Adjustable artificial chordeae tendineae with suture loops

• US 8,790,394 B2
• Filed: 05/24/2010
• Issued: 07/29/2014
• Est. Priority Date: 05/24/2010
• Status: Active Grant

• Current Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Original Assignee: Valtech Cardio Ltd (Edwards Lifesciences Corporation)
• Inventors: Miller, Eran, Cabiri, Oz
• Primary Examiner(s): Sweet, Thomas J
• Assistant Examiner(s): SCHALL, MATTHEW WAYNE
• Application Number:
  US12/785,717
• Publication Number:
  US 20110288635A1
• Time in Patent Office: 1,527 Days
• Field of Search: 623/2.1
• US Class Current: 623/2.1
• 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 17/0482 Needle or suture guides guides for drills, pins or wire A61B17/17; for puncturing needles A61B17/3403
• CPC Class Codes: A61B 2017/00464 for use with different instruments with hole for different instruments A61B2017/22072
• CPC Class Codes: A61B 2017/0409 Instruments for applying suture anchors for applying suture clamps, clips or locks A61B2017/0488
• CPC Class Codes: A61B 2017/0414 having a suture-receiving opening, e.g. lateral opening lateral eyelet for attaching suture to needle A61B2017/06019
• CPC Class Codes: A61B 2017/0441 the shaft being a rigid coil or spiral
• CPC Class Codes: A61B 2017/0496 for tensioning sutures
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses

Abstract

Apparatus is provided, including an artificial-chordeae-tendineae-adjustment mechanism and at least one primary artificial chordea tendinea coupled at a distal portion thereof to the artificial-chordeae-tendineae-adjustment mechanism. A degree of tension of the at least one primary artificial chordea tendinea is adjustable by the artificial-chordeae-tendineae-adjustment mechanism. One or more loops are coupled at a proximal portion of the at least one primary artificial chordea tendinea. The one or more loops are configured to facilitate suturing of the one or more loops to respective portions of a leaflet of an atrioventricular valve of a patient. Other applications are also described.

Claims

1. Apparatus for use with a heart of a subject, the apparatus comprising an implant, the implant comprising:

an implantable artificial-chordeae-tendineae-adjustment mechanism, configured to be coupled to tissue that faces a ventricle of the heart of the subject;

at least one primary artificial chordea tendinea coupled at a distal portion thereof to the artificial-chordeae-tendineae-adjustment mechanism such that a degree of tension of the at least one primary artificial chordea tendinea is adjustable by the artificial-chordeae-tendineae-adjustment mechanism;

one or more loops coupled at a proximal portion of the at least one primary artificial chordea tendinea, the one or more loops being configured to facilitate suturing of the one or more loops to respective portions of a leaflet of an atrioventricular valve of a patient; and

an anchor, configured to be coupled to tissue of the heart, and to be coupled, via the implantable artificial-chordeae-tendineae-adjustment mechanism, to the at least one primary artificial chordea tendinea, wherein;

the artificial-chordeae-tendineae-adjustment mechanism comprises a spool,

the at least one primary artificial chordea tendinea is coupled to the spool, and

the spool is bidirectionally rotatable to adjust the degree of tension of the at least one primary artificial chordea tendinea.

2. The apparatus according to claim 1, further comprising one or more sutures configured to suture the one or more loops to the respective portions of the leaflet.

3. The apparatus according to claim 1, wherein the at least one primary artificial chordea tendinea is shaped as a continuous loop.

4. The apparatus according to claim 1, wherein:

the one or more loops comprises a plurality of loops,

the apparatus further comprises a plurality of sutures, and

each loop of the plurality of loops is configured to facilitate suturing of each suture of the plurality of sutures to a respective portion of the leaflet.

5. The apparatus according to claim 1, wherein the distal portion of the at least one primary artificial chordea tendinea is coupled to the artificial-chordeae-tendineae-adjustment mechanism by being looped through a portion of the artificial-chordeae-tendineae-adjustment mechanism.

6. The apparatus according to claim 1, further comprising a coupling element configured to couple the one or more loops to the proximal portion of the at least one primary artificial chordea tendinea.

7. The apparatus according to claim 6, wherein the coupling element is shaped so as to define a lumen, and wherein the proximal portion of the at least one primary artificial chordea tendinea and the one or more loops are looped through the lumen of the coupling element.

8. The apparatus according to claim 1, wherein the at least one primary artificial chordea tendinea is configured to be wound around spool during the rotation of the spool in a first direction thereof.

9. The apparatus according to claim 1, further comprising a locking mechanism displaceable with respect to the spool so as to:

release the spool during rotation of the spool, and

lock in place the spool following rotation of the spool.

10. The apparatus according to claim 1, wherein the distal portion of the at least one primary artificial chordea tendinea is looped through a portion of the spool.

11. The apparatus according to claim 10, wherein the distal portion of the at least one primary artificial chordea tendinea is wound around a portion of the spool, and wherein the distal portion of the at least one primary artificial chordea tendinea is configured to be unwound from around the portion of the spool following the suturing of the one or more loops to the respective portions of the leaflet.

12. The apparatus according to claim 1, wherein:

first and second portions of the at least one primary artificial chordea tendinea extend from the artificial-chordeae-tendineae-adjustment mechanism,

a portion between the first and second portions of the at least one primary artificial chordea tendinea defines the distal portion of the at least one primary artificial chordea tendinea,

the first and second portions of the at least one primary artificial chordea tendinea each have free ends which define the proximal portion of the at least one primary artificial chordea tendinea,

the one or more loops comprise one or more first loops and one or more second loops,

the free end of the first portion of the at least one primary artificial chordea tendinea is coupled to the one or more first loops, and

the free end of the second portion of the at least one primary artificial chordea tendinea is coupled to the one or more second loops.

13. The apparatus according to claim 12, wherein the one or more first loops facilitate suturing of the one or more first loops to a first leaflet of the atrioventricular valve, and wherein the one or more second loops facilitate suturing of the one or more second loops to the first leaflet of the atrioventricular valve.

14. The apparatus according to claim 12, wherein the one or more first loops facilitate suturing of the one or more first loops to a first leaflet of the atrioventricular valve, and wherein the one or more second loops facilitate suturing of the one or more second loops to a second leaflet of the atrioventricular valve.

15. The apparatus according to claim 14 , wherein the artificial-chordeae-tendineae-adjustment mechanism is configured to adjust a distance between the first and second leaflets by adjusting the first and second portions of the at least one primary artificial chordea tendinea.