Method and apparatus for mitral valve annuloplasty

• US 9,445,899 B2
• Filed: 03/15/2013
• Issued: 09/20/2016
• Est. Priority Date: 08/22/2012
• Status: Active Grant

• Current Assignee: Joseph M. Arcidi
• Original Assignee: Joseph M. Arcidi
• Inventors: Arcidi, Joseph M.
• Primary Examiner(s): Lynch, Robert
• Application Number:
  US13/844,117
• Publication Number:
  US 20140277406A1
• Time in Patent Office: 1,285 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61F 2/2442 Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2451 Inserts in the coronary sinus for correcting the valve shape
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0033 made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit
• CPC Class Codes: A61F 2250/0007 for adjusting length
• CPC Class Codes: A61F 2250/001 for adjusting a diameter

Abstract

A method for mitral valve annuloplasty includes inserting a catheter apparatus across an aortic valve, the catheter apparatus including a tissue penetration member having a distal fixation end. The method further includes penetrating an aortomitral continuity and tissue of a fibrous trigone with the catheter apparatus from a left ventricular outflow tract beneath the aortic valve, and advancing the catheter apparatus along annular tissue of a mitral valve annulus. The distal fixation end is deployed to engage the annular tissue, the tissue penetration member is retracted within the catheter apparatus to compress the annular tissue a desired distance for reduction of the annular tissue, and the retracted tissue penetration member is secured to anchor the annular tissue reduction.

Claims

1. A method for mitral valve annuloplasty, comprising:

inserting a catheter apparatus across an aortic valve, the catheter apparatus including a tissue penetration member having a distal fixation end;

penetrating an aortomitral continuity at tissue of a fibrous trigone with the catheter apparatus from a left ventricular outflow tract without entering a remainder of the left ventricle;

advancing the catheter apparatus within annular tissue of a mitral valve annulus;

deploying the distal fixation end to engage the annular tissue;

retracting the tissue penetration member within the catheter apparatus to compress the annular tissue a desired distance for reduction of the annular tissue; and

securing the retracted tissue penetration member to anchor the annular tissue reduction.

2. The method of claim 1, further comprising guiding and monitoring the catheter apparatus using ultrasound.

3. The method of claim 1, further comprising guiding and monitoring the catheter apparatus using transesophageal echocardiography (TEE).

4. The method of claim 1, wherein deploying the distal fixation end includes retracting a sheath surrounding the tissue penetration member.

5. The method of claim 1, wherein the distal fixation end includes tines, and deploying the distal fixation end includes deploying the tines radially outward to engage the annular tissue.

6. The method of claim 1, further comprising calibrating the desired distance for annular tissue reduction using TEE.

7. The method of claim 1, wherein securing the retracted tissue penetration member includes deploying a grommet along the tissue penetration member to secure the tissue penetration member.

8. The method of claim 7, wherein the tissue penetration member has a distal portion and a proximal portion, the proximal portion including spaced protrusions, the protrusions engaging the grommet to secure the tissue penetration member.

9. The method of claim 7, further comprising amputating the tissue penetration member proximal of the grommet.

10. The method of claim 1, wherein the annular tissue reduction is anchored at the aortomitral continuity and the fibrous trigone.

11. The method of claim 1, including at least one of penetrating a posteromedial circumference of the mitral valve annulus through a right fibrous trigone and penetrating an anterolateral circumference of the mitral valve annulus through a left fibrous trigone.

12. A method for mitral valve annuloplasty, comprising:

inserting a catheter apparatus across an aortic valve, the catheter apparatus including a tissue penetration member having a distal fixation end, the tissue penetration member surrounded by a sheath;

penetrating an aortomitral continuity at tissue of a fibrous trigone with the catheter apparatus from a left ventricular outflow tract without entering a remainder of the left ventricl;

advancing the catheter apparatus within annular tissue of a mitral valve annulus;

retracting the sheath to deploy the distal fixation end and engage the annular tissue;

calibrating a desired distance for reduction of the annular tissue;

retracting the tissue penetration member within the catheter apparatus to compress the annular tissue the desired distance; and

deploying a grommet along the tissue penetration member to secure the retracted tissue penetration member and anchor the annular tissue reduction at the aortomitral continuity.

13. The method of claim 12, wherein the distal fixation end includes tines, and deploying the distal fixation end includes deploying the tines radially outward to engage the annular tissue.

14. The method of claim 12, further comprising amputating the tissue penetration member proximal of the grommet.