MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT

• US 20110082539A1
• Filed: 10/05/2010
• Published: 04/07/2011
• Est. Priority Date: 10/05/2009
• Status: Active Grant

• Current Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Original Assignee: Mayo Foundation For Medical Education And Research (Mayo Clinic)
• Inventors: Suri, Rakesh M.
• Granted Patent: US 8,808,369 B2
• Time in Patent Office: Days
• US Class Current: 623/2.11
• CPC Class Codes: A61B 2017/3466 for simultaneous sealing of multiple instruments
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/243 Deployment by mechanical expansion
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0054 V-shaped

Abstract

A minimally invasive method of implanting a prosthetic aortic valve includes forming a surgical site within a patient'"'"'s chest that includes a first access port, a second access port, a viewing port and a delivery port. A camera is inserted into the viewing port. The native aortic valve leaflets may each be grasped and removed via tools inserted through the first and second access ports. The prosthetic aortic valve may be delivered through the delivery port to the valve annulus using a delivery device. The prosthetic aortic valve is implanted at the valve annulus and the delivery device is withdrawn. A surgeon may perform the remotely operated steps while viewing images provided by the camera.

Claims

1. A minimally invasive method of implanting a self-expanding prosthetic aortic valve in a valve annulus, the method comprising the steps of:

forming a surgical site within a patient'"'"'s chest, the surgical site including a first access port, a second access port, a viewing port and a delivery port;

inserting a camera into the viewing port;

grasping each of the native aortic valve leaflets with a remotely operated tissue grasping device inserted into one of the first and second access ports;

excising each of the grasped native aortic valve leaflets with a remotely operated cutting device inserted into another of the first and second access ports;

delivering the self-expanding prosthetic aortic valve to the valve annulus through the delivery port using a delivery device;

implanting the self-expanding prosthetic aortic valve at the valve annulus; and

withdrawing the delivery device;

wherein a surgeon performs the remotely operated steps while viewing images provided by the camera.

2. The method of claim 1, further comprising a step, prior to valve delivery, of suturing guide lines to tissue proximate the valve annulus.

3. The method of claim 2, further comprising a step, prior to valve delivery, of attaching the guide lines to the self-expanding prosthetic aortic valve to rotationally locate the self-expanding prosthetic aortic valve relative to the valve annulus.

4. The method of claim 1, further comprising a step, after inserting the camera, of remotely transecting the patient'"'"'s aorta to gain access to the native aortic valve.

5. The method of claim 4, wherein the step of remotely transecting the patient'"'"'s aorta comprises cutting the aorta with the remotely operated cutting device.

6. The method of claim 1, further comprising a step, subsequent to withdrawing the delivery device, of remotely suturing the transected aorta.

7. The method of claim 1, wherein the step of implanting the self-expanding prosthetic aortic valve using the delivery device comprises using the delivery device to position and subsequently expand the self-expanding prosthetic aortic valve.

8. The method of claim 1, wherein the surgeon performs the remotely operated steps by manipulating a control device that translates the surgeon'"'"'s hand movements into operational commands for the remotely operated devices.

9. The method of claim 8, wherein the control device also scales the surgeon'"'"'s hand movements.

10. A minimally invasive method of robotically replacing a patient'"'"'s native aortic valve with a self-expanding prosthetic aortic valve by operating one or more master input devices that provide commands to a plurality of slave tools, the method comprising the steps of:

providing access to the native aortic valve having a valve annulus;

grasping each of the native aortic valve leaflets with one of the plurality of slave tools;

excising each of the grasped native aortic valve leaflets with another of the plurality of slave tools; and

implanting the self-expanding prosthetic aortic valve at the valve annulus.

11. The method of claim 10, wherein the step of providing access to the native aortic valve comprises performing an aortotomy with another of the plurality of slave tools.

12. The method of claim 10, wherein a surgeon operates the one or more master input devices while viewing the surgical site via displayed images provided by a camera disposed within the surgical site.

13. The method of claim 10, wherein movement of the one or more master input devices are translated into commands for the plurality of slave tools.

14. The method of claim 10, wherein the step of implanting the self-expanding prosthetic aortic valve with another of the plurality of slave tools comprises implanting the self-expanding prosthetic aortic valve with a slave tool that is configured to hold the self-expanding prosthetic aortic valve in a collapsed position for delivery and subsequently permit expansion of the self-expanding prosthetic aortic valve.

15. A minimally invasive method of performing an aortic valve replacement procedure, the method comprising the steps of:

establishing surgical access including a working port, a delivery port and a viewing port;

inserting a camera through the viewing port;

removing valve leaflets using a removal device inserted through the working port;

attaching at least one suture at the valve annulus at a location near a center of a Valsalva sinus;

delivering a prosthetic valve over the suture, the prosthetic valve having a protrusion adapted to conform to the Valsalva sinus; and

implanting the prosthetic valve at the valve annulus such that the protrusion is located in the Valsalva sinus.