Method of replacing a defective atrio-ventricular valve with a total atrio-ventricular valve bioprosthesis

• US 4,960,424 A
• Filed: 06/30/1988
• Issued: 10/02/1990
• Est. Priority Date: 06/30/1988
• Status: Expired due to Fees

• Current Assignee: Ronald K. Grooters
• Original Assignee: Ronald K. Grooters
• Inventors: Grooters, Ronald K.
• Primary Examiner(s): NOT, DEFINED
• Assistant Examiner(s): Iantorno, Stephanie L.
• Application Number:
  US07/214,128
• Time in Patent Office: 824 Days
• Field of Search: 623/2, 623/1, 623/3, 128/334 R
• US Class Current: 128/898
• CPC Class Codes: A61F 2/2412 with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses

Abstract

The method of replacing a defective atrio-ventricular valve in a patient'"'"'s heart with a tissue atrio-ventricular valve bioprosthesis is provided. The replacement atrio-ventricular valve from the donor heart includes an annulus, a plurality of chordae, and papillary muscles attached thereto. The surgical operation includes removal of the defective valve from the patient'"'"'s heart, and the insertion of each papillary muscle of the replacement valve longitudinally into a corresponding papillary muscle in the patient'"'"'s heart. The papillary muscles of the replacement valve are secured in position within the patient'"'"'s heart and the annulus of the replacement valve is secured to the annulus of the patient'"'"'s heart. An introducer is utilized for inserting the papillary muscles of the replacement valve into the papillary muscle of the patient'"'"'s heart, using the Seldinger technique.

Claims

1. A method of replacing a defective atrio-ventricular valve in a heart of a patient with a replacement atrio-ventricular valve from, a donor heart, the replacement atrio-ventricular valve having an annulus, a plurality of chordae and papillary muscles attached thereto, and an elongated membrane extending from each papillary muscle, the method comprising:

removing the defective valve from the patient'"'"'s heart;

inserting each elongated membrane of the replacement valve longitudinally through a papillary muscle of the patient'"'"'s heart so that the membrane extends through the heart wall of the patient'"'"'s heart;

securing the annulus of the replacement valve to the annulus of the patient'"'"'s heart; and

securing the elongated membranes of the replacement valve to the exterior of the heart wall of the patient.

2. The method of claim 1 further comprising reducing the diameter of the papillary muscle of the replacement valve prior to insertion into the papillary muscle of the patient'"'"'s heart.

3. The method of claim 2 wherein the diameter of the papillary muscle of the replacement valve is reduced by removing interior muscle thereof.

4. The method of claim 1 wherein the securing of the membrane is with sutures.

5. The method of claim 1 further comprising temporarily securing the membrane and papillary muscle of the replacement valve in an elongated introducer means, and inserting the introducer means longitudinally through the papillary muscle of the patient'"'"'s heart and through the wall of the patient'"'"'s heart.

6. The method of claim 5 wherein the introducer means is inserted through the papillary muscle and wall of the patient'"'"'s heart by the Seldinger technique.

7. The method of claim 5 further comprising removing the introducer means from the patient'"'"'s heart.

8. The method of claim 7 wherein the introducer means includes separable upper and lower sections, the lower section being removed from the patient'"'"'s heart by passing through the wall thereof, and the upper section being removed from the patient'"'"'s heart by withdrawal from the papillary muscle of the patient'"'"'s heart.

9. The method of claim 8 wherein the upper section of the introducer means is split along its length and the upper section is spread open for removal from the membrane surrounding the papillary muscle of the replacement valve.

10. The method of claim 1 further comprising adjusting the position of the chordae and papillary muscles of the replacement valve within the patient'"'"'s heart prior to securement of the elongated membranes to the heart wall.

11. A method of replacing a defective atrio-ventricular valve in a heart of a patient with a replacement valve having an annulus and a plurality of elongated members extending therefrom, the method comprising:

removing the defective valve from the patient'"'"'s heart;

inserting each elongated member of the replacement valve longitudinally through a papillary muscle and the heart wall of the patient'"'"'s heart;

securing the annulus of the replacement valve to the annulus of the patient'"'"'s heart; and

securing the elongated members of the replacement valve to the exterior of the heart wall of the patient.

12. The method of claim 11 wherein further comprising adjusting the lengths of the elongated members within the patient'"'"'s heart prior to securement to the heart wall.

13. The method of claim 11 wherein the elongated members includes choradae and papillary muscles extending from the annulus of the valve, with the securing membrane extending from each of the papillary muscles, the securing membrane being attached to the exterior heart wall of the patient.

14. The method of claim 13 further comprising extending the papillary muscles of the replacement valve into the papillary muscles of the patient'"'"'s heart.

15. The method of claim 11 wherein the elongated members are secured to the heart with sutures.

16. The method of claim 11 further comprising temporarily securing the elongated member of the replacement valve in an elongated introducer means, and inserting the introducer means longitudinally through the papillary muscle of the patient'"'"'s heart and through the wall of the patient'"'"'s heart.

17. The method of claim 16 wherein the introducer means is inserted through the papillary muscle and wall of the patient'"'"'s heart by guiding he introducer along a wire previously inserted through the papillary muscle and wall of the patient'"'"'s heart.

18. The method of claim 16 further comprising removing the introducer means from the patient'"'"'s heart.

19. The method of claim 18 wherein the introducer means includes separable upper and lower sections, the lower section being removed from the patient'"'"'s heart by passing through the wall thereof, and the upper section being removed from the patient'"'"'s heart by withdrawal from the papillary muscle of the patient'"'"'s heart.

20. The method of claim 19 wherein the upper section of the introducer means is split along its length and the upper section is spread open for removal from the elongated member of the replacement valve.

21. The method of claim 11 wherein the replacement valve is fixed prior to removing the defective valve from the patient'"'"'s heart so as to enhance compatibility of the replacement valve with the patient'"'"'s heart.