ENDOVASCULAR SUTURE LOCK

• US 20190328530A1
• Filed: 07/11/2019
• Published: 10/31/2019
• Est. Priority Date: 12/30/2016
• Status: Active Grant

• Current Assignee: Pipeline Medical Technologies, Inc.
• Original Assignee: Pipeline Medical Technologies, Inc.
• Inventors: McDaniel, Stephen, Bishop, Gordon B., Griswold, Erik, Pham, Trung Ho, Purcell, Cameron Paul
• Granted Patent: US 11,666,441 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 17/0467 Instruments for cutting sutures surgical cutting instruments A61B17/32
• CPC Class Codes: A61B 17/0469 Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
• CPC Class Codes: A61B 17/0487 Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks suture anchors A61B17/0401; wound clamps or clips A61B17/08; ligaturing clamps or clips A61B17/122
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0406 Pledgets
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/06052 Needle-suture combinations in which a suture is extending inside a hollow tubular needle, e.g. over the entire length of the needle
• CPC Class Codes: A61B 2017/061 hollow or tubular
• CPC Class Codes: A61B 2090/033 Abutting means, stops, e.g. abutting on tissue or skin
• CPC Class Codes: A61B 2090/062 penetration depth
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61F 2/2454 Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 : Delivery devices therefor
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0075 : sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0091 : helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section

Abstract

Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. From an atrium side, a leaflet anchor having a leaflet suture is secured to the mitral valve leaflet. A ventricular anchor is anchored to the wall of the ventricle to secure the ventricular wall to a ventricle suture. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae. The suture lock has a body with a suture path extending therethrough. A wall in the housing is movable to reduce the cross section of the suture path. A drive mechanism advances the movable wall to clamp sutures extending through the suture path, in response to rotation of a coupling on the housing.

Claims

1. An endovascular suture lock, comprising

a body having a suture path extending therethrough;

a movable wall in the housing, for reducing a cross sectional dimension of the suture path;

a rotatable coupling on the housing; and

a drive mechanism for advancing the movable wall in response to rotation of the coupling.

2. An endovascular suture lock as in claim 1, comprising a friction enhancing surface exposed to the suture path.

3. An endovascular suture lock as in claim 2, wherein the friction enhancing surface is on the movable wall.

4. An endovascular suture lock as in claim 1, comprising a push wedge having an angled surface and axially movable within the housing.

5. An endovascular suture lock as in claim 4, wherein rotation of the coupling advances the push wedge axially which advances the movable wall laterally to change the cross sectional dimension of the suture path.

6. An endovascular suture lock as in claim 5, wherein the movable wall comprises a suture gripping surface on a first side and a ramp surface on a second side, the ramp surface configured for sliding contact with the angled surface on the push wedge.

7. An endovascular suture lock as in claim 1, wherein the movable wall comprises a clamp with a friction enhancing surface exposed to the suture path.

8. An endovascular suture lock as in claim 7, wherein the lock has a clamping efficiency sufficient to withstand tension on a suture of at least about 60% of the suture breaking strength.

9. An endovascular suture lock as in claim 7, wherein the lock has a clamping efficiency sufficient to withstand tension on a suture of at least about 80% of the suture breaking strength.

10. An endovascular suture lock as in claim 7, wherein the clamp comprises a notched surface.

11. An endovascular suture lock as in claim 10, wherein the clamp comprises a notched opposing surface, spaced apart from the notched clamp surface by the suture path.

12. An endovascular suture lock as in claim 1, comprising a spring to bias the movable wall away from the suture path.

13. An endovascular suture lock as in claim 1, wherein the drive mechanism includes a screw.

14. An endovascular suture lock as in claim 11, wherein the notched opposing surface and the notched clamp surface are configured to mate with each other.

15. An endovascular suture lock as in claim 1, configured for clamping a suture, releasing the suture, and reclamping the suture.

16. An endovascular suture lock as in claim 1, comprising a notched clamp surface and a notched opposing surface configured to provide mechanical interference for retention of sutures therebetween.

17. An endovascular suture lock as in claim 4 further comprising a screw configured to distally advance or proximally retract the push wedge.

18. An endovascular suture lock as in claim 17, further comprising a recess for releasable engagement with a torque shaft for rotating the screw.

19. An endovascular suture lock as in claim 1, wherein the suture path is configured to receive at least two sutures therethrough.

20. An endovascular suture lock as in claim 1, wherein the suture lock is configured for transluminal delivery to a ventricle in a heart.