Means and method of replacing a heart valve in a minimally invasive manner
First Claim
1. In combination:
- A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) means for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool for attaching said flexible sewing cuff to the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on one end of said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) means for releasably mounting said flexible sewing cuff to said tool, and (5) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
4 Assignments
0 Petitions
Accused Products
Abstract
A heart valve can be replaced using minimally invasive methods which include a sutureless sewing cuff that and a fastener delivery tool that holds the cuff against the patient'"'"'s tissue while delivering fasteners to attach the cuff to the tissue from the inside out. The tool stores a plurality of fasteners and is self-contained whereby a fastener is delivered and placed all from inside a vessel. The fasteners are self-forming whereby they do not need an anvil to be formed. Anchor elements are operated from outside the patient'"'"'s body to cinch a prosthesis to an anchoring cuff of the valve body. The cuff is releasably mounted on the tool and the tool holds the cuff against tissue and drives the fastener through the cuff and the tissue before folding over the legs of the fastener whereby secure securement between the cuff and the tissue is assured. Fasteners are placed and formed whereby fasteners are located continuously throughout the entire circumference of the cuff. A minimally invasive surgical method is disclosed, and a method and tool are disclosed for repairing abdominal aortic aneurysms in a minimally invasive manner. Fasteners that are permanently deformed during the process of attaching the cuff are disclosed as are fasteners that are not permanently deformed during the attaching process.
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Citations
72 Claims
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1. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) means for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool for attaching said flexible sewing cuff to the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on one end of said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) means for releasably mounting said flexible sewing cuff to said tool, and (5) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit. - View Dependent Claims (2, 11)
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3. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate from said flexible sewing cuff, and (3) means for attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been placed in a patient; and
B) a tool for placing said flexible sewing cuff in the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) means for releasably mounting said flexible sewing cuff to said tool, and (5) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10)
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12. In combination:
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A) a heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve body separate from said flexible sewing cuff, and (3) means for securely attaching said valve body to said flexible sewing cuff after said flexible sewing cuff has been placed in a patient; and
B) a tool for placing said flexible sewing cuff in the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) means for releasably mounting said flexible sewing cuff to said tool, and (5) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
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13. In combination:
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A) a multipart heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis heart valve body separate from said flexible sewing cuff, (3) means for attaching said heart valve body to said flexible sewing cuff after said flexible sewing cuff has been placed in a patient; and
B) a tool for placing said flexible sewing cuff in the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) means for releasably mounting said flexible sewing cuff to said tool, and (5) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
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14. In combination:
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A) a heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate from said flexible sewing cuff, and (3) means for securely attaching said valve to said flexible sewing cuff after said flexible sewing cuff has been placed in a patient; and
B) a tool for placing said flexible sewing cuff in the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, and (4) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
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15. In combination:
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A) a heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) means for securely attaching said valve to said flexible sewing cuff after said flexible sewing cuff has been placed in a patient; and
B) a tool for placing said flexible sewing cuff in the patient in a minimally invasive manner and which includes (1) a housing, (2) an operating handle mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, and (4) a fastener handling means on said housing and operationally connected to said operating handle to be controlled by said operating handle for storing said fastener and securing said fastener through said flexible sewing cuff and into the patient'"'"'s tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
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16. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool for attaching said flexible sewing cuff to the patient and which includes (1) a housing, (2) at least one fastener stored in said housing in a tissue-penetrating shape and having an elastic limit, and (3) a fastener handling means on said tool for forcing said fastener into the patient from one side of said flexible sewing cuff and the patient'"'"'s tissue to attach said flexible sewing cuff to the patient and deforming said fastener beyond its elastic limit into a cuff-retaining shape.
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17. In combination:
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A) a multipart prosthesis valve includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool for attaching said flexible sewing cuff to the patient and which includes (1) a housing, (2) at least one fastener stored in said housing, said fastener being self-tapping to penetrate the patient'"'"'s tissue when rotated, (3) a fastener handling means on said tool for imparting rotation to said fastener and forcing said fastener into the patient'"'"'s tissue from one side of the patient'"'"'s tissue to attach said flexible sewing cuff to the patient.
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18. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool for attaching said flexible sewing cuff to the patient and which includes (1) a housing, (2) at least one fastener stored in said housing, and (3) a fastener handling means on said tool for forcing said fastener into the patient from one side of the patient'"'"'s tissue and attaching said flexible sewing cuff to the patient.
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19. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements for securely attaching said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient;
B) a fastener for attaching said sewing cuff to the patient from one side of said sewing cuff, said fastener having an elastic limit; and
C) means for forcing said fastener through said sewing cuff and attaching said sewing cuff to the patient without exceeding the elastic limit of said fastener whereby said fastener is non-formed when said sewing cuff is attached to the patient by said fastener.
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20. In combination:
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A) a multipart heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis heart valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements for securely attaching said prosthesis heart valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient;
B) a fastener for attaching said sewing cuff to the patient from one side of said sewing cuff, said fastener having an elastic limit and an initial shape; and
C) means a tool carrying the fastener, the tool configured for forcing said fastener through said sewing cuff and attaching said sewing cuff to the patient without exceeding the elastic limit of said fastener. - View Dependent Claims (28, 29, 30, 31, 32, 33, 34)
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21. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, said prosthesis valve being attachable to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient, and B) a tool operative to attach said flexible sewing cuff to the patient in a minimally invasive manner, the tool including (1) a housing, (2) an operating member mounted on one end of said housing, (3) at least one fastener carried by said housing, said fastener having an elastic limit, (4) mounting structure on said tool operative to releasably carry said flexible sewing cuff, and (5)(4) a fastener carrier on said housing, said fastener carrier being operatively connected to said operating member such that actuation of said operating member secures said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit. - View Dependent Claims (35, 36, 37, 38, 39, 40, 41, 42, 43)
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22. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate from said flexible sewing cuff and attachable to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient, and B) a tool operative to attach said flexible sewing cuff in the patient in a minimally invasive manner, the tool including (1) a housing, (2) an operating member mounted on said housing, (3) at least one fastener stored in said housing, said fastener having an elastic limit, (4) mounting structure on said tool operative to releasably carry said flexible sewing cuff, and (5)(4) a fastener carrier on said housing, said fastener carrier being operatively connected to said operating member such that actuation of said operating member secures said fastener through said flexible sewing cuff and into the patient'"'"'s tissue from one side of said sewing cuff and the tissue to attach said flexible sewing cuff to the patient without deforming said fastener beyond its elastic limit.
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23. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements configured to attach said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool operative to attach said flexible sewing cuff to the patient, said tool including (1) a housing, (2) at least one fastener carried by said housing, said fastener having a tissue-penetrating shape and an elastic limit, and (3) a fastener handling device on said tool operating to force said fastener into the patient from one side of said flexible sewing cuff and the patient'"'"'s tissue to attach said flexible sewing cuff to the patient and thereby deform said fastener beyond its elastic limit into a cuff-retaining shape.
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24. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements configured to attach said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool operative to attach said flexible sewing cuff to the patient, said tool including (1) a housing, (2) at least one fastener carried by said housing, said fastener being self-tapping to penetrate the patient'"'"'s tissue when rotated, (3) a fastener handling device on said tool operative to impart rotation to said fastener and thereby force said fastener into the patient'"'"'s tissue from one side of the patient'"'"'s tissue to attach said flexible sewing cuff to the patient.
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25. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements configured to attach said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient; and
B) a tool operative to attach said flexible sewing cuff to the patient, said tool including (1) a housing, (2) at least one fastener carried by said housing, and (3) a fastener handling device on said tool operative to force said fastener into the patient from one side of the patient'"'"'s tissue and thereby attach said flexible sewing cuff to the patient.
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26. In combination:
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A) a multipart prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements configured to attach said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient;
B) a fastener for attaching said sewing cuff to the patient from one side of said sewing cuff, said fastener having an elastic limit; and
C) a tool carrying said fastener and operative to force said fastener through said sewing cuff and thereby attach said sewing cuff to the patient without exceeding the elastic limit of said fastener, whereby said fastener is nonformed when said sewing cuff is attached to the patient by said fastener.
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27. In combination:
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A) a multipart heart valve prosthesis which includes (1) a flexible sewing cuff, (2) a prosthesis heart valve separate and spaceable from said flexible sewing cuff, and (3) anchor elements configured to attach said prosthesis valve to said flexible sewing cuff after said flexible sewing cuff has been attached to a patient;
B) a fastener configured to attach said sewing cuff to the patient from one side of said sewing cuff, said fastener having an elastic limit and an initial shape; and
C) a tool carrying said fastener and operative to force said fastener through said sewing cuff thereby attach said sewing cuff to the patient without exceeding the elastic limit of said fastener and while retaining the initial shape of said fastener.
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44. A system for implanting a prosthesis heart valve within an annulus in a heart of a patient, comprising:
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a flexible sewing cuff having a shape for implantation within the annulus in the heart;
a tool carrying one or more fasteners, each fastener having an elastic limit, an initial shape, and two legs that overlap in the initial shape, the tool configured for separating the legs of each fastener apart, and forcing the legs through the sewing cuff into tissue of the annulus to attach the sewing cuff to the patient without exceeding the elastic limit of each fastener; and
a prosthesis heart valve separate and spaceable from the sewing cuff, the prosthesis valve being attachable to the sewing cuff after the sewing cuff has been attached to the annulus. - View Dependent Claims (45, 46, 47, 48, 49, 50, 51, 52)
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53. A system for implanting a prosthesis heart valve within a annulus in a heart of a patient, comprising:
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a flexible sewing cuff having a shape for implantation within the annulus in the heart;
a tool carrying one or more fasteners, each fastener having an elastic limit, an initial shape, and two legs that overlap in the initial shape, the tool configured for holding the legs of each fastener apart, and forcing the legs through the sewing cuff into tissue of the annulus to attach the sewing cuff to the patient without exceeding the elastic limit of each fastener; and
a prosthesis heart valve separate and spaceable from the sewing cuff, at least one of the sewing cuff and the prosthesis heart valve comprising anchor elements for securely attaching the prosthesis heart valve to the sewing cuff. - View Dependent Claims (54, 55, 56, 57, 58, 59, 60, 61)
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62. A system for implanting a prosthesis heart valve within an annulus in a heart of a patient, comprising:
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a sewing cuff having a shape for implantation with the annulus in the heart;
a tool carrying one or more fasteners, each fastener having an elastic limit, an initial shape, and two legs that overlap in the initial shape, the tool configured for holding the legs of each fastener apart, and forcing the legs through the sewing cuff into tissue of the annulus to attach the sewing cuff to the patient without exceeding the elastic limit of each fastener; and
a prosthesis heart valve separate and spaceable from the sewing cuff, at least one of the sewing cuff and the prosthesis heart valve comprising anchor elements for securely attaching the prosthesis heart valve to the sewing cuff. - View Dependent Claims (63, 64, 65, 66, 67, 68, 69, 70, 71, 72)
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Specification