further embodiments of the present invention. The scope of the present invention is accordingly defined as set forth in the appended claims.
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U.S. Classification | 600/37 |
International Classification | A61B17/00, A61F2/02, A61L31/14, A61F2/00, A61F2/24, A61B17/12, A61L27/22, A61L27/50, A61L27/56, A61L31/16, A61L27/24, A61L27/52 |
Cooperative Classification | A61L2300/258, A61L27/50, A61L31/14, A61L27/56, A61B17/12172, A61B17/12022, A61L27/222, A61L31/16, A61F2/02, A61B17/12122, A61B2017/00044, A61L27/52, A61M2210/125, A61L27/227, A61F2/2481, A61B17/1219, A61B17/00234, A61L27/24, A61B17/12186, A61L2300/412, A61B2017/00243 |
European Classification | A61B17/12P7W1, A61B17/12P7Z3, A61B17/12P5H, A61B17/12P7Z1, A61F2/24W2, A61B17/00E, A61L27/52, A61L31/16, A61L27/24, A61L31/14, A61L27/50, A61L27/22E, A61L27/22R, A61F2/02, A61L27/56 |
Date | Code | Event | Description |
Dec 9, 2011 | FPAY | Fee payment | Year of fee payment: 4 |
Feb 5, 2016 | REMI | Maintenance fee reminder mailed | |
Jun 24, 2016 | LAPS | Lapse for failure to pay maintenance fees | |
Aug 16, 2016 | FP | Expired due to failure to pay maintenance fee | Effective date: 20160624 |


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text:
Jesus James Llorico
The Garden
'In this garden I take a rest
To ease the sorrow in my chest
For I have seen so many years
Before I felt this flowing tears
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The Mount Royal University Archives acquires, preserves, and makes accessible archival records that are significant to the history and life of Mount Royal University and its students, faculty, and staff. The archives are open to everyone: students, faculty, staff and the general public.
HoldingsThe archives holds many types of records including: textual records (such as correspondence, meeting minutes, and reports), photographs, audio/video recordings, maps, architectural drawings, digital records, and artwork. The archives also holds campus publications including yearbooks, academic calendars, as well as newspapers, magazines, and newsletters published by university offices and campus organizations.
We're currently working on establishing online archives database that will contain searchable finding aids of our holdings. Until it's ready to launch, please contact us for detailed information about what the archives holds, or for help with your research.
Open hoursThe archives is regularly open Monday to Friday from 10am to 12pm, and is located in room I-157. Please feel to drop by anytime during open hours! Appointments for other times can also be booked by contacting us.
Please direct donation inquiries to Peter Houston, Archivist and Special Collections Librarian at firstname.lastname@example.com or 403.440.5197.
New facilityIn summer 2017, the archives will be moving to an exciting new space on the fourth floor of the Riddell Library + Learning Centre, which is currently under construction. The new space will contain:
- a public reading room for working with the collection
- a compact storage area for maximum collection space
- office and conservation areas to provide the necessary tools for care, digitization, and preservation of archival holdings
Contact usMount Royal University Archives
Room I-157, 4825 Mount Royal Gate SW
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t: 403.440.5197


text:
Get an overview of this hotel3-star hotel with free breakfast and restaurant
Collect 200 Nectar points!
Simply enter your Nectar card number when you check out. Your points will be credited 35 days after you return from your trip.*Offers may apply
Situated in Cranbrook, this hotel is steps from St Dunstan's Church and Cranbrook Museum. Cranbrook Union Mill and The American Garden are also within 15 minutes.
Hotel Features
This hotel features a restaurant, a bar/lounge, and wedding services. Free WiFi in public areas and free self parking are also provided. Other amenities include a lobby fireplace and free breakfast.
Room Amenities
All 12 individually decorated rooms feature free WiFi and room service. Other amenities available to guests include satellite TV, premium bedding, and coffee makers.
Information missing or incorrect? Tell us!Opens in a new windowThe George Hotel
Hotel Amenities
The hotel offers a restaurant. A bar/lounge is on site where guests can unwind with a drink. A complimentary breakfast is offered. Public areas are equipped with complimentary high-speed wireless Internet access.
This Cranbrook hotel also offers a fireplace in the lobby and room service (during limited hours). Onsite self parking is complimentary.
- Total number of rooms - 12
- Number of floors - 2
- Bar/lounge
- Free breakfast
- Fireplace in lobby
- Front desk (limited hours)
- Free WiFi
- Restaurant
- Free self parking
- Number of buildings/towers - 1
- Wedding services
Available in all rooms: Free WiFi
Available in some public areas: Free WiFi
Free self parking
Room Amenities
- Premium bedding
- Free bottled water
- Coffee/tea maker
- Private bathroom
- Designer toiletries
- Bathrobes
- Shower only
- Satellite TV service
- Free WiFi
- Room service (limited hours)
- Individually furnished
- Individually decorated
- Free cribs/infant beds
- Rollaway/extra beds (surcharge)
Where to Eat
A complimentary breakfast is offered.
Brasserie - This restaurant serves lunch and dinner.
Cranbrooke Bar - Onsite restaurant.
The Dining Room - This restaurant serves breakfast, lunch, and dinner.
Room service (during limited hours) is available.
Hotel Policies
Check-in time starts at 2 PM
Special check-in instructions:
Check-out time is 11 AM
Payment types
Children and extra beds
- Children are welcome.
- Rollaway/extra beds are available for GBP 20 per night.
- Free cribs (infant beds)!
- Pets allowed for an extra charge of GBP 5 per pet, per night
- Dogs only
- Specific rooms only
- Pet-friendly rooms can be requested by contacting the property at the number on the booking confirmation
You need to know
Extra-person charges may apply and vary depending on property policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
Optional extras
- Pet fee: GBP 5 per pet, per night
- Rollaway bed fee: GBP 20 per night
Hotel Name
- George Cranbrook
- George Hotel Cranbrook
We should mention
This property allows pets in specific rooms only (surcharges apply and can be found in the Fees section). Guests can request one of these rooms by contacting the property directly, using the contact information on the booking confirmation.
National Rating
This establishment has received its official star rating from VisitEngland, the National Tourist Board for England.


text: TomTom VIA 1505M 5-Inch Portable GPS Navigator with Lifetime Maps $72.00 $169.95 + Free Shipping See It! About this Deal Sold by Amazon.com Usually ships within 1 to 4 weeks Flag this deal Edit deal What's the matter? Choose a reason Dead deal Duplicate Bad link Spam Inaccurate No value Alive again Comments (4) monster1991 Jan 22, 2015 price drop! Reply Cancel tr1plication Jan 21, 2015 Back again Reply Cancel monster1991 Jan 13, 2015 price drop! only $77.99 now :) Reply Cancel newguy Dec 17, 2011 Now $89.00 Reply Cancel Load More Comments


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Routes : North America : United States : Idaho : Lost River Range : Sacjewea Peak : Sacjewea : Broken Wings
Broken Wings - WI5
Average Rating : 0.00 out of 5Route sequence (left to right): 1
Route Summary | Ascent Notes (1)
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Standard rock rack up to 3 inches. Knifeblades and short ice screws.
Located on the remote north face of Sacjewea, Broken Wings follows a tight couloir/chimney on the right margin of the face. The climbing consists of ephemeral water ice in a one meter wide chimney and involves approx. 1,500 feet of steep climbing. Expect some rock climbing/drytooling. Broken Wings could be one of the best alpine routes in Idaho.
Submitted by: deanlords on 2005-10-07
Views: 628
Route ID: 67457
1 Ascent Recorded
Ratings | |
Difficulty |
Onsight ascent by: deanlords on 2005-05-18
(View Climbing Log)
Ascent Note
This route offered four of the best alpine pitches i've ever climbed in the mountains of Idaho. The exit pitch onto the ridge was your typical Canadian Rockies or Alaskan exit scare fest, but it's doable. The route protected well in the condition we found it in. Future ascents could find thicker ice making it a wee bit easier, and thinner conditions would up the seriousness a couple of grades!
Added: 2005-05-18


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Lack of knowledge about U.S. export controls can create commercial headaches, inventory management issues and shipping delays. The seminar will cover the basics of U.S. export control rules and the key elements of an effective compliance system to prevent violations and protect businesses from facing civil and/or criminal penalties.
Brian Peck will speak to the 4th Tuesday Tech Exchange group about complying with U.S. export and re-export controls.


text:
Rodzaj pokoju
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Maysville, Georgia 30558, Stany Zjednoczone
Wendy was more than good to us and the home is absolutely beautiful. I would definitley stay here again. Southern hospitality at its best!
Jesse2016-04-19T00:00:00ZWendy was an excellent host! She has set the bar high for cozy and comfortable accommodations. The bed was plush and the bathroom was stock with everything we could need.
Betsy2016-03-07T00:00:00ZFelt at home staying with Wendy and Shawn, safe, friendly, clean and responded quickly to our questions. Would definitely stay here again.
Edwin2017-01-10T00:00:00ZAs a traditional hotel traveler I decided to break the mold with encouragement from my daughter. To my surprise I found this first time experience with Airbnb to be more pleasurable than what I could have imagined. Wendy was a fantastic hostess and her accommodations were well above a five-star hotel. Wendy and Shawn made my daughter and I feel very at home as though they were family friends seen once a year. I will definitely use their place again if traveling through Athens. If you are apprehensive about trying Airbnb I encourage you to break the mold.
Laurie2016-06-15T00:00:00ZWendy's home is as lovely as depicted and immaculate. Due to the activities of my visit in Athens, my stay was brief, but it is hard to imagine anyone not finding these accommodations impeccable.
Camilla2016-05-27T00:00:00ZThis was our first time trying Airbnb. We were not disappointed. Wendy and Shawn were very friendly and willing to accommodate our needs. Beautiful home- clean, comfortable and private room.
Brandi2016-09-17T00:00:00ZWendy and Shawn were absolutely wonderful. They are a couple of sweet souls. The house was very well kept and beautiful all around. I couldn't complain if I tried. Thanks so much for a great stay!
Nikki2016-06-11T00:00:00ZGreat hosts! Wendy and Terrell are very friendly people. Beautiful house in a beautiful neighborhood. Will definitely look them up again if I'm ever headed back to Athens.
Justin2016-04-12T00:00:00ZRodzaj pokoju
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Ateny, Georgia 30607, Stany Zjednoczone
The posting was very accurate. This house was perfect for our stay. The location is peaceful and we enjoyed coffee on the front porch each morning. Coni was very pleasant and attentive. She went above and beyond, finding places and making suggestions for things to do. She was great about checking to see if we needed anything. the house was very clean and well stocked.
Becki2016-12-27T00:00:00ZBeautiful home and fun decor! Very relaxing. Highly recommend!!
mae2017-01-26T00:00:00ZConi's guest house was absolutely fantastic! The house is a lot larger than it looks in the pictures, and there was more than enough room for 6 people. The location is stunning, the view is incredible, and we felt super welcome. I will definitely be staying here again!
Jenna2017-01-01T00:00:00ZWe had such a great time at Coni's home for our girls weekend. It is much better than the pictures, with lovely little touches of snacks, coffee and tea when we arrived. Also, it was wonderful to come into the home and have it exceptionally clean and warm and welcoming. It is also much larger than we thought. We hiked all around the house the first day, the 2nd and 3rd days we went to Gainsville, Helen, and Tallulah Falls, all within a 40 minute drive. One of the best dinners we had was our last night we went into Lula to "At the Tracks" restaurant. Very good food and wonderful staff! Loved it. thank you Coni for a wonderful time in your home.
Midge2017-02-21T00:00:00ZOur stay was wonderful! Coni was very responsive and they provided everything we needed, including lots of firewood so we could stay warm and cozy. The house was clean and well decorated, the beds were comfortable and we enjoyed all the outside space.
Amy2017-01-09T00:00:00ZConi's house is a really nice home, it is large, warm, clean,well-decorated in splendid sense. every thing is comfortable for staying and we were completely relaxed for 4 nights. even staying in house and doing some exploring nearby all day long wouldn't be boring. Coni and her husband Gene are very nice person, Gene waited us when we arrived and give us a very detailed explanation of the equipment. During our stay Coni and Gene visited us again to ask if we need help and told us about the winery and sightseeing point and towns nearby which helped a lot. 3 bedrooms are large enough for a big family, we cannot wait to be back again with our sons. Would highly recommend!
Jingwen2016-12-09T00:00:00ZOur stay was wonderful! Communication with Connie with clear and easy and made for an even better stay. The Lula area was a nice break from the ATL-metro. The house was clean and lovely and had everything we needed. And the value was fantastic!! Thank you!
Kendrick2017-01-09T00:00:00ZThanks! We really enjoyed the peace and quiet.
Kevin 2017-01-10T00:00:00ZRodzaj pokoju
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Lula, Georgia 30554, Stany Zjednoczone
Perfect secluded couples get away within walking distance to a lovely vineyard. Impeccable cottage with 2 decks overlooking scenic rolling hills. The sunrise off the back deck is fantastic. If you are looking for quiet, and cozy, this is your place. Hosts always responded immediately and were available, yet not intruding. Bed is comfy, and the architecture in this spotless home is beautiful.
Joy2017-03-06T00:00:00ZThis cottage is perfect for a weekend getaway, the views are amazing. Butch and June are a great, friendly couple and met our every need. You are missing out if you don't wake up for the spectacular sunrise view. My girlfriend and I are looking forward to returning soon and trying out Boutier Winery next time. Thanks for providing us with an awesome first Airbnb experience!
Luke2017-01-08T00:00:00ZThis was the most amazing experience ever! Butch and June are by far the sweetest individuals ever! They were attentive, polite, hospitable, and were filled with such a love for hosting! I didn't want to leave at all! I look forward to coming back to the perfect spot for relaxation and rest! I love this cottage! The scenery, the amazing rustic feel, just everything was perfect!!!! From watching the sunrise and sunset to reading a book on the porch while over looking the amazing scenery. I LOVED this place!!
Richelle2016-12-28T00:00:00ZOur stay was all we hoped for and more. The cottage is beautiful and extremely clean. Butch and June are very nice and even helped our daughter in law with a flower and wine delivery to help celebrate our wedding anniversary. The flowers and wine were waiting for us when we arrived. What a way to start a vacation! We highly recommend this cottage. The neighborhood is beautiful and quite. This is the prefect place to go to get away from your real life. Thank you Butch and June for a wonderful stay (and the pizza pan)!
Darlene2016-08-02T00:00:00ZWe had a lovely and brief stay at the cottage. I walked over to the winery next door and grabbed a bottle of wine and sat and talked with the owner for a bit. Beautiful property with great Georgian views. We wish we had a longer stay but will look forward to our next visit. Thanks Butch!
Stephen2016-08-17T00:00:00ZOur stay was so wonderful! Butch was super nice and very helpful! The cottage was very clean and beautiful! The bed was super comfy too!
Kristin2016-11-19T00:00:00ZWill leave you speechless! Only word for Butch's place is fabulous!
Angel2017-01-04T00:00:00ZThis cottage was absolutely beautiful! I wish I could have stayed longer. The area is peaceful and the natural scenery is very relaxing. It's a perfect place for a weekend getaway. The cottage itself is very homey and spacious. Thank you Butch for the warm stay. I hope to visit again.
Enoch2016-07-05T00:00:00ZRodzaj pokoju
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Danielsville, Georgia 30633, Stany Zjednoczone
Wendy and Shawn were fantastic hosts, we really enjoyed our stay in Athens at their place. Clean room, clean bathroom, fantastic stay. Thanks for the ride into town Shawn!
Ben2016-11-13T00:00:00ZVery easy and immediate communications with the hosts. Room was nicer and cleaner than any hotel room we've ever rented. We would stay again.
Michael2016-05-16T00:00:00ZAbsolutely phenomenal and welcoming hosts! Will definitely use in the future. Very close to UGA, but far enough away that you still have a chance to enjoy the quietness away from the hustle and bustle. The room was absolutely perfect, and nicer than almost any hotel I've ever stayed in. Can't wait to book again with them!
Jenny2017-03-06T00:00:00ZWendy greeted us as soon as we pulled up, showed us the house and where we would be staying. She we above and beyond to help us out with anything we needed, even drove us to the city for the game. Anytime I visit again I will surely be staying here!
Jared2016-10-16T00:00:00ZWonderful stay. Everything was nearly and clean. We had a lot of privacy. Couldn't have had a better experience.
trenton2016-06-12T00:00:00ZWendy was a wonderful host! Shawn was away on business so we didn't have the pleasure of meeting him. Wendy was warm , cordial, and very helpful. She gave wonderful advice about where to eat in the area. We had a wonderful time in Athens and found our room to be absolutely perfect! I would highly recommend Wendy and Shawn to anyone.
Phil2016-08-20T00:00:00ZI absolute loved staying at Wendy's home. When we arrived Wendy and her husband were waiting to welcome us and show us our room. Her home was immaculate and all linens were fresh and clean. Smelled superb. She even has chocolate mints waiting on the bed with a note of house amenities. I would most certainly stay with Wendy again!
VICTORIA2016-05-15T00:00:00ZThis is a lovely house that located in Athens. The hosts are very nice and friendly. And, our room is decorated by Wendy herself. It is very clean and comfortable. Thank you so much for giving us such great experience!*\(^o^)/*
Miao2016-10-11T00:00:00ZRodzaj pokoju
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Ateny, Georgia 30607, Stany Zjednoczone
Awesome place and awesome people!
angie2016-10-04T00:00:00ZA very unique and enjoyable Airbnb experience! John was easy to communicate with, an incredible host and pleasure to spend time with. If you're in the area this is a great deal. Exploring the farm is a fun added bonus to the great accommodations.
Hace2016-10-15T00:00:00ZGreat place!
john2017-02-03T00:00:00ZThis was our second stay at John's beautiful and comfortable home. He and Rebecca welcomed us and made us feel at home. We will definitely stay again.
Sue2016-12-28T00:00:00ZMy wife, our pug and I were greeted by John upon arrival. He was working on gravel which led to a newly built deck with a view of the pastures and the foothills of north Georgia. We were then introduced to Rebecca who gave us a tour of the house. The Air BnB rooms are in a private downstairs area (three in total). The space was great for resting with an adjoining area that was conducive to focused working. The common areas of the home were beautiful and well kept. Rebecca prepared a thoughtful breakfast (since my wife and I are vegetarians) that included tasty, made from scratch biscuits. She also provided a dinner meal since we stayed multiple nights which was above and beyond what we expected. John communicated clearly and we enjoyed sitting and chatting with him and Rebecca. You are within an hour from vineyards, Atlanta and Athens. Highly recommend this place and hope to return soon.
Dennis2016-10-11T00:00:00ZLodging at the Lindsay Corriedale Farm: 10-28-16 thru 10-30-16 If you're thinking about a place to stay during your visit to the Athens, Georgia area … We highly recommend the Lindsay Corriedale Farm in Jefferson. It is about a half an hour up the road from Athens. Bryce, I, and our Italian Greyhound Sophie, stayed at the farm residence of John & Rebecca over the course of this past weekend, to celebrate our 8th Wedding Anniversary and check out a church internship site for Bryce. We had a wonderful experience at John and Rebecca's AirBnB. John was very responsive from the outset. He sent an e-mail prior to the time of our scheduled departure, asking about our anticipated time of arrival. There were even periodic follow-up text messages sent to make sure we were making it through the challenging Friday night traffic in Atlanta. He provided specific directions about the exit and roads to take just in case our GPS lead us astray. John is a gracious host! He greeted us when we arrived and offered to assist us settling into our room. He gave us a tour of the beautiful residence and the grounds. The setting reminded us of Tuscany. John is also an engaging conversationalist, discussing with us subjects from literature, philosophy, theology, law, and animal husbandry. He gave us great recommendations for local dinning. In as much as we read the great reviews of Rebecca's cooking, John was very much up to the task (even in Rebecca's absence due to business), and made us wonderful breakfasts! We do, however, look forward to duck eggs and sausage prepared by Rebecca the next time we stay at the farm; which everyone raves about. I'm certain that Rebecca would have been extremely proud of John for pulling off another successful weekend for their AirBnB guests. This is a working farm. You will find a large vegetable garden (reminds me of the kind my grandmother had on the family farm), ducks eager for kibbles, sheep (who will give you a good look over, but as you are not their shepherd [an inside theological joke], will keep their distance), and two very friendly Great Pyrenees, used as a livestock guard dogs for the sheep and to protect them from coyotes. Great Pyrenees are strong willed, gentle, confident, fearless, patient, and very affectionate! And if you are in season, you can feed the pigs! We admire how John and Rebecca have time to maintain the farm with such demanding professions. We plan to return to the Lindsey Corridale Farm AirBnB again when the opportunity presents itself. We highly recommend this experience. Thank you John (and Rebecca) for making our time and the celebration of our 8th your wedding anniversary spectacular! Bryce & Ethan
Ethan2016-11-02T00:00:00ZSo relaxing!!!! Beautiful home and inviting, cozy, and quiet bedrooms. Wonderfully kind and generous hosts! Staying here brought my blood pressure down to 0 - a place to find peace and rest.
sarah2017-02-20T00:00:00ZJohn was an excellent host and the house is beautiful. I understand I missed out as Rebecca was out of town. I suppose I will have to come again. I stayed one night and arrived after dark and left before dawn. I could not have asked for better accommodations.
Aaron2017-02-03T00:00:00ZRodzaj pokoju
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Jefferson, Georgia 30549, Stany Zjednoczone
Had an excellent stay! Very clean place for a great price, highly recommended.
Daniel2017-02-18T00:00:00ZThe place was great. It was just as described. Thanks Matt.
Ronald2017-01-08T00:00:00ZVery nice gated community neighborhood that was quite and great spacing between the homes. The space is like a large master bed room with the bed, loveseat, chair & ottoman, walk in closet with hangers and ironing board & iron (extra linens and towels also). TV is internet connected so you can select from a ton of movies. Place looks new with full size refrain and micro and all the kitchen stuff needed - you could live here with the amount of space in the bedroom and living/kitchen area, also full bath w/hair drier. Would recommend staying here - home away from home.
Robert2016-10-31T00:00:00ZI stayed at Matt's place for 2 nights and everything starting from my very first communication with Matt has been just fabulous. The place was exactly as advertised and it was just the way I like. Very clean, quiet, comfortable and cozy. I had absolutely no issues at any point and would love to stay at Matt's place if and when I am back in the area. Thanks Matt
Divya2017-02-27T00:00:00ZMatt's place was awesome! I was in town for an event at Road Atlanta, and being 15 minutes away, this was a great choice. Matt provided me with the code to open the community's front gate as well as the door to the mother in law suite. I encountered absolutely no issues on my first day or the rest of my stay. Even though I was no driving, there is space to park on a driveway adjacent to the room/suite. The place is well decorated, clean, comfortable and cozy. I had brought my chromecast to stream movies on the tv, but there is a roku tv in the room with Netflix available. The internet seemed to lag a bit at times but I was always able to connect with no issues or password. I was glad to see a few waters, sodas, snacks and even keurig coffee cups available for me to use. There were plenty of plates, silverware, coffee mugs for a family of four to use. The bathroom had the basic soap, shampoo and conditioner products available as you find in hotel rooms. There were plenty of towels, and sheets. There's even a walk in closet with an ironing board, iron, heater, hangers, and etc. I never got to meet Matt, but I'm glad I stayed at this place. I definitely recommend this place if you're looking to stay around the area. I may come back next year. Thank you Matt!
David2016-10-05T00:00:00ZThe place was s(PHONE NUMBER HIDDEN) clean! It was a brand new house with all the luxury décor. Matt's places gave privacy and seclusion. The TV was awesome. High ceilings and comfortable furniture. He also had a goodie basket for us. Stay here if your in the area. Thanks Matt your the best
Mishael2016-09-19T00:00:00ZWhst a beautiful peaceful place! I'm so thankful for all the great touches. I got in extra late and didn't have a chance to eat - to my surprise and appreciation Matt had a nice assortment of snacks and water! Great place and very cozy. Thank you!
Mel2016-11-14T00:00:00ZMatt's place was perfect. A nice, quiet, & private location that wasn't too far away from Athens. The bed was comfortable and the rooms spacious, clean, and perfect for two. The host was very considerate and provided small touches and amenities that made our stay delightful. I can't wait to come again. Wonderful home and perfect experience! Thank you, Matt, for opening your beautiful home to us! It made our trip!
Sheena2016-10-15T00:00:00ZRodzaj pokoju
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Hoschton, Georgia 30548, Stany Zjednoczone
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Gainesville, Georgia 30506, Stany Zjednoczone
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Lula, Georgia 30554, Stany Zjednoczone
Great home away from home. Donna is a great and accommodating host!
Mark2016-09-26T00:00:00ZDonna is the perfect hostess. She is so laid back and so easy to talk to! The house is immaculate. It is close to Athens and is a great place to escape to after taking on the Athens nightlife.
Russ2016-09-21T00:00:00ZEs war super sehr nett und freundlich. Und wir haben super Reise tips bekommen
Christian2017-02-05T00:00:00ZGreat place with the famous hospitality of the south. Donna's doggies were great friends too.
Gia2017-02-27T00:00:00ZEs war super alle waren sehr nett. Es gab sehr viele Reise tips.
Christian2017-02-22T00:00:00ZDonna was a fabulous host. It was everything described and more Donna is a Immaculate housekeeper the home is exquisite I could not have asked for more thanks Donna I would love to come back again sometime.
Michael2016-10-23T00:00:00ZDonna was a great host. The place was not far from the UGA stadium at all. The house was clean and comfortable. I would definitely stay there again next time I am in in Athens.
Martin2016-09-30T00:00:00ZDonna was friendly and gracious and we had a fun time. House is a comfortable suburban home.
anita2016-12-11T00:00:00ZRodzaj pokoju
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Jefferson, Georgia 30549, Stany Zjednoczone
Beth and Peter went over and above to help my girlfriend and I feel comfortable and happy during our three week stay in their wonderful flat. We were in the area for a canoe and kayak competition, and they made sure we were well looked after. We couldn't believe how accommodating they were and loved every chance we had to talk and socialize with them while enjoying some of their delicious cooking! The flat was even better than the photos show, and we both spent many of our evenings shooting pool or watching their big screen tv! One cold evening we were very thankful for the beautiful gas fireplace. Anyone who is savvy can make full use of the toaster oven to cook up anything you want. This was hands down the best rental we have ever stayed at, and we are happy to have walked away having met two wonderful individuals who left an impression on our stay. We would recommend this to anyone looking for a warm, safe, and enjoyable stay!
Mark2016-05-16T00:00:00ZThis was a true retreat! Perfect for my Husband, I and our little one! She even had a pack and play set up for us and it was perfect! The pictures do it no justice, it's much more spacious and lovely. We will defiantly visit again.
Christina 2016-09-08T00:00:00ZThe host canceled this reservation 14 days before arrival. This is an automated posting.
Ann MarieBeth and Peter were great host. The flat is back away from everything and a great place to relax. Yet, close enough to town and the square that you can enjoy that aspect too. I visited for a month while studying for my NCLEX, and Peter and Beth made me feel like I was at my home away from home. Quick to answer any questions, but also gave me enough space to study. The lake is just a short walk away and I spent some of my down time swimming. Everything from extra linens to Netflix (and WIFI) to snacks were provided. Amazing people, amazing place. Would definitely stay again.
Jenna2016-07-01T00:00:00ZSuch a great stay! And they were very responsive in their communication.
Tara2016-07-22T00:00:00ZPeter and Beth were awesome! They were very warm and welcoming and were available to answer questions and provide recommendations in the area. The space was absolutely lovely and cozy. We highly recommend it!
(EMAIL HIDDEN)2017-01-02T00:00:00ZThis was a pleasant surprise - it's much bigger than the pictures imply. It's a very nice flat, and Peter and Beth take great care of their property. Lots of windows showcase the beautiful trees and hydrangeas, and it's close enough to everything yet far enough to enjoy a little escape... Avocados and 2 Dogs were quite good, btw. I highly recommend Peter and Beth's flat.
Michael2016-05-30T00:00:00ZThe hosts were available to answer all questions, the neighborhood was quiet and the listing was accurate, but larger than pictures can depict.
Debra2016-05-20T00:00:00ZRodzaj pokoju
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Gainesville, Georgia 30501, Stany Zjednoczone
John and Rebecca were the best hosts! Their house was wonderful and the sheep, ducks, Louis the dog and River the cat-dog all added to the perfectness. We shared a wonderful meal with them and a guest of theirs and were also treated to a lovely breakfast as well. Rebecca is an awesome cook! We stayed in the room with 2 twin beds and it was very comfortable. The beds were nice and the room was perfect for our needs. They made us feel like it was our home which was so nice. If you are looking for a great home with wonderful folks then this is the place for you! We not only feel like we found a great place to stay, we feel like we made some wonderful friends too!
Carrie2016-07-31T00:00:00ZOnce again had a great stay here! Love it!
Laura2016-10-02T00:00:00ZI had a wonderful stay at John's farm. The farm is beautiful and the bed was so comfortable that I slept in every morning. It was very easy to find and conveniently located to both Jefferson and Athens. Breakfast was wonderful--fresh muffins, great bacon and eggs, homemade bread. John and Rebecca were so welcoming that I immediately felt right at home. Best surprise was the swimming pool--so refreshing to take a cool swim at the end of a hot day. I enjoyed all the animals and the quiet setting as well. This visit exceeded all my expectations.
Melissa2016-07-06T00:00:00ZThis was a beautiful country setting on a sheep farm. We enjoyed being there, very peaceful. John went out of his way to accommodate us and made us feel right at home. Great place to stay.
Gail2016-07-27T00:00:00ZWe had a great stay at John and Rebecca's. They made us feel right at home. The place is beautiful and peaceful. We had homemade biscuits and baba bread that was delicious! Will recommend for anyone looking for a little peace and quiet. Loved it!
Laura2016-07-19T00:00:00ZThis was my first time in an Airbnb and it was great experience! Really nice hosts with lovely property, would highly recommend!
Caitlin2016-09-06T00:00:00ZWonderful stay on the farm, with the most amazing hosts. Rebecca and John stayed up to greet us when we arrived later than anticipated, and made us feel very welcome and comfortable. It was like home away from home, with a cozy room and fun conversation. Rebecca made the most delicious breakfast with farm-fresh eggs, blueberry muffins, bread, and coffee! They really enjoy Athens and gave us great recommendations of things to do downtown (it is a 15-minute, super-easy drive to downtown Athens.) There was a beautiful pool, as well as a patio with relaxing chairs, that we would have enjoyed if we were there longer. Would definitely have stayed longer if we could! Can't think of a better place to stay, and would love to go back sometime.
Laura2016-08-17T00:00:00ZOur stay in John's beautiful home and sheep farm could not have been better. My son loved the sheep and the beautiful farm dog, we both enjoyed the pool well. The accommodations were an incredible value for the money and I'm grateful for John's kindness and hospitality, as well as the delicious breakfast served to us by Lindsey. Thanks for that! We would not hesitate to stay again, in fact we're already planning our next visit. One of our best airbnb experiences yet!
Jon2016-07-26T00:00:00ZRodzaj pokoju
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Jefferson, Georgia 30549, Stany Zjednoczone
This was my first experience using Air B&B. I was hesitant but am so happy with our experience because of Colby and Sarah. Colby is so thoughtful he even made sure that my daughter had a ride to the airport. Their farmhouse is super adorable. Sarah is certainly gifted in making a home feel like home. They have thought of everything and more to ensure a very comfortable, fun getaway. They are an adorable couple who look forward to opening their beautiful home and making strangers feel like family. We look forward to returning soon and highly recommend their farmhouse to anyone looking for a comfortable, clean, welcoming place to enjoy staying while visiting the area and it's many hiking trails, local restaurants , lake activities etc.
Deanna2016-09-02T00:00:00ZThis was our first Airbnb expierence. Sarah and Colby instantly made us feel welcome! The house is exactly what the description lists, a little piece of heaven. This property is nestled amongst other large property homes on a county road, not far from hiking trails, dining and shopping. We loved our stay and will definitely be back!
Madison2016-06-20T00:00:00ZFantastic hosts who went above and beyond to make us feel comfortable and at home -- truly a charming and hospitable couple. Looking forward to staying again next year.
Andy2016-03-25T00:00:00ZWe absolutely loved staying with Colby and Sarah! Everything was s(PHONE NUMBER HIDDEN) much more than we expected! We loved especially the convos about Christ and the encouragement from your life! Thanks so much for your hospitality!!!
tee2017-02-12T00:00:00ZBeautiful little house, amazing hosts. My boyfriend and I had a wonderful stay with Colby and Sarah. Don't fret about the single bathroom to share, you'll be fine!
Olivia2016-05-11T00:00:00ZYes arrival was great. communication perfect and room was better than described
David2016-10-19T00:00:00ZColby and Sarah were so welcoming and kind. They made us feel like we were at home. This was a great stay and I would definitely stay there again!
Alexa2016-03-23T00:00:00ZColby and Sarah are an absolute delight. Upon arriving to their quaint farmhouse I was warmly received with handshakes and hugs. Colby and Sarah made me feel welcome and made me feel like I was part of a family. The house and I room that I stayed in was incredible. I loved every second of it. I would absolutely, without a doubt, recommend Colby and Sarah!!
Andrew2016-09-15T00:00:00ZRodzaj pokoju
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Gainesville, Georgia 30506, Stany Zjednoczone
This is my second stay at McKenna's rental. Just as great an experience as the first time. Clean, spacious, cable (and Netflix!), and spectacular views. And deer. Saw a family of four deer. 1,000 times better than staying at a hotel. I wholeheartedly, 100% recommend this AirBnb.
Glenn2016-11-25T00:00:00ZAwesome trip! Beautiful apartment and view on the lake! Way better than the pictures! We totally recommend this airbnb! Moreover free access to Netflix in the bedroom, always appreciated :p
Ilona2016-09-13T00:00:00ZGreat property and welcoming host. Nice place and the jets rental was very convenient.
Josh2016-06-02T00:00:00ZGreat place, pictures don't match the view, phenomenal
Phillip2016-11-22T00:00:00ZThis is a beautiful spot on the lake, a spacious and comfortable place to stay with a great view of the natural surroundings. Everything was clean and prepared for our arrival, and our hosts were friendly and courteous. A great place for a quiet weekend.
Matthew2016-10-25T00:00:00ZPlace was very quiet and relaxing. Best part was the deck and firepit, had fire almost every night. Rest of place was basic but comfortable. It's very steep around the lake so there's no backyard, so probably not a good choice for those with kids.
Jason2017-01-02T00:00:00ZMckenna's husband leaded us to the apartment and provided more blankets even when we didn't ask for
Hung2017-01-02T00:00:00ZWe loved staying at this Lake Lanier getaway. The apartment itself was lovely! It was roomy and well decorated. The owner was prompt in helping us with any additional needs we had. We especially enjoyed the dock and its location on the lake. It was very quiet and had to be one of the most beautiful areas I have ever encountered on Lake Lanier! One of the biggest attractions for our visit was that we could take our boat and dock it in the boat slip at no additional charge! It was a bit of a workout bringing our gear up from the boat to the apartment as the property is up on the side of a steep hill. However, the view of the lake from the apartment was also very beautiful. This was a wonderful getaway and great hosts!
Kathi 2016-06-29T00:00:00ZRodzaj pokoju
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Gainesville, Georgia 30501, Stany Zjednoczone
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Commerce, Georgia, Stany Zjednoczone
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Jefferson, Georgia 30549, Stany Zjednoczone
John has an absolutely beautiful house. The rooms he has available on Airbnb are downstairs with a private bath which is so nice. They are well appointed. You truly feel welcomed here. I really enjoyed my stay - John is friendly, smart and great company.
Kelly2016-08-03T00:00:00ZNice place!
john2017-02-09T00:00:00ZWhat a great place to "hang your hat"! We and a couple friend of ours came to Athens for the game but didn't want to stay in town. I saw Johns place and snatched it up. From the beautiful fresh air and scenery to the hands-down best breakfast ever, this place is a gold mine! We didn't get to stay long but I am oh so happy we got to stay at all! Thank you both!
angie2016-10-03T00:00:00ZRodzaj pokoju
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Jefferson, Georgia 30549, Stany Zjednoczone
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Commerce, Georgia 30530, Stany Zjednoczone