TRICUSPID VALVE REPAIR USING TENSION

• US 20160367367A1
• Filed: 08/30/2016
• Published: 12/22/2016
• Est. Priority Date: 01/22/2010
• Status: Active Grant

• Current Assignee: 4Tech Inc.
• Original Assignee: 4Tech Inc.
• Inventors: MAISANO, Francesco, VANERMEN, Hugo, TOBIS, Idan
• Granted Patent: US 10,405,978 B2
• Time in Patent Office: Days
• US Class Current: 1/1
• 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 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 2017/00243 cardiac
• CPC Class Codes: A61B 2017/00407 Ratchet means
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0412 having anchoring barbs or pins extending outwardly from suture anchor body
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0437 the barbs being resilient or spring-like
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0443 the shaft being resilient and having a coiled or helical shape in the released state
• CPC Class Codes: A61B 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/048 for reducing heart wall tension, e.g. sutures with a pad on each extremity
• CPC Class Codes: A61B 2017/0488 Instruments for applying suture clamps, clips or locks for applying suture anchors A61B2017/0409; for applying wound clamps A61B17/10; for applying ligaturing clamps or clips A61B17/128
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/2442 Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
• CPC Class Codes: A61F 2/2454 Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2/246 Devices for obstructing a leak through a native valve in a closed condition
• CPC Class Codes: A61F 2/2487 : Devices within the heart chamber, e.g. splints
• CPC Class Codes: A61F 2/848 : having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/915 : with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2002/8483 : Barbs
• CPC Class Codes: A61F 2002/8486 : provided on at least one of the ends
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0054 : V-shaped

Abstract

A method is provided of reducing tricuspid valve regurgitation of a patient. A first tissue anchor is implanted at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient. A second tissue anchor is implanted at a second implantation site of the patient, different from the first implantation site. After the first and the second tissue anchors have been implanted, a longitudinal member that couples the first and the second tissue anchors together is longitudinally deflected.

Claims

1-88. -88. (canceled)

89. A method of reducing tricuspid valve regurgitation of a patient, comprising:

implanting a first tissue anchor at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient;

implanting a second tissue anchor at a second implantation site of the patient, different from the first implantation site; and

after implanting the first and the second tissue anchors, laterally deflecting a longitudinal member that couples the first and the second tissue anchors together.

90. The method according to claim 89, wherein laterally deflecting the longitudinal member occurs after the longitudinal member has been drawn taut between the first and the second tissue anchors.

91. The method according to claim 89, wherein laterally deflecting comprises implanting a third tissue anchor at a third implantation site of the patient.

92. The method according to claim 91, wherein the third implantation site comprises the vicinity of the tricuspid valve of the patient.

93. The method according to claim 92, wherein the third implantation site comprises the annulus of the tricuspid valve.

94. The method according to claim 89, wherein the first or second implantation site comprises the annulus of the tricuspid valve.

95. The method according to claim 89, wherein the first or second implantation site comprises the vena cava.

96. The method according to claim 89, wherein the first or second tissue anchor comprises an expandable stent.

97. The method according to claim 89, wherein laterally deflecting the longitudinal member comprises increasing tension on the longitudinal member while laterally deflecting the longitudinal member.

98. The method according to claim 89, wherein laterally deflecting the longitudinal member modifies an angle between (a) a longitudinal portion of the longitudinal member and (b) a tricuspid valve plane generally defined by the annulus of the tricuspid valve.

99. The method according to claim 98, wherein the vertex of the angle is at the first tissue anchor.

100. The method according to claim 98, wherein laterally deflecting the longitudinal member reduces the angle.

101. The method according to claim 98, wherein laterally deflecting the longitudinal member increases the angle.

102. The method according to claim 98, further comprising maintaining the modified angle by implanting a third tissue anchor at a third implantation site.

103. The method according to claim 98, wherein the angle is a first angle, and the longitudinal portion is a first longitudinal portion, the method further comprising modifying a second angle between the first longitudinal portion and a second longitudinal portion of the longitudinal member.

104. The method according to claim 89, wherein laterally deflecting the longitudinal member modifies an angle between first and second longitudinal portions of the longitudinal member.

105. The method according to claim 104, further comprising maintaining the modified angle by implanting a third tissue anchor at a third implantation site.

106. The method according to claim 89, wherein laterally deflecting the longitudinal member comprises deflecting a portion of the longitudinal member closer to the tricuspid valve.

107. The method according to claim 89, wherein laterally deflecting the longitudinal member comprises applying a lateral force to a site along the longitudinal member other than at ends thereof.

108. The method according to claim 89, wherein laterally deflecting the longitudinal member comprises laterally pulling the longitudinal member.

109. A method of reducing tricuspid valve regurgitation of a patient, comprising:

implanting a first tissue anchor at a first implantation site in cardiac tissue in the vicinity of the tricuspid valve of the patient;

implanting a second tissue anchor at a second implantation site of the patient;

using a longitudinal member that couples the first and the second tissue anchors together, applying tension between the first and the second tissue anchors to alter the geometry of the tricuspid valve;

after applying the tension, implanting a third tissue anchor at a third implantation site in cardiac tissue in the vicinity of the tricuspid valve, the first, the second, and the third implantation sites different from one another; and

further altering the geometry of the tricuspid valve using the third tissue anchor, so as to reduce the tricuspid valve regurgitation.

110. The method according to claim 109, wherein the first implantation site includes a portion of the annulus of the tricuspid valve.

111. The method according to claim 109, wherein the third implantation site includes a portion of the annulus of the tricuspid valve.