GUIDE WIRES WITH COMMISSURAL ANCHORS TO ADVANCE A PROSTHETIC VALVE

• US 20120022639A1
• Filed: 07/21/2010
• Published: 01/26/2012
• Est. Priority Date: 07/21/2010
• Status: Active Grant

• Current Assignee: Cardiovalve Ltd.
• Original Assignee: Mitraltech Ltd.
• Inventors: HACOHEN, Gil, GROSS, Yossi, PAPA, Marco
• Granted Patent: US 9,132,009 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2/2439 Expansion controlled by filaments
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2250/0063 Nested prosthetic parts

Abstract

Apparatus is provided, including one or more valve support guide members configured to be delivered to one or more commissures of a native atrioventricular valve of a patient, one or more valve support anchors configured to be anchored to the one or more commissures of the native valve, a prosthetic valve support advanceable toward the native valve along the one or more valve support guide members and anchored to the native valve at least the one or more commissures, and a prosthetic valve configured to be coupled to the valve support. Other applications are also described.

Claims

1. Apparatus, comprising:

one or more valve support guide members configured to be delivered to one or more commissures of a native atrioventricular valve of a patient;

one or more valve support anchors configured to be anchored to the one or more commissures of the native valve;

a prosthetic valve support advanceable toward the native valve along the one or more valve support guide members and anchored to the native valve at least the one or more commissures; and

a prosthetic valve configured to be coupled to the valve support.

2. The apparatus according to claim 1, wherein the valve support is collapsible for transcatheter delivery and expandable to contact the native atrioventricular valve.

3. The apparatus according to claim 1, wherein the one or more valve support anchors are configured to be anchored to the one or more commissures from ventricular surfaces thereof.

4. The apparatus according to claim 1, wherein the one or more valve support guide members comprises one valve support guide member that is looped through first and second commissures of the atrioventricular valve in a manner in which a looped portion of the valve support guide member is disposed in a ventricle of the patient and first and second free ends of the valve support guide member are accessible from a site outside a body of the patient.

5. The apparatus according to claim 1, wherein the one or more valve support anchors comprises first and second tissue anchors, the first and second tissue anchors being configured to be anchored to respective first and second commissures of the atrioventricular valve of the patient.

6. The apparatus according to claim 1, wherein:

the one or more valve support anchors each comprise one or more radially-expandable prongs, and

the one or more prongs are disposed within a sheath in a compressed state prior to the anchoring, and exposed from within the sheath in order to expand and facilitate anchoring of the valve support anchor to the respective commissures.

7. The apparatus according to claim 1, wherein the prosthetic valve comprises two or more prosthetic leaflets.

8. The apparatus according to claim 1, wherein the native atrioventricular valve includes a mitral valve, and wherein the prosthetic valve comprises three prosthetic leaflets.

9. The apparatus according to claim 1, wherein the valve support guide members are removable from the patient following the anchoring of the prosthetic valve support at the atrioventricular valve.

10. The apparatus according to claim 1, wherein the valve support is shaped so as to define a distal portion which is configured to push aside, at least in part, native leaflets of the valve of the patient.

11. The apparatus according to claim 1, wherein the one or more valve support anchors are advanceable along the one or more valve support guide members.

12. The apparatus according to claim 1, wherein the valve support is shaped so as to define one or more holes, the one or more holes being configured to facilitate slidable passage therethrough of a respective one of the one or more valve support guide members.

13. The apparatus according to claim 1, wherein the prosthetic valve is shaped so as to define one or more snares configured to ensnare one or more native leaflets of the native valve of the patient.

14. The apparatus according to claim 1, wherein the one or more valve support anchors comprises one or more ventricular anchors, and wherein the apparatus further comprises one or more atrial anchors, each atrial anchor being configured to be advanced toward an atrial surface of the valve support and anchor in place the valve support in a vicinity of a respective one of the ventricular anchors.

15. The apparatus according to claim 1, further comprising one or more delivery lumens, wherein:

each one of the one or more valve support anchors is removably coupled to a distal end of a respective delivery lumen,

the delivery lumen is configured to facilitate advancement of the one or more anchors along the one or more guide members, and

the delivery lumen is decoupled from the anchor following the anchoring of the anchor to the one or more commissures.

16. The apparatus according to claim 15, wherein the one or more valve support guide members are removable from the body of the patient following the advancement of the one or more anchors along the one or more guide members.

17. The apparatus according to claim 15, wherein:

the valve support is shaped so as to define one or more holes,

the one or more holes are configured to facilitate slidable passage therethrough of a respective one of the one or more delivery lumens, and

the one or more delivery lumens are decoupleable from the respective valve support anchor following the anchoring of the valve support to at least the one or more commissures.

18. The apparatus according to claim 17, wherein the one or more delivery lumens are removable from the body of the patient following the anchoring of the valve support to at least the one or more commissures.

19. The apparatus according to claim 1, wherein the valve support comprises an annular element and a generally cylindrical element coupled to the annular element, the generally cylindrical element being configured to push aside native leaflets of the native valve, wherein the cylindrical element has first and second ends and a cylindrical body that is disposed between the first and second ends.

20. The apparatus according to claim 19, further comprising one or more annular element tissue anchors, wherein the annular element has an upper surface and a lower surface, and wherein the lower surface is coupled to the one or more annular element tissue anchors, the one or more annular element tissue anchors being configured to puncture tissue of a native annulus of the native valve of the patient.

21. The apparatus according to claim 20, wherein the one or more annular element tissue anchors comprises a plurality of annular element tissue anchors positioned around the lower surface of the annular element.

22. The apparatus according to claim 20, wherein the one or more annular element tissue anchors comprises a first commissural anchor configured to puncture tissue of the native valve at a first commissure thereof, and a second commissural anchor configured to puncture tissue of the native valve at a second commissure thereof.

23. The apparatus according to claim 20, wherein each anchor of the one or more annular element tissue anchors comprises a distal pointed tip and one or more radially-expandable prongs, the prongs being configured to expand and facilitate anchoring of the anchor and restrict proximal motion of the annular element tissue anchor.

24. The apparatus according to claim 19, further comprising one or more prosthetic valve guide members reversibly couplable to the cylindrical element in a vicinity of the second end of the cylindrical element, the prosthetic valve guide members being configured to facilitate advancement of the prosthetic valve therealong and toward the valve support.

25. The apparatus according to claim 24, wherein:

the first end of the cylindrical element is coupled to the annular element,

during a first period, the second end of the cylindrical element is disposed above the annular element in a manner in which the body of the cylindrical element is disposed above the annular element, and

the cylindrical element is invertible in a manner in which, during a second period, the second end of the cylindrical element is disposed below the annular element and the body of the cylindrical element is disposed below the annular element.

26. The apparatus according to claim 25, wherein:

during the first period, the second end of the cylindrical element is disposed in an atrium of a heart of the patient and the annular element is positioned along an annulus of the native valve,

the prosthetic valve is advanceable along the one or more prosthetic valve guide members into a ventricle of the heart of the patient, and

in response to advancement of the prosthetic valve into the ventricle, the one or more prosthetic valve guide members are pulled into the ventricle and pull the second end and the body of the cylindrical element into the ventricle to invert the cylindrical element.

27-99. -99. (canceled)