APPARATUSES AND METHODS FOR CUTTING A TISSUE BRIDGE AND/OR REMOVING A HEART VALVE CLIP OR SUTURE

• US 20180028215A1
• Filed: 09/25/2017
• Published: 02/01/2018
• Est. Priority Date: 09/28/2011
• Status: Active Grant

• Current Assignee: Evalve, Inc. (Abbott Laboratories Incorporated)
• Original Assignee: Mitracore Technologies, Inc.
• Inventors: COHEN, Gideon
• Granted Patent: US 10,624,664 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/122 Clamps or clips , e.g. for the umbilical cord for the vas deferens A61F6/206
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• CPC Class Codes: A61B 17/29 Forceps for use in minimally invasive surgery
• CPC Class Codes: A61B 17/320016 Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes A61B10/0233, A61B17/29, A61B17/3207 take precedence
• CPC Class Codes: A61B 17/32053 Punch like cutting instruments, e.g. using a cylindrical or oval knife A61B17/326 takes precedence; trepans A61B17/1695; for use on the cornea A61F9/007
• CPC Class Codes: A61B 18/1442 Probes having pivoting end effectors, e.g. forceps
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/3435 using everted sleeves
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/1452 including means for cutting A61B2018/146 takes precedence
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/376 using X-rays, e.g. fluoroscopy
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 90/40 Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092

Abstract

Disclosed is an instrument having an elongated shaft, a first member configured in the elongated shaft such that the first member can be deployed from a first portion of the instrument. The first member, when deployed, is configured over a tissue bridge within a heart, the tissue bridge having a clip or suture. A second member is also configured in the elongated shaft such that the second member is deployed from a second portion of the elongated shaft, wherein the second member, when deployed, is configured under the tissue bridge and the clip or suture. The elongated shaft is configured such that the second member, when deployed, moves towards the first member to yield a combined member which receives the tissue bridge and the clip or suture. The elongated shaft receives the combined member. The first member and/or the second member include a signal emitter to cut the tissue bridge.

Claims

1. A method comprising:

inserting an instrument into a valve orifice within a human heart;

deploying a first member from a first portion of the instrument, wherein the first member is configured over a tissue bridge having an associated clip or suture;

deploying a second member from a second portion of the instrument, wherein the second member is configured below the tissue bridge having the associated clip or suture;

moving the second member towards the first member, to yield a combined member such that the tissue bridge is cut and the combined member contains the associated clip or suture;

folding the combined member into the instrument; and

retrieving the instrument from the valve orifice.

2. The method of claim 1, wherein cutting the tissue bridge occurs via an interaction between edges of the first member and the second member.

3. The method of claim 1, wherein cutting the tissue bridge occurs via an electromagnetic signal emitted from one of the first member or the second member.

4. The method of claim 1, wherein the combine member comprises a cylindrical shaped member containing the associated clip or suture.

5. The method of claim 1, further comprising:

cutting the tissue bridge prior to folder the combined member into the instrument.

6. The method of claim 5, further comprising:

controlling a position of an emitter of an electromagnetic signal prior to cutting the tissue bridge.

7. The method of claim 1, wherein at least one of the first member and the second member comprises an electromagnetic signal emitter used for cutting the tissue bridge.

8. The method of claim 7, wherein each of the first member and the second member comprises a respective electromagnetic signal emitter.

9. An instrument comprising:

an elongated shaft;

a first member configured in the elongated shaft such that the first member can be deployed from a first portion of the instrument, wherein the first member, when deployed, is configured over a tissue bridge within a heart, the tissue bridge having a clip or suture; and

a second member configured in the elongated shaft such that the second member can be deployed from a second portion of the elongated shaft, wherein the second member, when deployed, is configured under the tissue bridge within the heart and the clip or suture, wherein the elongated shaft is configured such that the second member, when deployed, can move towards the first member, when deployed, to yield a combined member which receives the tissue bridge and the clip or suture, wherein the elongated shaft receives the combined member.

10. The instrument of claim 9, wherein when the second member moves towards the first member, a cutting of the tissue bridge occurs via an interaction between edges of the first member and the second member.

11. The instrument of claim 10, wherein cutting the tissue bridge occurs via an electromagnetic signal emitted from one of the first member or the second member.

12. The instrument of claim 9, wherein the combine member comprises a cylindrical shaped member containing the clip or suture.

13. The instrument of claim 9, wherein cutting the tissue bridge occurs prior to folding the combined member into the elongated shaft.

14. The instrument of claim 13, further comprising:

a controller that controls a position of an emitter of an electromagnetic signal prior to cutting the tissue bridge.

15. The instrument of claim 9, wherein at least one of the first member and the second member comprises an electromagnetic signal emitter used for cutting the tissue bridge.

16. The instrument of claim 15, wherein each of the first member and the second member comprises a respective electromagnetic signal emitter.

17. The instrument of claim 15, wherein the electromagnetic signal emitter further comprises a directional controller which controls a direction of the electromagnetic signal emitter.

18. The instrument of claim 17, further comprising:

a controller in communication with the electromagnetic signal emitter that enables a user to directionally control the electromagnetic signal emitter via the directional controller.