Methods and apparatus for atrioventricular valve repair

• US 20070118154A1
• Filed: 11/23/2005
• Published: 05/24/2007
• Est. Priority Date: 11/23/2005
• Status: Active Grant

• Current Assignee: Traves Crabtree
• Original Assignee: Traves Crabtree
• Inventors: Crabtree, Traves
• Granted Patent: US 8,043,368 B2
• Time in Patent Office: Days
• US Class Current: 606/151
• 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 17/085 with adhesive layer
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• 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 2017/0464 for soft tissue
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses

Abstract

Methods and apparatus for use in repairing an atrioventricular valve in a patient are provided. The methods comprise accessing the patient'"'"'s atrioventricular valve percutaneously, securing a fastening mechanism to a valve leaflet, and coupling the valve leaflet, while the patient'"'"'s heart remains beating, to at least one of a ventricular wall adjacent the atrioventricular valve, a papillary muscle, at least one valve chordae, and a valve annulus to facilitate reducing leakage through the valve.

Claims

1. A method of repairing an atrioventricular valve in a patient, said method comprising:

accessing the patient'"'"'s atrioventricular valve percutaneously;

securing a fastening mechanism to a valve leaflet; and

coupling the valve leaflet, while the patient'"'"'s heart remains beating, to at least one of a ventricular wall adjacent the atrioventricular valve, a papillary muscle, and at least one valve chordae, and a valve annulus to facilitate reducing leakage through the valve.

2. A method in accordance with claim 1 wherein securing a fastening mechanism to a valve leaflet further comprises securing the fastening mechanism to an edge of the valve leaflet.

3. A method in accordance with claim 1 wherein securing a fastening mechanism to a valve leaflet further comprises:

forming an opening extending at least partially through the valve leaflet; and

inserting the fastening mechanism through the opening defined in the valve leaflet prior to coupling the fastening mechanism to the valve leaflet.

4. A method in accordance with claim 1 wherein securing a fastening mechanism to a valve leaflet further comprises securing the fastening mechanism to the valve leaflet using at least one of a staple, a rivet, an adhesive material, and a suture.

5. A method in accordance with claim 1 wherein securing a fastening mechanism to a valve leaflet further comprises securing the fastening mechanism to the valve leaflet of one of a tricuspid valve and a mitral valve.

6. A method in accordance with claim 1 wherein coupling the valve leaflet further comprises inserting a portion of the fastening mechanism at least partially through a portion of at least one papillary muscle.

7. A method in accordance with claim 1 wherein coupling the valve leaflet further comprises securing the fastening mechanism substantially circumferentially around a portion of one of a papillary muscle and a chordae.

8. A method in accordance with claim 1 wherein coupling the valve leaflet further comprises:

forming an opening extending at least partially through at least one of the ventricular wall adjacent the atrioventricular valve, the at least one valve chordae, the papillary muscle, and the valve annulus; and

securing the fastening mechanism to the at least one of the at least one valve chordae, and the valve annulus.

9. A method in accordance with claim 1 wherein coupling the valve leaflet further comprises securing the fastening mechanism to at least one of the ventricular wall adjacent the atrioventricular valve, the papillary muscle, the at least one valve chordae, and the valve annulus using at least one of a staple, a rivet, an adhesive material, and a suture.

10. A method in accordance with claim 1 wherein coupling the valve leaflet further comprises threadably coupling the fastening mechanism to at least one of the ventricular wall adjacent the atrioventricular valve, the papillary muscle, the at least one valve chordae, and the valve annulus.

11. A method in accordance with claim 1 wherein securing a fastening mechanism to a valve leaflet comprises securing a fastening mechanism fabricated from at least one of a superelastic material, and a shaped memory alloy material.

12. A method of repairing a mitral valve in the heart of a patient wherein the mitral valve is connected to at least one natural chordae, said method comprising:

accessing the patient'"'"'s mitral valve endovascularly;

securing a first end of a fastening mechanism to a valve leaflet of the mitral valve; and

coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet to facilitate simulating the function of a natural chordae.

13. A method in accordance with claim 12 wherein securing a first end of a fastening mechanism to a valve leaflet further comprises securing the first and second ends of the fastening mechanism within the patient while the patient'"'"'s heart is non-arrested.

14. A method in accordance with claim 12 wherein securing a first end of the fastening mechanism to a valve leaflet further comprises securing the fastening mechanism first end to an edge of the mitral valve leaflet to facilitate reducing leakage through the patient'"'"'s mitral valve.

15. A method in accordance with claim 12 wherein securing a first end of the fastening mechanism to a valve leaflet further comprises inserting the first end of the fastening mechanism through an opening extending at least partially through the mitral valve leaflet.

16. A method in accordance with claim 12 wherein securing a first end of the fastening mechanism to a valve leaflet further comprises fusing the first end of the fastening mechanism to the mitral valve leaflet.

17. A method in accordance with claim 12 wherein securing a first end of the fastening mechanism to a valve leaflet further comprises:

inserting the fastening mechanism from a first side of the mitral valve leaflet through an opening extending through the mitral valve leaflet; and

securing the fastening mechanism to the second side of the mitral valve leaflet.

18. A method in accordance with claim 12 wherein securing a first end of the fastening mechanism to a valve leaflet further comprises securing the first end of the fastening mechanism to the mitral valve leaflet using at least one of stapling, riveting, fusing, gluing, and suturing.

19. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises securing the second end of the fastening mechanism through an opening formed in a papillary muscle.

20. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises extending the second end of the fastening mechanism substantially circumferentially around a papillary muscle.

21. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises securing the second end of the fastening mechanism substantially circumferentially around a portion of a mitral valve chordae.

22. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises inserting the second end of the fastening mechanism into an opening extending at least partially through at least one of a ventricular wall adjacent the atrioventricular valve, a valve chordae, a papillary muscle, and a valve annulus.

23. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises coupling the second end of the fastening mechanism to the cardiac structure using at least one of stapling, riveting, fusing, gluing, and suturing.

24. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises fusing the second end of the fastening mechanism to the cardiac structure.

25. A method in accordance with claim 12 wherein coupling a second end of the fastening mechanism to a cardiac structure other than a mitral valve leaflet further comprises threadably coupling the second end of the fastening mechanism to the cardiac structure.

26. A method of enhancing operation of a patient'"'"'s heart valve, said method comprises:

inserting a guide catheter along the venous system of the patient to approach the mitral valve;

guiding a fastening mechanism towards one of a mitral valve and a tricuspid valve within the patient'"'"'s heart;

securing a first end of the fastening mechanism to one of the mitral valve and the tricuspid valve using one of fusing, gluing, stapling, clipping, riveting, anchoring, and suturing; and

securing a second end of the fastening mechanism to a cardiac structure other than a valve leaflet to facilitate enhancing operation of the valve.

27. A method in accordance with claim 26 wherein securing a second end of the fastening mechanism further comprises securing the second end to the cardiac structure using one of fusing, gluing, stapling, clipping, riveting, and suturing.

28. A method in accordance with claim 26 further comprising deploying a shaped memory fastener to effect securing the fastening mechanism to the valve.

29. A method in accordance with claim 26 wherein securing a second end of the fastening mechanism to a cardiac structure further comprises securing the second end of the fastening mechanism through an opening defined in the cardiac structure to which the second end is secured.

30. A method in accordance with claim 26 wherein securing a second end of the fastening mechanism to a cardiac structure further comprises extending the fastening mechanism second end substantially circumferentially around the cardiac structure.

31. A method in accordance with claim 26 wherein securing a second end of the fastening mechanism to a cardiac structure comprises threadably coupling the fastening mechanism second end to the cardiac structure.

32. A medical kit for use in repairing a mitral valve, said kit comprising:

a guide catheter configured for insertion along the arterial system of the patient to approach the mitral valve; and

a fastening mechanism positionable endovascularly within the patient using said guide catheter, said fastening mechanism comprising a first end and an opposite second end, said first end configured to couple to the mitral valve using one of fusing, gluing, stapling, clipping, riveting, anchoring, and suturing, said second end configured to only couple to a cardiac structure other than a valve leaflet to facilitate enhancing operation of the valve during ventricular systole.

33. A medical kit in accordance with claim 32 wherein at least one of said fastening mechanism first and second ends comprises an anchor member comprising at least two arms.

34. A medical kit in accordance with claim 32 wherein at least a portion of said fastening mechanism is braided.

35. A medical kit in accordance with claim 32 wherein said fastening mechanism comprises at least one loop.

36. A medical kit in accordance with claim 32 wherein one of said fastening mechanism first end and said fastening mechanism second end comprises a helical coil.

37. A medical kit in accordance with claim 32 wherein said guide catheter comprises one of a mitral leaflet catheter, a cinching device, and a papillary muscle catheter.

38. A surgical kit in accordance with claim 32 wherein said fastening mechanism is fabricated from at least one of a superelastic material, and a shaped memory alloy material.

39. A medical kit in accordance with claim 32 wherein one end of said fastening mechanism comprises a clip configured to couple to an edge of the mitral valve.

40. A medical kit in accordance with claim 32 wherein one end of said fastening mechanism comprises at least one adjustable loop.