Method and apparatus for tissue connection

• US 20090276038A1
• Filed: 07/15/2009
• Published: 11/05/2009
• Est. Priority Date: 06/12/2002
• Status: Active Grant

• Current Assignee: Mitral Interventions Incorporated
• Original Assignee: Mitral Interventions Incorporated
• Inventors: Tremulis, William S., Razavi, Mahmood K.
• Granted Patent: US 8,556,963 B2
• Time in Patent Office: Days
• US Class Current: 623/2.110
• 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 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/00411 actuated by application of energy from an energy source outside the body
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/00893 pharmaceutically effective
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/044 with a threaded shaft, e.g. screws
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/349 Trocar with thread on outside
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2463 Implants forming part of the valve leaflets
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2230/0091 helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section

Abstract

A tissue connecting device is provided. The device comprise an elongate delivery device having a lumen, a proximal end, and a distal end. The distal end is configured to engage tissue and advance said device into tissue. At least one anchor deliverable through a lumen of the elongate delivery device. The distal end of the device may be designed to engage tissue upon rotation of the device about its longitudinal axis.

Claims

1. A delivery assembly, comprising:

a elongated carrier;

a plurality of anchors configured to engage tissue, the plurality of anchors including a distal anchor, one or more intermediate anchors and a proximal anchor releasable carried within the elongated carrier and deliverable by the elongated carrier to a target tissue area;

a tissue support member; and

a slidable clamp coupled to the tissue support member, wherein when tension is applied by the slidable clamp to the tissue support member the target tissue area is constricted.

2. A delivery assembly, comprising:

a elongated carrier;

a plurality of sutures configured to engage tissue, the plurality of sutures carried within the elongated carrier and deliverable by the elongated carrier to a target tissue area;

a tissue support member coupled to the plurality of sutures; and

a slidable clamp coupled to the tissue support member, wherein when tension is applied by the slidable clamp to the tissue support member the target tissue area is constricted.

3. A delivery assembly, comprising:

a elongated carrier;

a mesh configured to engage tissue, the mesh carried within the elongated carrier and deliverable by the elongated carrier to a target tissue area;

a tissue support member coupled to the mesh; and

a slidable clamp coupled to the tissue support member, wherein when tension is applied by the slidable clamp to the tissue support member the target tissue area is constricted.

4. A tissue connecting assembly, comprising:

at least one anchor;

an elongate delivery device with a longitudinal axis, a proximal end and a distal end, the distal end configured to releasably engage the at least one anchor;

a tissue support member, the tissue support member being slidably delivered along at least one suture coupled to the at least one anchor; and

wherein the anchor is capable of piercing tissue through rotation of the delivery device about the longitudinal axis.

5. The assembly of claim 4, wherein at least a portion of the tissue support member is made of mesh.

6. The assembly of claim 4, wherein the anchor is expandable from a small diameter to a larger diameter.

7. The assembly of claim 4, wherein the anchor has a helical geometric configuration.

8. The assembly of claim 4, wherein the anchor is made of at least one of metal or a polymer.

9. The assembly of claim 4, wherein the anchor includes barbs.

10. The assembly of claim 4, wherein the anchor has a tip with a diameter that is larger than non-tip sections of the anchor.

11. The assembly of claim 4, wherein the anchor has a back end with a diameter that is larger than a diameter of non-back end portions.

12. The assembly of claim 4, wherein the anchor incorporates outwardly projecting barbs.

13. The assembly of claim 4, wherein at least a portion of the anchor is sufficiently porous to provide for tissue in-growth.

14. The assembly of claim 4, wherein the anchor includes medicamant delivery to tissue.

15. The assembly of claim 4, wherein the anchor incorporates at least one of, a healing hormone or a composition that provides a therapeutic response to tissue.

16. The assembly of claim 5, wherein the mesh is configured to provide support to at least one of a urethra and bladder.

17. The assembly of claim 5, wherein the mesh is configured to provide support to a vagina.

18. The assembly of claim 5, wherein the mesh is woven of a monofilament.

19. The assembly of claim 5, wherein the mesh is made of a polymer.

20. The assembly of claim 5, wherein the mesh is configured to deliver a medicament to tissue.

21. The assembly of claim 5, wherein the medicament is selected from at least one of, estrogen, estrodiol, a substance that promotes tissue in-growth and a substance that provides a therapeutic response to tissue.

22. The assembly of claim 4, wherein the suture is at least one of, a monofilament and a braided multifilament.

23. The assembly of claim 4, wherein the suture is made of a material that is absorbable.

24. The assembly of claim 4, wherein the suture is configured to deliver a medicament to tissue.

25. The assembly of claim 4, wherein the suture is porous to promote tissue in-growth.

26. A tissue anchor assembly, comprising;

a helical tissue anchor capable of piercing tissue through rotation, a tissue support member;

a releasable elongated delivery device, a distal end of the delivery device configured to releasably engage at least the anchor; and

wherein the helical tissue anchor is configured to pierce tissue upon rotation of the delivery device.

27. The assembly of claim 26, wherein at least a portion of the tissue support is made of a mesh coupled to the anchor.

28. The assembly of claim 26, wherein at least a portion of the tissue support member is made of mesh.

29. The assembly of claim 26, wherein the anchor is expandable from a small diameter to a larger diameter.

30. The assembly of claim 26, wherein the anchor is made of at least one of metal or a polymer.

31. The assembly of claim 26, wherein the anchor includes barbs.

32. The assembly of claim 26, wherein the anchor has a tip with a diameter that is larger than non-tip sections of the anchor.

33. The assembly of claim 26, wherein the anchor has a back end with a diameter that is larger than a diameter of non-back end portions.

34. The assembly of claim 26, wherein the anchor incorporates outwardly projecting barbs.

35. The assembly of claim 26, wherein at least a portion of the anchor is sufficiently porous to provide for tissue in-growth.

36. The assembly of claim 26, wherein the anchor includes medicamant delivery to tissue.

37. The assembly of claim 26, wherein the anchor incorporates at least one of, a healing hormone or a composition that provides a therapeutic response to tissue.

38. The assembly of claim 28, wherein the mesh is configured to provide support to at least one of a urethra and bladder.

39. The assembly of claim 28, wherein the mesh is configured to provide support to a vagina.

40. The assembly of claim 28, wherein the mesh is woven of a monofilament.

41. The assembly of claim 28, wherein the mesh is made of a polymer.

42. The assembly of claim 28, wherein the mesh is configured to deliver a medicament to tissue.

43. The assembly of claim 28, wherein the medicament is selected from at least one of, estrogen, estrodiol, a substance that promotes tissue in-growth and a substance that provides a therapeutic response to tissue.

44. The assembly of claim 26, wherein the suture is at least one of, a monofilament and a braided multifilament.

45. The assembly of claim 26, wherein the suture is made of a material that is absorbable.

46. The assembly of claim 26, wherein the suture is configured to deliver a medicament to tissue.

47. The assembly of claim 26, wherein the suture is porous to promote tissue in-growth.

48. A tissue anchor assembly, comprising;

a helical tissue anchor capable of piercing tissue through rotation,

a suture coupled to the anchor,

a tissue support member;

a clamp coupled to the suture to provide tension between the support member and the anchor, and

a releasable elongated delivery device with a distal end configured to releasably engage the anchor

49. The assembly of claim 48, wherein at least a portion of the tissue support member is a mesh slideably coupled to the suture.

50. The assembly of claim 48, wherein at least a portion of the tissue supporting member is made of mesh.

51. The assembly of claim 48, wherein the anchor is expandable from a small diameter to a larger diameter.

52. The assembly of claim 48, wherein the anchor has a helix geometric configuration.

53. The assembly of claim 48, wherein the anchor is made of at least one of metal or a polymer.

54. The assembly of claim 48, wherein the anchor includes barbs.

55. The assembly of claim 48, wherein the anchor has a tip with a diameter that is larger than non-tip sections of the anchor.

56. The assembly of claim 48, wherein the anchor has a back end with a diameter that is larger than a diameter of non-back end portions.

57. The assembly of claim 48, wherein the anchor incorporates outwardly projecting barbs.

58. The assembly of claim 48, wherein at least a portion of the anchor is sufficiently porous to provide for tissue in-growth.

59. The assembly of claim 48, wherein the anchor includes medicamant delivery to tissue.

60. The assembly of claim 48, wherein the anchor incorporates at least one of, a healing hormone or a composition that provides a therapeutic response to tissue.

61. The assembly of claim 50, wherein the mesh is configured to provide support to at least one of a urethra and bladder.

62. The assembly of claim 50, wherein the mesh is configured to provide support to a vagina.

63. The assembly of claim 50, wherein the mesh is woven of a monofilament.

64. The assembly of claim 50, wherein the mesh is made of a polymer.

65. The assembly of claim 50, wherein the mesh is configured to deliver a medicament to tissue.

66. The assembly of claim 50, wherein the medicament is selected from at least one of, estrogen, estrodiol, a substance that promotes tissue in-growth and a substance that provides a therapeutic response to tissue.

67. The assembly of claim 48, wherein the suture is at least one of, a monofilament and a braided multifilament.

68. The assembly of claim 48, wherein the suture is made of a material that is absorbable.

69. The assembly of claim 48, wherein the suture is configured to deliver a medicament to tissue.

70. The assembly of claim 48, wherein the suture is porous to promote tissue in-growth.