Devices and methods for intracardiac procedures
First Claim
1. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
- a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, the valve prosthesis also having a movable valve portion; and
a holder releasably attached to the valve prosthesis and having a holder body with a holder height in the axial direction, the holder body including a handle coupling configured to receive an elongated handle for introducing the prosthesis assembly into the patient, the handle coupling having a coupling axis along which the tip of the handle is received, the handle coupling being positioned such that the coupling axis is at an angle substantially greater than zero relative to the axial direction;
wherein the holder and valve prosthesis together have a profile having a height in the axial direction of less than about 20 mm.
3 Assignments
0 Petitions
Accused Products
Abstract
The invention provides devices and methods for performing less-invasive surgical procedures within an organ or vessel. In an exemplary embodiment, the invention provides a method of closed-chest surgical intervention within an internal cavity of a patient'"'"'s heart or great vessel. According to the method, the patient'"'"'s heart is arrested and cardiopulmonary bypass is established. A scope extending through a percutaneous intercostal penetration in the patient'"'"'s chest is used to view an internal portion of the patient'"'"'s chest. An internal penetration is formed in a wall of the heart or great vessel using cutting means introduced through a percutaneous penetration in an intercostal space in the patient'"'"'s chest. An interventional tool is then introduced, usually through a cannula positioned in a percutaneous intercostal penetration. The interventional tool is inserted through the internal penetration in the heart or great vessel to perform a surgical procedure within the internal cavity under visualization by means of the scope. In a preferred embodiment, a cutting tool is introduced into the patient'"'"'s left atrium from a right portion of the patient'"'"'s chest to remove the patient'"'"'s mitral valve. A replacement valve is then introduced through an intercostal space in the right portion of the chest and through the internal penetration in the heart, and the replacement valve is attached in the mitral valve position.
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Citations
32 Claims
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1. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, the valve prosthesis also having a movable valve portion; and a holder releasably attached to the valve prosthesis and having a holder body with a holder height in the axial direction, the holder body including a handle coupling configured to receive an elongated handle for introducing the prosthesis assembly into the patient, the handle coupling having a coupling axis along which the tip of the handle is received, the handle coupling being positioned such that the coupling axis is at an angle substantially greater than zero relative to the axial direction; wherein the holder and valve prosthesis together have a profile having a height in the axial direction of less than about 20 mm. - View Dependent Claims (3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 15, 16)
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2. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane; a holder releasably attached to the valve prosthesis, the holder having a holder body with a holder height in the axial direction; and a handle coupled to the holder, the handle having a length sufficient to reach a patient'"'"'s heart when a proximal end of the handle is positioned outside the patient'"'"'s chest cavity; wherein the holder, handle and valve prosthesis have a profile having a height in the axial direction; the attachment ring of the valve prosthesis having an outer diameter which is greater than the height of the profile. - View Dependent Claims (13, 14)
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17. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, the valve prosthesis also having a movable valve portion; a holder releasably attached to the valve prosthesis and having a holder body with a holder height in the axial direction;
wherein the holder and valve prosthesis together have a profile having a height in the axial direction of less than about 20 mm; anda releasing mechanism for releasing the valve prosthesis from the holder, wherein the handle includes an actuator operably coupled to the releasing mechanism for releasing the valve prosthesis from the holder, the actuator being positioned near a proximal end of the handle.
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18. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, the valve prosthesis also having a movable valve portion; and a holder releasably attached to the valve prosthesis and having a holder body with a holder height in the axial direction, the holder body and valve prosthesis together having a profile having a height in the axial direction of less than about 20 mm; a handle coupled to the holder; and a pivoting mechanism for pivoting the valve prosthesis relative to the handle with the holder remaining coupled to the valve prosthesis. - View Dependent Claims (20)
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19. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, the valve prosthesis also having a movable valve portion; and a holder releasably attached to the valve prosthesis and having a holder body with a holder height in the axial direction, wherein the holder body and valve prosthesis together have a profile having a height in the axial direction of less than about 20 mm; a handle coupled to the holder body; and a pivoting mechanism for pivoting the valve prosthesis relative to the handle, wherein the handle has a longitudinal axis, the pivoting mechanism being operative to pivot the valve prosthesis to a position in which the longitudinal axis of the handle is generally perpendicular to the axial direction.
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21. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane; a holder releasably attached to the valve prosthesis, the holder having a holder body, the holder body having a holder height in the axial direction; and an elongated handle having a distal end attached to the holder body, a proximal end opposite the distal end, and a longitudinal axis; wherein the handle, holder body and valve prosthesis together have a profile height in a direction perpendicular to the longitudinal axis less than about 20 mm. - View Dependent Claims (28)
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22. A prosthesis assembly for introduction into a patient'"'"'s heart, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane; and a holder releasably attached to the valve prosthesis, the holder having a holder body and a coupling configured for attachment to a distal end of an elongated handle, the coupling being configured to attach to the handle such that at least a distal portion of the handle is approximately perpendicular to the axial direction, the valve prosthesis and holder having a combined height in the axial direction less than about 20 mm.
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23. A prosthesis assembly for introduction into a patient'"'"'s heart, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane; a holder releasably attached to the valve prosthesis; and an elongated handle having a distal end attached to the holder, a proximal end, and a longitudinal axis; wherein the holder is configured to attach to the handle such that the longitudinal axis is approximately perpendicular to the axial direction, the valve prosthesis, holder and handle having a combined height in the axial direction of less than about 20 mm.
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24. A prosthesis assembly for introduction into a patient'"'"'s heart, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart; a holder releasably attached to the valve prosthesis, the holder having a holder body configured to engage the valve prosthesis; an elongated handle having a distal end, and a proximal end; and a pivoting mechanism on the handle for pivoting the valve prosthesis and the holder relative to the handle through an angle of at least about 90 degrees. - View Dependent Claims (25, 29, 30, 31, 32)
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26. A prosthesis assembly for introduction into a patient'"'"'s heart, the heart being within a chest defined by a plurality of ribs, each rib being separated from an adjacent rib by an intercostal space, the prosthesis assembly comprising:
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a valve prosthesis having an attachment ring for attaching to cardiac tissue in the heart, the attachment ring defining a valve plane and an axial direction which is perpendicular to the valve plane, a holder releasably attached to the valve prosthesis, the holder having a holder body with a holder height in the axial direction; and a handle coupled to the holder, the handle having a length sufficient to reach a patient'"'"'s heart when a proximal end of the handle is positioned outside the patient'"'"'s chest cavity; wherein the holder, handle and valve prosthesis have a profile having a height in the axial direction; the attachment ring of the valve prosthesis having an outer diameter which is greater than the height of the profile and wherein the handle includes a displacing mechanism configured to move the valve relative to the handle, the handle also including an actuator near the proximal end, the actuator being manually operable to actuate the displacing mechanism for moving the valve relative to the handle. - View Dependent Claims (27)
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Specification