Method and apparatus for in vivo heart valve decalcification
First Claim
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1. Apparatus for in vivo removal of deposits from an aortic heart valve, comprising:
- a deposit removal tool; and
an anchoring balloon catheter fixatable across the aortic valve, the anchoring balloon catheter including anchoring balloon means, having an outer surface, for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally from the balloon means and including attachment means for securing the tool with respect to the anchoring balloon means and the aortic valve, the attachment means including positioning means for adjustably positioning the deposit removal tool along a range of rotational positions about at least a portion of the outer surface of the anchoring balloon means.
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Abstract
A method and apparatus for in vivo removal of calcified deposits from an aortic valve. The apparatus includes an anchoring balloon catheter fixatable across the aortic valve, a tool for removing the deposits, and attachment means for securing the tool with respect to the anchoring balloon and the aortic valve. The method involves advancing an anchoring balloon catheter through the aorta and positioning it across the aortic valve, inflating the anchoring balloon to fixate it with respect to the aorta and aortic valve, and then operating a deposit removal tool secured to the anchoring balloon to remove the deposits.
990 Citations
55 Claims
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1. Apparatus for in vivo removal of deposits from an aortic heart valve, comprising:
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a deposit removal tool; and an anchoring balloon catheter fixatable across the aortic valve, the anchoring balloon catheter including anchoring balloon means, having an outer surface, for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally from the balloon means and including attachment means for securing the tool with respect to the anchoring balloon means and the aortic valve, the attachment means including positioning means for adjustably positioning the deposit removal tool along a range of rotational positions about at least a portion of the outer surface of the anchoring balloon means. - View Dependent Claims (2)
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3. Apparatus for in vivo removal of deposits from an aortic heart valve, comprising:
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an anchoring balloon catheter fixatable across the aortic valve; a deposit removal tool including an elongated shaft; and a guiding catheter through which the deposit removal tool may be advanced toward the aortic valve, the guiding catheter including a distal end portion; the anchoring balloon catheter including anchoring balloon means, having an outer surface and being positionable against an inferior surface of the valve, for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally therefrom, and including attachment means for securing the distal end portion of the guiding catheter to the anchoring balloon means, the attachment means including positioning means for adjustably positioning the deposit removal tool with respect to the anchoring balloon means; and a positioning catheter carried within the guiding catheter, the positioning catheter being rotatable with respect to the guiding catheter and including an off-center lumen in which the shaft of the deposit removal tool is closely received, whereby rotation of the positioning catheter allows selective positioning of the deposit removal tool.
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4. Apparatus for in vivo removal of deposits from an aortic heart valve of the type having multiple leaflets with superior and inferior surfaces, comprising:
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an anchoring balloon catheter fixatable across the aortic valve including anchoring balloon means, having an outer surface and being positionable against an inferior surface of the valve, for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally therefrom, and including proximal and distal balloon portions, the distal balloon portion being inflatable to a diameter larger than the proximal balloon portion; and a deposit removal tool; the anchoring balloon means including attachment means for securing the tool with respect to the anchoring balloon means and the aortic valve; the distal and proximal balloon portions defining a shoulder that is engagable with the inferior surface of the valve leaflets to support the leaflets as deposits are removed from the superior surface thereof, the proximal balloon portion being generally elongated and cylindrical in shape and having an outer surface, the shoulder being formed by attaching a secondary distal balloon portion to the outer surface of the proximal balloon portion, the anchoring balloon means having a longitudinal axis, the shoulder portion thereof being made of a stretchable material so that it can conform to the inferior surface of the leaflet, other portions thereof being constructed to be substantially non-stretchable in a direction perpendicular to the longitudinal axis.
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5. Apparatus for in vivo removal of deposits from an aortic valve, comprising:
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a deposit removal tool having an elongated shaft; a guiding catheter through which the tool may be advanced toward the aortic valve, the guiding catheter including a distal end portion; an anchoring balloon catheter fixatable across the aortic valve, including anchoring balloon means, having an outer surface and being positionable against an inferior surface of the valve, for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally from the balloon and including attachment means for securing the distal end portion of the guiding catheter with respect to the outer surface of the anchoring balloon means, the attachment means comprising; a circumferential band having first and second ends respectively attached to the anchoring balloon, and an intermediate portion operatively connected to the guiding catheter; a pair of positioning balloons interposed between the circumferential band and the anchoring balloon for selectively moving the guiding catheter about the anchoring balloon in response to inflation and deflation of the positioning balloons; and means for selectively inflating and deflating the positioning balloons whereby the guiding catheter will move clockwise about the anchoring balloon means when one of the positioning balloons is inflated, and the guiding catheter will move counterclockwise about the anchoring balloon means when the other positioning balloon is inflated; and a positioning catheter carried within the guiding catheter, the positioning catheter being rotatable with respect to the guiding catheter and including an off-center lumen in which the shaft of the deposit removal tool is closely received, whereby rotation of the positioning catheter allows selective positioning of the deposit removal tool.
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6. Apparatus for in vivo removal of deposits from an aortic heart valve, comprising:
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a deposit removal tool; an anchoring balloon catheter fixatable across the aortic valve, the anchoring balloon catheter including anchoring balloon means having an outer surface and being positionable against an inferior surface of the valve for supporting the valve and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally therefrom and including attachment means for securing the tool with respect to the anchoring balloon means and the aortic valve, the attachment means including positioning means for adjustably positioning the deposit removal tool with respect to the anchoring balloon means; and a guiding catheter through which the deposit removal tool may be advanced toward the aortic valve, the guiding catheter including a distal end portion secured to the anchoring balloon means by the attachment means; the attachment means comprising a circumferential band having first and second ends respectively attached to the anchoring balloon means, and an intermediate portion operatively connected to the guiding catheter. - View Dependent Claims (7, 8, 9, 10, 11, 12, 13)
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14. Apparatus for in vivo removal of tissue deposits from a superior surface of a leaflet of an aortic heart valve, comprising:
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a deposit removal tool; a guiding catheter through which the deposit removal tool may be advanced toward the aortic valve, the guiding catheter including a distal end portion; and an anchoring balloon catheter fixatable across the aortic valve, the anchoring balloon catheter including anchoring balloon means, having an outer surface and being positionable against an inferior surface of the valve leaflet, for supporting the valve leaflet and for allowing movement of the deposit removal tool in relation to said outer surface, the anchoring balloon means having an inflation lumen extending proximally therefrom; the anchoring balloon means including attachment means for securing the distal end portion of the guiding catheter with respect to the outer surface of the anchoring balloon means and the aortic valve leaflet so that the deposit removal tool can be spaced away from the outer surface of the anchoring balloon, the attachment means being capable of adjustably moving the distal end portion of the guiding catheter, and, thereby, the deposit removal tool around the anchoring balloon means to adjustably position the deposit removal tool over and adjacent to the superior surface of the leaflet when the outer surface of the anchoring balloon means is positioned against the inferior surface of the leaflet, permitting use of the tool to remove tissue from the superior surface of the leaflet. - View Dependent Claims (15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55)
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Specification