Methods for accessing a left ventricle

• US 10,456,260 B2
• Filed: 02/07/2019
• Issued: 10/29/2019
• Est. Priority Date: 12/08/2001
• Status: Active Grant

• Current Assignee: Transcardiac Therapeutics Incorporated
• Original Assignee: Transcardiac Therapeutics Incorporated
• Inventors: Lattouf, Omar M.
• Primary Examiner(s): Gherbi, Suzette J
• Application Number:
  US16/269,808
• Publication Number:
  US 20190209325A1
• Time in Patent Office: 264 Days
• Field of Search: 623 21- 219
• CPC Class Codes: A61B 17/0218 for minimally invasive surgery A61B17/0281, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/3421 Cannulas
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• 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 17/3498 Valves therefor, e.g. flapper valves, slide valves haemostasis valves A61M39/06; check valves A61M39/24
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00278 Transorgan operations, e.g. transgastric
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/0237 for heart surgery endoscopic heart surgery A61B2017/00243; endoscopic access devices, i.e. trocars, A61B17/34
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3486 Balloon
• CPC Class Codes: A61B 2017/3492 against the outside of the body
• CPC Class Codes: A61B 2018/00351 Heart
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• 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 2/2454 Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
• CPC Class Codes: A61F 2/2457 : Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2250/0097 : Visible markings, e.g. indicia
• CPC Class Codes: A61M 2039/0646 : Duckbill-valve
• CPC Class Codes: A61M 39/06 : Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
• CPC Class Codes: A61N 1/059 : Anchoring means

Abstract

Two minimally invasive therapeutic procedures, particularly for patients with congestive heart failure, may be performed separately or together. One procedure involves providing a valved passageway through the patient'"'"'s left ventricular wall at the apex of the patient'"'"'s heart and advancing instruments through the valved passageway to connect the valve leaflets of the patient'"'"'s heart valve, e.g. the mitral valve. The second procedure involves advancing a pacing lead and a pacing lead implanting device through a trocar in the patient'"'"'s chest and implanting the pacing lead on an exposed epicardial region of the patient'"'"'s heart wall. The pacing lead has a penetrating electrode which is secured within the heart wall. Improved devices for these procedures include a minimally invasive grasping device for heart leaflets, a leaflet connector with artificial cordae tendenae and a pacing lead implant instrument.

Claims

1. A method for tensioning a mitral valve in a patient'"'"'s heart, said method comprising:

forming a passageway through an apical wall into a left ventricle of the heart;

attaching a distal end of an artificial chordae to free ends of the leaflets of the mitral valve;

securing a proximal end of the artificial chordae near or in the passageway, wherein the artificial chordae is sufficiently taut to position the leaflets to better seal the leaflets and minimize leakage through the mitral valve.

2. A method as in claim 1, wherein forming the passageway through the apical wall into a left ventricle of the heart comprises placing a valve structure in the passageway.

3. A method as in claim 1, wherein attaching the distal end of the artificial chordae to free ends of the leaflets of the mitral valve comprises placing a clip secured to the distal end of the artificial chordae over the free ends of the leaflets.

4. A method as in claim 1, wherein the clip is placed to form a bow-tie closure of the leaflets.

5. A method as in claim 4, wherein securing the proximal end of the artificial chordae comprises capturing the proximal end in a valve structure placed in the passageway.

6. A method as in claim 1, wherein the artificial chordae is formed from formed of a non-compliant material.

7. A method as in claim 2, wherein the valve structure is secured in the passageway by a securing element is disposed circumferentially about a cylindrical wall of the valve structure.

8. A method as in claim 7, wherein the securing element comprises a plurality of hooks or barbs.

9. A method as in claim 8, wherein the valve structure comprises a one-way valve.

10. A method as in claim 9, wherein the one-way valve comprises a duck bill valve.