Method and apparatus for resecting and replacing an aortic valve

• US 20040034380A1
• Filed: 04/16/2003
• Published: 02/19/2004
• Est. Priority Date: 06/29/2001
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cohn, William E., Streeter, Richard B., Taylor, Daniel C., Woolfson, Steven B.
• Granted Patent: US 7,201,761 B2
• Time in Patent Office: Days
• US Class Current: 606/170
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1608 the two jaw elements being linked to two elongated shaft elements moving longitudinally relative to each other
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22097 Valve removal in veins
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation

Abstract

Apparatus for resecting a diseased heart valve, the apparatus comprising: a body portion having a first end and a second end in opposition to one another, a lateral wall extending from the first end to the second end, the lateral wall defining an inner surface and an outer surface in opposition to one another, the inner surface and the outer surface defining arcuate surfaces, respectively, and the body portion defining a longitudinal axis from the first end to the second end; a first handle and a second handle attached to the body portion to extend from the first end thereof and the second end thereof, respectively; a cutting blade selectively rotatable about the longitudinal axis and disposed adjacent to the inner surface of the body portion; a set of retaining arms positionably mounted between the second handle and the second end of the body portion, the set of retaining arms being selectively positionable from a contracted state to an expanded state, the contracted state forming a first diameter having a first width in a direction perpendicular to the longitudinal axis of the body portion, the expanded state forming a second diameter having a second width in a direction perpendicular to the longitudinal axis of the body portion; the second width being larger than a first width of the first diameter in the direction perpendicular to the longitudinal axis of the body portion; a pass-off tool having a proximal end and a distal end, a first attachment device at the distal end thereof, the first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve; and a controller tool having a proximal end and a distal end, a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the second end of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate relative to the longitudinal axis of the body portion, and a retaining arm actuator configured to selectively position the set of retaining arms from the contracted state to the expanded state.

Claims

1. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a first frame member and a second frame member configured in opposition to one another;

a cutting edge configured on the first frame member;

an adjustable connector positionably joining the first frame member to the second frame member, the adjustable connector configured to selectively position the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting blade so as to resect the diseased heart valve;

an actuator configured in operable connection to the adjustable connector, the actuator configurable to selectively position the adjustable connector between the first position and the second position; and

a first screen portion and a second screen portion disposed on the first frame portion and the second frame portion, respectively, the first screen portion and the second screen portion configured to allow blood flow through first frame member and second frame member and to contain the at least a portion of the diseased heart valve between the first frame member and the second frame member.

2. Apparatus according to claim 1 wherein the adjustable connector further comprises a spring configured to bias the first frame portion and the second frame portion into the second position.

3. Apparatus according to claim 1 wherein the adjustable connector comprises a threadable connection with one of the first frame member and the second frame member so as to allow the adjustable connector to selectively position the first frame member and the second frame member between the first position and the second position using a twisting motion for the actuator.

4. Apparatus according to claim 1 wherein the second frame member comprises a cutting edge configured thereon, and further wherein the cutting edge of the first frame member and the cutting edge of the second frame member each comprise cutting teeth configured for rotatable engagement with one another, and the actuator is configured for selective rotation and engagement of the first frame member and the second frame member relative to one another so as to cut the at least a portion of the diseased heart valve disposed therebetween.

5. Apparatus according to claim 1 wherein one of the first frame member and the second frame member is mounted to a screw-driven assembly so as to rotate the one of the first frame member and the second frame member mounted to the screw-driven assembly to aid in cutting the diseased heart valve therebetween.

6. A method of resecting a diseased heart valve, the method comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a first frame member and a second frame member configured in opposition to one another;

a cutting edge configured on the first frame member;

an adjustable connector positionably joining the first frame member to the second frame member, the adjustable connector configured to selectively position the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting blade so as to resect the diseased heart valve;

an actuator configured in operable connection to the adjustable connector, the actuator configurable to selectively position the adjustable connector between the first position and the second position; and

a first screen portion and a second screen portion disposed on the first frame portion and the second frame portion, respectively, the first screen portion and the second screen portion configured to allow blood flow through first frame member and second frame member and to contain the at least a portion of the diseased heart valve between the first frame member and the second frame member;

positioning the first frame member and the second frame member on opposed sides of the diseased heart valve, with the first frame member and the second frame member in the first position;

closing the first frame member and the second frame member from the first position to the second position by manipulating the actuator in operable connection to the adjustable connector so as to move the cutting edge through the at least a portion of the diseased heart valve; and

removing from a patient the first frame member and the second frame member closed together in the second position, with the at least a portion of the diseased heart valve therebetween.

7. A method according to claim 6 wherein the first frame member and the second frame member are advanced through a chamber of the heart to the diseased heart valve.

8. A method according to claim 6 wherein the diseased heart valve comprises an aortic valve, and further wherein the first frame member and the second frame member are advanced through the aorta to the aortic valve.

9. A method of resecting a diseased heart valve, the method comprising:

positioning a first frame member and a second frame member on opposed sides of the diseased heart valve, with the first frame member and the second frame member positioned apart from one another;

closing the first frame member and the second frame member toward one another so as to pass a cutting edge disposed on the first frame member through at least a portion of the diseased heart valve; and

removing from the patient the first frame member and the second frame member closed together, with the at least a portion of the diseased heart valve therebetween.

10. A method according to claim 9 wherein the first frame member and the second frame member are advanced to the diseased heart valve through a chamber of a heart.

11. A method according to claim 9 wherein the diseased heart valve comprises an aortic valve, and further wherein the first frame member and the second frame member are advanced through the aorta to the aortic valve.

12. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a power shaver having a proximal end and a distal end, the power shaver defining a longitudinal axis from the proximal end to the distal end, and a cutting element disposed adjacent to the distal end of the power shaver; and

a power shaver guide having a first end and a second end in opposition to one another, the power shaver guide defining a first opening extending into the first end, the first opening defining a first axis from the first end of the power shaver guide to the second end of the power shaver guide, the first opening configured to receive a portion of the power shaver therein, the power shaver guide having a given width from the first opening to an outer surface in a direction perpendicular to the first axis, the given width of the power shaver guide configured to prevent the wall of a cardiovascular structure from being cut by the power shaver disposed within the first opening and to permit the power shaver to be placed within the diseased valve.

13. Apparatus according to claim 12 wherein a lateral surface of the power shaver guide further defines a second hole therein, the second hole extending between the lateral surface of the power shaver guide and the first hole so as to allow cutting of the diseased valve by the power shaver through the second hole.

14. Apparatus according to claim 12 wherein the first opening extends from the first end of the power shaver guide through the second end of the power shaving guide so as to allow placement of the distal end of the power shaver into the first opening through the first end and the second end, with the cutting element disposed adjacent to the second end of the power shaver guide.

15. Apparatus according to claim 12 wherein the power shaver guide comprises a rigid ring forming a blood flow passageway parallel to the first axis.

16. Apparatus according to claim 12 wherein the power shaver guide comprises a collapsible portion.

17. Apparatus according to claim 16 wherein the collapsible portion comprises an inflatable balloon.

18. A method for resecting a diseased heart valve comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a power shaver having a proximal end and a distal end, the power shaver defining a longitudinal axis from the proximal end to the distal end, and a cutting element disposed adjacent to the distal end of the power shaver; and

a power shaver guide having a first end and a second end in opposition to one another, the power shaver guide defining a first opening extending into the first end, the first opening defining a first axis from the first end of the power shaver guide to the second end of the power shaver guide, the first opening configured to receive a portion of the power shaver therein, the power shaver guide having a given width from the first opening to an outer surface in a direction perpendicular to the first axis, the given width of the power shaver guide configured to prevent the wall of a cardiovascular structure from being cut by the power shaver disposed within the first opening and to permit the power shaver to be placed within the diseased valve;

positioning the power shaver within the power shaving guide;

positioning the power shaver and power shaving guide through a cardiovascular structure to the diseased heart valve; and

cutting the diseased valve with the cutting element of the power shaver so as to resect the diseased heart valve.

19. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a set of at least three expandable arms having a proximal end and a distal end in opposition to one another, the set of expandable arms defining a longitudinal axis from the proximal end to the distal end;

a first restraining element and a second restraining element configured at the proximal end of the set of expandable arms and the distal end of the set of at least three expandable arms, respectively, the first restraining element and the second restraining element configured to selectively position the set of at least three expandable arms between a first position and a second position, the set of at least three expandable arms having a given width in a perpendicular direction to the longitudinal axis at the first position and having a larger width in the perpendicular direction to the longitudinal axis at the second position; and

a cutting device disposed on at least one of the at least three expandable arms, the cutting device configured to cut through the diseased heart valve.

20. Apparatus according to claim 19 wherein the cutting device comprises a wire.

21. Apparatus according to claim 20 wherein the wire is rotary driven.

22. Apparatus according to claim 20 wherein the wire is reciprocally driven.

23. Apparatus according to claim 20 wherein the at least one of the at least three expandable arms having the cutting device disposed thereon defines a window recess therein having a given depth from an outer surface, and further wherein the cutting device is disposed in the window recess.

24. Apparatus according to claim 20 wherein the wire comprises a rough surface.

25. Apparatus according to claim 20 wherein the wire comprises an electrocautery element.

26. Apparatus according to claim 19 wherein the cutting device comprises a power shaver.

27. A method for resecting a diseased heart valve, the apparatus comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a set of at least three expandable arms having a proximal end and a distal end in opposition to one another, the set of expandable arms defining a longitudinal axis from the proximal end to the distal end;

a first restraining element and a second restraining element configured at the proximal end of the set of expandable arms and the distal end of the set of at least three expandable arms, respectively, the first restraining element and the second restraining element configured to selectively position the set of at least three expandable arms between a first position and a second position, the set of at least three expandable arms having a given width in the perpendicular direction to the longitudinal axis at the first position and having a larger width in the perpendicular direction to the longitudinal axis at the second position; and

a cutting device disposed on at least one of the at least three expandable arms, the cutting device configured to cut through the diseased heart valve;

positioning the set of at least three expandable arms adjacent to the diseased heart valve;

expanding the set of at least three expandable arms from the first position to the second position; and

cutting the diseased heart valve with the cutting device disposed on the at least one of the at least three expandable arms.

28. Apparatus-for resecting a diseased heart valve, the apparatus comprising:

a first frame member and a second frame member configured in opposition to one another;

a cutting edge configured on the first frame member;

an adjustable connector positionably joining the first frame member to the second frame member, the adjustable connector configured to selectively position the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting blade so as to resect the diseased heart valve;

an actuator configured in operable connection to the adjustable connector, the actuator configurable to selectively position the adjustable connector between the first position and the second position; and

at least two spikes extending from the first frame member toward the second frame member, the at least two spikes being configured to pierce and secure leaflets of the diseased heart valve as the first frame member and the second frame member are positioned toward one another.

29. Apparatus according to claim 28 wherein the second frame member defines a cavity configured to receive at least one of the at least two spikes therein.

30. Apparatus according to claim 28 further comprising at least two additional spikes extending from the second frame member, the at least two additional spikes being configured to pierce and hold in place the leaflets of the diseased heart valve as the first frame member and the second frame member are positioned toward one another.

31. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a catheter having a proximal end and a distal end, the catheter defining a longitudinal axis from the proximal end to the distal end; and

a set of blades positionably configurable at the distal end of the catheter, a hinge mechanism holding the distal end of the set of blades together, and a control rod extending from the proximal end of the blades into the catheter, the control rod being configured to selectively position the set of blades from a first position within the catheter to a second position outside of the distal end of the catheter, to selectively expand the set of blades from a narrow width for disposition within the catheter to a wide width for cutting portions of the diseased heart valve with the set of blades, and to rotate the set of blades with respect to the longitudinal axis of the catheter.

32. Apparatus according to claim 31 further comprising a filter mounted on the hinge mechanism.

33. Apparatus according to claim 31 wherein the blades comprise serrated portions so as to aid in cutting through the diseased heart valve.

34. A method of resecting a diseased heart valve, the method comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a catheter having a proximal end and a distal end, the catheter defining a longitudinal axis from the proximal end to the distal end; and

a set of blades positionably configurable at the distal end of the catheter, a hinge mechanism holding the distal end of the set of blades together, and a control rod extending from the proximal end of the blades into the catheter, the control rod being configured to selectively position the set of blades from a first position within the catheter to a second position outside of the distal end of the catheter, to selectively expand the set of blades from a narrow width for disposition within the catheter to a wide width for cutting portions of the diseased heart valve with the set of blades, and to rotate the set of blades with respect to the longitudinal axis of the catheter;

placing distal end of the catheter adjacent to the diseased heart valve;

positioning the set of blades from the first position within the catheter to the second position outside of the distal end of the catheter;

expanding the set of blades from the narrow width for disposition within the catheter to the wide width for cutting portions of the diseased heart valve with the set of blades; and

rotating the set of blades with respect to the longitudinal axis of the catheter so as to cut through the diseased heart valve.

35. A method according to claim 34 further comprising a filter mounted on the hinge mechanism, and further comprising the step of closing the set of blades to capture portions of the resected heart valve in the filter.

36. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a catheter having a proximal end and a distal end, and the catheter defining a longitudinal axis from the proximal end to the distal end;

a control rod having a proximal end and a distal end, the control rod being selectively positionable through the catheter and being selectively rotatable with respect to the longitudinal axis of the catheter;

an outer shell portion having a first edge and a second edge in opposition to one another, the outer shell portion having an inwardly facing side and an outwardly facing side in opposition to one another, the first edge of the outer shell portion being attached to the control rod along a surface thereof parallel to the longitudinal axis of the catheter, and the outer shell portion adapted to be wound around the control rod; and

a spring having a first end and a second end, the first end of the spring being attached to the inwardly facing side of the outer shell portion adjacent to the second edge thereof, and the spring being disposed against the inwardly facing side of the outer shell portion;

wherein rotation of the control rod in a first direction in combination with a force applied by the spring contracts the outer shell portion toward the control rod so as to reduce a maximum outer diameter of the-outer shell in a given direction perpendicular to the longitudinal axis of the catheter, and rotation of the control rod in a second direction in combination with the force applied by the spring rolls the outer shell portion away from the control rod so as to expand the maximum outer diameter of the outer shell portion in the given direction perpendicular to the longitudinal axis of the catheter.

37. Apparatus according to claim 36 further comprising another outer shell portion disposed on the control rod at a location proximal to the outer shell portion, and further wherein the control rod between the outer shell portion and the another outer shell portion is adjustable to selectively open and close together the outer shell portion and the another outer shell portion.

38. Apparatus according to claim 37 wherein the outer shell portion and the another shell portion each have a cutting edge in opposition to one another.

39. A method for resecting a diseased heart valve, the method comprising:

providing apparatus for resecting a diseased heart valve, the apparatus comprising;

a catheter having a proximal end and a distal end, and the catheter defining a longitudinal axis from the proximal end to the distal end;

a control rod having a proximal end and a distal end, the control rod being selectively positionable through the catheter and being selectively rotatable with respect to the longitudinal axis of the catheter;

an outer shell portion having a first edge and a second edge in opposition to one another, the outer shell portion having an inwardly facing side and an outwardly facing side in opposition to one another, the first edge of the outer shell portion being attached to the control rod along a surface thereof parallel to the longitudinal axis of the catheter, and the outer shell portion adapted to be wound around the control rod; and

a spring having a first end and a second end, the first end of the spring being attached to the inwardly facing side of the outer shell portion adjacent to the second edge thereof, and the spring being disposed against the inwardly facing side of the outer shell portion;

positioning the distal end of the catheter adjacent to the diseased heart valve;

rotating the control rod in the second direction so as to expand the outer shell portion; and

withdrawing the apparatus from the human body.

40. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a tubular body having a proximal end and a distal end, the tubular body defining a longitudinal axis from the proximal end to the distal end; and

an auger blade disposed within the tubular body and configured to selectively rotate with respect to the longitudinal axis of the tubular body;

the tubular body defining an opening configured therein so as to allow portions of the diseased heart valve therein, and the opening defining a junction region at a location where the auger blade contacts the tubular body and cuts the portions carried by the auger blade thereto.

41. Apparatus according to claim 40 wherein the auger blade and the tubular body are configured to carry the cut portions of the heart valve through the distal end of the tubular body away from the opening.

42. Apparatus according to claim 40 wherein the tubular body further comprises a set of guide shields positioned adjacent to the opening into the auger blade so as to prevent cutting surrounding cardiovascular structure.

43. A method for resecting a diseased heart valve, the method comprising:

positioning an opening of a tubular body adjacent to the diseased heart valve; and

cutting the diseased heart valve with an auger blade rotating within the tubular body.

44. Apparatus for resecting a diseased heart valve, the apparatus comprising:

an inner rod having a proximal end and a distal end, the inner rod defining a longitudinal axis from the proximal end to the distal end, and the inner rod defining a first opening and a second opening in a lateral side thereof between the proximal end and the distal end;

a first outer shell and a second outer shell each having a selectively configurable length through the first opening and the second opening of the inner rod, respectively, the first outer shell and the second outer shell configured to be radially expandable depending on the length of the first outer shell and the second outer shell configured through the first opening and the second opening, respectively; and

a blade extending between the first outer shell and the second outer shell, the blade being radially expandable away from the inner rod together with the first outer shell.

45. Apparatus for resecting a diseased heart valve, the apparatus comprising:

an inner cylinder having an outer tube rotatably disposed thereto, the inner cylinder and outer tube having a distal end and a proximal end, and the inner cylinder defining a longitudinal axis from the distal end to the proximal end;

at least one barb extending away from the distal end of the inner cylinder; and

three blades pivotally attached to the distal end of the outer tube, the three blades being selectively configurable in a first position and a second position, the first position configured with the blades closed toward one another so as to cover the at least one barb and provide a narrow cross-section therethrough in a perpendicular direction to the longitudinal axis, and a second position configured with the blades opened away from one another so as to expose the at least one barb and provide a cutting diameter having a greater cross-section therethrough than the narrow cross-section in the perpendicular direction to the longitudinal axis;

wherein the three blades are positioned closed toward one another through a body to a location adjacent to a diseased heart valve, the three blades are opened away from one another so as to expose the at least one barb extending away from the distal end of the inner cylinder, the inner cylinder is positioned toward the diseased heart valve so as to spear the at least one barb therethrough, and the outer tube is rotated around the inner cylinder so as to rotate the three blades to cut the diseased valve.

46. Apparatus according to claim 45 wherein the three blades are configured to cut at forward sections thereof, respectively.

47. Apparatus according to claim 45 wherein the three blades are configured to cut at side sections thereof, respectively.

48. Apparatus according to claim 45 further comprising a filter extending away from the distal end of the inner cylinder, the filter being configured to contain portions of the diseased heart valve cut away from a body of a patient.

49. A method for resecting a diseased heart valve, the method comprising:

providing apparatus for resecting a diseased heart valve, the apparatus comprising;

an inner cylinder having an outer tube rotatably disposed thereto, the inner cylinder and outer tube having a distal end and a proximal end, and the inner cylinder defining a longitudinal axis from the distal end to the proximal end;

at least one barb extending away from the distal end of the inner cylinder; and

three blades pivotally attached to the distal end of the outer tube, the three blades being selectively configurable in a first position and a second position, the first position configured with the blades closed toward one another so as to cover the at least one barb and provide a narrow cross-section thereto in a perpendicular direction to the longitudinal axis, and a second position configured with the blades opened away from one another so as to expose the at least one barb and provide a cutting diameter having a greater cross-section therethrough than the narrow cross-section in the perpendicular direction to the longitudinal axis;

wherein the three blades closed toward one another through a body to a location are positioned adjacent to a diseased heart valve, the three blades are opened away from one another so as to expose the at least one barb extending away from the distal end of the inner cylinder, the inner cylinder is positioned toward the diseased heart valve so as to spear the at least one barb therethrough, and the outer tube is rotated around the inner cylinder so as to rotate the three blades to cut the diseased valve;

positioning the three blades toward the diseased heart valve;

opening the three blades away from one another so as to expose the at least one barb;

spearing the at least one barb through the diseased heart valve; and

rotating the three blades so as to cut the diseased valve.

50. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a chamber having a proximal end and a distal end, and a sidewall extending between the proximal end and the distal end;

a retractable barb selectively positionable between a first position and a second position, the retractable bar being configured within the distal end of chamber in the first position, and the retractable bar being configured to extend beyond the distal end of the chamber in the second position; and

a set of blades surrounding the distal end of the chamber;

wherein the retractable barb extends from the chamber, pierces a portion of the diseased heart valve, and retracts into the chamber; and

wherein the set of blades cuts through the portion of the diseased heart valve pierced by the retractable barb as the retractable barb retracts into the chamber.

51. Apparatus according to claim 50 wherein the set of blades rotates around the retractable barb so as to cut through the portion of the diseased heart valve pierced by the retractable barb as the retractable barb retracts into the chamber.

52. Apparatus according to claim 50 wherein the cylinder rotates around the retractable barb so as to cut through the portion of the diseased heart valve pierced by the retractable barb as the retractable barb retracts into the chamber.

53. A method for resecting a diseased heart valve, the method comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a chamber having a proximal end and a distal end, and a sidewall extending between the proximal end and the distal end;

a retractable barb selectively positionable between a first position and a second position, the retractable bar being configured within the distal end of chamber in the first position, and the retractable bar being configured to extend beyond the distal end of the chamber in the second position; and

a set of blades surrounding the distal end of the chamber;

wherein the retractable barb extends from the chamber, pierces a portion of the diseased heart valve, and retracts into the chamber; and

wherein the set of blades cuts through the portion of the diseased heart valve pierced by the retractable barb as the retractable barb retracts into the chamber;

positioning the distal end of the chamber adjacent to the diseased heart valve;

extending the retractable barb from the chamber;

piercing the portion of the diseased heart valve with the retractable barb;

retracting the retractable barb into the chamber; and

cutting through the portion of the diseased heart valve pierced by the retractable barb with the set of blades.

54. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a body portion having a proximal end and a distal end, the body portion defining a longitudinal axis from the proximal end to the distal end, and the body portion defining an opening at the distal end thereof;

a grasping tool being selectively positionable within the body portion along the longitudinal axis from a first position to a second position, the grasping tool being configured within the body portion in the first position, the grasping tool extending through the opening at the distal end of the body portion in the second position, and the grasping tool being configured to selectively close together a first portion and a second portion so as to selectively grip the diseased heart valve therebetween; and

a cutting element disposed within the body portion at a given distance from the opening, the cutting element configured to close together to cut the diseased heart valve therebetween at the given distance from the opening after the grasping tool is withdrawn to a given location between the cutting element and the proximal end of the body portion;

wherein a portion of the diseased heart valve portion cut away from an intact portion of the diseased heart valve is contained within the body portion.

55. A method of resecting a diseased heart valve, the method comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a body portion having a proximal end and a distal end, the body portion defining a longitudinal axis from the proximal end to the distal end thereof, and the body portion defining an opening at the distal end;

a grasping tool being selectively positionable within the body portion along the longitudinal axis from a first position to a second position, the grasping tool being configured within the body portion in the first position, the grasping tool extending through the opening at the distal end of the body portion, and the grasping tool being configured to selectively close together a first portion and a second portion so as to selectively grip the diseased heart valve therebetween; and

a cutting element disposed within the body portion at a given distance from the opening, the cutting element configured to close together to cut the diseased heart valve therebetween at the given distance from the opening after the grasping tool is withdrawn to a given location between the cutting element and the proximal end of the body portion;

wherein a portion of the diseased heart valve portion cut away from an intact portion of the diseased heart valve is contained within the body portion;

positioning the distal end of the body portion adjacent to the diseased heart valve;

extending the grasping tool through the opening in the body portion to the diseased heart valve portion;

closing the first portion and the second portion of the grasping tool toward one another so as to secure a portion of the diseased heart valve therebetween;

retracting the grasping tool into the body element past the cutting element to the given location between the cutting element and the proximal end of the body portion so as to allow the cutting element to close and cut the portion of the diseased heart valve at the given distance from the opening.

56. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a body portion having a first end and a second end in opposition to one another, a lateral wall extending from the first end to the second end, the lateral wall defining an inner surface and an outer surface in opposition to one another, the inner surface and the outer surface defining arcuate surfaces, respectively, and the body portion defining a longitudinal axis from the first end to the second end;

a first handle and a second handle attached to the body portion to extend from the first end thereof and the second end thereof, respectively;

a cutting blade selectively rotatable about the longitudinal axis and disposed adjacent to the inner surface of the body portion;

a set of retaining arms positionably mounted between the second handle and the second end of the body portion, the set of retaining arms being selectively positionable from a contracted state to an expanded state, the contracted state forming a first diameter having a first width in a direction perpendicular to the longitudinal axis of the body portion, the expanded state forming a second diameter having a second width in a direction perpendicular to the longitudinal axis of the body portion, the second width being larger than a first width of the first diameter in the direction perpendicular to the longitudinal axis of the body portion;

a pass-off tool having a proximal end and a distal end, a first attachment device at the distal end thereof, the first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve; and

a controller tool having a proximal end and a distal end, a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the second end of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate relative to the longitudinal axis of the body portion, and a retaining arm actuator configured to selectively position the set of retaining arms from the contracted state to the expanded state.

57. Apparatus according to claim 56 further comprising a cage structure extending away from the first end of the body portion, the cage structure being configured to hold the cut portion of the diseased heart valve within the body portion.

58. Apparatus according to claim 56 further comprising a first filter material at the first end of the body portion, the first filter material being configured to hold the cut portion of the diseased heart valve within the body portion.

59. Apparatus according to claim 56 further comprising a second filter material disposed on the set of retaining arms, the second filter material being configured to hold the cut portion of the diseased heart valve within the body portion.

60. Apparatus according to claim 56 wherein the cutting blade comprises a serrated cylindrical razor.

61. Apparatus according to claim 56 wherein the cutting blade is configured for selective advancement from the second end of the body portion.

62. Apparatus according to claim 56 wherein the body portion is advanced to the diseased heart valve through a chamber of a heart.

63. Apparatus according to claim 56 wherein the body portion is advanced to the diseased heart valve through the aorta.

64. A method for resecting a diseased heart valve, the method comprising:

providing apparatus for resecting a diseased heart valve, the apparatus comprising;

a body portion having a first end and a second end in opposition to one another, a lateral wall extending from the first end to the second end, the lateral wall defining an inner surface and an outer surface in opposition to one-another, the inner surface and the outer surface defining arcuate surfaces, respectively, and the body portion defining a longitudinal axis from the first end to the second end thereof;

a first handle and a second handle attached to the body portion to extend from the first end thereof and the second end, respectively;

a cutting blade selectively rotatable about the longitudinal axis and disposed adjacent to the inner surface of the body portion;

a set of retaining arms positionably mounted between the second handle and the second end of the body portion, the set of retaining arms being selectively positionable from a contracted state to an expanded state, the contracted state forming a first diameter having a first width in a direction perpendicular to the longitudinal axis of the body portion, the expanded state forming a second diameter having a second width in a direction perpendicular to the longitudinal axis of the body portion, the second width being larger than a first width of the first diameter in the direction perpendicular to the longitudinal axis of the body portion;

a pass-off tool having a proximal end and a distal end, a first attachment device at the distal end thereof, the first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve; and

a controller tool having a proximal end and a distal end, a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the second end of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate relative to the longitudinal axis of the body portion, and a retaining arm actuator configured to selectively position the set of retaining arms from the contracted state to the expanded state;

engaging the first handle attached to the body portion with the pass-off tool;

positioning the second handle of the body portion adjacent to the diseased heart valve;

engaging the second handle attached to the body portion with the controller tool;

disengaging the pass-off tool and the first handle from one another;

positioning the second end of the body portion adjacent to the diseased heart valve;

expanding the set of retaining arms with the retaining arm actuator so as to hold the cut portion of the diseased heart valve within the body portion;

rotating the cutting blade relative to the longitudinal axis of the body portion with the cutting blade actuator;

positioning the body portion toward the diseased heart valve with the controller tool so as to cut the diseased heart valve.

65. A method according to claim 64 further comprising:

repositioning and re-engaging the first handle to the pass-off tool;

disengaging the controller tool from the second handle; and

removing the body portion with the pass-off tool.

66. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a cylindrical body portion having a first end and a second end;

a first handle and a second handle attached to the body portion to extend from the first end thereof and the second end thereof, respectively;

a cylindrical cutting blade selectively rotatable about the longitudinal axis and disposed within the body portion;

a set of retaining arms positionably mounted therebetween the second handle and the second end of the body portion, the set of retaining arms being selectively positionable from a contracted state to an expanded state, the contracted state forming a first diameter having a first width in a direction perpendicular to the longitudinal axis of the body portion, the expanded state forming a second diameter having a second width in a direction perpendicular to the longitudinal axis of the body portion, the second width being larger than a first width of the first diameter in the direction perpendicular to the longitudinal axis of the body portion.

67. Apparatus according to claim 66 further comprising a pass-off tool having a proximal end and a distal end, a first attachment device at the distal end thereof, the first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve.

68. Apparatus according to claim 66 further comprising a controller tool having a proximal end and a distal end, a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the second end of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate relative to the longitudinal axis of the body portion, and a retaining arm actuator configured to selectively position the set of retaining arms from the contracted state to the expanded state.