Tricuspid valve repair using tension

• US 10,238,491 B2
• Filed: 11/16/2016
• Issued: 03/26/2019
• Est. Priority Date: 01/22/2010
• Status: Active Grant

• Current Assignee: 4Tech Inc.
• Original Assignee: 4Tech Inc.
• Inventors: Tobis, Idan, Maisano, Francesco, Vanermen, Hugo, Perevalov, Valery, Hof, Rephael
• Primary Examiner(s): Mathew, Seema
• Application Number:
  US15/353,230
• Publication Number:
  US 20170056174A1
• Time in Patent Office: 860 Days
• 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 17/06166 Sutures suture materials A61L17/00; manufacture of artificial threads D01D; treatment of threads D06M
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00314 Separate linked members
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• 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 2017/0443 the shaft being resilient and having a coiled or helical shape in the released state
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2451 Inserts in the coronary sinus for correcting the valve shape
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/246 : Devices for obstructing a leak through a native valve in a closed condition
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2/915 : with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 : Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2002/9511 : the retaining means being filaments or wires
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0054 : V-shaped

Abstract

A method is provided for repairing the tricuspid valve of a patient using tension. A radially-expandable stent is implanted in a coronary sinus of the patient. A tissue anchor is implanted in tissue in the vicinity of the tricuspid valve. The tricuspid valve is repaired by applying tension between the radially-expandable stent and the tissue anchor using a flexible longitudinal member that connects the radially-expandable stent and the tissue anchor.

Claims

1. A method for repairing the tricuspid valve of a patient using tension, the method comprising:

implanting a radially-expandable stent in a coronary sinus of the patient;

implanting exactly one tissue anchor in tissue in the vicinity of the tricuspid valve at a site selected from the group consisting of;

a site on the annulus of the tricuspid valve, and a site in a portion of tissue of a wall defining the right atrium; and

repairing the tricuspid valve by applying tension between the radially-expandable stent and the exactly one tissue anchor using a flexible longitudinal member that (a) connects the radially-expandable stent and the tissue anchor and (b) crosses over a portion of the tricuspid valve.

2. The method according to claim 1, wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor on the annulus of the tricuspid valve.

3. The method according to claim 2, wherein applying the tension comprises altering the geometry of the annulus of the tricuspid valve.

4. The method according to claim 1, wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor in a portion of tissue of a wall defining the right atrium.

5. The method according to claim 4, wherein applying the tension comprises altering the geometry of the wall of the right atrium.

6. The method according to claim 1, wherein applying the tension comprises drawing at least first and second leaflets of the tricuspid valve toward each other.

7. The method according to claim 1, wherein implanting the exactly one tissue anchor comprises implanting the exactly one tissue anchor at an implantation site selected from the group consisting of:

an anteroposterior commissure of the tricuspid valve, and

a site between (a) the middle of the junction between the annulus and an anterior leaflet of the tricuspid valve and (b) the middle of the junction between the annulus and the posterior leaflet of the tricuspid valve.

8. The method according to claim 1, wherein applying the tension comprises adjusting a distance between the radially-expandable stent and the exactly one tissue anchor, and monitoring a parameter indicative of regurgitation of the tricuspid valve while adjusting the distance.

9. The method according to claim 1, wherein applying the tension comprises cinching the tricuspid valve.

10. The method according to claim 9, wherein cinching the tricuspid valve comprises causing bicuspidization of the tricuspid valve.

11. The method according to claim 1, wherein implanting the radially-expandable stent and the exactly one tissue anchor comprises implanting the radially-expandable stent and the exactly one tissue anchor on generally opposite sides of the tricuspid valve.

12. The method according to claim 1, wherein implanting the exactly one tissue anchor comprises rotating the exactly one tissue anchor.