Techniques for guide-wire based advancement of artificial chordae

• US 9,968,454 B2
• Filed: 11/10/2015
• Issued: 05/15/2018
• Est. Priority Date: 10/29/2009
• Status: Active Grant

• Current Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Original Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Inventors: Reich, Tal, Miller, Eran, Sheps, Tal
• Primary Examiner(s): Shi, Katherine M
• Application Number:
  US14/937,233
• Publication Number:
  US 20160058557A1
• Time in Patent Office: 917 Days
• Field of Search: 623 21, 623 211, 623 236, 623 237
• CPC Class Codes: A61B 17/0401 Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00783 Valvuloplasty
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0448 Additional elements on or within the anchor
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/2445 Annuloplasty rings in direct contact with the valve annulus
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/2466 Delivery devices therefor
• CPC Class Codes: A61F 2/2487 Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2250/0007 for adjusting length

Abstract

Apparatus is provided, comprising (1) a guide member, (2) a tissue-adjustment mechanism having (a) an upper surface and a lower surface, (b) at least one first opening at the upper surface, (c) at least one second opening at the lower surface, and (4) a channel extending between the first and second openings, the channel facilitating advancement of the tissue-adjustment mechanism along the guide member; and (3) at least one repair chord coupled at a first portion thereof to the tissue-adjustment mechanism and having at least a first end that is configured to be coupled to a portion of tissue of a patient, the repair chord being configured to adjust a distance between the portion of tissue and the tissue-adjustment mechanism, in response to adjustment of the repair chord by the tissue-adjustment mechanism. Other embodiments are also described.

Claims

1. A method for use with a heart of a subject, the method comprising:

advancing, into the heart, a tissue-engaging element coupled to a guide member;

coupling the tissue-engaging element to a portion of tissue of the heart;

sliding at least a distal portion of an artificial chorda tendinea distally along the guide member toward the tissue-engaging element; and

coupling the distal portion of the chorda tendinea to the tissue-engaging element.

2. The method according to claim 1, further comprising decoupling the guide member from the tissue-engaging element while the chorda tendinea remains coupled to the tissue-engaging element.

3. The method according to claim 1, wherein the portion of the tissue of the heart is a portion of a papillary muscle of the heart, and wherein coupling the tissue-engaging element to the portion of tissue of the heart comprises coupling the tissue-engaging element to the portion of the papillary muscle.

4. The method according to claim 1, wherein the portion of tissue of the heart faces a ventricle of the heart, and wherein coupling the tissue-engaging element to the portion of tissue of the heart comprises coupling the tissue-engaging element to the portion of tissue that faces the ventricle.

5. A method comprising:

obtaining a system comprising;

a tissue-engaging element having a distal portion configured to engage a portion of tissue of the heart;

a guide member;

an artificial chorda tendinea having a distal end and a proximal end, at least the distal end being slidably coupled to the guide member; and

advancing, into the heart, the tissue-engaging element while the tissue-engaging element is reversibly coupled to the guide member;

coupling the tissue-engaging element to a portion of tissue of the heart;

sliding at least a distal portion of the artificial chorda tendinea distally along the guide member toward the tissue-engaging element; and

coupling the distal portion of the chorda tendinea to the tissue-engaging element.

6. The method according to claim 5, wherein the system further comprises a tool slidable along the guide member distally toward the tissue-engaging element while the tool is coupled to at least the distal end of the chorda tendinae, and wherein sliding at least the distal portion of the artificial chorda tendinea includes using the tool to slide at least the distal portion of the artificial chorda tendinea distally along the guide member toward the tissue-engaging element while (i) the tool is coupled to at least the distal end of the chorda, and (ii) the guide member is coupled to the tissue-engaging element.

7. The method according to claim 6, wherein the tool is configured to couple the distal end of the chorda tendinea to the tissue-engaging element, and wherein coupling the distal portion of the chorda tendinea to the tissue-engaging element is done using the tool.

8. The method according to claim 6, wherein the tool is configured to decouple the guide member from the tissue-engaging element, and further comprising decoupling the guide member from the tissue-engaging element using the tool while leaving the chorda tendinea coupled to the tissue-engaging element.

9. The method according to claim 5, wherein the system further comprises a cap that is shaped to define an opening through which the guide member is slidable, wherein at least the distal end of the chorda tendinea is slidably coupled to the guide member via the cap.

10. The method according to claim 5, further comprising decoupling the guide member from the tissue-engaging element while the chorda tendinea remains coupled to the tissue-engaging element.

11. The method according to claim 5, wherein the portion of the tissue of the heart is a portion of a papillary muscle of the heart, and wherein coupling the tissue-engaging element to the portion of tissue of the heart comprises coupling the tissue-engaging element to the portion of the papillary muscle.

12. The method according to claim 5, wherein the portion of tissue of the heart faces a ventricle of the heart, and wherein coupling the tissue-engaging element to the portion of tissue of the heart comprises coupling the tissue-engaging element to the portion of tissue that faces the ventricle.