ANNULOPLASTY RINGS AND METHODS FOR HEART VALVE REPAIR

• US 20130030523A1
• Filed: 04/07/2009
• Published: 01/31/2013
• Est. Priority Date: 04/09/2008
• Status: Active Grant

• Current Assignee: Emory University, Georgia Tech Research Corporation (University System of Georgia)
• Original Assignee: Emory University, Georgia Tech Research Corporation (University System of Georgia)
• Inventors: Padala, Sai Muralidhar, Yoganathan, Ajit P., Thourani, Vinod H., Jimenez, Jorge H.
• Granted Patent: US 9,295,553 B2
• Time in Patent Office: Days
• US Class Current: 623/2.37
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2442 Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2448 D-shaped rings
• CPC Class Codes: A61F 2230/0023 triangular
• CPC Class Codes: A61F 2230/0063 Three-dimensional shapes
• CPC Class Codes: A61F 2230/0095 Saddle-shaped
• CPC Class Codes: A61F 2250/0004 adjustable

Abstract

An annuloplasty ring, configured for implantation in the annulus of a heart valve, comprising multiple segments each of which are geometrically shaped from a three dimensional perspective to conform to the anatomic shape of the valve annulus. In one embodiment, the annuloplasty ring is configured to facilitate a reduction of tension on heart valve tissue and eliminate a substantial portion of potential pressure or force that may be applied to the atrioventricular node by the annuloplasty ring when implanted. In another embodiment, at the annuloplasty ring is configured to include an assembly that facilitates selective adjustment of a segment'"'"'s respective length and/or shape. The adjustment of the length of one of the ring segment'"'"'s results in an adjustment of at least one angle between at least one set of other ring segments, thereby causing an adjustment to the geometric characteristics of the ring.

Claims

1. A tricuspid annuloplasty ring configured for implantation in a tricuspid valve annulus having an anterior annulus section, a septal annulus section and a posterior annulus section, the annuloplasty ring comprising:

a triangular shaped continuous body having an anterior segment, a septal segment and a posterior segment, wherein each of the anterior, septal and posterior segments are geometrically shaped to conform to the anatomic shape of the anterior, septal and posterior sections of tricuspid valve annulus.

2. The tricuspid annuloplasty ring of claim 1 wherein the anterior, septal and posterior segments of the annuloplasty ring vary in length and curvature when compared to each other.

3. The tricuspid annuloplasty ring of claim 1 wherein the annuloplasty ring has a defined edge comprised of geometric configuration of the exterior portions of the anterior, septal and posterior segments.

4. The tricuspid annuloplasty ring of claim 2 wherein the septal segment of the annuloplasty ring is longer than the posterior segment of the annuloplasty ring and the posterior segment of the annuloplasty ring is longer than the anterior segment of the annuloplasty ring.

5. The tricuspid annuloplasty ring of claim 4 wherein the septal segment extends from a posterior-septal commissure to an anterior-septal commissure, the anterior segment extends from the anterior-septal commissure to a anterior-posterior commissure and the posterior segment extends from the anterior-posterior commissure to the posterior-septal commissure.

6. The tricuspid annuloplasty ring of claim 1 wherein curvature of the septal segment of the tricuspid valve is greater than the curvature of the anterior and posterior segments of the tricuspid valve, wherein:

(a) the two lowest points of the septal segment are located at a posterior-septal commissure of the tricuspid valve and a anterior-septal commissure of the tricuspid valve; and

(b) a zenith of the ring is midway between the two lowest points on the septal segment.

7. The tricuspid annuloplasty ring of claim 1 wherein section of the septal segment of the ring that is positioned proximate the location of the sin θ

-atrial node of the human heart when the ring is inserted into the tricuspid valve annulus is configured to include a flap extending from the septal segment in a manner whereby the flap rests on a wall of the heart.

8. The tricuspid annuloplasty ring of claim 1 wherein a part of the septal segment of the ring that is positioned proximate the location of the sin θ

-atrial node of the human heart when the ring is inserted into the tricuspid valve annulus is cutaway.

9. The tricuspid annuloplasty ring of claim 8 wherein cut-away segment comprises first and second metallic face plates at each end of the cut-away segment with multiple curved struts connecting the first and second metallic face plates, such that it maintains the continuity of the annuloplasty ring.

10. The tricuspid annuloplasty ring of claim 1 wherein a part of the septal segment of the ring that is positioned proximate the location of the sino-atrial node of the human heart when the ring is inserted into the tricuspid valve annulus includes a bridged structure configured to reduce tension on tricuspid valve tissue.

11. The tricuspid annuloplasty ring of claim 1 wherein the anterior segment is configured such that the lowest point of the anterior segment corresponds to the septal-anterior commissure and the highest point of the anterior segment corresponds to the anterior-posterior commissure.

12. The tricuspid annuloplasty ring of claim 1 wherein the posterior segment is configured such that the lowest point on the posterior segment corresponds to the septal-posterior commissure and the highest point on the posterior segment corresponds to the anterior-posterior commissure.

13. The tricuspid annuloplasty ring of claim 1 including a first line segment connecting the two lowest on the ring and a second line segment connecting the two highest points on the ring, wherein the first and second line segments offset by a definite distance and are non-coincident.

14. The tricuspid annuloplasty ring of claim 1 has an inner circumferential shape such that projection of the ring onto a planar surface depicts a scalar triangle with unequal edges, wherein the geographic shape of the septal segment of the ring corresponds to the geographic shape of the septal segment of the tricuspid valve annulus, the geographic shape of the anterior segment of the ring corresponds to the geographic shape of the anterior segment of the tricuspid valve annulus and the geographic shape of the posterior segment of the ring corresponds to the geographic shape of the posterior segment of the tricuspid valve annulus.

15. The tricuspid annuloplasty ring of claim 1 wherein the ring is comprised of a titanium core, an inner layer of silicone tubing and an outler layer of comprised of a rigid polymer.

16. The tricuspid annuloplasty ring of claim 1 wherein the ring is configured for modifying the linear distance between at least of the following pairs of segments, septal and anterior segments and septal and posterior segments.

18. The tricuspid annuloplasty ring of claim 16 wherein an adjustment of the length of one of the one of the ring segment results in an adjustment of the angle between the remaining two ring segments, thereby causing an adjustment to the geometric characteristics of the tricuspid annuloplasty ring.

19. The tricuspid annuloplasty ring of claim 16 wherein an adjustment of the length of one of the one of the ring segment results in an adjustment of the shape of the one ring segment adjusted.

21. The method of claim 19 further including the step of selectively adjusting the shape of at least one of the anterior, posterior and septal segments.

17. A tricuspid annuloplasty ring configured for implantation in a tricuspid valve annulus, the annuloplasty ring comprising:

a triangular shaped continuous body having an anterior ring segment having first and second ends, a septal ring segment having first and second ends and a posterior ring segment having first and second ends, wherein the first end of the anterior ring segment is connected to the second end of the posterior ring segment, the second end of the anterior ring segment is connected to the first end of the septal ring segment, and the second end of the septal ring segment is connected to the first end of the posterior ring segment, wherein at least one of the anterior, septal and posterior ring segments is configured to facilitate selective adjustment of its respective length.

20. A method for restoring coaptation of a heart valve comprising:

(a) inserting a triangular shaped annuloplasty ring comprised of anterior, posterior and septal segments along the perimeter of the annulus of a tricuspid valve;

(b) selectively adjusting the length of at least one of the anterior, posterior and septal segments;

(c) selectively adjusting the geometric properties of the triangular shaped annuloplasty ring by adjusting at least one angle between at least one set of the segments comprising the annuloplasty ring.

22. Adjusting the shape of the ring changes specific linear dimensions between the different annular segments at specific points on the ring perimeter.