Apparatuses and methods for heart valve repair

• US 7,485,143 B2
• Filed: 11/15/2002
• Issued: 02/03/2009
• Est. Priority Date: 11/15/2002
• Status: Expired due to Fees

• Current Assignee: Advanced Cardiovascular Systems Incorporated
• Original Assignee: Abbott Cardiovascular Systems Incorporated (Abbott Laboratories Incorporated)
• Inventors: Feezor, Christopher, Webler, William E., Cox, Daniel L., Hyde, Gregory Mathew
• Primary Examiner(s): Sweet; Thomas J
• Application Number:
  US10/295,714
• Publication Number:
  US 20050038506A1
• Time in Patent Office: 2,272 Days
• Field of Search: 623/2.36, 623/2.37
• US Class Current: 623/2.37
• CPC Class Codes: A61F 2/2451 Inserts in the coronary sinus for correcting the valve shape
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61F 2250/001 for adjusting a diameter
• CPC Class Codes: Y10T 24/39 Cord and rope holders

Abstract

A medical device for treating a defective heart valve. The medical device comprises a distal anchoring member for disposing in a blood vessel. A proximal anchoring member for disposing in or at an entrance of the blood vessel. A telescoping assembly coupling at a first end to the distal anchoring member and at a second end to the proximal anchoring member. The telescoping assembly is deployable into the blood vessel. The telescoping assembly reduces a distance between the distal anchoring member and the proximal anchoring member, wherein the telescoping assembly comprises of at least two members capable of sliding into each other giving the telescoping assembly adjustable lengths.

Claims

1. A medical device comprising:

a distal anchoring member for disposing in a blood vessel;

a proximal anchoring member for disposing in or at an entrance of the blood vessel; and

a telescoping assembly coupling at a first end to the distal anchoring member and at a second end to the proximal anchoring member, wherein the telescoping assembly comprises at least one bent portion and at least two tubular members capable of sliding into or over the other giving the telescoping assembly an adjustable length and wherein (i) the entire telescoping assembly is capable of being deployed into the blood vessel at a time of delivery and, once deployed, (ii) the telescoping assembly including a cord coupled to the distal anchoring member to cause the telescoping assembly to be modifiable to reduce a distance or increase a radius of curvature of the blood vessel between the distal anchoring member and the proximal anchoring member.

2. The medical device as in claim 1 wherein the blood vessel is a coronary sinus.

3. The medical device as in claim 2 wherein the distal anchoring member and the proximal anchoring member are adapted to anchor to cardiac tissues selected from the group consisting of a myocardial tissue, an annulus tissue, a left trigone, and a right trigone surrounding a mitral valve.

4. The medical device as in claim 1 wherein at least a portion of the distal anchoring member is adapted to penetrate a wall of the blood vessel and anchor to a cardiac tissue proximate a first portion of the blood vessel.

5. The medical device as in claim 1 wherein the proximal anchoring member is adapted to be disposed at an entrance of the coronary sinus.

6. The medical device as in claim 1 wherein the telescoping assembly comprises at least one cord disposed within the telescoping assembly, the at least one cord to slide the at least two tubular members of the telescoping assembly into each other.

7. The medical device as in claim 1 wherein the telescoping assembly has at least one of an ability to resist elongation, a flexural modulus, and an ability to maintain a long-term stiffness.

8. The medical device as in claim 1 wherein the telescoping assembly, the distal anchoring member, and the proximal anchoring member are percutaneously deployable into the blood vessel.

9. The medical device as in claim 1 wherein the at least one bent portion is capable of being positioned over an area that the blood vessel crosses over, the at least one bent portion to prevent pressure from the telescoping assembly upon the area.

10. The medical device as in claim 1 wherein the distal anchoring member is a self-expanding structure and wherein upon deployment, the distal anchoring member deploys against an inner diameter of the blood vessel.

11. The medical device as in claim 1 wherein the distal anchoring member is a self-expanding structure that upon deployment, the distal anchoring member is adapted to deploy against an inner diameter of the blood vessel, the distal anchoring member comprising a plurality of anchors adapted to penetrate a wall of the blood vessel and anchor into a cardiac tissue proximate the blood vessel.

12. The medical device as in claim 1 wherein the distal anchoring member comprises an outer member and an inner member moveably fitted within the outer member, the inner member comprising a plurality of anchors, the outer member comprising a plurality of openings, wherein during deployment, the plurality of anchors is confined within the outer member and wherein upon deployment, the inner member slides across the outer member to allow the plurality of anchors to pass through the plurality of openings.

13. The medical device as in claim 12 wherein the plurality of anchors is selected from a group consisting of hooks, bards, screws, corkscrews, coils, helixes, and flanges.

14. The medical device as in claim 12 wherein the plurality of anchors is distributed on one side of the distal anchoring member, the one side of the distal anchoring member being the side facing a cardiac tissue whereto the plurality of anchors attach.

15. The medical device as in claim 1 wherein the distal anchoring member includes portions having a variable flexural modulus wherein the distal anchoring member is oriented to a preferred orientation to facilitate anchoring of the distal anchoring member.

16. The medical device as in claim 1 wherein the distal anchoring member is further coupled to a tension cord extending from the distal anchoring member through the telescoping assembly wherein pulling on the tension cord compresses a longitudinal length of the distal anchoring member and expands a cross-sectional area of the distal anchoring member pushing the distal anchoring member against the inner diameter of the blood vessel.

17. The medical device as in claim 1 wherein the proximal anchoring member comprises a plurality of anchors to anchor the proximal anchoring member to a cardiac tissue proximate the blood vessel.

18. The medical device as in claim 17 wherein the plurality of anchors is selected from a group consisting of hooks, barbs, screws, corkscrews, coils, helixes, and flanges to anchor the proximal anchoring member to the cardiac tissue.

19. The medical device as in claim 1 wherein the telescoping assembly comprises a locking device positioned at least at one of a proximal end of the telescoping assembly and a distal end of the telescoping assembly to maintain the telescoping assembly at a predetermined length.

20. The medical device as in claim 1 wherein the proximal anchoring member further comprises a collapsible flange portion wherein during deployment, the collapsible flange portion is compressed and after deployment, the collapsible flange is expanded to prevent the proximal anchoring member from being displaced distally into the blood vessel.

21. The medical device as in claim 20 wherein the collapsible flange portion comprises a plurality of anchors to enhance the anchoring of the proximal anchoring member to a cardiac tissue.

22. The medical device as in claim 1 wherein the proximal anchoring member is at least one of a self-expanding structure and an expandable structure.

23. The medical device as in claim 1 wherein the proximal anchoring member is expandable to form a globe-like structure upon deployment, the globe-like structure being larger than an entrance of the blood vessel to prevent the proximal anchoring member from being displaced distally within the blood vessel.

24. The medical device as in claim 1 wherein the proximal anchoring member comprises an outer member and an inner member moveably fitted within the outer member, the outer member comprising a plurality of openings cut into the outer member, the inner member comprising a plurality of anchors, wherein during deployment, the plurality of anchors is confined within the outer member and wherein upon deployment, the inner member slides across the outer member to allow the plurality of anchors to pass through the plurality of openings.

25. The medical device as in claim 1 further comprising:

a cord coupling to a distal end of the telescoping assembly, extending along the telescoping assembly, and extending outside a proximal end of the telescoping assembly, wherein pulling on the cord adjusts at least one of the length of the telescoping assembly, the tension of the telescoping assembly, and the distance between the distal anchoring member and the proximal anchoring member, and

a locking device positioned at least at one of at a proximal end of the telescoping assembly and at a distal end of the telescoping assembly to lock the cord in position.

26. The medical device as in claim 25 wherein the locking device further comprises:

a rotating arm; and

a pivot residing in a housing wherein the cord is disposed through the housing and wherein the rotating arm rotates about the pivot in a direction that allows the cord to be pulled in one direction and prevents the cord from retracing from the one direction.

27. The medical device as in claim 1 wherein the telescoping assembly comprises portions having a variable flexural modulus and wherein the telescoping assembly is oriented to a preferred orientation to facilitate deployment of the telescoping assembly into the blood vessel.

28. The medical device as in claim 1 wherein the telescoping assembly further couples to at least one force distribution member, the force distribution member to be positioned against an inner wall of the blood vessel to prevent the telescoping assembly from damaging the blood vessel.

29. The medical device as in claim 1 wherein the at least one bent portion is capable of being positioned over an artery where the blood vessel crosses over, the at least one bent portion to prevent pressure from the medical device upon the artery.

30. The medical device as in claim 1 wherein each of the distal anchoring member, the proximal anchoring member, and the telescoping assembly comprises a material to facilitate tissue ingrowths to provide a long term anchor support for the medical device.

31. The medical device as in claim 1 wherein each of the distal anchoring member and the proximal anchoring member comprises at least one anchor, the at least one anchor comprising a material that facilitates anchoring of the distal anchoring member and the proximal anchoring member to the cardiac tissue.

32. The medical device as in claim 1 wherein the telescoping assembly further comprises:

a distal tube engaging the distal anchoring member;

a proximal tube engaging the proximal anchoring member;

a center tube that is larger in cross-sectional area than either one of the distal tube and the proximal tube, wherein the distal tube is slidably fitted inside the center tube at one end and the proximal tube is slidably fitted inside the center tube at the other end; and

a cord disposed through the telescoping assembly extending from the distal tube through the proximal tube and extending for a predetermined distance past the proximal tube.

33. The medical device as in claim 32 wherein pulling on the cord proximally relative to the proximal tube adjusts the distance between the distal anchoring member and the proximal anchoring member.

34. The medical device as in claim 32 wherein the distal tube further comprises the bent portion to be positioned over an area that the blood vessel crosses over, the at least one bent portion to prevent pressure from the medical device upon the area.

35. The medical device as in claim 32 wherein the center tube further comprises an interference member disposed in the inner diameter of the center tube to bias the distal tube and the proximal tube.

36. The medical device as in claim 32 wherein the telescoping assembly is configured such that the distal tube and the proximal tube extend a predetermined distance from the center tube with at least a portion of each of the distal tube and the proximal tube being inside the center tube at all time.

37. The medical device as in claim 36 wherein a mechanical interference is included within the telescoping assembly to maintain the predetermined distance.

38. The medical device as in claim 36 wherein the mechanical interference prevents the distal tube and the proximal tube from disengaging with the center tube.

39. The medical device as in claim 32 wherein the center tube further comprises a connecting cord coupling at one end to the distal tube and at another end to the proximal tube, the connecting cord functions in one of maintaining a maximum distance that the distal tube and the proximal tube extend from each other and preventing the distal tube and the proximal tube from extending out of the center tube.

40. The medical device as in claim 1 wherein the telescoping assembly comprises a mechanical interference to prevent the at least two members from the telescoping assembly from disengaging one another.

41. A medical device comprising:

a distal anchoring member for disposing in a blood vessel;

a proximal anchoring member for disposing in or at an entrance of the blood vessel; and

a telescoping assembly coupling at a first end to the distal anchoring member and at a second end to the proximal anchoring member, the entire telescoping assembly being deployable into the blood vessel, and the telescoping assembly reducing a distance of the blood vessel between the distal anchoring member and the proximal anchoring member positions, wherein the telescoping assembly comprises at least two members capable of sliding one into or over the other giving the telescoping assembly an adjustable length and wherein the distal anchoring member is further coupled to a tension cord extending from the distal anchoring member through the telescoping assembly wherein pulling on the tension cord compresses a longitudinal length of the distal anchoring member and expands a cross-sectional area of the distal anchoring member pushing the distal anchoring member against the inner diameter of the blood vessel.

42. A medical device comprising:

a distal anchoring member for disposing in a blood vessel;

a proximal anchoring member for disposing in or at an entrance of the blood vessel; and

a telescoping assembly coupling at a first end to the distal anchoring member and at a second end to the proximal anchoring member, the entire telescoping assembly being deployable into the blood vessel, and the telescoping assembly reducing a distance of the blood vessel between the distal anchoring member and the proximal anchoring member positions, wherein the telescoping assembly comprises at least two members capable of sliding one into or over the other giving the telescoping assembly an adjustable length and wherein the telescoping assembly further comprises (i) a distal tube engaging the distal anchoring member wherein the distal tube comprises a bent portion to be positioned over an area that the blood vessel crosses over, the at least one bent portion to prevent pressure from the medical device upon the area;

(ii) a proximal tube engaging the proximal anchoring member, (iii) a center tube that is larger in cross-sectional area than either one of the distal tube and the proximal tube, wherein the distan tube is slidably fitted inside the center tube at one end and the proximal tube is slidably fitted inside the center tube at the other end; and

(iv) a cord disposed through the telescoping assembly extending from the distal tube through the proximal tube and extending for a predetermined distance past the proximal tube.