CARDIAC VALVE LEAFLET AUGMENTATION

• US 20100204662A1
• Filed: 06/04/2008
• Published: 08/12/2010
• Est. Priority Date: 06/04/2007
• Status: Active Grant

• Current Assignee: Boris Orlov
• Original Assignee: Mor Research Applications Ltd. (Clalit Health Services), Nisan Zef
• Inventors: Zef, Nisan, Orlov, Boris
• Granted Patent: US 8,758,431 B2
• Time in Patent Office: Days
• US Class Current: 604/264
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/32 Surgical cutting instruments A61B18/042 takes precedence; suture cutters A61B17/0467; instruments for ligaturing or cutting A61B17/128; instruments for rupturing the amniotic membrane A61B17/4208; specially adapted knives for eye surgery A61F9/0133
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/320048 Balloon dissectors
• CPC Class Codes: A61B 2090/036 abutting on tissue or skin
• CPC Class Codes: A61F 2/2463 Implants forming part of the valve leaflets
• CPC Class Codes: A61F 2/2466 Delivery devices therefor

Abstract

Methods and devices for augmenting an atrioventricular valve leaflet is disclosed. A method according to an exemplary embodiment includes piercing a leaflet of the valve to at least a portion of the leaflet'"'"'s thickness to form a pierced section; and extending the leaflet using said pierced section. A device according to an exemplary embodiment of the invention includes a catheter comprising: a longitudinal tube having a lumen; and a cutting element extendable from the lumen. The cutting element is adapted for forming a limited cut in an atrioventricular valve. A device according to another exemplary embodiment of the invention includes a catheter comprising a longitudinal tube having a lumen; a cutting element extendable from the lumen and adapted for forming a cut in a leaflet of an atrioventricular valve; and a frame, configured to attach to the leaflet and stay attached to the leaflet when the heart beats.

Claims

1. A method of augmenting an atrioventricular valve leaflet, the method comprising:

transcutaneously piercing a leaflet of the valve to at least a portion of the leaflet'"'"'s thickness to form a pierced section; and

extending said leaflet using said pierced section.

2. A method according to claim 1, wherein said antrioventricular valve is a mitral valve.

3. A method of according to claim 1, comprising:

delivering, with a catheter, a piercing element to the vicinity of the valve leaflet; and

cutting, with said piercing element, a valve leaflet to at least a portion of the leaflet'"'"'s thickness so as to allow the leaflet to stretch.

4. A method according to claim 1, wherein piercing a leaflet to at least a portion of the leaflet'"'"'s thickness substantially consists of cutting to a portion of the leaflet'"'"'s thickness so as to leave one of the leaflet'"'"'s surfaces intact.

5. A method according to claim 1, wherein piercing a leaflet to at least a portion of the leaflet'"'"'s thickness comprises piercing the leaflet through the entire leaflet'"'"'s thickness so as to form an opening going through the leaflet from one surface to the other.

6. A method according to claim 1, wherein piercing comprises performing a plurality of discontinuous pierced segments.

7. A method according to claim 5, comprising:

permanently obstructing the opening so as to decrease or prevent blood flow through the opening.

8. A method according to claim 5, comprising:

momentarily obstructing the opening so as to decrease or prevent blood flow through the opening.

9. A method according to claim 6, comprising:

obstructing a plurality of said discontinuous pierced segments with a single obstructor.

10. A method according to claim 5, comprising dilating the opening.

11. A method according to claim 10, comprising:

deploying a dilation brace in the dilated opening so as to maintain the dilated opening in a dilated state.

12. A method according to claim 1, comprising attaching to a surface of an atrioventricular valve leaflet a frame that holds a portion of the leaflet when the heart beats.

13. A method according to claim 12, wherein attaching comprises attaching by suction.

14. A method according to claim 1, comprising overlaying a cutting guide on a portion of the leaflet and piercing comprising piercing with the guidance of said cutting guide.

15. A method according to claim 14, wherein the cutting guide comprises a plurality of openings, and piercing comprises piercing through at least one of said openings.

16. A method according to claim 1, wherein piercing comprises:

delivering the piercing device to a first position in the vicinity of the leaflet during a first systole, such that at a first diastole the leaflet hits against the piercing device and is pierced at a first place.

17. A method according to claim 16, further comprising moving the piercing device to a second position, such that at a second diastole the leaflet hits against the piercing device and cut at a second place.

18. A catheter comprising:

a first longitudinal tube having a lumen; and

a cutting element extendable from said lumen and adapted for forming a limited cut in a leaflet of an atrioventricular valve.

19. A catheter according to claim 18, wherein said atrioventricular valve is a mitral valve.

20. A catheter according to claim 18, comprising a stopper, limiting the depth to which the cutting element can cut.

21-69. -69. (canceled)