Treating Valvular Insufficiency

• US 20080288060A1
• Filed: 07/06/2005
• Published: 11/20/2008
• Est. Priority Date: 07/06/2004
• Status: Abandoned Application

• Current Assignee: Baker Medical Research Institute
• Original Assignee: Baker Medical Research Institute
• Inventors: Bilney, Adam Lucas, Mathis, Mark L., Alferness, Clifton A., Power, John Melmouth, Kaye, David Martin
• Application Number:
  US11/631,832
• Publication Number:
  US 20080288060A1
• Time in Patent Office: Days
• US Class Current: 623/2.36
• 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 17/0487 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 17/068 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 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0453 threaded elements, e.g. set screws
• CPC Class Codes: A61B 2017/0458 Longitudinal through hole, e.g. suture blocked by a distal suture knot
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/081 Tissue approximator A61B2017/1103, A61B17/8866 take precedence
• CPC Class Codes: A61B 2017/2215 having an open distal end
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus

Abstract

In a method of treating valvular insufficiency in a patient, a plurality of filaments (2) are used to engage tissue at spaced apart locations of an annulus (1) of the valve being treated. The engaged filaments (2) are drawn inward so as to draw the engaged tissue around the valve annulus (1) inward. The filaments (2) are then secured with the engaged tissue in the drawn-in configuration. Inward drawing of the engaged tissue improves valve function by reducing the valve annulus (1). Alternatively or additionally, anchor means may be used to secure the filaments to a region of robust tissue, thus drawing the engaged tissue toward the anchor means to further improve valve function.

Claims

1. A method of treating a disorder associated with a heart valve of a patient, the method comprising the steps of:

engaging tissue at spaced apart locations of an annulus of the valve by attaching at least one of a plurality of filaments to tissue at each of the locations;

drawing the locations radially inward by drawing the filaments inward to a drawn-in configuration; and

securing the filaments in the drawn-in configuration.

2. A method according to claim 1 further including the step of delivering a collar over a length of the filaments, wherein relative movement between the filaments and the collar draws the locations inward.

8. A method according to claim 1 further including the step of anchoring at least one of the locations to a region of tissue spaced from the annulus so as to draw the at least one of the locations toward the region.

13. A method according to claim 1 further including the step of using one or more of the filaments to conduct an electric signal to an analysis device for use in positioning the one or more filaments.

15. A method according to claim 1 wherein one or more of the filaments includes a marker identifiable from outside the body to facilitate positioning of the filaments prior to engagement with the annular tissue.

3-7. -7. (canceled)

9-12. -12. (canceled)

14. (canceled)

16-20. -20. (canceled)

21. A device for treating a disorder associated with a heart valve of a patient, the device including:

a plurality of filaments each having an engaging portion for engaging annular tissue of the valve; and

a collar facilitating a drawn-in configuration of engaged annular tissue by relative movement between the filaments and the collar.

22. A device according to claim 21 wherein each engaging portion includes a helical tip engageable with annular tissue of the valve using a torque tool.

23. A device according to claim 21 wherein each of the filaments further includes a connecting region for releasably connecting a tool configured to facilitate engagement of the engaging portion of each filament with the annular tissue.

24. A device according to claim 21 wherein one or more of the filaments is configured to conduct an electric signal to an analysis device, to facilitate positioning of an associated engaging portion.

25. A device according to claim 21 wherein one or more of the filaments further includes a marker identifiable from outside the patient'"'"'s body to facilitate positioning of the filaments.

28. A device according to claim 21 further including a locking member for securing the filaments in the drawn-in configuration.

30. A device according to claim 21 further including an anchor to anchor at least one of the engaged filaments to a region of tissue spaced from the valve to facilitate drawing of the engaged tissue toward the region.

31. A device according to claim 21 wherein each of the filaments is tapered toward a smaller cross-sectional area proximal the engaging portion.

26-27. -27. (canceled)

29. (canceled)

32-34. -34. (canceled)

35. Apparatus for delivering a valve annulus constriction device, the apparatus including:

a catheter configured to deliver a plurality of filaments percutaneously to an annulus of a heart valve being constricted and to deliver a collar to be applied over a length of the filaments,

wherein relative movement between the catheter and a filament facilitates positioning of the filament prior to engagement with the valve annulus tissue.

36. Delivery apparatus according to claim 35 wherein the filaments each include an engaging portion, and the catheter is configured to deliver the filaments therein in a staggered arrangement.

37. Delivery apparatus according to claim 35 wherein the relative movement includes retraction of the catheter relative to the filament, thereby causing the filament to splay facilitating engagement with the annulus tissue.

38. Delivery apparatus according to claim 35 further including a percutaneously operable tool configured to facilitate engagement of an engaging portion associated with each of the filaments with the annular tissue.

41. Delivery apparatus according to claim 35 further including a centering member having a tip locatable on a distal side of the valve being constricted to facilitate centralization of the constriction device relative to the valve annulus.

39-40. -40. (canceled)

42. A method of treating a disorder associated with a heart valve of a patient wherein the valve includes an annulus having tissue surrounding a valve opening and valve leaflets at the opening, the method including the steps of:

engaging the tissue at spaced apart engaged locations around the valve opening;

urging the engaged locations to move in a direction substantially perpendicular to a plane of the valve opening to displaced positions; and

anchoring the engaged locations in the displaced positions.

43. A method according to claim 42, further including the steps of drawing the engaged locations radially inward to a drawn-in configuration, and securing the engaged locations in the drawn-in configuration.

46. A method according to claim 43 wherein the engaged locations are engaged by attaching a filament to tissue at each of the locations and drawing the filaments in the direction substantially perpendicular to a plane of the valve opening.

47. A method according to claim 43 wherein the engaged locations are engaged by attaching a filament to tissue at each of the locations and drawing the filaments inwardly within the valve opening.

44. A device for treating a disorder associated with a heart valve of a patient, the device including:

a plurality of filaments each having an engaging portion for engaging annular tissue of the valve; and

an anchor for anchoring the engaged filaments to a region of tissue spaced from said annulus to facilitate drawing of the engaging portion toward the anchor.

45. A device according to claim 44 further including a collar facilitating a radially inward movement of said engaging portions by relative movement between the filaments and the collar.