Exchangeable system for minimally invasive beating heart repair of heart valve leaflets

• US 10,130,474 B2
• Filed: 05/08/2015
• Issued: 11/20/2018
• Est. Priority Date: 12/29/2010
• Status: Active Grant

• Current Assignee: NeoChord, Inc.
• Original Assignee: NeoChord, Inc.
• Inventors: Zentgraf, John, Parins, David Joseph, Saini, Arun
• Primary Examiner(s): Erezo, Darwin
• Assistant Examiner(s): Hollm, Jonathan
• Application Number:
  US14/707,945
• Publication Number:
  US 20150313713A1
• Time in Patent Office: 1,292 Days
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/04 combined with photographic or television appliances
• CPC Class Codes: A61B 1/3137 for examination of the interior of blood vessels
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0483 Hand-held instruments for holding sutures A61B17/0469 takes precedence; other holders for needles or sutures A61B17/06061; surgical forceps A61B17/28; surgical pincettes A61B17/30
• CPC Class Codes: A61B 17/06114 Packages or dispensers for needles or sutures packages for sharps A61B50/3001; for dental floss A61C15/043; packages for needles in general B65D85/24
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/3462 with means for changing the diameter or the orientation of the entrance port of the cannula, e.g. for use with different-sized instruments, reduction ports, adapter seals expandable cannulas A61B17/3417
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00349 Needle-like instruments having hook or barb-like gripping means, e.g. for grasping suture or tissue A61B17/06066 takes precedence
• CPC Class Codes: A61B 2017/0042 with special provisions for gripping
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/00876 magnetic
• CPC Class Codes: A61B 2017/0406 : Pledgets
• CPC Class Codes: A61B 2017/0409 : Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 : T-fasteners
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/3419 : Sealing means between cannula and body
• CPC Class Codes: A61B 2017/3425 : for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/349 : Trocar with thread on outside
• CPC Class Codes: A61B 2090/034 : abutting on parts of the device itself
• CPC Class Codes: A61B 5/0044 : for the heart
• CPC Class Codes: A61B 5/0084 : for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61F 2/2412 : with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2442 : Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/2445 : Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2457 : Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: A61M 2039/064 : Slit-valve
• CPC Class Codes: A61M 2039/0653 : Perforated disc
• CPC Class Codes: A61M 37/0015 : by using microneedles

Abstract

Improved methods and apparatuses for heart valve repair in a beating heart of a patient utilize an exchangeable heart valve repair system. Heart valve repair system can include a port adapted to be seated in the heart wall and a catheter slidable within the port. The catheter can be selectively locked relative to the port for insertion into the heart and unlocked once the port is seated to allow the catheter to move distally towards target tissue. System elements can be selectively removed from and replaced within port to deploy repair devices while port maintains a seal while elements are and are not inserted.

Claims

1. A system for repairing heart tissue in a beating heart of a patient, comprising:

a port adapted to span a wall of the heart of the patient, the port having an opening extending therethrough and including a sealing portion including at least one seal configured to be positioned in the opening between an interior and an exterior of the heart;

a catheter selectively slidably insertable into the opening of the port, wherein the at least one seal substantially prevents blood from escaping the heart through the port while providing for selective insertion and removal of the catheter through the port; and

an elongate removable locking mechanism selectively removable from contact with both the catheter and the port and configured to engage the catheter longitudinally along a length of an outer circumferential surface of the catheter to prevent the catheter from moving distally towards the target tissue relative to the port when the removable locking mechanism is engaged with the catheter and a proximal force is applied to the catheter for inserting the catheter into the heart of the patient, the removable locking mechanism configured to move together with the catheter when engaged with the catheter, wherein the catheter is free to slide distally relative to the port to access the target tissue in the heart when the removable locking mechanism is not engaged with the catheter.

2. The system of claim 1, wherein the elongate removal locking mechanism prevents the catheter from moving distally towards the target tissue when engaged with the port and the catheter by providing a physical barrier sandwiched between a proximally facing surface of the port and a distally facing surface of the catheter.

3. The system of claim 2, wherein the distally facing surface of the catheter is raised relative to the outer surface of the catheter.

4. The system of claim 1, where the at least one seal includes a first seal and a second seal, the first seal having an opening configured to seal around the outer circumferential surface of the catheter and the second seal having a plurality off slits that remain generally sealed when the catheter is not inserted through the second seal.

5. The system of claim 1, wherein an outer surface of a portion of the port includes at least one of threads and ribs configured to engage with the heart wall.

6. The system of claim 1, wherein the port includes an outer circumferential groove that defines a narrowed central portion of the port configured to be positioned within the heart wall to promote natural constriction of the heart wall around the narrowed central portion.

7. The system of claim 1, further comprising a repair device configured to be delivered to a tissue structure in the heart through the port.

8. The system of claim 7, wherein the repair device is a suture.

9. The system of claim 7, wherein the repair device is a clip.

10. The system of claim 7, wherein the repair device includes a pledget and a suture configured to attach the pledget to the tissue structure.

11. The system of claim 7, wherein the repair device is a leaflet extender.

12. The system of claim 7, wherein the repair device comprises a collapsible wire form structure.