Methods and apparatus for cardiac valve repair
First Claim
1. A method for repairing an atrioventricular valve within a heart, said method comprising:
- accessing a patient'"'"'s vasculature remote from the heart;
advancing an interventional catheter through the vasculature into the heart, the interventional catheter having an interventional tool at a distal end thereof;
orienting the interventional tool relative to a tissue structure on or near the atrioventricular valve by deflecting the distal end of the interventional catheter; and
implanting a portion of the interventional tool in engagement with the tissue structure to modify the tissue structure in a manner that reduces leakage through the valve during ventricular systole.
1 Assignment
0 Petitions
Accused Products
Abstract
The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.
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Citations
70 Claims
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1. A method for repairing an atrioventricular valve within a heart, said method comprising:
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accessing a patient'"'"'s vasculature remote from the heart;
advancing an interventional catheter through the vasculature into the heart, the interventional catheter having an interventional tool at a distal end thereof;
orienting the interventional tool relative to a tissue structure on or near the atrioventricular valve by deflecting the distal end of the interventional catheter; and
implanting a portion of the interventional tool in engagement with the tissue structure to modify the tissue structure in a manner that reduces leakage through the valve during ventricular systole. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17)
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18. A system for repairing a cardiac valve, said system comprising:
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a guide catheter configured to pass from the remote vasculature of a patient to a position within the heart adjacent to the cardiac valve;
an interventional catheter configured to pass through the guide catheter to a tissue location on or near the cardiac valve, the valve annulus, the papillary muscles, or the valve chordae;
means for orienting the interventional catheter so as to be in alignment with the tissue location;
an interventional tool on the interventional catheter, at least a portion of the interventional tool being deployable from the interventional catheter and adapted to modify the cardiac valve, the valve annulus, the papillary muscles, or the valve chordae to reduce regurgitation. - View Dependent Claims (19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32)
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33. A system for repairing a cardiac valve, said system comprising:
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a guide catheter configured to pass from the remote vasculature of a patient to a position within the heart adjacent to the cardiac valve;
an interventional catheter configured to pass through the guide catheter to a tissue location on or near the cardiac valve, a valve annulus, a papillary muscle, or a valve chordae, the interventional catheter comprising a stabilizing mechanism for engaging a tissue structure within the heart to reduce relative motion between the interventional catheter and the heart; and
an interventional tool on the interventional catheter, at least a portion of the interventional tool being deployable from the interventional catheter and adapted to modify the cardiac valve, the valve annulus, the papillary muscle, or the valve chordae to reduce regurgitation. - View Dependent Claims (34, 35, 36, 37, 38, 39, 40)
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41. A method for treating an atrioventricular valve having a first valve leaflet and a second valve leaflet within a heart, said method comprising:
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accessing a patient'"'"'s vasculature remote from the heart;
advancing an interventional tool through the vasculature to near the atrioventricular valve, the interventional tool comprising at least one capture element; and
capturing chordae attached to the first valve leaflet and chordae attached to the second valve leaflet with the at least one capture element; and
manipulating the captured chordae attached to the first valve leaflet or to the second valve leaflet in a manner that reduces leakage through the valve during ventricular systole. - View Dependent Claims (42, 43, 44, 45, 46, 47)
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48. A method for stabilizing an atrioventricular valve within a heart, said method comprising:
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accessing a patient'"'"'s vasculature remote from the heart;
advancing an interventional catheter through the vasculature into the heart, the interventional catheter having an interventional tool at a distal end thereof;
orienting the interventional tool relative to a chordae attached to at least one leaflet of the atrioventricular valve by deflecting the distal end of the interventional catheter; and
capturing chordae attached to at least one leaflet of the valve while the heart is beating; and
holding the chordae in a position that reduces leakage through the valve during ventricular systole. - View Dependent Claims (49, 50, 51, 52, 53, 54)
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55. A method for stabilizing an atrioventricular valve, said method comprising:
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capturing chordae attached to at least one leaflet of the valve while the heart is beating by surrounding the chordae with a capture device; and
repositioning or changing the shape of the capture device so as to tension at least a portion of the chordae to modify movement of the leaflet.
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56. A chordae capture catheter comprising:
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a catheter body having a proximal end and a distal end;
a capture device at the distal end of the catheter for capturing chordae; and
means for repositioning or reshaping the capture device so as to tension the chordae. - View Dependent Claims (57, 58)
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59. A valve leaflet capture catheter, said catheter comprising:
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a catheter body having a proximal end and a distal end; and
a leaflet grasper at the distal end of the catheter body, said grasper including a central member and at least two arms pivotable relative to the central member for capturing leaflets between the arms and the central member. - View Dependent Claims (60, 61, 62, 63, 64, 65, 66, 67, 68, 69, 70)
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Specification