Method and apparatus for prosthesis attachment using discrete elements

• US 20070129794A1
• Filed: 10/03/2006
• Published: 06/07/2007
• Est. Priority Date: 10/05/2005
• Status: Abandoned Application

• Current Assignee: Fidel Realyvasquez
• Original Assignee: Fidel Realyvasquez
• Inventors: Realyvasquez, Fidel
• Application Number:
  US11/538,294
• Publication Number:
  US 20070129794A1
• Time in Patent Office: Days
• US Class Current: 623/2.110
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/115 Staplers for performing anastomosis in a single operation
• CPC Class Codes: A61B 17/1155 Circular staplers comprising a plurality of staples
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/049 Instruments for removing suture clamps, clips or locks for removing suture anchors A61B2017/0411; for removing wound clamps A61B17/10; for removing ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0641 having at least three legs as part of one single body
• CPC Class Codes: A61B 2017/1157 applying the staples radially
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation

Abstract

A percutaneous valve replacement assembly has a catheter and a plurality of discrete elements for tissue attachment. A fastener device is mounted to the catheter. The fastener device includes a working end that is movable to a first configuration to engage one of the discrete elements and a second configuration to crimp the discrete element into target tissue.

Claims

1. A percutaneous valve replacement assembly comprising:

a catheter;

a plurality of discrete elements for tissue attachment; and

a fastener device mounted to the catheter;

wherein the fastener device includes a working end that is movable to a first configuration to engage one of the discrete elements and a second configuration to crimp the discrete element into target tissue.

2. The valve replacement assembly of claim 1 further comprising:

a debris tent positioned over the valve cutter to capture debris created by the valve cutter during tissue removal.

3. The valve replacement assembly of claim 1 further comprising:

a expandable temporary valve coupled to the catheter to regulate blood flow during delivery of the expandable valve prosthesis.

4. The valve replacement assembly of claim 1 further comprising:

a shaft having a geared portion to rotate the fastening device to different radial positions to engage different tissue areas.

5. The device of claim 2 further comprising an embolic screen positioned downstream from the debris tent.

6. The device of claim 2 wherein the valve cutter, debris tent, and embolic screen are all positioned over a catheter.

7. The device of claim 1 further comprising a valve prosthesis mounted on a catheter coupled to the valve cutter and the debris tent.

8. A method of percutaneous valve replacement, the method comprising:

accessing a femoral blood vessel and inserting a guidewire to guide a catheter to a target site in the heart;

advancing the catheter along the guidewire in a collapsed configuration;

positioning at least one of a plurality of discrete elements on the catheter for tissue attachment;

using a fastener device mounted to the catheter, wherein the fastener device includes a working end that is movable to a first configuration to engage one of the discrete elements and a second configuration to crimp the discrete element into target tissue.

9. The method of claim 8 wherein the prosthesis and the discrete elements are on separate catheters.

10. The method of claim 8 wherein the prosthesis and the discrete elements are on the same catheter.

11. The method of claim 8 further comprising an embolic screen that is deployed downstream from the target site to capture debris from the valve.

12. The method of claim 8 wherein prosthesis includes a stent.

13. The method of claim 8 further comprising pushing a plunger to crimp the discrete elements to couple to tissue.

14. The method of claim 8 further comprising rotating a shaft to index the fastening device to a new location.

15. The method of claim 8 further comprising attaching said valve apparatus at the ventriculo-arterial junction.

16. The method of claim 8 further comprising driving said penetrating members through the valve prosthesis to anchor the prosthesis to the target tissue.

17. A minimally invasive prosthesis attachment device comprising:

a shaft;

a plurality of discrete elements for tissue attachment;

a clamp system for holding each of the discrete elements in position to engage target tissue; and

a fastener device mounted to the shaft;

wherein the fastener device includes a working end that is movable to a first configuration to engage one of the discrete elements and a second configuration to crimp the discrete element into target tissue..

18. The device of claim 17 wherein the shaft has an elongate portion, a distal end and a proximal end.

19. The device of claim 17 further comprising a plunger longitudinally slidable to crimp each element and advance the element into target tissue.

20. The device of claim 17 further comprising a pericardial tent positioned to capture valve leaflets between the tent and the valve excisor.

21. The device of claim 17 further comprising an embolic screen mounted on said second apparatus.

22. The device of claim 17 further comprising a pericardial tent on said second apparatus and formed of a mesh and positioned to capture valve leaflets between the tent and the valve excisor.

23. The device of claim 17 wherein said penetrating members are made of nitinol.

24. The device of claim 17 wherein said penetrating members are made of stainless steel.