Tissue anchor with dynamic depth indicator

• US 10,617,523 B2
• Filed: 07/11/2019
• Issued: 04/14/2020
• Est. Priority Date: 12/30/2016
• Status: Active Grant

• Current Assignee: Pipeline Medical Technologies, Inc.
• Original Assignee: Pipeline Medical Technologies, Inc.
• Inventors: Purcell, Cameron Paul, Bishop, Gordon B., Griswold, Erik, McDaniel, Stephen, Pham, Trung Ho
• Primary Examiner(s): Fishback, Ashley L
• Application Number:
  US16/509,244
• Publication Number:
  US 20190328528A1
• Time in Patent Office: 278 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• 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 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• 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 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/061 hollow or tubular
• CPC Class Codes: A61B 2090/033 Abutting means, stops, e.g. abutting on tissue or skin
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• 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 2220/0016 : 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 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section

Abstract

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium to attach a leaflet anchor having a leaflet suture to a mitral valve leaflet. A ventricular anchor has a hub with a helical anchor and a core wire extending through the helical anchor. A radiopaque marker may be axially movably carried on the core wire, and a spring biases the marker in a distal direction. The marker is advanced proximally on the tissue surface relative to the helical anchor as the helical anchor is advanced distally into tissue to secure a ventricular suture to the ventricular wall. A leaflet suture and the ventricular suture may be tensioned and connected by a suture lock to form an artificial chordae.

Claims

1. A tissue anchor, comprising:

a hub;

a suture extending proximally from the hub;

a helical anchor extending distally from the hub;

a core wire attached to the hub and extending concentrically through the helical anchor; and

a tubular sleeve having a length of no more than about 10 cm extending proximally from the hub.

2. The tissue anchor as in claim 1, further comprising a suture anchor guide extending proximally from the hub.

3. The tissue anchor as in claim 1, further comprising a radiopaque marker carried by the sleeve.

4. The tissue anchor as in claim 1, further comprising a radiopaque marker axially movably carried by the core wire.

5. The tissue anchor as in claim 4, further comprising a spring carried by the core wire.

6. The tissue anchor as in claim 5, further comprising a distal stop on the core wire, to limit distal travel of the radiopaque marker.

7. The tissue anchor as in claim 1, further comprising a tissue piercing point on a distal end of the helical anchor, and a barb on the helical anchor, proximal to the point and configured to resist rotation of the helical anchor out of engagement with tissue.

8. The tissue anchor as in claim 1, wherein the core wire extends distally beyond the helical anchor.

9. The tissue anchor as in claim 1, further comprising a connector on the proximal end of the hub, for releasably connecting to a rotatable driver.

10. The tissue anchor as in claim 1, further comprising a cross pin in the hub, for attachment of the suture.

11. The tissue anchor as in claim 1, further comprising at least a first radiopaque marker carried by the suture and spaced apart from the hub.

12. The A tissue anchor as in claim 11, further comprising at least a second radiopaque marker carried by the suture and spaced apart from the hub and from the first radiopaque marker.

13. A tissue anchor with dynamic depth indicator, comprising:

a hub;

a helical tissue anchor extending distally from the hub;

a core wire extending distally from the hub;

a radiopaque marker movably carried with respect to the hub;

a spring for biasing the radiopaque marker in a distal direction;

wherein the radiopaque marker is advanced proximally with respect to the tissue anchor in response to the tissue anchor advancing into tissue; and

wherein the core wire extends through and distally beyond the helical tissue anchor.

14. The tissue anchor as in claim 13 wherein the radiopaque marker is axially slidably carried by the core wire.

15. The tissue anchor as in claim 14 wherein the spring is carried concentrically about the core wire.

16. The tissue anchor as in claim 13, further comprising a tubular sleeve extending proximally from the hub.

17. The A tissue anchor as in claim 16, wherein the sleeve comprises ePTFE.

18. The tissue anchor as in claim 13, further comprising a suture extending proximally from the hub.

19. A tissue anchor, comprising:

a hub;

a suture extending proximally from the hub;

a helical anchor extending distally from the hub; and

a core wire attached to the hub and extending concentrically through the helical anchor;

wherein the core wire extends distally beyond the helical anchor.

20. The tissue anchor as in claim 19, further comprising a suture anchor guide extending proximally from the hub.

21. The tissue anchor as in claim 19, further comprising a tubular sleeve having a length of no more than about 10 cm extending proximally from the hub.

22. The tissue anchor as in claim 21, further comprising a radiopaque marker carried by the sleeve.

23. The tissue anchor as in claim 19, further comprising a radiopaque marker axially movably carried by the core wire.

24. The tissue anchor as in claim 23, further comprising a spring carried by the core wire.

25. The tissue anchor as in claim 24, further comprising a distal stop on the core wire, to limit distal travel of the radiopaque marker.

26. The tissue anchor as in claim 19, further comprising a tissue piercing point on a distal end of the helical anchor, and a barb on the helical anchor, proximal to the point and configured to resist rotation of the helical anchor out of engagement with tissue.

27. The tissue anchor as in claim 19, further comprising connector on the proximal end of the hub, for releasably connecting to a rotatable driver.

28. The tissue anchor as in claim 19, further comprising a cross pin in the hub, for attachment of the suture.

29. The tissue anchor as in claim 19, further comprising at least a first radiopaque marker carried by the suture and spaced apart from the hub.

30. The tissue anchor as in claim 29, further comprising at least a second radiopaque marker carried by the suture and spaced apart from the hub and from the first radiopaque marker.

31. A tissue anchor, comprising:

a hub;

a suture extending proximally from the hub;

a helical anchor extending distally from the hub;

a core wire attached to the hub and extending concentrically through the helical anchor; and

a cross pin in the hub, for attachment of the suture.

32. The tissue anchor as in claim 31, further comprising a suture anchor guide extending proximally from the hub.

33. The tissue anchor as in claim 31, further comprising a tubular sleeve having a length of no more than about 10 cm extending proximally from the hub.

34. The tissue anchor as in claim 33, further comprising a radiopaque marker carried by the sleeve.

35. The tissue anchor as in claim 31, further comprising a radiopaque marker axially movably carried by the core wire.

36. The tissue anchor as in claim 35, further comprising a spring carried by the core wire.

37. The tissue anchor as in claim 36, further comprising a distal stop on the core wire, to limit distal travel of the radiopaque marker.

38. The tissue anchor as in claim 31, further comprising a tissue piercing point on a distal end of the helical anchor, and a barb on the helical anchor, proximal to the point and configured to resist rotation of the helical anchor out of engagement with tissue.

39. The tissue anchor as in claim 31, wherein the core wire extends distally beyond the helical anchor.

40. The tissue anchor as in claim 31, further comprising connector on the proximal end of the hub, for releasably connecting to a rotatable driver.

41. The tissue anchor as in claim 31, further comprising at least a first radiopaque marker carried by the suture and spaced apart from the hub.

42. The tissue anchor as in claim 41, further comprising at least a second radiopaque marker carried by the suture and spaced apart from the hub and from the first radiopaque marker.

43. A tissue anchor, comprising:

a hub;

a suture extending proximally from the hub;

a helical anchor extending distally from the hub;

a core wire attached to the hub and extending concentrically through the helical anchor; and

at least a first radiopaque marker carried by the suture and spaced apart from the hub.

44. The tissue anchor as in claim 43, further comprising a suture anchor guide extending proximally from the hub.

45. The tissue anchor as in claim 43, further comprising a tubular sleeve having a length of no more than about 10 cm extending proximally from the hub.

46. The tissue anchor as in claim 45, further comprising a radiopaque marker carried by the sleeve.

47. The tissue anchor as in claim 43, further comprising a radiopaque marker axially movably carried by the core wire.

48. The tissue anchor as in claim 47, further comprising a spring carried by the core wire.

49. The tissue anchor as in claim 48, further comprising a distal stop on the core wire, to limit distal travel of the radiopaque marker.

50. The tissue anchor as in claim 43, further comprising a tissue piercing point on a distal end of the helical anchor, and a barb on the helical anchor, proximal to the point and configured to resist rotation of the helical anchor out of engagement with tissue.

51. The tissue anchor as in claim 43, wherein the core wire extends distally beyond the helical anchor.

52. The tissue anchor as in claim 43, further comprising connector on the proximal end of the hub, for releasably connecting to a rotatable driver.

53. The tissue anchor as in claim 43, further comprising a cross pin in the hub, for attachment of the suture.

54. The tissue anchor as in claim 53, further comprising at least a second radiopaque marker carried by the suture and spaced apart from the hub and from the first radiopaque marker.