Method and apparatus for resecting and replacing an aortic valve

• US 7,201,761 B2
• Filed: 04/16/2003
• Issued: 04/10/2007
• Est. Priority Date: 06/29/2001
• Status: Expired due to Term

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Cohn, William E., Streeter, Richard B., Taylor, Daniel C., Woolfson, Steven B.
• Primary Examiner(s): Stewart; Alvin J.
• Application Number:
  US10/414,741
• Publication Number:
  US 20040034380A1
• Time in Patent Office: 1,455 Days
• Field of Search: 606/167, 606170-171, 606/174, 606/180, 606184-185, 623 2- 11
• US Class Current: 606/170
• CPC Class Codes: A61B 10/06 Biopsy forceps , e.g. with cup-shaped jaws
• CPC Class Codes: A61B 17/1604 Chisels; Rongeurs; Punches; Stamps
• CPC Class Codes: A61B 17/1608 the two jaw elements being linked to two elongated shaft elements moving longitudinally relative to each other
• 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 17/32002 with continuously rotating, oscillating or reciprocating cutting instruments
• 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 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/32075 Pullback cutting; combined forward and pullback cutting, e.g. with cutters at both sides of the plaque
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/22034 for gripping the obstruction or the tissue part from inside
• CPC Class Codes: A61B 2017/22097 Valve removal in veins
• CPC Class Codes: A61B 2017/2937 with flexible part
• CPC Class Codes: A61B 2017/320064 with tissue or sample retaining means
• CPC Class Codes: A61B 2017/320733 with a flexible cutting or scraping element, e.g. with a whip-like distal filament member
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation

Abstract

Apparatus for resecting a diseased heart valve, the apparatus comprising: a body portion; a first handle and a second handle; a cutting blade; a set of retaining arms; a pass-off tool having a first attachment device configured to selectively engage the first handle attached to the body portion so as to allow placement of the second handle of the body portion adjacent to the diseased heart valve; and a controller tool having a second attachment device at the distal end thereof, the second attachment device configured to selectively engage the second handle attached to the body portion so as to allow positioning of the body portion adjacent to the diseased heart valve, a cutting blade actuator configured to cause the cutting blade to selectively rotate, and a retaining arm actuator configured to selectively position the set of retaining arms from a contracted state to an expanded state.

Claims

1. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a first frame member and a second frame member movably disposed and opposed to one another;

the first frame member comprising a cutting edge;

an adjustable connector positionably joining the first frame member to the second frame member, the adjustable connector configured to selectively positioning the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting edge so as to resect the diseased heart valve;

an actuator that is operatively connected to the adjustable connector, the actuator movable so as to selectively position the adjustable connector between the first position and the second position; and

a first screen portion and a second screen portion disposed on the first frame portion and the second frame portion, respectively, the first screen portion and the second screen portion being sufficiently open to allow blood flow through first frame member and second frame member and to contain the at least a portion of the diseased heart valve between the first frame member and the second frame member.

2. Apparatus according to claim 1 wherein the adjustable connector further comprises a spring operatively positioned to bias the first frame portion and the second frame portion into the second position.

3. Apparatus according to claim 1 wherein the adjustable connector comprises a threadable connection with one of the first frame member and the second frame member so as to allow the adjustable connector to selectively position the first frame member and the second frame member between the first position and the second position using a twisting motion for the actuator.

4. Apparatus according to claim 1 wherein the second frame member comprises a cutting edge, and further wherein the cutting edge of the first frame member and the cutting edge of the second frame member each comprise cutting teeth configured for rotatable engagement with one another, and the actuator is selectively rotatable so that the first frame member and the second frame member are rotatable in engagement with and relative to one another so as to cut the at least a portion of the diseased heart valve disposed therebetween.

5. Apparatus according to claim 1 wherein one of the first frame member and the second frame member is mounted to a screw-driven assembly so as to rotate the one of the first frame member and the second frame member mounted to the screw-driven assembly to aid in cutting the diseased heart valve therebetween.

6. A method of resecting a diseased heart valve, the method comprising:

providing apparatus for resecting the diseased heart valve, the apparatus comprising;

a first frame member and a second frame member movably disposed and opposed to one another;

the first frame member;

an adjustable connector operatively joining the first frame member to the second frame member, the adjustable connector for selectively positioning the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting edge so as to resect the diseased heart valve;

an actuator that is operatively connected to the adjustable connector, the actuator being sufficiently open to selectively position the adjustable connector between the first position and the second position; and

a first screen portion and a second screen portion disposed on the first frame portion and the second frame portion, respectively, the first screen portion and the second screen portion configured to allow blood flow through first frame member and second frame member and to contain the at least a portion of the diseased heart valve between the first frame member and the second frame member;

positioning the first frame member and the second frame member on opposite sides of the diseased heart valve, with the first frame member and the second frame member in the first position;

closing the first frame member and the second frame member from the first position to the second position by manipulating the actuator in operable connection to the adjustable connector so as to move the cutting edge through the at least a portion of the diseased heart valve; and

removing from a patient the first frame member and the second frame member closed together in the second position, with the at least a portion of the diseased heart valve therebetween.

7. A method according to claim 6 wherein the first frame member and the second frame member are advanced through a chamber of the heart to the diseased heart valve.

8. A method according to claim 6 wherein the diseased heart valve comprises an aortic valve, and further wherein the first frame member and the second frame member are advanced through the aorta to the aortic valve.

9. Apparatus for resecting a diseased heart valve, the apparatus comprising:

a first frame member and a second frame member movably disposed and opposed to one another;

the first frame member comprising a cutting edge;

an adjustable connector positionably joining the first frame member to the second frame member, the adjustable connector configured to selectively positioning the first frame member and the second frame member between a first position and a second position, wherein the first frame member and the second frame member are positioned apart from one another in the first position so as to allow at least a portion of the diseased heart valve therebetween, and the first frame member and the second frame member are positioned together in the second position so as to cut the at least a portion of the diseased heart valve therebetween with the cutting edge so as to resect the diseased heart valve, wherein the adjustable connector comprises a threadable connection with one of the first frame member and the second frame member so as to allow the adjustable connector to selectively position the first frame member and the second frame member between the first position and the second position using a twisting motion for the actuator

an actuator that is operatively connected to the adjustable connector, the actuator movable so as to selectively position the adjustable connector between the first position and the second position; and

a first screen portion and a second screen portion disposed on the first frame portion and the second frame portion, respectively, the first screen portion and the second screen portion being sufficiently open to allow blood flow through first frame member and second frame member and to contain the at least a portion of the diseased heart valve between the first frame member and the second frame member.