Implantation of repair chords in the heart
First Claim
1. Apparatus, comprising:
- a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses;
a mechanical element having a surface coupled to the lower surface of the rotatable structure, the mechanical element being shaped to provide;
a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, anda depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool; and
a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure;
the first end portion of the longitudinal member advances with respect to the rotatable structure, anda configuration of the longitudinal member changes,wherein;
the longitudinal member comprises an implant comprising an artificial chorda tendinea, and the apparatus is for adjusting at least one dimension of the implant,the rotatable structure is implantable at a first portion of tissue facing a ventricular lumen of a ventricle of a patient,the second end portion of the longitudinal member is couplable to at least one leaflet of an atrioventricular valve of the patient, andthe rotatable structure is rotatable to advance the first end portion of the longitudinal member with respect to the rotatable structure, in a manner which alters a distance between the second end portion of the longitudinal member and the rotatable structure.
1 Assignment
0 Petitions
Accused Products
Abstract
Apparatus is provided for adjusting at least one dimension of an implant, including a rotatable structure having first and second openings and a channel extending between the first and second openings. The channel allows passage therethrough of an elongate tool. The second end of the structure has a lower surface having one or more recesses along a circumference thereof. A mechanical element provides a protrusion that is disposed within one of the recesses of the rotatable structure during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure. The mechanical element includes a depressible portion coupled to the protrusion disposed in communication with the second opening of the lower surface, and configured to dislodge the protrusion from within the recess in response to a force applied thereto by the elongate tool. Other applications are also described.
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Citations
38 Claims
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1. Apparatus, comprising:
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a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses; a mechanical element having a surface coupled to the lower surface of the rotatable structure, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool; and a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure; the first end portion of the longitudinal member advances with respect to the rotatable structure, and a configuration of the longitudinal member changes, wherein; the longitudinal member comprises an implant comprising an artificial chorda tendinea, and the apparatus is for adjusting at least one dimension of the implant, the rotatable structure is implantable at a first portion of tissue facing a ventricular lumen of a ventricle of a patient, the second end portion of the longitudinal member is couplable to at least one leaflet of an atrioventricular valve of the patient, and the rotatable structure is rotatable to advance the first end portion of the longitudinal member with respect to the rotatable structure, in a manner which alters a distance between the second end portion of the longitudinal member and the rotatable structure. - View Dependent Claims (2, 3, 4, 5, 6)
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7. Apparatus, comprising:
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a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses; a mechanical element having a surface coupled to the lower surface of the rotatable structure, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool; and a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure; the first end portion of the longitudinal member advances with respect to the rotatable structure, and a configuration of the longitudinal member changes, wherein; the apparatus comprises an annuloplasty device having at least one end portion, the annuloplasty device comprises an implant, and the apparatus is for adjusting at least one dimension of the implant, the rotatable structure is coupled to the annuloplasty device, the longitudinal member is coupled at the second end portion thereof to the at least one end portion of the annuloplasty device, and the rotatable structure is rotatable to advance the first end portion of the longitudinal member with respect to the rotatable structure in a manner which alters a distance between the second end portion of the longitudinal member and the rotatable structure. - View Dependent Claims (8, 9, 10, 11)
wherein, during a second period; the elongate tool is removable from the channel to position the protrusion in the recess, and the rotatable structure is restricted from being rotated.
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9. The apparatus according to claim 8, wherein during the first period, the rotatable structure is rotatable in first and second directions, the first direction being opposite the second direction.
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10. The apparatus according to claim 7, further comprising a housing surrounding the rotatable structure, the housing being coupled in part to a cap having a surface that is disposed in parallel with the lower surface of the rotatable structure, wherein the depressible portion is disposed between the lower surface of the rotatable structure and the cap, and wherein the cap is shaped to define a recessed portion thereof configured to receive the depressible portion during a depressed state of the depressible portion.
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11. The apparatus according to claim 7, further comprising a housing surrounding the rotatable structure, the housing being shaped to define a recessed portion thereof configured to receive the protrusion during the resting state of the mechanical element.
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12. Apparatus for adjusting at least one dimension of an implant, comprising:
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a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses; a mechanical element having a surface coupled to the lower surface of the rotatable structure, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool; and a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure; the first end portion of the longitudinal member advances with respect to the rotatable structure, and a configuration of the longitudinal member changes, wherein the rotatable structure comprises a spool, and wherein the longitudinal member is coupled at at least the first end portion thereof to the spool and is wrapped around the spool in response to rotation of the spool in a first direction. - View Dependent Claims (13, 14, 15, 16, 17, 18, 19, 20)
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21. A method for adjusting at least one dimension of an implant, comprising:
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providing a rotatable structure including a spool, the spool having a first end shaped to define a first opening, and a second end shaped to define a second opening, the spool being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the spool having a lower surface thereof shaped to define one or more recesses, the spool and being coupled to; a mechanical locking element having a surface coupled to a lower surface of the spool, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the spool, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool, and a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the spool in a manner in which, as a result of rotation of the spool in a first direction; the first end portion of the longitudinal member advances with respect to and is wrapped around the spool, and a configuration of the longitudinal member changes; implanting the spool in cardiac tissue; advancing an elongate tool through a channel provided by the spool; unlocking the spool from the mechanical locking element by pushing the depressible portion of the surface of the locking element; responsively to the pushing of the depressible portion, dislodging a protrusion protruding out of a plane of the surface of the mechanical element from within a recess defined by the spool; and in response to the dislodging, rotating the spool. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28, 29, 30, 31)
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32. A method for adjusting at least one dimension of an implant, comprising:
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providing a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses, the rotatable structure being coupled to; a mechanical locking element having a surface coupled to a lower surface of the rotatable structure, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool, and a flexible, longitudinal member defining the implant, the flexible, longitudinal member including an artificial chorda tendineae, the longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure; the first end portion of the longitudinal member advances with respect to and is wrapped around the rotatable structure, and a configuration of the longitudinal member changes; implanting the rotatable structure at a first portion of tissue facing a ventricular lumen of a ventricle of a patient; coupling the second end portion of the longitudinal member to at least one leaflet of an atrioventricular valve of the patient; and altering a distance between the second end portion of the longitudinal member and the rotatable structure by rotating the rotatable structure to advance the first end portion of the longitudinal member with respect to the rotatable structure. - View Dependent Claims (33, 34, 35)
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36. A method for adjusting at least one dimension of an implant, comprising:
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providing a rotatable structure having a first end shaped to define a first opening, and a second end shaped to define a second opening, the rotatable structure being shaped to define a channel extending from the first opening to the second opening, the channel being configured for passage therethrough of an elongate tool, and the second end of the rotatable structure having a lower surface thereof shaped to define one or more recesses, the rotatable structure being coupled to; a mechanical locking element having a surface coupled to a lower surface of the rotatable structure, the mechanical element being shaped to provide; a protrusion protruding out of a plane of the surface of the mechanical element, the protrusion being disposed within one of the recesses during a resting state of the mechanical element, in a manner that restricts rotation of the rotatable structure, and a depressible portion coupled to the protrusion, the depressible portion being disposed in communication with the second opening of the second end, and configured to dislodge the protrusion from within the recess in response to a force applied to the depressible portion by the elongate tool, and a flexible, longitudinal member having first and second end portions thereof, at least the first end portion of the longitudinal member being coupled to the rotatable structure in a manner in which, as a result of rotation of the rotatable structure; the first end portion of the longitudinal member advances with respect to and is wrapped around the rotatable structure, and a configuration of the longitudinal member changes; implanting in a body of a patient an annuloplasty device defining the implant, the annuloplasty device; having at least one end portion being coupled to the rotatable structure, and being coupled at the at least one end portion thereof to the second end portion of the longitudinal member; and altering a distance between the second end portion of the longitudinal member and the rotatable structure by rotating the rotatable structure to advance the first end portion of the longitudinal member with respect to the rotatable structure. - View Dependent Claims (37, 38)
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Specification