APPARATUS AND METHODS FOR DELIVERING FASTENERS DURING VALVE REPLACEMENT

• US 20090036903A1
• Filed: 05/05/2008
• Published: 02/05/2009
• Est. Priority Date: 05/05/2007
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Arbor Surgical Technologies, Inc. (Medtronic Plc)
• Inventors: Knab, Dwight J. JR., Drews, Michael J., Gurskis, Donnell W., Ino, Takashi Harry
• Granted Patent: US 8,147,504 B2
• Time in Patent Office: Days
• US Class Current: 606/143
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/0684 having a forming anvil staying above the tissue during stapling
• CPC Class Codes: A61B 17/1222 Packages or dispensers therefor clip magazines incorporated in a clip-applying instrument A61B17/128; for surgical articles A61B50/30
• CPC Class Codes: A61B 17/1227 Spring clips
• CPC Class Codes: A61B 2017/00473 Distal part, e.g. tip or head A61B2017/00464 takes precedence
• CPC Class Codes: A61B 2017/0053 Loading magazines or sutures into applying tools
• CPC Class Codes: A61B 2017/00544 pneumatically
• CPC Class Codes: A61B 2017/00862 elastic or resilient for sutures A61B2017/0618
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442

Abstract

A fastener delivery tool includes a belt including pairs of features for releasably engaging tines of respective fasteners in a relaxed state defining a loop. The tool includes a loading chamber for receiving a fastener from the belt, a retaining member for limiting movement of the fastener within the loading chamber, an ejection track communicating with the loading chamber, a handle including an actuator, and a tongue and pusher member coupled to the actuator. Activation of the actuator advances the tongue to transform the fastener from the relaxed state to a U-shaped constrained state, and advances the pusher member to direct the fastener from the loading chamber down the ejection track. The tool may include a trigger for ejecting the fastener completely from the ejection track. The fastener may be used to secure a prosthetic heart valve or components thereof into surrounding tissue, e.g., within a tissue annulus.

Claims

1. A fastener delivery tool, comprising:

a belt comprising pairs of features for releasably engaging tines of respective fasteners in a relaxed state;

a loading chamber for receiving a fastener from the belt in the relaxed state;

a releasable retaining member for limiting movement of the fastener within the loading chamber;

an ejection track communicating with the loading chamber;

a handle including an actuator; and

a tongue and a pusher member coupled to the actuator, activation of the actuator advancing the tongue to engage the tines so as to transform the fastener from the relaxed state to a constrained state and advancing the pusher member to advance the fastener from the loading chamber down the ejection track.

2. The fastener delivery tool of claim 1, further comprising a trigger for ejecting the fastener distally from the ejection track.

3. The fastener delivery tool of claim 1, wherein, in the relaxed state, the tines of the fastener overlap one another to define a loop, the retaining member being received in the loop for limiting movement of the fastener, and, in the constrained state, the fastener comprises a U-shape.

4. The fastener delivery tool of claim 3, wherein the ejection track comprises side walls for constraining the fastener in the U-shape as the fastener is advanced down the ejection track.

5. The fastener delivery tool of claim 4, wherein the tines are exposed distally beyond the ejection track when the actuator is activated without ejecting the fastener completely from the ejection track.

6. The fastener delivery tool of claim 1, wherein the retaining member comprises a movable release pin.

7. The fastener delivery tool of claim 6, wherein the release pin is coupled to at least one of the tongue and the pusher member such that the release pin releases the fastener after the actuator is activated.

8. The fastener delivery tool of claim 1, further comprising a staging section including a plurality of fasteners disposed therein.

9. The fastener delivery tool of claim 8, wherein the plurality of fasteners are carried by a cartridge receivable in the staging section.

10. The fastener delivery tool of claim 1, the retaining member being releasable upon engagement with a cam located on the pusher member.

11. A fastener delivery tool, comprising:

a housing comprising an actuator;

a cartridge assembly extending from the housing and carrying a plurality of fasteners, the cartridge assembly comprising a belt comprising pairs of features releasably engaging tines of respective fasteners in a relaxed state, each of the fasteners defining a loop between the tines in the relaxed state;

a loading chamber for successively receiving a fastener from the belt in the relaxed state;

a retaining member for limiting movement of the fastener received within the loading chamber;

an ejection track communicating with the loading chamber; and

a tongue and a pusher member coupled to the actuator, activation of the actuator advancing the tongue to engage the tines so as to transform the fastener received within the loading chamber from the relaxed state to a U-shaped constrained state, advancing the pusher member to advance the fastener from the loading chamber down the ejection track, and advancing the belt to deliver another fastener within the loading chamber.

12. The fastener delivery tool of claim 11, wherein the cartridge assembly is removable from the housing such that a new cartridge assembly carrying a plurality of fasteners is connectable to the housing.

13. The fastener delivery tool of claim 11, wherein the cartridge assembly is connectable to the housing, the belt, retaining member, tongue, and pusher member being coupled to the actuator after the cartridge assembly is connected to the housing.

14. The fastener delivery tool of claim 11, wherein the actuator comprises a first actuator for advancing the tongue to engage the tines so as to transform the fastener received within the loading chamber from the relaxed state to a U-shaped constrained state and advancing the pusher member to advance the fastener from the loading chamber down the ejection track, and a second actuator for ejected the constrained fastener entirely from the ejection track.

15. The fastener delivery tool of claim 11, wherein the actuator comprises an air cylinder.

16. The fastener delivery tool of claim 11, wherein the cartridge assembly is connectable to the housing, and wherein the housing comprises a lockout feature that prevents actuation of the actuator when the cartridge assembly is not connected to the housing.

17. The fastener delivery tool of claim 16, wherein the lockout feature comprises a lever arm that is locked to prevent the actuator from being actuated before the cartridge assembly is connected to the housing, the lever arm being coupled to a latch when the cartridge assembly is connected to the housing such that actuator of the actuator activates the latch to deliver a fastener within the loading chamber from the ejection track.

18. The fastener delivery tool of claim 11, wherein the cartridge assembly comprises a frame comprising first and second ends within the cartridge assembly, the second end disposed adjacent the loading chamber the belt comprising a pair of endless bands extending between the first and second ends of the frame, each band a plurality of features disposed adjacent features of the other band to provide the pairs of features releasably engaging tines of respective fasteners.

19. The fastener delivery tool of claim 18, further comprising a cross-bar for coupling movement of the pair of endless bands together, and a pushrod coupled to the actuator for advancing the cross-bar to simultaneously advance the pair of endless bands.

20. The fastener delivery tool of claim 11, wherein the features comprise one of hooks and clips defining recesses for releasably receiving the tines therein.

21. A fastener delivery tool, comprising:

a housing comprising an actuator;

an elongate shaft extending from the housing and terminating in a distal tip, the shaft comprising a belt assembly therein comprising pairs of features releasably engaging tines of respective fasteners in a relaxed state, each of the fasteners defining a loop between the tines in the relaxed state;

a loading chamber in the distal tip for successively receiving a fastener from the belt in the relaxed state;

a retaining member for limiting movement of the fastener received within the loading chamber;

an ejection track communicating with the loading chamber; and

a tongue and a pusher member coupled to the actuator, activation of the actuator advancing the tongue to engage the tines so as to transform the fastener received within the loading chamber from the relaxed state to a U-shaped constrained state, advancing the pusher member to advance the fastener from the loading chamber down the ejection track, and advancing the belt to deliver another fastener within the loading chamber.

22. The fastener delivery tool of claim 21, wherein the cartridge assembly comprises a frame comprising first and second ends within the cartridge assembly, the second end disposed adjacent the loading chamber the belt comprising a pair of endless bands extending between the first and second ends of the frame, each band a plurality of features disposed adjacent features of the other band to provide the pairs of features releasably engaging tines of respective fasteners.

23. The fastener delivery tool of claim 22, further comprising a cross-bar for coupling movement of the pair of endless bands together, and a pushrod coupled to the actuator for advancing the cross-bar to simultaneously advance the pair of endless bands.

24. The fastener delivery tool of claim 21, wherein the features comprise one of hooks and clips defining recesses for releasably receiving the tines therein.

25. The fastener delivery tool of claim 21, wherein the features comprise nonmetallic material to avoid damaging the tines releasably engaged by the features.

26. The fastener delivery tool of claim 21, further comprising a cover on the elongate shaft overlying the belt assembly, the cover being removable for accessing the belt assembly.

27. The fastener delivery tool of claim 26, wherein the belt assembly is removably secured within the elongate shaft to allow a new belt assembly to be loaded into the elongate shaft after the fasteners have been delivered from the belt assembly.

28. A method for delivering a fastener using a tool including a belt assembly carrying a plurality of fasteners, the method comprising:

advancing the belt assembly to deliver a first fastener from the belt assembly onto a retaining member, the fastener comprising a pair of tines;

advancing a tongue in the delivery tool relative to the restrained fastener to transform the fastener from a relaxed state to a constrained state;

releasing the fastener from the retaining member while the fastener is in the constrained state;

advancing the fastener in the constrained state distally within the delivery tool;

ejecting the fastener from the delivery tool; and

advancing the belt assembly to deliver a second fastener from the belt assembly onto the retaining member.

29. The method of claim 28, further comprising loading the belt assembly into the delivery tool.