Apparatus, system, and method for treatment of posterior leaflet prolapse

• US 20070123979A1
• Filed: 06/26/2006
• Published: 05/31/2007
• Est. Priority Date: 06/27/2005
• Status: Active Grant

• Current Assignee: Edwards Lifesciences Corporation
• Original Assignee: Edwards Lifesciences Corporation
• Inventors: Adzich, Vaso, Perier, Patrick
• Granted Patent: US 8,685,083 B2
• Time in Patent Office: Days
• US Class Current: 623/2.360
• CPC Class Codes: A61B 17/02 for holding wounds open; Tractors specula A61B1/32 ; drainage appliances for wounds A61M27/00
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/06057 Double-armed sutures, i.e. sutures having a needle attached to each end
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 Delivery devices therefor

Abstract

The invention is an apparatus, system, and method for repairing heart valves. A suture line is secured to a papillary muscle, and then passed through a portion of a heart valve leaflet. A reference element is provided at a desired distance from a plane defined by the heart valve annulus. The suture line is secured to the heart valve leaflet at a position adjacent the reference element. The reference element may part of a device configured for placement on or in a heart valve annulus. The reference element may be slidingly secured to the device so that the distance of the reference element from the main body of the device can be varied by a surgeon or other user. The reference element may be a line of suture, which may be pre-installed during manufacture of the device or may be installed by the surgeon or other user.

Claims

1. An apparatus for repairing a heart valve, comprising:

a support body, the support body defining a reference plane therethrough and being configured for placement on or in a heart valve annulus;

a first reference element, the first reference element secured to the support body and positioned at a distance of 3 mm to 15 mm from the support body reference plane.

2. The apparatus of claim 1, wherein the first reference element comprises an elongated device having a first end and a second end, wherein the first end is secured to the support body at a first distance from the support body reference plane, and the second end is secured to the support body at a second distance from the support body reference plane.

3. The apparatus of claim 2, wherein the first distance is substantially equal to the second distance.

4. The apparatus of claim 3, wherein the first distance is greater than the second distance.

5. The apparatus of claim 2, wherein the first reference element is configured to fit between adjacent valve leaflets of a heart valve when the support body is placed on or in a heart valve annulus of the heart valve.

6. The apparatus of claim 2, wherein the first reference element comprises an elongated bar.

7. The apparatus of claim 2, wherein the first end is releasably secured to the support body.

8. The apparatus of claim 2, wherein the first end is connected to the support body via a sliding connection.

9. The apparatus of claim 8, wherein the sliding connection further comprises a locking mechanism.

10. The apparatus of claim 2, wherein the first reference element comprises a line of suture.

11. The apparatus of claim 2, wherein the apparatus is configured to provide variation in the first distance and in the second distance.

12. The apparatus of claim 2, further comprising:

a second reference element, the second reference element secured to the support body and positioned at a second reference distance of 3 mm to 15 mm from the support body reference plane, wherein the second reference distance is different from the first reference distance.

13. The apparatus of claim 12, further comprising:

a third reference element, the third reference element secured to the support body and positioned at a third reference distance of 3 mm to 15 mm from the support body reference plane, wherein the third reference distance is different from the second reference distance and from the first reference distance.

14. An apparatus for repairing a heart valve, comprising:

a support body, the support body defining a reference plane therethrough and being configured for placement on or in a heart valve annulus;

a first elongated member extending from the support body in a direction away from the support member reference plane to a first member length of at least 3 mm; and

a second elongated member extending from the support body in a direction away from the support member reference plane to a second member length of at least 3 mm.

15. The apparatus of claim 14, wherein the first elongated member comprises a plurality of first suture attachment points, the first suture attachment points positioned at different positions along the length of the first elongated member.

16. The apparatus of claim 15, further comprising:

indicia indicating the distance from one or more of the first suture attachment points to the support member reference plane.

17. The apparatus of claim 15, wherein the second elongated member comprises a plurality of second suture attachment points, the second suture attachment points positioned at different positions along the length of the second elongated member.

18. The apparatus of claim 17, further comprising:

indicia indicating the distance from one or more of the second suture attachment points to the support member reference plane.

19. The apparatus of claim 15, wherein each of the first suture attachment points comprises a hole passing through the first elongated member.

20. The apparatus of claim 17, further comprising:

a first suture line passing from a first of the first suture attachment points to a first of the second suture attachment points.

21. The apparatus of claim 20, further comprising:

A second suture line passing from a second of the first suture attachment points to a second of the second suture attachment points.

22. The apparatus of claim 21, further comprising:

A third suture line passing from a third of the first suture attachment points to a third of the second suture attachment points.

23. A method of repairing a heart valve having a heart valve annulus with corresponding annular plane, comprising:

securing a first suture line to a first papillary muscle at a first attachment point, wherein the first papillary muscle is positioned in a heart chamber adjacent the heart valve;

passing a portion of the first suture line through a first heart valve leaflet of the heart valve;

providing a chordae reference element;

positioning the chordae reference element within the heart chamber at a position at least 3 mm from the annular plane of the heart valve annulus;

securing the first suture line to the first heart valve leaflet, wherein the first suture line is secured to the first heart valve at a position adjacent the chordae reference element.

24. The method of claim 23, wherein securing the first suture line to the first heart valve leaflet comprises passing the suture line around the chordae reference element and tying a knot in the first suture line such that the chordae reference element is positioned between the knot and the first heart valve leaflet.

25. The method of claim 23, wherein the heart valve comprises a mitral valve, the heart valve leaflet comprises a first portion, a second portion, and a middle portion positioned between the first and second portions, and the method further comprises:

suturing a first surface indentation between the first portion and the middle portion of the leaflet; and

suturing a second surface indentation between the second portion and the middle portion of the leaflet.

26. The method of claim 23, wherein providing the chordae reference element comprises:

providing a main support body configured to be placed on or in the heart valve annulus, the main support body defining a support body plane;

providing a reference element that is slidingly secured to the apparatus so that the distance from the reference element to the support body plane can be varied by sliding the reference element toward and/or away from the support body plane.

27. The method of claim 26, wherein providing the chordae reference elements comprises:

sliding the reference element to a desired position with respect to the support body plane.

28. The method of claim 23, wherein providing the chordae reference element comprises:

providing a main support body configured to be placed on or in the heart valve annulus, the main support body defining a support body plane;

providing a plurality of reference elements secured to the apparatus, each of the plurality of reference elements positioned at different distance from the support body plane.

29. The method of claim 28, wherein providing the chordae reference element comprises:

selecting the chordae reference element from among the plurality of reference elements; and

removing all of the reference elements except the chordae reference element.

30. The method of claim 23, wherein providing the chordae reference element comprises:

providing a main support body configured to be placed on or in the heart valve annulus, the main support body defining a support body plane;

providing a first element extending away from the main support body plane, the first element comprising a plurality of first suture attachment points;

providing a second element extending away from the main support body plane, the second element comprising a plurality of second suture attachment points;

securing a first end of a suture line to one of the first suture attachment points; and

securing a second end of the suture line to one of the second suture attachment points.