Methods and devices for repairing and/or preventing paravalvular leakage post-implantation of a valve prosthesis

• US 9,144,663 B2
• Filed: 10/24/2012
• Issued: 09/29/2015
• Est. Priority Date: 10/24/2012
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Ahlberg, Sarah, Clague, Cynthia, Peterson, Susan, Mosher, Scott, Punga, Karan
• Primary Examiner(s): Gherbi, Suzette J
• Application Number:
  US13/659,668
• Publication Number:
  US 20140114402A1
• Time in Patent Office: 1,070 Days
• Field of Search: 623 211- 219
• US Class Current: 1/1
• CPC Class Codes: A61B 17/12036 partial occlusion
• CPC Class Codes: A61B 17/12122 within the heart for closing a cardiac septal defect A61B17/0057
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2210/0085 hardenable in situ, e.g. epoxy resins
• CPC Class Codes: A61F 2220/005 using adhesives
• CPC Class Codes: A61F 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0067 conical
• CPC Class Codes: A61F 2230/0078 hyperboloidal
• CPC Class Codes: A61F 2230/008 paraboloidal
• CPC Class Codes: A61F 2230/0091 helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
• CPC Class Codes: A61F 2250/006 modular
• CPC Class Codes: A61F 2250/0069 Sealing means
• CPC Class Codes: A61M 2025/0087 Multiple injection needles protruding laterally from the distal tip
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• CPC Class Codes: A61M 31/005 : for contrast media

Abstract

Devices and methods for delivering a sealing element post-implantation of valve prosthesis that functions to occlude or fill gaps present between the valve prosthesis and the native valve tissue, thereby reducing, minimizing, or eliminating leaks there through. In a first method, an injectable material is placed within a native valve sinus to form a sealing element that presses native valve leaflets against an outer surface of a heart valve prosthesis. In a second method, an injectable sealing material or a preformed annular sealing component is positioned between the outer surface or perimeter of a heart valve prosthesis and native heart valve tissue. In a third method, a preformed sealing element or component is placed within a heart valve prosthesis to press the prosthesis against native valve tissue.

Claims

1. A method of preventing and/or repairing paravalvular leakage, the method comprising the steps of:

advancing a catheter to a previously implanted valve prosthesis, wherein the catheter is configured to deliver an injectable sealing material;

injecting the sealing material around an outer surface of the implanted valve prosthesis via the catheter by extending a plurality of needles of the catheter through graft material of the implanted valve prosthesis and delivering the sealing material through the plurality of needles; and

allowing the sealing material to expand and solidify in situ to form an annular sealing element that extends between the outer surface of the implanted valve prosthesis and native valve tissue to close and/or prevent gaps between the implanted valve prosthesis and native valve tissue to repair and/or prevent paravalvular leakage.

2. The method of claim 1, further comprising the step of withdrawing the plurality of needles through the graft material, thereby leaving a plurality of small holes in the graft material.

3. The method of claim 2, further comprising the step of injecting additional sealing material into the plurality of holes.

10. The method of claim 1, wherein the plurality of needles of the catheter are spaced apart in equal intervals around the outer surface of the implanted valve prosthesis during the step of injecting the sealing material around the outer surface of the implanted valve prosthesis.

11. The method of claim 1, wherein the plurality of needles each include distal tips configured for piercing through the graft material of the implanted valve prosthesis.

12. The method of claim 1, wherein the step of allowing the sealing material to expand and solidify in situ to form an annular sealing element includes allowing the sealing material to spread away from the plurality of needles and track circumferentially around the implanted valve prosthesis to merge into the annular sealing element.

13. The method of claim 2, wherein the graft material is self-sealing and the plurality of holes self-seal after the plurality of needles are withdrawn.

4. A method of preventing and/or repairing paravalvular leakage, the method comprising the steps of:

advancing a catheter to a previously implanted valve prosthesis, wherein the catheter is configured to deliver an injectable sealing material;

injecting the sealing material around an outer surface of the implanted valve prosthesis via the catheter by positioning an umbrella-like delivery component of the catheter around an end of the implanted valve prosthesis and delivering the sealing material through the umbrella-like delivery component; and

allowing the sealing material to expand and solidify in situ to form an annular sealing element that extends between the outer surface of the implanted valve prosthesis and native valve tissue to close and/or prevent gaps between the implanted valve prosthesis and native valve tissue to repair and/or prevent paravalvular leakage.

14. The method of claim 4, wherein the umbrella-like delivery component of the catheter includes a plurality of circumferentially spaced apart support arms and a plurality of segments extending between the adjacent pairs of the support arms, each segment including a double layer of flexible material that defines a port for delivery of the sealing material.

15. The method of claim 14, wherein each support arm includes a hinge for radial expansion and radial collapse thereof.

5. A method of preventing and/or repairing paravalvular leakage, the method comprising the steps of:

advancing a catheter to a previously implanted valve prosthesis, wherein the catheter is configured to deliver an injectable sealing material;

injecting the sealing material around an outer surface of the implanted valve prosthesis via the catheter;

temporarily crimping a first end of the implanted valve prosthesis prior to the step of injecting the sealing material around an outer surface of the implanted valve prosthesis via the catheter; and

allowing the sealing material to expand and solidify in situ to form an annular sealing element that extends between the outer surface of the implanted valve prosthesis and native valve tissue to close and/or prevent gaps between the implanted valve prosthesis and native valve tissue to repair and/or prevent paravalvular leakage.

16. The method of claim 5, wherein the step of injecting the sealing material around the outer surface of the implanted valve prosthesis includes tracking the catheter around the outer surface of the implanted valve prosthesis.

17. The method of claim 5, wherein the step of injecting the sealing material around the outer surface of the implanted valve prosthesis includes circumferentially delivering the sealing material through a plurality of lumens and corresponding ports formed within a distal end of the catheter.

6. A method of preventing and/or repairing paravalvular leakage, the method comprising the steps of:

advancing a catheter to a previously implanted valve prosthesis, wherein the catheter includes an annular sealing component mounted thereon; and

positioning the annular sealing component onto the implanted valve prosthesis, wherein the annular sealing component is positioned within the implanted valve prosthesis to over-expand and press at least a portion of the implanted valve prosthesis against native valve tissue and wherein the annular sealing component closes and/or prevents gaps between the implanted valve prosthesis and native valve tissue to repair and/or prevent paravalvular leakage.

7. The method of claim 6, wherein the annular sealing component is a hollow polymeric sac and further comprising the step of delivering an inflation medium to the hollow polymeric sac to expand the sac in situ.

8. The method of claim 6, wherein the annular sealing component is a conformable polymeric ring.

9. The method of claim 6, wherein the annular sealing component is at least one loop of a self-expanding shape memory material.

18. The method of claim 6, wherein the annular sealing component has an expanded outer diameter that is predetermined to be greater than an expanded diameter of the implanted valve prosthesis.

19. The method of claim 7, further comprising the step of sealing of an inflation port of the hollow polymeric sac after delivery of the inflation medium.

20. The method of claim 9, wherein the annular sealing component has a substantially straightened delivery configuration during the step of advancing the catheter and wherein the annular sealing component self-expands against an interior surface of the implanted valve prosthesis during the step of positioning the annular sealing component onto the implanted valve prosthesis.