Transapical valve replacement
First Claim
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1. A transapical method of gaining access to an interior of a patient'"'"'s heart, the method comprising steps of:
- advancing a first hollow needle into a patient'"'"'s chest through an intercostal space that is above the apex of the patient'"'"'s heart;
advancing a guidewire through the first hollow needle;
advancing an S-shaped catheter through the first hollow needle and over the guidewire such that the S-shaped catheter has a distal end positioned proximate the apex of the patient'"'"'s heart and exterior to the patient'"'"'s pericardial sac;
advancing a second hollow needle through the S-shaped catheter to a position exterior to the patient'"'"'s pericardial sac;
penetrating the pericardial sac with the second hollow needle;
penetrating the heart wall of the patient'"'"'s heart;
advancing a first catheter including a first inflatable balloon on a distal region of the first catheter through the second hollow needle and into the patient'"'"'s heart; and
inflating the first inflatable balloon to provide a first seal between the first catheter and the heart wall.
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Abstract
Techniques for reaching the interior of the heart, such as for aortic valve replacement, can combine elements of percutaneous implantation methods and elements of surgical implantation methods. In some instances, aortic valve replacement may include a dual transapical approach in which a transfemoral approach is used to reach the apex of the patient'"'"'s heart from inside the left ventricle while a minimally invasive surgical procedure provides access to the exterior of the apex via an intercostal approach.
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Citations
17 Claims
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1. A transapical method of gaining access to an interior of a patient'"'"'s heart, the method comprising steps of:
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advancing a first hollow needle into a patient'"'"'s chest through an intercostal space that is above the apex of the patient'"'"'s heart; advancing a guidewire through the first hollow needle; advancing an S-shaped catheter through the first hollow needle and over the guidewire such that the S-shaped catheter has a distal end positioned proximate the apex of the patient'"'"'s heart and exterior to the patient'"'"'s pericardial sac; advancing a second hollow needle through the S-shaped catheter to a position exterior to the patient'"'"'s pericardial sac; penetrating the pericardial sac with the second hollow needle; penetrating the heart wall of the patient'"'"'s heart; advancing a first catheter including a first inflatable balloon on a distal region of the first catheter through the second hollow needle and into the patient'"'"'s heart; and inflating the first inflatable balloon to provide a first seal between the first catheter and the heart wall. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11)
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12. A transapical method of gaining access to an interior of a patient'"'"'s heart, the method comprising steps of:
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advancing a first hollow needle into a patient'"'"'s chest through an intercostal space that is above the apex of the patient'"'"'s heart; advancing a guidewire through the first hollow needle; advancing an S-shaped catheter through the first hollow needle and over the guidewire such that the S-shaped catheter has a distal end positioned proximate the apex of the patient'"'"'s heart and exterior to the patient'"'"'s pericardial sac; advancing a second hollow needle through the S-shaped catheter to a position exterior to the patient'"'"'s pericardial sac; penetrating the pericardial sac with the second hollow needle; penetrating the heart wall of the patient'"'"'s heart via the second hollow needle; and advancing a port into the patient'"'"'s heart through the penetration in the heart wall made via the second hollow needle to provide access for delivery of a replacement valve. - View Dependent Claims (13, 14, 15, 16, 17)
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Specification