MEMBRANE AUGMENTATION, SUCH AS OF FOR TREATMENT OF CARDIAC VALVES, AND FASTENING DEVICES FOR MEMBRANE AUGMENTATION
First Claim
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1. A surgical fastening device useful for securing a cardiac valve to an implant, comprising:
- a) a device body comprising a fastener magazine having a fastener ejection ring configured to project a plurality of tissue-piercing elements of one or more fasteners in the shape of a closed curve from said fastener magazine; and
b) an anvil configured to act as a counterpoise during said projection of said tissue-piercing elements which comprises an anvil head including an anvil head top surface having a shape of a closed-curve and a size substantially similar to that of said fastener ejection ring, said anvil configured to be reversibly secured to said device body through a stem surrounded by said fastener ejection ring, so that when secured, said anvil head surface is opposite said fastener ejection ringwherein said anvil head comprises at least two mateable anvil head parts, wherein each said mateable anvil head part spans a sector of said closed curve of said anvil head.
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Abstract
Disclosed are methods for augmenting tissue, for example membranes such as cardiac leaflets and tissue surrounding a cardiac valve, which in embodiments improve leaflet coaptation. Also disclosed are devices useful for augmenting tissue.
1375 Citations
63 Claims
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1. A surgical fastening device useful for securing a cardiac valve to an implant, comprising:
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a) a device body comprising a fastener magazine having a fastener ejection ring configured to project a plurality of tissue-piercing elements of one or more fasteners in the shape of a closed curve from said fastener magazine; and b) an anvil configured to act as a counterpoise during said projection of said tissue-piercing elements which comprises an anvil head including an anvil head top surface having a shape of a closed-curve and a size substantially similar to that of said fastener ejection ring, said anvil configured to be reversibly secured to said device body through a stem surrounded by said fastener ejection ring, so that when secured, said anvil head surface is opposite said fastener ejection ring wherein said anvil head comprises at least two mateable anvil head parts, wherein each said mateable anvil head part spans a sector of said closed curve of said anvil head. - View Dependent Claims (2)
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- 3. An anvil for a surgical fastening device useful for securing a cardiac valve to an implant, comprising at least two mateable anvil head parts that when mated said anvil head parts constitute an anvil head that is substantially a closed curve including an anvil head top surface, wherein each said mateable anvil head part spans a sector of said closed curve, and a width of said mateable anvil head part is less than half of a radius of said closed curve.
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13-37. -37. (canceled)
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38. A lockable fastener useful for securing the periphery of a cardiac valve to an implant material comprising:
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a) a loop-shaped body with a bottom side defining a lumen and describing at least a 320°
sector about an axis; andb) at least three elongated piercing elements protruding from said bottom side substantially parallel to said axis. - View Dependent Claims (39, 40, 41)
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42. A method of augmenting a membrane, comprising:
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a) slitting an in vivo membrane so as to produce a slit having a first slit edge and a second slit edge; b) providing a patch of tissue having a periphery as a membrane augmenting implant; c) placing said patch of tissue to define an overlap region comprising an overlap of a first portion of said periphery with said first slit edge and an overlap of a second portion of said periphery with said second slit edge; and d) securing said patch to said membrane around a plurality of locations of said overlap region substantially simultaneously, thereby augmenting said membrane by increasing a surface area of said membrane with said patch. - View Dependent Claims (47, 48)
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43-46. -46. (canceled)
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49. A method of augmenting the tissue surrounding a cardiac valve, comprising:
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a) excising leaflets of a cardiac valve with an incision having a shape of a closed curve so as to define a valve seat edge of said incision and a valve periphery edge of said incision; b) providing an implant including a wall, the wall delimited by two edges each in the shape of a closed curve and defining a lumen as a cardiac valve augmenting implant; c) placing said implant to define a proximal overlap region comprising an overlap of a first portion near a first edge of said implant with said valve seat edge d) placing said implant to define a distal overlap region comprising an overlap of a second portion near a second edge of said implant with said valve periphery edge; e) securing said first portion of said implant to said valve seat edge around a plurality of locations of said proximal overlap region; and f) securing said second portion of said implant to said valve periphery edge around a plurality of locations of said distal overlap region, substantially simultaneously thereby augmenting a surface area of tissue surrounding said cardiac valve with said implant. - View Dependent Claims (50, 51, 52, 53, 57, 58, 59)
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54-56. -56. (canceled)
Specification