MEDICAL DEVICE FOR CONSTRICTING TISSUE OR A BODILY ORIFICE, FOR EXAMPLE A MITRAL VALVE

• US 20110022166A1
• Filed: 10/06/2010
• Published: 01/27/2011
• Est. Priority Date: 05/13/2008
• Status: Active Grant

• Current Assignee: Kardium Inc.
• Original Assignee: Kardium Inc.
• Inventors: Dahlgren, Jon, Goertzen, Doug, Gelbart, Daniel
• Granted Patent: US 9,744,038 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• 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 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0485 Devices or means, e.g. loops, for capturing the suture thread and threading it through an opening of a suturing instrument or needle eyelet
• CPC Class Codes: A61B 2017/00331 with preformed bends
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• 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 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/22038 with a guide wire
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2454 Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses

Abstract

A medical apparatus positionable in a cavity of a bodily organ (e.g., a heart) may constrict a bodily orifice (e.g., a mitral valve). The medical apparatus may include tissue anchors that are implanted in the annulus of the orifice. The tissue anchors may be guided into position by an intravascularly or percutaneously deployed anchor guiding frame. Constriction of the orifice may be accomplished by cinching a flexible cable attached to implanted tissue anchors. The medical device may be used to approximate the septal and lateral (clinically referred to as anterior and posterior) annulus of the mitral valve in order to move the posterior leaflet anteriorly and the anterior leaflet posteriorly and thereby improve leaflet coaptation and eliminate mitral regurgitation.

Claims

1-20. -20. (canceled)

21. A medical system to perform percutaneous medical procedures, the medical system comprising:

a plurality of multi-lumen push tubes, each of the multi-lumen push tubes having at least a first longitudinal lumen and a second longitudinal lumen;

a plurality of release rods, at least a portion of a respective one of each of the release rods movably received by the first longitudinal lumen of a respective one of the multi-lumen push tubes for longitudinal translation with respect thereto, the release rods selectively releasably coupled to respective ones of a plurality of tissue anchors; and

a plurality of guide rails, at least a portion of at least a respective one of each of the guide rails moveably received by the second longitudinal lumen of a respective one the multi-lumen push tubes for longitudinal translation of the push tube with respect thereto, each of the tissue anchors physically coupled to move with a respective one of the push tubes along a respective one of the guide rails to a respective anchor position at least proximate a portion of the respective guide rail.

22. The medical system of claim 21, further comprising:

at least one articulated mechanism having a plurality of lumens, at least a respective one of each of the multi-lumen push tubes at least partially received by a respective one of the lumens of the articulated mechanism for translation and articulation therewith.

23. The medical system of claim 21, further comprising:

a plurality of constricting tubes, at least a respective one of each of the constricting tubes coupled to a respective one of the multi-lumen push tubes to translate therewith, at least a portion of at least a respective one of the tissue anchors received by a respective one of the constricting tubes at a first time and selectively releasable therefrom during a second time, the second time following the first time.

24. The medical system of claim 23 wherein each of the tissue anchors includes at least one barb and the portion of the tissue anchors received by the respective ones of the constricting tubes includes at least the at least one barb.

25. The medical system of claim 21 wherein each of the tissue anchors is physically constrained to move along the respective one of the guide rails to the respective anchor position at least proximate an end portion of the respective guide rail.

26. The medical system of claim 21 each of the tissue anchors is physically constrained to move along the respective one of the guide rails to the respective anchor position at least proximate a bend portion of the respective guide rail.

27. The medical system of claim 21 wherein the guide rails are wires and the release rods are wires.

28. The medical system of claim 21 wherein at least two of the guide rails are physically coupled to one another distally from the multi-lumen push tubes to form a guide frame.

29. The medical system of claim 28 wherein the guide frame includes a self-location structure that physically interacts with leaflets of a valve to self locate the guide frame.

30. The medical system of claim 21, further comprising:

the plurality of tissue anchors; and

at least one tensionable cable that physical couples at least two of the tissue anchors to form a constricting assembly.

31. The medical system of claim 30, further comprising:

at least one fastener that selectively physically fastens the at least one cable under tension.

32. The medical system of claim 30, further comprising:

at least one actuator that physically couples at least two of the tissue anchors, the actuator responsive to change a dimension in response to an applied stimulus.

33. The medical system of claim 32 wherein the actuator is responsive to a magnetic field.

34. The medical system of claim 30, further comprising:

at least one spreader physically coupled between at least two of the tissue anchors to fix a distance therebetween.

35. The medical system of claim 30 wherein the tissue anchors each have a hole which releasably receives a portion of a respective one of the release rods and the constricting tubes each have a slot sized to receive a portion of the respective one of the tissue anchors with the hole extending therefrom.

36. A method of operating a medical system to perform percutaneous medical procedures, the method comprising:

intravascularly delivering at least a portion of a device to a bodily organ, the portion of the device having a plurality of multi-lumen push tubes each having at least a first and a second longitudinal lumen;

a plurality of release rods at least a portion of which is slidably received by the first longitudinal lumen of a respective one of the multi-lumen push tubes, the release rods selectively releasably coupled to respective ones of a plurality of tissue anchors; and

a plurality of guide rails at least a portion of which is slidably received by the second longitudinal lumen of a respective one the multi-lumen push tubes, each of the tissue anchors physically coupled to move with a respective one of the push tubes along a respective one of the guide rails;

positioning each of the guide rails with respect to a respective anchor position on tissue of the bodily organ;

advancing the push tubes along the guide rails at least until the tissue anchors are at least partially embedded in the tissue; and

causing the release rods to release the tissue anchors while the tissue anchors are at least partially embedded in the tissue.

37. The method of claim 36, further comprising:

withdrawing the push tubes after causing the release rods to release the tissue anchors.

38. The method of claim 36 wherein at least one tensionable cable physically couples at least two of the tissue anchors, and further comprising:

tensioning the at least one tensionable cable to constrict an orifice in the tissue.

39. The method of claim 36, further comprising:

securing at least one fastener to the tensioned at least one tensionable cable to physically fasten the at least one tensionable cable under tension.

40. The method of claim 36 wherein at least one actuator that physically couples at least two of the tissue anchors, and further comprising:

applying a stimulus to the actuator to change a dimension of the actuator.

41. The method of claim 40 wherein applying a stimulus to the actuator includes applying a magnetic field externally from the body organ.