Mitral valve treatment techniques

• US 9,526,613 B2
• Filed: 11/19/2013
• Issued: 12/27/2016
• Est. Priority Date: 03/17/2005
• Status: Active Grant

• Current Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Original Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Inventors: Gross, Amir, Gross, Yossi
• Primary Examiner(s): Sevilla, Christian
• Assistant Examiner(s): Mathew, Seema
• Application Number:
  US14/084,426
• Publication Number:
  US 20140148898A1
• Time in Patent Office: 1,134 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 2017/00243 cardiac
• 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 2/2442 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 2/2448 D-shaped rings
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61F 2220/0008 Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2250/0003 having an inflatable pocket filled with fluid, e.g. liquid or gas
• CPC Class Codes: A61F 2250/0004 adjustable
• CPC Class Codes: A61F 2250/0007 for adjusting length
• CPC Class Codes: A61F 2250/0096 Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound markers

Abstract

A method is provided for treating mitral valve regurgitation, including inserting a band around between 90 and 270 degrees of a mitral valve of a heart, including around at least a portion of a posterior cusp of the valve, in a space defined by (a) a ventricular wall, (b) a ventricular surface of the posterior cusp in a vicinity of an annulus of the valve, and (c) a plurality of chordae tendineae of one or more types of chordae tendineae selected from the group consisting of: second-order chordae tendineae and third-order chordae tendineae. The method also includes applying pressure to the posterior cusp by inflating the band.

Claims

1. A method for treating mitral valve regurgitation, comprising:

inserting an implant including a band around between 90 and 270 degrees of a mitral valve of a heart, including around at least a portion of a posterior cusp of the valve, in a space defined by (a) a ventricular wall, (b) a ventricular surface of the posterior cusp in a vicinity of an annulus of the valve, and (c) a plurality of chordae tendineae of one or more types of chordae tendineae selected from the group consisting of;

second-order chordae tendineae and third-order chordae tendineae, and by the inserting, contacting the band with one or more tissues selected from the group consisting of;

one or more of the plurality of chordae tendineae and the ventricular surface of the posterior cusp; and

supporting the posterior cusp by pressing the band against the posterior cusp, the plurality of chordae tendineae, and the ventricular wall, by inflating the band.

2. The method according to claim 1, wherein inflating the band comprises inflating the band so as to hold the band in place.

3. The method according to claim 1, wherein inflating the band comprises inflating the band with a liquid that at least partially solidifies after inflation.

4. The method according to claim 1, wherein inflating the band does not comprise coupling either a distal or a proximal end of the band to any portion of the heart, other than by the inflating.

5. The method according to claim 1, wherein the plurality of chordae tendineae includes the third-order chordae tendineae.

6. The method according to claim 1, wherein the plurality of chordae tendineae includes the second-order chordae tendineae.

7. The method according to claim 1, wherein inserting comprises inserting the implant including the band around no portion of an anterior cusp of the valve.

8. The method according to claim 1, wherein inserting comprises inserting the implant including the band such that a first portion of the band surrounds the at least the portion of the posterior cusp and a second portion of the band surrounds at least a portion of an anterior cusp of the valve, and wherein a length of the first portion of the band that surrounds the at least the portion of the posterior cusp is at least 5 times a total length of the second portion of the band that surrounds the at least the portion of the anterior cusp of the valve.

9. The method according to claim 1, wherein at least a portion of the band includes an elastic material, configured to shorten a length of the band, and wherein inserting the implant including the band comprises inserting the implant including the band including the elastic material.

10. The method according to claim 1, wherein the plurality of chordae tendineae comprises at least a first chorda tendinea and a second chorda tendinea, and wherein the method further comprises coupling a distal end and a proximal end of the band to the first chorda tendinea and the second chorda tendinea, respectively, each of the first and second chordae tendineae selected from the group consisting of:

one of the third-order chordae tendineae, and a first-order chorda tendinea that inserts on a commissural cusp of the mitral valve.

11. The method according to claim 10, wherein coupling the distal end and the proximal end of the band to the first chorda tendinea and the second chorda, respectively, comprises tightening the annulus of the valve.

12. The method according to claim 10, wherein coupling the distal end and the proximal end of the band comprises:

coupling a distal coupling element at the distal end of the band to the first chorda tendinea; and

coupling a proximal coupling element at the proximal end of the band to the second chorda tendinea.

13. The method according to claim 12, wherein the distal and proximal coupling elements include respective hooks, and wherein coupling the distal and proximal coupling elements comprises hooking the distal and proximal coupling elements to the first and second chordae tendineae, respectively.