Devices and methods for heart valve repair
First Claim
1. A method constricting a valve annulus, the method comprising:
- introducing a plurality of clips to the heart valve annulus, the clips coupled with a tether, wherein at least a first clip is fixed to a lead end of the tether and the remaining clips are slidably coupled to the tether;
securing individual clips at circumferentially spaced-apart locations about at least a portion of the annulus including the first clip, a series of intermediate clips, and a terminal clip;
cinching the tether through the clips to circumferentially tighten the annulus; and
deforming at least the terminal clip so that it becomes fixed to the tether.
2 Assignments
0 Petitions
Accused Products
Abstract
Methods and devices provide constriction of a heart valve annulus to treat cardiac valve regurgitation and other conditions. Embodiments typically include a device for attaching a cinching or tightening apparatus to a heart valve annulus to reduce the circumference of the annulus, thus reducing valve regurgitation. Tightening devices may include multiple tethered clips, multiple untethered crimping clips, stabilizing devices, visualization devices, and the like. In one embodiment, a plurality of tethered clips is secured circumferentially to a valve annulus, and the tether coupling the clips is cinched to reduce the circumference of at least a portion of the annulus. Methods and devices may be used in open heart surgical procedures, minimally invasive procedures, catheter-based procedures, and/or procedures on beating hearts or stopped hearts.
355 Citations
78 Claims
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1. A method constricting a valve annulus, the method comprising:
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introducing a plurality of clips to the heart valve annulus, the clips coupled with a tether, wherein at least a first clip is fixed to a lead end of the tether and the remaining clips are slidably coupled to the tether;
securing individual clips at circumferentially spaced-apart locations about at least a portion of the annulus including the first clip, a series of intermediate clips, and a terminal clip;
cinching the tether through the clips to circumferentially tighten the annulus; and
deforming at least the terminal clip so that it becomes fixed to the tether. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A method for constricting a valve annulus in a beating heart, said method comprising:
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stabilizing the heart valve annulus;
securing individual clips at circumferentially spaced-apart locations about at least a portion of the valve annulus while said valve annulus remains stabilized, and cinching a tether through the clips to circumferentially tighten the annulus. - View Dependent Claims (34, 35, 36, 37)
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38. A method for constricting a valve annulus in a beating heart, said method comprising:
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directly viewing at least a portion of the valve annulus through from within a heart chamber;
securing individual clips at circumferentially spaced-apart locations about at least a portion of the valve annulus while said valve annulus remains under direct viewing; and
cinching a tether through the clips to circumferentially tighten the annulus. - View Dependent Claims (39, 40, 41, 42)
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43. A device for applying tethered clips to an annulus, the device comprising:
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a shaft having a proximal end and a distal end;
a plurality of clips slidably coupled to the tether;
the tethered clips delivered by the shaft;
a clip applier at or near the distal end of the shaft for securing the clips to the annulus; and
at least one actuator at or near the proximal end of the shaft for causing the device to advance the clips and for activating the clip applier to secure the clips to the annulus. - View Dependent Claims (44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57, 65, 66, 67, 71, 72, 73, 74)
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58. A device for applying tethered clips to an annulus, the device comprising:
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a shaft having a proximal end and a distal end, a tether having at least two parallel segments;
a plurality of clips which slidably receive both segments of the tether, wherein said clips are arranged successively on said tether, and a clip applier at or near the distal end of the shaft for securing clips to the annulus while said clips remain on said tether. - View Dependent Claims (68, 69, 70, 75, 76, 77, 78)
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- 59. A device as in claim 59 wherein the clips each include a pair of spaced-apart eyelets, wherein one segment is received in each eyelet of the pair.
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61. An annular fastener comprising:
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a tether comprising a pair of parallel segments, and a plurality of clips which each include a pair of spaced-apart eyelets, wherein one ether segment is received in each of the eyelets on each clip. - View Dependent Claims (62, 63, 64)
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Specification