Method and apparatus for improving mitral valve function
First Claim
Patent Images
1. An assembly for reducing mitral regurgitation, the assembly comprising:
- an elongated carrier of material sufficiently flexible to assume a first configuration generally conforming to a coronary sinus upon insertion of said carrier into the coronary sinus, and to assume a straighter second configuration when biased toward the straighter configuration, said carrier having a lumen extending lengthwise therethrough; and
an elongated rod of a material less flexible than said carrier and adapted to be received by the lumen in said carrier;
whereby to urge said carrier from the first configuration to the second configuration, to straighten a natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet of the mitral valve, to move the posterior annulus anteriorly and thereby improve leaflet coaptation and reduce mitral regurgitation.
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Abstract
A method and apparatus for reducing mitral regurgitation. The apparatus is inserted into the coronary sinus of a patient in the vicinity of the posterior leaflet of the mitral valve, the apparatus being adapted to straighten the natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet of the mitral valve, whereby to move the posterior annulus anteriorly and thereby improve leaflet coaptation and reduce mitral regurgitation.
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Citations
46 Claims
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1. An assembly for reducing mitral regurgitation, the assembly comprising:
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an elongated carrier of material sufficiently flexible to assume a first configuration generally conforming to a coronary sinus upon insertion of said carrier into the coronary sinus, and to assume a straighter second configuration when biased toward the straighter configuration, said carrier having a lumen extending lengthwise therethrough; and
an elongated rod of a material less flexible than said carrier and adapted to be received by the lumen in said carrier;
whereby to urge said carrier from the first configuration to the second configuration, to straighten a natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet of the mitral valve, to move the posterior annulus anteriorly and thereby improve leaflet coaptation and reduce mitral regurgitation. - 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)
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25. An assembly for reducing mitral regurgitation, the assembly comprising:
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an elongated carrier of material sufficiently flexible to assume a first configuration generally conforming to a coronary sinus upon insertion of said carrier into the coronary sinus, and to assume a straighter second configuration when biased toward the straighter configuration, said carrier having a plurality of lumens extending lengthwise therethrough; and
a plurality of elongated rods of a material less flexible than said carrier and adapted to be received by the lumens in said carrier;
whereby to urge said carrier from the first configuration to the second configuration, to straighten a natural curvature of at least a portion of the coronary sinus in the vicinity of the posterior leaflet of the mitral valve, to move the posterior annulus anteriorly and thereby improve leaflet coaptation and reduce mitral regurgitation.
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26. A method for reducing mitral regurgitation, the method comprising the steps of:
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providing a flexible carrier having at least one lumen extending lengthwise therethrough;
advancing a guidewire through the vascular system of a patient until a distal end of the guidewire is disposed in the coronary sinus of the patient;
advancing the carrier over the guidewire until a distal end of the carrier is disposed in the coronary sinus;
advancing a rod of a selected stiffness into said at least one lumen to exert a straightening force on the carrier and thereby on the coronary sinus to move the annulus of the mitral valve anteriorly, whereby to reduce mitral regurgitation. - View Dependent Claims (27, 28)
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29. An assembly for reducing mitral regurgitation, the assembly comprising:
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a carrier of material sufficiently flexible to assume a first configuration generally conforming to a coronary sinus upon insertion of said carrier into the coronary sinus, and to assume a straighter second configuration when biased toward the straighter configuration, said carrier having a plurality of first lumens extending lengthwise therethrough;
a catheter shaft having a plurality of first lumens extending lengthwise therethrough, each alignable with one of the carrier first lumens, a distal end of said catheter shaft being engageable with a proximal end of said carrier;
a plurality of straightening rods, each less flexible than said carrier and adapted to be received by the catheter shaft first lumens and by the carrier first lumens; and
a push rod adapted to be received by at least the catheter shaft first lumens and engageable with one of said straightening rods and operable to push the one straightening rod into one of the carrier first lumens in alignment with the catheter shaft lumen in which said push rod is disposed;
whereby to bias the carrier from the first configuration to the second configuration. - View Dependent Claims (30, 31, 32, 33, 34, 35)
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36. An assembly for reducing mitral regurgitation, the assembly comprising:
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an elongated carrier of material sufficiently flexible to assume a first configuration generally conforming to a coronary sinus upon insertion of said carrier into the coronary sinus, and to assume a straighter second configuration when biased toward the straighter configuration, said carrier having a plurality of first lumens extending lengthwise therethrough and a plurality of second lumens, smaller in diameter than the first lumens, extending therethrough;
a catheter shaft having a plurality of first and second lumens extending lengthwise therethrough and alignable with the respective first and second lumens of said carrier, a distal end of said catheter shaft being engageable with a proximal end of said carrier;
a plurality of straightening rods less flexible than said carrier and adapted to be received by the catheter shaft first lumens and by the carrier first lumens;
a plurality of push rods adapted to be received by at least the catheter shaft first lumens; and
a tether fixed in at least one carrier second lumen and extending through the catheter shaft second lumen and manipulatable to draw said carrier into abutting engagement with said catheter shaft;
wherein at least one selected stiffening rod is insertable into at least one selected catheter shaft first lumen, and at least one push rod is insertable into the selected catheter shaft lumen and into engagement with the selected stiffening rod to push the selected stiffening rod into one of the carrier first lumens, to bias the carrier from the first configuration towards the second configuration.
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37. A method for reducing mitral regurgitation, the method comprising the steps of:
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inserting a guidewire into a patient'"'"'s vascular system and into the coronary sinus;
loading a carrier onto the guidewire, the carrier being of a material sufficiently flexible to assume a first configuration generally conforming to the coronary sinus, the carrier having a plurality of first lumens extending lengthwise therethrough;
loading a catheter shaft onto the guidewire, the catheter shaft having a plurality of first lumens extending lengthwise therethrough and alignable with the carrier first lumens;
advancing the catheter shaft and the carrier distally along the guidewire until the carrier is disposed in the coronary sinus and adjacent the posterior leaflet of the mitral valve;
loading a straightening rod into a selected one of the catheter shaft first lumens, the straightening rod being of a material less flexible than the lumen;
loading a push rod into the catheter shaft selected first lumen;
engaging the straightening rod with the push rod and advancing the push rod distally to push the straightening rod distally into one of the carrier first lumens aligned with the selected catheter shaft first lumen to advance the engaged straightening rod into the carrier first lumen, to cause the carrier to assume a straighter second configuration;
whereby to apply an anteriorly-directed force to the posterior leaflet of the mitral valve, thereby to reduce mitral regurgitation. - View Dependent Claims (38, 39)
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40. A method for reducing mitral regurgitation, the method comprising the steps of:
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providing a flexible carrier having at least one lumen extending lengthwise therethrough;
advancing a guidewire through the vascular system of a patient until a distal end of the guidewire is disposed in the coronary sinus of the patient;
advancing the carrier over the guidewire until a distal end of the carrier is disposed in the coronary sinus;
advancing a rod of a selected stiffness into said at least one lumen to exert a straightening force on the carrier and thereby on the coronary sinus to move the annulus of the mitral valve anteriorly, whereby to reduce mitral regurgitation;
positioning the proximal end of said flexible carrier in a tissue pocket. - View Dependent Claims (41, 42, 43)
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44. A method for reducing mitral regurgitation, the method comprising the steps of:
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providing a flexible carrier having at least one lumen extending lengthwise therethrough;
advancing a guidewire through the vascular system of a patient until a distal end of the guidewire is disposed in the coronary sinus of the patient;
advancing the carrier over the guidewire until a distal end of the carrier is disposed in the coronary sinus;
advancing a rod of a selected stiffness into said at least one lumen to exert a straightening force on the carrier and thereby on the coronary sinus to move the annulus of the mitral valve anteriorly, whereby to reduce mitral regurgitation;
cutting said flexible carrier to length;
positioning a bumper into at least one lumen;
capping the proximal end of said flexible carrier;
positioning the proximal end of said flexible carrier in a tissue pocket. - View Dependent Claims (45, 46)
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Specification