Techniques for guide-wire based advancement of a tool
First Claim
1. A method for use with a papillary muscle of a heart of a subject, the papillary muscle being coupled to one or more chordae tendineae of the heart of the subject, the method comprising:
- advancing a guide member to the chordae tendineae, the guide member having a proximal portion that includes a longitudinal element, and a distal portion that includes a chord-engaging element, configured to be slidably coupled to the chordae tendineae;
coupling the chord-engaging element to at least one of the one or more chordae tendineae;
sliding the chord-engaging element over the at least one of the chordae tendineae toward the papillary muscle;
advancing a tool toward the papillary muscle of the subject by sliding the tool along the longitudinal element; and
following the step of advancing the tool, anchoring a tissue anchor to ventricular muscle tissue using the tool.
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Accused Products
Abstract
Apparatus comprises: (A) a housing (248), percutaneously deliverable to a heart of a subject, slidable along a guidewire (242), and shaped to define at least one opening (249); (B) a guide member (250), percutaneously deliverable to the heart, percutaneously removable from the subject, couplable to the housing, and having: (i) a distal portion, comprising a chord-engaging element (252), configured to be percutaneously slidably coupled to and decouplable from at least one chordae tendineae (244), and (ii) a proximal portion, comprising a longitudinal element (251); and (C) a deployment tool, configured (i) to be reversibly coupled to a tissue anchor (50,280), (ii) to be slidably coupled to the longitudinal element of the guide member, and (iii) to anchor the tissue anchor to a papillary muscle (254) of the subject. Other embodiments are also described.
817 Citations
19 Claims
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1. A method for use with a papillary muscle of a heart of a subject, the papillary muscle being coupled to one or more chordae tendineae of the heart of the subject, the method comprising:
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advancing a guide member to the chordae tendineae, the guide member having a proximal portion that includes a longitudinal element, and a distal portion that includes a chord-engaging element, configured to be slidably coupled to the chordae tendineae; coupling the chord-engaging element to at least one of the one or more chordae tendineae; sliding the chord-engaging element over the at least one of the chordae tendineae toward the papillary muscle; advancing a tool toward the papillary muscle of the subject by sliding the tool along the longitudinal element; and following the step of advancing the tool, anchoring a tissue anchor to ventricular muscle tissue using the tool. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14)
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15. A method for use with a papillary muscle of a heart of a subject, the papillary muscle being coupled to one or more chordae tendineae of the heart of the subject, the method comprising:
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advancing a guidewire to a ventricle of the heart; providing (1) a guide member having (a) a proximal portion that includes a longitudinal element, and (b) a distal portion that includes a chord-engaging element, configured to be slidably coupled to the chordae tendineae, and (2) a housing that is slidable along the guide member; advancing the housing to the heart and the guide member to the chordae tendineae, wherein advancing the housing comprises sliding the housing over the guidewire; coupling the chord-engaging element to at least one of the one or more chordae tendineae; sliding the chord-engaging element over the at least one of the chordae tendineae toward the papillary muscle; and advancing a tool toward the papillary muscle of the subject by sliding the tool along the longitudinal element. - View Dependent Claims (16)
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17. A method for use with a papillary muscle of a heart of a subject, the papillary muscle being coupled to one or more chordae tendineae of the heart of the subject, the method comprising:
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providing (1) a guide member having (a) a proximal portion that includes a longitudinal element, and (b) a distal portion that includes a chord-engaging element, configured to be slidably coupled to the chordae tendineae, and (2) a housing that is slidable along the guide member; advancing the housing to the heart and the guide member to the chordae tendineae; subsequently to advancing the housing, sliding the chord-engaging element distally out of the housing; coupling the chord-engaging element to at least one of the one or more chordae tendineae; sliding the chord-engaging element over the at least one of the chordae tendineae toward the papillary muscle; and advancing a tool toward the papillary muscle of the subject by sliding the tool along the longitudinal element. - View Dependent Claims (18, 19)
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Specification