METHOD AND APPARATUS FOR PROSTHETIC VALVE REMOVAL

• US 20120010699A1
• Filed: 08/19/2008
• Published: 01/12/2012
• Est. Priority Date: 08/21/2007
• Status: Active Grant

• Current Assignee: Valvexchange, Inc.
• Original Assignee: Valvexchange, Inc.
• Inventors: Vesely, Ivan
• Granted Patent: US 8,486,138 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• CPC Class Codes: A61B 17/221 Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions surgical snare instruments A61B17/32056
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/22 the beam being directed along or through a flexible conduit, e.g. an optical fibre; Couplings or hand-pieces therefor
• CPC Class Codes: A61B 18/245 for removing obstructions in blood vessels or calculi
• CPC Class Codes: A61B 2017/22035 for retrieving or repositioning foreign objects
• CPC Class Codes: A61B 2017/22097 Valve removal in veins
• CPC Class Codes: A61B 2018/2272 with reflective or refractive surfaces for deflecting the beam A61B2018/2261, A61B2018/2266 take precedence
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/243 Deployment by mechanical expansion
• CPC Class Codes: A61F 2002/9528 for retrieval of stents
• CPC Class Codes: A61F 2230/0054 V-shaped

Abstract

A method and apparatus for facilitating transapical removal of a prosthetic heart valve, i.e., percutaneously implantable valve (PIV), with-out open-heart surgery. The apparatus includes a holding tool for holding the PIV, a cutting tool for separating the PrV from fibrotic tissue accumulating around the PIV, and a removal tool for extracting the PIV from the heart.

Claims

1. A holding tool for facilitating removal of an implantable cardiovascular valve, the holding tool comprising:

a first sliding member;

a second sliding member moveable relative to the first sliding member; and

a first articulating joint member connected to the first and second sliding members, said articulating joint member moveable between a collapsed position and an expanded position, wherein movement of the second sliding member relative to the first sliding member moves the first articulating joint member between the collapsed and expanded positions.

2. A holding tool according to claim 1, wherein said first articulating joint member is comprised of:

a plurality of articulating legs, each of said legs including a projection dimensioned to engage with the implantable cardiovascular valve.

3. A holding tool according to claim 1, wherein said holding tool further comprises a detachable handle attachable to said first sliding member.

4. A holding tool according to claim 1, wherein said holding tool further comprises a detachable handle attachable to said second sliding member.

5. A holding tool according to claim 1, wherein said holding tool further comprises:

a third sliding member;

a fourth sliding member moveable relative to the third sliding member; and

a second articulating joint member connected to the third and fourth sliding members, said articulating joint member moveable between a collapsed position and an expanded position, wherein movement of the fourth sliding member relative to the third sliding member moves the second articulating joint member between the collapsed and expanded positions.

6. A holding tool according to claim 5, wherein said second articulating joint member is comprised of:

a plurality of articulating legs, each of said legs including a projection dimensioned to engage with the implantable cardiovascular valve.

7. A cutting tool for facilitating removal of an implantable cardiovascular valve, the cutting tool comprising:

a shaft having a longitudinal axis; and

a cutting arm extending from the hollow shaft, wherein said cutting arm includes cutting means for cutting tissue.

8. A cutting tool according to claim 7, wherein said cutting means includes:

at least one axially-mounted fiber optic guide for projecting a laser beam in a direction generally parallel to the longitudinal axis of the shaft, said at least one axially-mounted fiber optic guide is positioned to cut a channel adjacent to the implantable cardiovascular valve.

9. A cutting tool according to claim 7, wherein said cutting means includes:

at least one transverse-mounted fiber optic guide for projecting a laser beam in a direction transverse to the longitudinal axis of the shaft, said at least one transverse-mounted fiber optic guide is positioned to cut a generally annular recess around the periphery of the implantable cardiovascular valve.

10. A cutting tool according to claim 7, wherein said cutting means includes a source of laser energy that is transmitted via a fiber optic cable.

11. A cutting tool according to claim 7, wherein said cutting means includes a mechanical cutting device.

12. A cutting tool according to claim 7, wherein said cutting means includes an electrosurgical cutting device.

13. A cutting tool according to claim 7, wherein said shaft is a hollow shaft defining a recess dimensioned to receive a stem portion of a holding tool for holding the implantable cardiovascular valve.

14. A cutting tool according to claim 7, wherein said cutting tool further comprises a handle portion for maneuvering said cutting tool.

15. A valve removal tool for facilitating removal of an implantable cardiovascular valve from a heart, the valve removal tool comprising:

a body;

capture means mounted to the body and moveable between a collapsed position and an expanded position, for capturing the implantable cardiovascular valve; and

an actuator for actuating movement of the capture means between the collapsed and expanded positions.

16. A valve removal tool according to claim 15, wherein said capture means includes a plurality of articulating arms.

17. A valve removal tool according to claim 16, wherein said actuator moves an inner sleeve relative to said body in order to effect movement of said arms between the collapsed and expanded positions.

18. A valve removal tool according to claim 15, wherein said capture means includes a wire mesh basket.

19. A valve removal tool according to claim 18, wherein said actuator applies tension to the wire mesh basket in order to effect movement of said wire mesh basket to the collapsed position.

20. A valve removal tool according to claim 18, wherein said body includes a recess dimensioned to receive a stem portion of a holding tool for holding the implantable cardiovascular valve.

21. A method for removing an implantable cardiovascular valve from a heart, the method comprising:

holding the cardiovascular valve using a valve holding tool;

separating the cardiovascular valve from fibrotic tissue that accumulates adjacent to the cardiovascular valve; and

removing the cardiovascular valve from the heart using a valve removal tool, said step of removing including;

capturing the cardiovascular valve, and

extracting the cardiovascular valve from the heart.

22. A method according to claim 21, wherein said step of capturing the cardiovascular valve includes moving articulating arms of the valve removal tool from an expanded position to a collapsed position.

23. A method according to claim 21, wherein said step of capturing the cardiovascular valve includes moving a wire mesh basket of the valve removal tool from an expanded position to a collapsed position.

24. A method according to claim 21, wherein said step of separating includes:

cutting a channel adjacent to the cardiovascular valve using a cutting tool; and

cutting an annular recess around the periphery of the cardiovascular valve using the cutting tool.