Methods and devices for termination

• US 20060122633A1
• Filed: 11/08/2005
• Published: 06/08/2006
• Est. Priority Date: 06/13/2002
• Status: Abandoned Application

• Current Assignee: Guided Delivery Systems, Inc.
• Original Assignee: Guided Delivery Systems, Inc.
• Inventors: Calhoun, Tenny C., Starksen, Niel F., To, John, Tang, Brian
• Application Number:
  US11/270,034
• Publication Number:
  US 20060122633A1
• Time in Patent Office: Days
• US Class Current: 606/139
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/0682 for applying U-shaped staples or clamps, e.g. without a forming anvil
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0443 the shaft being resilient and having a coiled or helical shape in the released state
• CPC Class Codes: A61B 2017/0451 Cams or wedges holding the suture by friction
• CPC Class Codes: A61B 2017/0454 the anchor being crimped or clamped on the suture
• CPC Class Codes: A61B 2017/0456 Surface features on the anchor, e.g. ribs increasing friction between the suture and the anchor
• CPC Class Codes: A61B 2017/0458 : Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0462 : One way system, i.e. also tensioning the suture
• CPC Class Codes: A61B 2017/0464 : for soft tissue
• CPC Class Codes: A61B 2017/0488 : Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 : for tensioning sutures
• CPC Class Codes: A61B 2017/06176 : with protrusions, e.g. barbs
• CPC Class Codes: A61F 2/2445 : Annuloplasty rings in direct contact with the valve annulus

Abstract

Devices and methods used in termination of a tissue tightening procedure are described. Termination includes the cinching of a tether to tighten the tissue, locking the tether to maintain tension, and cutting excess tether. In procedures involving anchors secured to the tissue, the tether is coupled to the anchors and the tissue is tightened via tension applied to the anchors by cinching the tether. In general, the devices and methods can be used in minimally invasive surgical procedures, and can be applied through small incisions or intravascularly. A method for tightening tissue by fixedly coupling a first anchor to a tether and slidably coupling a second anchor to the tether, securing both anchors to the tissue, applying tension to the tether intravascularly, fixedly coupling the tether to the second anchor, and cutting the tether is described. The tissue to be tightened can comprise heart tissue, in particular heart valve annulus tissue. Various devices and methods for locking the tether in place and cutting excess tether are described.

Claims

1. A termination device for locking an implantable and cinchable tether, the termination device comprising:

an elongate body; and

a locking feature releasably attached to the distal end of the elongate body, the locking feature configured to couple to the tether;

the locking feature having an unsecured state, wherein the tether may move with respect to the locking feature, and a secured state, wherein the tether is secured by the locking feature.

2. The termination device of claim 1, further comprising a tether cutter.

3. The termination device of claim 2, wherein the tether cutter is located distally to the locking feature.

4. The termination device of claim 2, wherein the tether cutter comprises a cutting tube within the elongate body.

5. The termination device of claim 1, wherein the elongate body is configured as a catheter.

6. The termination device of claim 1, further comprising a force applicator for releasing the locking feature from the rest of the termination device.

7. The termination device of claim 6, wherein the force applicator comprises a push rod extending longitudinally within the elongate body of the termination device.

8. The termination device of claim 1, further comprising a releasable attachment region between the locking feature and the elongate body.

9. The termination device of claim 8, wherein the releasable attachment region comprises a frangible region.

10. The termination device of claim 1, further configured to separate the locking feature from the elongate body when a force of greater than about 2 lbs is applied to the locking feature.

11. The termination device of claim 8, wherein the releasable attachment region comprises a perforated region.

12. The termination device of claim 1, wherein the locking feature comprises a different material than the elongate body.

13. The termination device of claim 1, wherein the locking feature comprises a clamp.

14. The termination device of claim 1, wherein the locking feature comprises a plug configured compress the tether against a wall of the locking feature in the secured state.

15. The termination device of claim 1, wherein the locking feature comprises a plug configured to fix the tether in a tight winding path within the locking feature in the secured state.

16. A termination device comprising:

an elongate body;

a locking feature releasably attached to the distal end of the elongate body, the locking feature configured to couple to the tether; and

a tether cutter coupled to the elongate body, wherein the tether cutter may be activated to cut the tether.

17. A method of securing a cinchable tether comprising:

coupling the tether to a termination device, wherein the termination device comprises;

an elongate body; and

a locking feature releasably attached to the distal end of the elongate body, the locking feature configured to couple to the tether;

cinching the tether; and

securing the tether with the locking feature.

18. The method of claim 17, further comprising cutting the tether.

19. The method of claim 17, further comprising separating the locking feature from the elongate body.

20. The method of claim 19, wherein the step of separating the locking feature from the elongate body comprises:

applying force to separate the locking feature from the elongate body.

21. The method of claim 20, wherein the step of applying force comprises pushing a push rod located at least partly within the elongate body.