Expandable epicardial pads and devices and methods for delivery of same
First Claim
1. An apparatus, comprising:
- an epicardial pad configured to engage an outside surface of a heart to secure a prosthetic heart valve in position within the heart, the prosthetic heart valve having a tether extending therefrom and outside the heart when the prosthetic heart valve is disposed within the heart, the epicardial pad defining a lumen configured to receive the tether therethrough,the epicardial pad being movable between a first configuration in which the epicardial pad has a first outer perimeter and is configured to be disposed within a lumen of a delivery sheath and a second configuration in which the epicardial pad has a second outer perimeter greater than the first outer perimeter,the epicardial pad configured to be disposed against the outside surface of the heart when in the second configuration to secure the prosthetic valve and tether in a desired position within the heart,the apparatus also including an internal anchor coupleable to the epicardial pad, the internal anchor configured to be disposed within a ventricle of the heart when the epicardial pad is disposed against the outside surface of the heart to secure the prosthetic valve and tether in a desired position within the heart,wherein the internal anchor is coupleable to the epicardial pad with sutures that extend through an opening in the apex of the heart, the internal anchor and epicardial pad configured to close the opening.
1 Assignment
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Accused Products
Abstract
An apparatus for use in the delivery of a prosthetic mitral valve may include an epicardial pad configured to engage an outside surface of a heart to secure a prosthetic heart valve in position within the heart. The epicardial pad defines a lumen configured to receive therethrough a tether extending from the prosthetic valve. The epicardial pad is movable between a first configuration in which the epicardial pad has a first outer perimeter and is configured to be disposed within a lumen of a delivery sheath and a second configuration in which the epicardial pad has a second outer perimeter greater than the first outer perimeter. The epicardial pad can be disposed against the outside surface of the heart when in the second configuration to secure the prosthetic valve and tether in a desired position within the heart.
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Citations
19 Claims
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1. An apparatus, comprising:
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an epicardial pad configured to engage an outside surface of a heart to secure a prosthetic heart valve in position within the heart, the prosthetic heart valve having a tether extending therefrom and outside the heart when the prosthetic heart valve is disposed within the heart, the epicardial pad defining a lumen configured to receive the tether therethrough, the epicardial pad being movable between a first configuration in which the epicardial pad has a first outer perimeter and is configured to be disposed within a lumen of a delivery sheath and a second configuration in which the epicardial pad has a second outer perimeter greater than the first outer perimeter, the epicardial pad configured to be disposed against the outside surface of the heart when in the second configuration to secure the prosthetic valve and tether in a desired position within the heart, the apparatus also including an internal anchor coupleable to the epicardial pad, the internal anchor configured to be disposed within a ventricle of the heart when the epicardial pad is disposed against the outside surface of the heart to secure the prosthetic valve and tether in a desired position within the heart, wherein the internal anchor is coupleable to the epicardial pad with sutures that extend through an opening in the apex of the heart, the internal anchor and epicardial pad configured to close the opening. - View Dependent Claims (2)
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3. An apparatus, comprising:
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a delivery sheath defining a first lumen; a dilator device defining a second lumen and being movably disposed within the first lumen of the delivery sheath, the dilator device including an elongate member and an expandable member disposed at a distal end of the elongate member, the expandable member having a collapsed configuration and an expanded configuration, the dilator device being in the collapsed configuration when disposed within the first lumen; and an epicardial pad having a collapsed configuration and an expanded configuration, the epicardial pad configured to be disposed within the second lumen when in the collapsed configuration, the epicardial pad configured to be disposed against an outside surface of a heart when in the expanded configuration, the dilator member of the dilator device configured to dilate tissue associated with the outside surface of the heart when moved from its collapsed configuration to its expanded configuration such that a space is formed in which the epicardial pad can be disposed, wherein the delivery sheath further includes a retractor portion disposed at a distal end portion of the delivery sheath, the retractor portion configured to separate a portion of pericardium tissue from a portion of epicardium tissue of the heart. - View Dependent Claims (4, 5)
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6. An apparatus, comprising:
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a delivery sheath defining a first lumen; a dilator device defining a second lumen and being movably disposed within the first lumen of the delivery sheath, the dilator device including an elongate member and an expandable member disposed at a distal end of the elongate member, the expandable member having a collapsed configuration and an expanded configuration, the dilator device being in the collapsed configuration when disposed within the first lumen; and an epicardial pad having a collapsed configuration and an expanded configuration, the epicardial pad configured to be disposed within the second lumen when in the collapsed configuration, the epicardial pad configured to be disposed against an outside surface of a heart when in the expanded configuration, the dilator member of the dilator device configured to dilate tissue associated with the outside surface of the heart when moved from its collapsed configuration to its expanded configuration such that a space is formed in which the epicardial pad can be disposed, wherein the epicardial pad defines a lumen configured to receive therethrough a tether extending from a prosthetic heart valve, the apparatus further comprising; an internal locator member movably disposable within the second lumen of the dilator device and movably disposable through the lumen of the epicardial pad, the internal locator member defining a lumen configured to receive therethrough the tether, the internal locator member having a collapsed configuration and an expanded configuration, the internal locator member configured to be inserted into the ventricle of the heart when in the collapsed configuration and moved to the expanded configuration within the ventricle of the heart to help position the epicardial pad against an outside surface of the heart.
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7. A method, comprising:
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disposing a distal end portion of a delivery sheath outside a surface of a heart near an apex of the heart, the delivery sheath having a dilator device movably disposed within a lumen of the delivery sheath, the dilator device including an elongate member and a dilator member disposed at a distal end portion of the elongate member, the dilator member being movable from a collapsed configuration when disposed within the lumen of the delivery sheath and an expanded configuration; after disposing a distal end portion of a delivery sheath outside a surface of a heart, disposing the dilator member of the dilator device outside a distal end of the delivery sheath; and moving the dilator member to the expanded configuration such that tissue associated with the surface of the heart is dilated from pressure exerted on the tissue by the dilator member and a space is formed to receive an epicardial pad device. - View Dependent Claims (8, 9, 10, 11, 12, 13, 14)
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15. A method, comprising:
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disposing a distal end portion of a delivery sheath outside a surface of a heart near an apex of the heart, the delivery sheath having an epicardial pad disposed within a lumen of the delivery sheath, the epicardial pad being in a collapsed configuration within the lumen of the delivery sheath and having an expanded configuration, the epicardial pad defining an opening and having a tether extending through the opening, the tether being coupled to a prosthetic heart valve implanted within the heart; disposing the epicardial pad outside a distal end of the delivery sheath and outside the surface of the heart near the apex of the heart; and securing the epicardial pad in the expanded configuration to the outside surface of the heart to secure the prosthetic heart valve and the tether in a desired position. - View Dependent Claims (16, 17, 18, 19)
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Specification