Methods and apparatus for off pump aortic valve replacement with a valve prosthesis
First Claim
1. A method of valve replacement, the method comprising:
- providing a valve excisor;
providing an apparatus having a valve prosthesis and a valve leaflet support, said apparatus having a first configuration and a second configuration;
accessing the aortic root without placing the patient on a heart-lung machine;
advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus;
expanding said apparatus into a second configuration so that said support will engage said valve;
moving said valve leaflet support and valve excisor together to remove leaflets of the valve;
advancing penetrating members on said apparatus into valve tissue, said penetrating members being secured in said valve tissue and a valve prosthesis, and act as fasteners to hold said valve prosthesis in position.
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Accused Products
Abstract
Methods and apparatus are provided for valve repair or replacement. In one embodiment, the method comprises providing an apparatus having a valve prosthesis, a valve leaflet support and a valve excisor, the apparatus having a first configuration and a second configuration; accessing the aortic root without placing the patient on a heart-lung machine; advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus; expanding the apparatus into a second configuration so that the support will engage the valve; and moving the valve leaflet support and valve excisor together to remove leaflets of the valve. Penetrating members may be advanced into the tissue wherein the penetrating members may act as fasteners to hold the prosthesis in place.
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Citations
38 Claims
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1. A method of valve replacement, the method comprising:
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providing a valve excisor;
providing an apparatus having a valve prosthesis and a valve leaflet support, said apparatus having a first configuration and a second configuration;
accessing the aortic root without placing the patient on a heart-lung machine;
advancing the apparatus in the first configuration where the valve leaflet support is advanced through a valve, wherein the support is positioned below a valve annulus;
expanding said apparatus into a second configuration so that said support will engage said valve;
moving said valve leaflet support and valve excisor together to remove leaflets of the valve;
advancing penetrating members on said apparatus into valve tissue, said penetrating members being secured in said valve tissue and a valve prosthesis, and act as fasteners to hold said valve prosthesis in position. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13)
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14. A valve delivery device comprising:
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a heart valve prosthesis support having a proximal portion and a distal portion;
a plurality of fasteners ejectably mounted on the support;
a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support;
said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient'"'"'s aorta;
a valve excisor; and
an anvil movable along a longitudinal axis of the device to engage tissue disposed between the anvil and the valve prosthesis. - View Dependent Claims (15)
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16. A valve delivery device comprising:
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a heart valve prosthesis support having a proximal portion and a distal portion;
a plurality of fasteners ejectably mounted on the support;
a heart valve prosthesis being releasably coupled to said distal portion of said heart valve prosthesis support;
said heart valve prosthesis and support being configured for delivery to the heart through an aortotomy formed in the patient'"'"'s aorta;
a valve cutting element;
a pericardial tent positioned to capture valve leaflets between the tent and the valve cutting element; and
a leaflet support movable along a longitudinal axis of the device to engage tissue disposed between the support and the valve prosthesis.
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17. An end-to-side access device comprising:
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a first portion of a tissue clamp;
a second portion of the tissue clamp, said second portion having a collapsed configuration and an expanded configuration;
a tissue cutter;
a hollow shaft;
wherein the second portion may be delivered through said hollow shaft into the vessel to engage an inner surface of the wall of the vessel while the first portion engages an outer surface of the wall;
wherein the tissue cutter is configured to cut the tissue engaged by the tissue clamp, said first portion and second portion slidable to remove tissue engaged between the tissue clamp from the vessel. - View Dependent Claims (18, 19, 20)
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21. A device for use with a heart surgery device in an off-pump heart procedure, the device comprising:
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a blood containment device wherein one portion of the device is configured to be attached to a blood vessel while blood is flowing in the vessel;
a hemostatic cap located on another portion of the blood containment device, wherein the hemostatic cap allows a portion of the heart device to extend through the hemostatic cap without creating a leak; and
a vent allowing for air to be removed from the containment device. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method of valve replacement, the method comprising:
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providing a valve prosthesis delivery apparatus;
attaching a blood containment device to the aorta to prevent substantial loss of blood when the aorta is cut to provide access to an interior of the heart;
cutting the aorta to access the aortic root without placing the patient on a heart-lung machine;
advancing the apparatus to the area of the diseased valve;
delivering the valve to the target site;
retracing the valve prosthesis delivery apparatus into the blood containment device; and
sealing off a portion of the containment device to allow the delivery device contained therein to be removed without significant blood loss. - View Dependent Claims (33, 34, 35, 36, 37, 38)
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Specification