Device For Carrying Out A Transapical Mitral Valve Annuloplasty

• US 20160045315A1
• Filed: 03/18/2014
• Published: 02/18/2016
• Est. Priority Date: 03/20/2013
• Status: Active Grant

• Current Assignee: Bernard Pain, Marco Vola
• Original Assignee: Bernard Pain, Marco Vola
• Inventors: Vola, Marco, Pain, Bernard
• Granted Patent: US 9,968,453 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• 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 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0498 for advancing a suture filament along a helical path through tissue
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2466 Delivery devices therefor

Abstract

The device is intended to be positioned in a sealed introducer arranged in the thoracic cavity between two ribs in order to penetrate into the left ventricle, passing through the apex of the heart. According to the invention, the device includes a body having a handle and at least one control member capable of acting on an assembly for installing and securing a braid to the mitral annulus by means of suturing elements, the assembly has a mechanism capable of enabling the extraction of a suture through the mitral valve while also being capable of enclosing the braid and becoming anchored to the periphery of the mitral annulus under the clamping effect of the suture, exerting two opposing pressure-bearing forces.

Claims

1. A device for carrying out a transapical mitral valve annuloplasty, and intended to be positioned in a sealed introducer arranged in the thoracic cavity between two ribs in order to penetrate into the left ventricle, passing through the apex of the heart, characterized in that it comprises a body having a handle and at least one control member capable of acting on an assembly for installing and securing a braid to the mitral ring by means of suturing elements, said assembly having means capable of enabling the extraction of a suture through the mitral valve while also being capable of enclosing the braid and becoming anchored to the periphery of the mitral annulus under the clamping effect of said suture, exerting two opposing pressure-bearing forces.

2. The device according to claim 1, characterized in that the assembly consists of a tubular arm comprising two portions and which can be separated after introduction into the left ventricle, one of the portions receiving the sutures and being adapted to be brought into contact in the commissure between the mitral valve and the walls of the left ventricle, the other portion receiving the braid, and being adapted to pass through the mitral valve and to be positioned at right angles relative to the end of said portion receiving the sutures.

3. The device according to claim 2, characterized in that the portion of the arm receiving the braid is made of several members, mounted movable and steerable relative to the portion which receives the sutures.

4. The device according to claim 3, characterized in that the free end of the portion receiving the braid is made of two hinged elements, and the end hinged member can be positioned substantially perpendicularly to the end of the portion receiving the sutures.

5. The device according to claim 2, characterized in that the portion of the arm receiving the sutures has, at its end, a needle mounted movable in translation to protrude from said end, said needle being shaped to allow the engagement, guiding and holding of the suture by protruding from said end.

6. The device according to claim 5, characterized in that in protruding position of the needle and the suture, and of the suture relative to the needle, said suture leads in an opening in the free end of the arm portion receiving the braid to form, by considering the nature of the material of the suture, a loop suitable to enclose a portion of the braid arranged transversely in said opening after removal of the needle, the suture being no longer restrained to becoming anchored to the periphery of the mitral annulus.

7. The device according to claim 6, characterized in that the braid is received in two parallel guide channels formed in the thickness of the corresponding portion of the arm, so as to form a loop to be enclosed by the suture at the opening of said portion.

8. The device according to claim 2, characterized in that the two end hinged members of the portion receiving the braid are coupled in an hinged manner to an element movable in translation connected to an actuating member as a linear slider, so that a movement of the slider in one direction causes the linear movement and the spacing between the two end members relative to the arm portion receiving the sutures in combination with an arrangement of said arm.

9. The device according to claim 8, characterized in that the arrangement of said arm is a ramp.

10. The device according to claim 2, characterized in that the end member of the portion of the arm receiving the braid is connected to a cable linked to a transmission member actuated by the control member of the body, so as to lower the end hinged member towards the end of the portion (4a) of the arm receiving the sutures

11. The device according to claim 2, characterized in that the end hinged member of the arm receiving the braid is biased in the alignment position with the other hinged member by a resilient member.

12. The device according to claim 11, characterized in that the end hinged member of the arm receiving the braid cooperates with a stop in the folded-down position.

13. The device according to claim 1, characterized in that the means capable of allowing the extraction of a suture to enclose the braid and be anchored on the periphery of the mitral annulus consist of a profiled cam for delivering the sutures, a profiled cam for implanting the sutures and a cam for the linear movement of the needle, said cams being connected to a gear system linked to the control trigger and a cable system.

14. The device according to claim 1, characterized in that the braid is connected to means suitable to reduce its circumference, after installing and securing on the periphery of the mitral annulus.

15. The device according to claim 14, characterized in that the means are formed by a pull cord mounted freely in translation in the central core of the braid.