Thorascopic heart valve repair method

• US 10,582,924 B2
• Filed: 06/27/2017
• Issued: 03/10/2020
• Est. Priority Date: 01/21/2005
• Status: Active Grant

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Inventors: Speziali, Giovanni
• Primary Examiner(s): Templeton, Christopher L
• Application Number:
  US15/634,412
• Publication Number:
  US 20170290582A1
• Time in Patent Office: 987 Days
• CPC Class Codes: A61B 1/00167 Details of optical fibre bundles, e.g. shape or fibre distribution
• CPC Class Codes: A61B 1/07 using light-conductive means, e.g. optical fibres
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 17/0491 Sewing machines for surgery
• CPC Class Codes: A61B 17/06 Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials puncturing needles A61B17/34; hypodermic needles A61M5/32 ; sewing needles D05B85/00
• CPC Class Codes: A61B 17/0625 the needle being specially adapted to interact with the manipulator, e.g. being ridged to snap fit in a hole of the manipulator A61B17/06109 takes precedence
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/295 combined with cutting implements
• CPC Class Codes: A61B 2017/00057 Light
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0608 J-shaped
• CPC Class Codes: A61B 2090/0807 Indication means
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: G02B 23/2469 : using optical fibres

Abstract

A method for performing thorascopic repair of heart valves includes inserting an instrument through the chest cavity and into a heart chamber providing access to a valve needing repair. A movable tip on the shaft is operable to capture a valve leaflet and a needle is operable to penetrate a captured valve leaflet and draw a suture therethrough.

Claims

1. A method of repairing a heart valve in a beating heart of a patient with a suture, the suture including a loop portion and a pair of free ends, the method comprising:

positioning the loop portion of the suture adjacent a first side of a moving heart valve leaflet;

drawing the loop portion of the suture through the leaflet to a second side of the leaflet;

inserting the pair of free ends of the suture through the loop portion; and

tightening the suture to form a knot around an edge of the leaflet,

wherein the step of inserting the pair of free ends of the suture through the loop portion is done exterior to the heart.

2. The method of claim 1, wherein the knot is a Lark'"'"'s Head knot.

3. The method of claim 1, further comprising anchoring the pair of free ends of the suture to a location within the heart.

4. The method of claim 3, wherein the location in the heart is a papillary muscle.

5. The method of claim 1, further comprising extending the suture over the edge of the leaflet.

6. The method of claim 1, further comprising:

inserting a heart valve repair device into the heart and the step of positioning the loop portion of the suture adjacent the first side of the moving heart valve leaflet is done with the heart valve repair device.

7. The method of claim 6, wherein the step of drawing the loop portion of the suture through the leaflet to a second side of the leaflet is done by extending a needle of the heart valve repair device from the second side of the leaflet to the first side of the leaflet to retrieve the suture by retracting the needle back to the second side of the leaflet.

8. The method of claim 7, wherein the needle retrieves the suture by hooking the loop portion in a notch of the needle.

9. The method of claim 7, further comprising withdrawing the heart valve repair device from the heart and then the step of inserting the pair of free ends of the suture through the loop portion is done exterior to the heart.

10. The method of claim 1, wherein the step of inserting the pair of free ends of the suture through the loop portion includes inserting the pair of free ends through the loop portion at a midpoint of the suture.

11. The method of claim 1, wherein the first side of the leaflet is a superior surface of the leaflet and the second side of the leaflet is an inferior surface of the leaflet.

12. A method of repairing a heart valve in a beating heart of a patient with a suture, the method comprising:

inserting a heart valve repair device into the heart;

grasping a moving heart valve leaflet with the heart valve repair device;

inserting a suture through the leaflet with the heart valve repair device; and

forming a Larks head knot with the suture around an edge of the leaflet, including inserting a pair of free ends of the suture through a loop portion of the suture and tightening the suture with the pair of free ends of the suture inserted through the loop portion of the suture to form the Lark'"'"'s Head knot around the edge of the leaflet, and

further comprising withdrawing the heart valve repair device from the heart and the step of inserting the pair of free ends of the suture through the loop portion is done exterior to the heart.

13. The method of claim 12, further comprising:

positioning a loop portion of the suture adjacent a first side of the leaflet with the heart valve repair device; and

wherein the step of inserting the suture through the leaflet includes drawing the loop portion of the suture through the leaflet to a second side of the leaflet.

14. The method of claim 13, wherein the step of drawing the loop portion of the suture through the leaflet includes extending a needle of the heart valve repair device from the second side of the leaflet to the first side of the leaflet to retrieve the suture by retracting the needle back to the second side of the leaflet.

15. The method of claim 14, wherein the needle retrieves the suture by hooking the loop portion in a notch of the needle.

16. The method of claim 12, wherein the step of inserting the pair of free ends of the suture through the loop portion includes inserting the pair of free ends through the loop portion at a midpoint of the suture.

17. The method of claim 12, further comprising extending the suture over the edge of the leaflet.

18. The method of claim 12, further comprising anchoring the suture to a location within the heart.

19. The method of claim 18, wherein the location in the heart is a papillary muscle.