Apparatus and method for cutting a heart valve

• US 20040116951A1
• Filed: 11/12/2003
• Published: 06/17/2004
• Est. Priority Date: 11/13/2002
• Status: Active Grant

• Current Assignee: Todd K. Rosengart
• Original Assignee: Todd K. Rosengart
• Inventors: Rosengart, Todd K.
• Granted Patent: US 7,255,706 B2
• Time in Patent Office: Days
• US Class Current: 606/167
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2017/22078 for rotating the instrument within a channel, e.g. an optical fibre
• CPC Class Codes: A61B 2017/22097 Valve removal in veins
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/2238 with means for selectively laterally deflecting the tip of the fibre
• CPC Class Codes: A61B 2090/049 against light, e.g. laser

Abstract

An apparatus for cutting and removing a tissue is described, which includes a rotational axle device, at least one non-mechanical cutting device radially disposed from the rotational axle device, at least one device capable of protecting the heart ventricle, and a first collapsible plate. Also described is a method for cutting a tissue, such as a heart valve using the apparatus of the present invention and temporary placing a device capable of protecting the heart ventricle until a percutaneous heart valve is placed.

Claims

1. An apparatus for cutting and removing living tissue comprising:

a rotational axle device;

at least one non-mechanical cutting device radially displaced from said rotational axle device; and

a first collapsible plate adapted to cover an area from said rotational axle device to said at least one non-mechanical cutting device.

2. The apparatus of claim 1, wherein said rotational axle device comprises a guide device;

a first elongated instrument having a proximal end and a distal end;

a second elongated instrument adapted to advance over said first elongated instrument and having a proximal end and a distal end; and

a second collapsible plate.

3. The apparatus of claim 2, wherein said guide device comprises a hemostatic object.

4. The apparatus of claim 2, wherein said second collapsible plate is of a diameter sufficient to pass through a heart valve when in a collapsed position.

5. The apparatus of claim 2, wherein said second collapsible plate is from about 2 mm to about 10 mm in diameter when said second collapsible plate is in a collapsed form.

6. The apparatus of claim 2, wherein said second collapsible plate is from about 15 mm to about 25 mm in diameter when said second collapsible plate is in an expanded form.

7. The apparatus of claim 2, wherein said second collapsible plate comprises a filter which permits blood flow, and prevents any loose tissue from flowing in a vascular system of a patient.

8. The apparatus of claim 2, wherein said second collapsible plate is at said distal end of said first elongated instrument or said second elongated instrument.

9. The apparatus of claim 2, wherein said second collapsible plate is conical in shape.

10. The apparatus of claim 2, wherein said second collapsible plate is adapted to detect transmural penetration of an energy having a predetermined wavelength.

11. The apparatus of claim 2, wherein said first collapsible plate is adapted to cover an area extending from an outer surface of said first elongated instrument to inner surface of said second elongated instrument, wherein said second elongated instrument has a diameter about equal to an inner diameter of a vessel at a location wherein said tissue is connected to said vessel.

12. The apparatus of claim 2, wherein said first collapsible plate is adapted to cover an area extending from an outer surface of said first elongated instrument or outer surface of said second elongated instrument to said non-mechanical cutting device.

13. The apparatus of claim 2, wherein said first collapsible plate expands by advancement of an armature.

14. The apparatus of claim 2, wherein said first collapsible plate and said second collapsible plate are magnetized.

15. The apparatus of claim 1, wherein said non-mechanical cutting device is a light-generating cutting device or a heat-generating cutting device.

16. The apparatus of claim 15, wherein said light-generating cutting device is a laser.

17. The apparatus of claim 16, wherein said laser is adapted to generate a laser beam, wherein said laser beam is adapted, diffused or diffracted to form a shape substantially similar to periphery of said tissue.

18. The apparatus of claim 15, wherein said heat generating cutting device is cauterizing device.

19. The apparatus of claim 2, wherein said non-mechanical cutting device is movably connected to said first elongated instrument or to said second elongated instrument.

20. The apparatus of claim 19, wherein said non-mechanical cutting device is movably connected to said first elongated instrument or said second elongated instrument by an armature.

21. A method of cutting a heart valve using said apparatus of claim 2 comprising:

inserting said guide device into a vascular system of a patient;

navigating said guide device to a pre-determined location;

advancing said first elongated instrument, adapted to include said first collapsible plate or said second collapsible plate, over said guide device and navigating said first elongated instrument to a predetermined location;

advancing said second elongated instrument, adapted to include said non-mechanical cutting device and further adapted to include said first collapsible plate or said second collapsible plate, over said first elongated instrument and navigating said second elongated instrument to a predetermined location;

wherein said non-mechanical cutting device is part of said second elongated instrument or is separately advanced over said second elongated instrument to a predetermined location;

extending said first elongated instrument or said second elongated instrument having said second collapsible plate through said heart valve, wherein said distal end of said first elongated instrument or said second elongated instrument having said second collapsible plate is on one side of said heart valve and said distal end of said first elongated instrument or said second elongated instrument having said first collapsible plate is on opposing sides of said heart valve;

expanding said first collapsible plate;

expanding said second collapsible plate; and

cutting said heart valve by said non-mechanical cutting device.

22. The method of claim 21, wherein said non-mechanical cutting device is movably connected to said first elongated instrument or said second elongated instrument.

23. The method of claim 21, further comprising extracting said non-mechanical cutting device from said vascular system of said patient;

and extracting said first collapsible plate and said second collapsible plate from said vascular system of said patient, including said heart valve located between said first and second collapsible plates.

24. The method of claim 21, wherein said first elongated instrument, said second elongated instrument, said first collapsible plate, said second collapsible plate, and said non-mechanical device are first arranged outside of said patient prior to said inserting.

26. The apparatus of claim 1, wherein said rotational axle device includes a heart ventricle protecting device to protect said heart ventricle from reflux of blood, from retrograde blood flow, or combinations thereof.

27. The apparatus of claim 26, wherein said heart ventricle protecting device is an inflatable balloon.

28. The apparatus of claim 26, wherein said heart ventricle protecting device includes a disc configuration.

29. The apparatus of claim 26, wherein said heart ventricle protecting device is a temporary valve.

30. The method of claim 21, further comprising advancing said heart ventricle protecting device over said rotational axle device or said guide wire.

31. The method of claim 21, further comprising advancing said heart ventricle protecting device to aorta proximal to a valve plate.

32. The method of claim 21, further comprising inflating said heart ventricle protecting device after said cut heart valve is passed over said heart ventricle protecting device.

33. The method of claim 32, wherein said cut heart valve is at least partially excised prior to inflating said heart ventricle protecting device.

34. The method of claim 21, wherein said heart ventricle protecting device is inflated and deflated by a trigger mechanism.

35. The method of claim 34, wherein said trigger mechanism is an electrocardiogram.

25. A method for cutting a heart valve comprising:

positioning a first collapsible plate in an artery approximate to said heart valve;

positioning a second collapsible plate in a heart chamber approximate to said heart valve;

positioning at least one non-mechanical cutting device approximate to said heart valve;

cutting said heart valve;

removing said heart valve;

expanding a hemostatic object at distal end of a guide device; and

inserting a new heart valve.