METHODS, DEVICES, AND KITS FOR TREATING VALVE PROLAPSE

• US 20110011917A1
• Filed: 12/31/2009
• Published: 01/20/2011
• Est. Priority Date: 12/31/2008
• Status: Abandoned Application

• Current Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Original Assignee: Hansen Medical Incorporated (Johnson & Johnson)
• Inventors: Loulmet, Didier
• Application Number:
  US12/651,287
• Publication Number:
  US 20110011917A1
• Time in Patent Office: Days
• US Class Current: 227/181.1
• 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 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0686 having a forming anvil staying below the tissue during stapling
• CPC Class Codes: A61B 17/07292 Reinforcements for staple line, e.g. pledgets
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/00867 shape memory effect
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening
• CPC Class Codes: A61B 2017/0417 T-fasteners
• CPC Class Codes: A61B 2017/0419 H-fasteners
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0445 cannulated, e.g. with a longitudinal through-hole for passage of an instrument
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61F 2/2457 : Chordae tendineae prostheses

Abstract

Methods, devices, and kits are described for addressing cardiac valve repair. A system for deploying a tensile member between two tissue structures may comprise a first anchor insertion instrument defining a working lumen therethrough, and a second anchor insertion instrument movably coupled through the working lumen, wherein the first anchor instrument defines a jaw space and is configured to deploy a staple prosthesis into a portion of a first tissue structure which may be captured within the jaw space, and wherein the second anchor instrument is configured to deploy an implantable anchor, such as an anchor dart, into a second tissue structure which is coupled to the staple prosthesis by a tensile member, such as a suture.

Claims

1. A system for deploying a tensile member between two tissue structures, comprising:

a. a first anchor insertion instrument defining a working lumen therethrough; and

b. a second anchor insertion instrument movably coupled through said working lumen;

wherein the first anchor instrument defines a jaw space and is configured to deploy a staple prosthesis into a portion of a first tissue structure which may be captured within said jaw space;

and wherein the second anchor instrument is configured to deploy an implantable anchor into a second tissue structure which is coupled to the staple prosthesis by a tensile member.

2. The system of claim 1, wherein the jaw space of the first anchor insertion instrument is defined distally by an anvil structure.

3. The system of claim 1, wherein the jaw space of the first anchor insertion instrument is defined proximally by a structure selected from the group consisting of a proximal stapler housing, an advanceable stapling member, and an advanceable jaw member.

4. The system of claim 3, wherein portion of the first tissue structure may be controllably compressed by the advanceable jaw member before a staple is advanced through such first tissue structure portion by the advanceable stapling member, thereby driving the staple through the portion of the first tissue structure.

5. The system of claim 1, wherein the implantable anchor comprises an anchor dart having a distal body portion and a plurality of legs defining a proximal portion.

6. The system of claim 5, wherein a lumen is defined through said body portion.

7. The system of claim 6, wherein a working space is defined in between the plurality of legs.

8. The system of claim 7, wherein the second anchor insertion instrument comprises an elongate probe having a distal end removably inserted through the working space and body portion lumen of the anchor dart.

9. The system of claim 5, wherein the second anchor insertion instrument comprises an elongate probe defining a working lumen through which the anchor dart may be advanced into the second tissue structure.

10. The system of claim 9, wherein the distal portion of the elongate probe comprises a sharp geometry configured for atraumatic advancement through the second tissue structure before deployment of the anchor dart.

20. The method of claim 1, wherein deploying a second anchor comprises deploying a staple.

11. A method for deploying a tensile member between two tissue structures, comprising:

a. navigating a delivery instrument assembly defining a working lumen to a position adjacent a first targeted tissue structure;

b. deploying an implantable anchor dart prosthesis into the first targeted tissue structure, the anchor dart prosthesis being coupled to a tensile member which remains coupled to the delivery instrument assembly;

c. navigating the delivery instrument assembly to a position adjacent a second targeted tissue structure;

d. deploying a second anchor into the second targeted tissue structure which remains coupled to the anchor dart prosthesis by the tensile member;

e. adjusting the length of the tensile member between the anchor dart and second anchor; and

f. removing the delivery instrument assembly.

12. The method of claim 11, wherein the first targeted tissue structure is a portion of a papillary muscle.

13. The method of claim 11, wherein the second targeted tissue structure is a portion of a mitral valve leaflet.

14. The method of claim 11, wherein navigating a delivery instrument comprises operating a remotely steerable catheter.

15. The method of claim 11, wherein deploying an implantable anchor dart prosthesis comprises inserting a deployment probe having a sharp distal tip and a working lumen in which the implantable anchor dart prosthesis is disposed.

16. The method of claim 15, wherein deploying an implantable anchor dart prosthesis further comprises advancing the anchor dart prosthesis distally relative to the deployment probe.

17. The method of claim 11, wherein deploying an implantable anchor dart prosthesis comprises inserting a deployment probe having a sharp distal tip positioned through a proximal workspace and body lumen defined by the anchor dart prosthesis, such that the sharp distal tip extends beyond a distal tip of the anchor dart prosthesis.

18. The method of claim 17, wherein deploying an implantable anchor dart prosthesis further comprises inserting the deployment probe sharp distal tip into the first targeted tissue structure with a relatively high impulse load/timing profile.

19. The method of claim 18, wherein deploying an implantable anchor dart prosthesis further comprises withdrawing the deployment probe proximally relative to the implantable anchor dart.