Closed band for percutaneous annuloplasty
First Claim
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1. A method comprising:
- providing an annuloplasty ring, which comprises a flexible sleeve;
during a percutaneous transcatheter procedure, placing the annuloplasty ring entirely around an annulus of a mitral valve of a subject in a closed loop;
fastening the flexible sleeve to the annulus by coupling tissue anchors to the annulus, with;
a first non-zero longitudinal density of the tissue anchors along a posterior portion of the annulus between left and right fibrous trigones of the annulus, including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the posterior portion of the annulus divided by (b) an entire length of the posterior portion of the annulus, anda second non-zero longitudinal density of the tissue anchors along an anterior portion of the annulus between left and the right fibrous trigones of the annulus, not including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the anterior portion of the annulus divided by (b) an entire length of the anterior portion of the annulus, wherein the first longitudinal density is at least twice the second longitudinal density; and
after (a) placing the annuloplasty ring entirely around the annulus in the closed loop and (b) fastening the flexible sleeve to the annulus, longitudinally contracting a longitudinal portion of the flexible sleeve.
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Abstract
A method is provided, which includes providing an annuloplasty ring, which comprises (a) a flexible sleeve, and (b) a contracting assembly. During a percutaneous transcatheter procedure, the flexible sleeve is placed entirely around an annulus of a mitral valve of a subject in a closed loop. The sleeve is fastened to the annulus by coupling a plurality of tissue anchors to a posterior portion of the annulus, without coupling any tissue anchors to an anterior portion of the annulus between left and right fibrous trigones of the annulus. Thereafter, a longitudinal portion of the sleeve is contracted. Other embodiments are also described.
475 Citations
19 Claims
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1. A method comprising:
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providing an annuloplasty ring, which comprises a flexible sleeve; during a percutaneous transcatheter procedure, placing the annuloplasty ring entirely around an annulus of a mitral valve of a subject in a closed loop; fastening the flexible sleeve to the annulus by coupling tissue anchors to the annulus, with; a first non-zero longitudinal density of the tissue anchors along a posterior portion of the annulus between left and right fibrous trigones of the annulus, including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the posterior portion of the annulus divided by (b) an entire length of the posterior portion of the annulus, and a second non-zero longitudinal density of the tissue anchors along an anterior portion of the annulus between left and the right fibrous trigones of the annulus, not including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the anterior portion of the annulus divided by (b) an entire length of the anterior portion of the annulus, wherein the first longitudinal density is at least twice the second longitudinal density; and after (a) placing the annuloplasty ring entirely around the annulus in the closed loop and (b) fastening the flexible sleeve to the annulus, longitudinally contracting a longitudinal portion of the flexible sleeve. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A method comprising:
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providing an annuloplasty ring, which comprises a flexible sleeve and a contracting assembly; during a percutaneous transcatheter procedure, placing the annuloplasty ring around an annulus of a mitral valve of a subject; fastening the flexible sleeve to the annulus by coupling tissue anchors to the annulus, wherein; a first non-zero longitudinal density of the tissue anchors along a posterior portion of the annulus between left and right fibrous trigones of the annulus, including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the posterior portion of the annulus divided by (b) an entire length of the posterior portion of the annulus, and a second non-zero longitudinal density of the tissue anchors along an anterior portion of the annulus between left and the right fibrous trigones of the annulus, not including the trigones, which density is equal to (a) a total number of the tissue anchors coupled to the annulus along the anterior portion of the annulus divided by (b) an entire length of the anterior portion of the annulus, wherein the first longitudinal density is at least twice the second longitudinal density; and after (a) placing the annuloplasty ring around the annulus and (b) fastening the flexible sleeve to the annulus, actuating the contracting assembly to longitudinally contract a longitudinal portion of the flexible sleeve.
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Specification