Suture-securing for cardiac valve repair

• US 10,206,673 B2
• Filed: 09/16/2016
• Issued: 02/19/2019
• Est. Priority Date: 05/31/2012
• Status: Active Grant

• Current Assignee: 4Tech Inc.
• Original Assignee: 4Tech Inc.
• Inventors: Maisano, Francesco, Vanermen, Hugo, Alfieri, Ottavio, Tobis, Idan, Guidotti, Andrea, Denti, Paolo
• Primary Examiner(s): Templeton, Christopher L
• Application Number:
  US15/267,769
• Publication Number:
  US 20170000474A1
• Time in Patent Office: 886 Days
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/0487 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• 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 2230/0006 circular

Abstract

Apparatus is provided that includes a casing, shaped to define a cavity, and one or more openings in the casing, in which openings one or more sutures are disposable; and a core, disposed in the cavity, and shaped to define a lumen in which the sutures are disposable. The apparatus has an unlocked configuration in which the sutures are disposable within and slidable through the openings and the lumen, and a locking configuration in which the sutures are inhibited from sliding through the openings and the lumen. The apparatus is movable from the unlocked configuration to the locking configuration, and is configured such that, when the sutures are disposed within the openings and the lumen, and the apparatus moves from the unlocked configuration to the locking configuration, the apparatus cuts the sutures at a cutting site, and becomes coupled to the sutures at a coupling site.

Claims

1. Apparatus for use with one or more sutures, the apparatus comprising a suture-securing device, which comprises:

a casing, which is shaped to define a first cutting edge, a cavity, and two openings in the casing at opposite ends of the casing, wherein the one or more sutures are disposable through the two openings; and

a core, which is (a) disposed in the cavity, and (b) shaped to define a second cutting edge and a lumen, wherein the one or more sutures are disposable in the lumen,

wherein the suture-securing device is configured;

(i) to have an unlocked configuration in which the one or more sutures are disposable within and slidable through the two openings and the lumen, and a locking configuration in which the one or more sutures are inhibited from sliding through the two openings and the lumen,

(ii) to be movable from the unlocked configuration to the locking configuration, such that, when the one or more sutures are disposed within the two openings and the lumen, and the suture-securing device moves from the unlocked configuration to the locking configuration, the suture-securing device (1) cuts entirely through the one or more sutures at a cutting site of the suture-securing device by pushing the one or more sutures against the first and the second cutting edges, and (2) becomes fixedly coupled to the one or more sutures at a coupling site of the suture-securing device, and

(iii) to be suspended along the one or more sutures in the locking configuration with the opposite ends of the casing disposed entirely within a body of a patient.

2. The apparatus according to claim 1,

wherein the two openings are provided along a longitudinal axis of the casing,

wherein in the unlocked configuration of the suture-securing device, the lumen of the core is disposed along the axis, and between the two openings, and

wherein in the locking configuration of the suture-securing device, the core is disposed with respect to the casing in a manner in which the lumen of the core is not disposed along the axis.

3. The apparatus according to claim 1,

wherein the unlocked configuration comprises a constrained configuration, and the locking configuration comprises an unconstrained configuration, and

wherein the suture-securing device is configured to be retained in the constrained unlocked configuration by a constraining force, and to automatically move toward the unconstrained locking configuration when the constraining force is removed.

4. The apparatus according to claim 3, wherein the apparatus further comprises a constraint, configured to provide the constraining force.

5. A method for use with one or more sutures at an anatomical site of a patient, the method comprising:

delivering, to a vicinity of the anatomical site, a suture-securing device that includes (1) a casing, which is shaped to define a first cutting edge, a cavity, and two openings in the casing at opposite ends of the casing, wherein the one or more sutures are disposable through the two openings and the two openings, and (2) a core, which is (a) disposed in the cavity, and (b) shaped to define a second cutting edge and a lumen, wherein the one or more sutures are disposable in the lumen;

sliding the suture-securing device over at least part of the one or more sutures while the suture-securing device is in an unlocked configuration in which the one or more sutures are slidable through the two openings and the lumen; and

subsequently, by moving the suture-securing device into a locking configuration, simultaneously (1) inhibiting the one or more sutures from sliding through the lumen by fixedly coupling the suture-securing device to the one or more sutures at a coupling site of the suture-securing device, and (2) cutting entirely through the one or more sutures at a cutting site of the suture-securing device by pushing the one or more sutures against the first and the second cutting edges, such that the suture-securing device is suspended along the one or more sutures in the locking configuration with the opposite ends of the casing disposed entirely within a body of the patient.

6. The method according to claim 5, wherein the suture-securing device is configured to be constrained in the unlocked configuration by a constraining force, and wherein moving the suture-securing device into the locking configuration comprises removing the constraining force.