Retaining mechanisms for prosthetic valves

• US 10,130,464 B2
• Filed: 05/25/2016
• Issued: 11/20/2018
• Est. Priority Date: 03/05/2010
• Status: Active Grant

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Edwards Lifesciences Corporation
• Inventors: Meiri, Oded, Levi, Tamir S., Witzman, Ofir
• Primary Examiner(s): Woo, Julian W
• Application Number:
  US15/164,306
• Publication Number:
  US 20160262879A1
• Time in Patent Office: 909 Days
• Field of Search: 606113
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/12013 for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2433 using balloon catheter
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2250/006 modular

Abstract

Embodiments of methods, apparatus, and systems used to deliver a prosthetic heart valve to a deficient valve. In one embodiment, for instance, a support member is positioned to at least partially surround the native leaflets of a valve. A locking member is used to couple both ends of the support member, forming a support band. An expandable prosthetic heart valve is delivered into the native heart valve and expanded while the expandable prosthetic valve is at least partially within the support band, thereby causing one or more of the native leaflets of the native heart valve to be frictionally secured between the support band and the expanded prosthetic heart valve.

Claims

1. A method comprising:

advancing a delivery catheter into a body of a patient;

advancing a cord distally through the delivery catheter such that a distal end portion of the cord extends beyond a distal end of the delivery catheter and the cord curves around tissue in the heart; and

capturing the distal end portion of the cord with a snare;

pulling the snare and the distal end portion of the cord so as to form a loop around the tissue in the heart; and

pulling the snare and the distal end portion of the cord proximally back through the delivery catheter.

2. The method of claim 1, further comprising advancing a support member over the cord such that the support member curves around tissue in the heart.

3. The method of claim 2, further comprising pushing a pusher member over the cord to push the support member over the cord and around the tissue in the heart.

4. The method of claim 2, wherein the support member comprises a tubular braided cover.

5. A method comprising:

advancing a delivery catheter into a body of a patient;

advancing a cord distally through the delivery catheter such that a distal end portion of the cord extends beyond a distal end of the delivery catheter and the cord curves around tissue in the heart;

advancing a snare out of the delivery catheter; and

capturing the distal end portion of the cord with the snare.

6. A method comprising:

advancing a delivery catheter into a body of a patient;

advancing a cord distally through the delivery catheter such that a distal end portion of the cord extends beyond a distal end of the delivery catheter and the cord curves around tissue in the heart; and

capturing the distal end portion of the cord with a snare;

wherein the cord comprises a precurved guidewire configured to curve around tissue in the heart when the precurved guidewire is advanced beyond the distal end of the delivery catheter.

7. A method comprising:

advancing a delivery catheter into a body of a patient;

advancing a cord distally through the delivery catheter such that a distal end portion of the cord extends beyond a distal end of the delivery catheter and the cord curves around tissue in the heart; and

capturing the distal end portion of the cord with a snare;

wherein advancing the cord distally through the delivery catheter comprises;

advancing a precurved catheter out of the delivery catheter, wherein the precurved catheter is configured to bend in a predetermined manner when it is advanced out of the delivery catheter; and

advancing the cord out of the precurved catheter.

8. A method comprising:

advancing a delivery catheter into a body of a patient;

advancing a cord distally through the delivery catheter such that a distal end portion of the cord extends beyond a distal end of the delivery catheter and the cord curves around tissue in the heart; and

capturing the distal end portion of the cord with a snare; and

pulling the snare and the distal end portion of the cord so as to form a loop around the tissue in the heart;

wherein the cord forms a loop around the native mitral valve leaflets, and the method further comprises delivering a prosthetic heart valve to a position between the native leaflets and expanding the prosthetic heart valve to capture the native leaflets between the cord and the prosthetic heart valve.

9. A system comprising:

a delivery catheter having a distal end;

a cord configured to extend distally through the delivery catheter in a first direction beyond the distal end of the delivery catheter;

a support member comprising an internal lumen for receiving the cord;

an elongated pusher member configured to push the support member over the cord; and

a snare configured to capture a distal end portion of the cord and pull the distal end portion of the cord in a second direction so as to form a loop around the tissue in the heart;

wherein the snare is further configured to pull the distal end portion of the cord in the second direction back through the delivery catheter.

10. A system comprising:

a delivery catheter having a distal end;

a cord configured to extend distally through the delivery catheter and beyond the distal end of the delivery catheter such that the cord can curve around tissue in the heart to form at least a partial loop around the tissue in the heart;

a support member having a lumen for receiving the cord, the cord being configured to support the support member adjacent the tissue in the heart;

an elongated pusher member configured to push the support member over the cord; and

a snare configured to capture a distal end portion of the cord;

wherein the snare is further configured to pull the distal end portion of the cord back through the delivery catheter.

11. A system comprising:

a delivery catheter having a distal end;

a cord configured to extend distally through the delivery catheter and beyond the distal end of the delivery catheter such that the cord can curve around tissue in the heart to form at least a partial loop around the tissue in the heart; and

a support member having a lumen for receiving the cord, the cord being configured to support the support member adjacent the tissue in the heart;

wherein the cord comprises a precurved guidewire having a precurved portion that is biased to return to a predetermined curved configuration when it is advanced beyond the distal end of the delivery catheter, the predetermined curved configuration configured to curve around the tissue in the heart to form at least a partial loop around the tissue in the heart.

12. A system comprising:

a delivery catheter having a distal end;

a cord configured to extend distally through the delivery catheter and beyond the distal end of the delivery catheter such that the cord can curve around tissue in the heart to form at least a partial loop around the tissue in the heart; and

a support member having a lumen for receiving the cord, the cord being configured to support the support member adjacent the tissue in the heart; and

a precurved catheter configured to extend through a lumen of the delivery catheter, the precurved catheter comprising a precurved distal end portion that is biased to return to a predetermined curved configuration when it is advanced out of an opening in the delivery catheter, the precurved catheter comprising a lumen configured to receive the cord such that the cord can be advanced through the precurved catheter and the delivery catheter.