Minimally invasive aortic valve replacement

• US 8,808,369 B2
• Filed: 10/05/2010
• Issued: 08/19/2014
• 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.
• Primary Examiner(s): McDermott, Corrine M
• Assistant Examiner(s): OU, JING RUI
• Application Number:
  US12/897,937
• Publication Number:
  US 20110082539A1
• Time in Patent Office: 1,414 Days
• Field of Search: 623/2.11, 623/2.1, 623/21.7, 623/2.14, 623/1.11, 623/1.23, 623/1.24, 623/904, 623/2.38, 623/2.39, 623/2.4, 128/898
• 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 The prosthetic aortic valve is implanted at the valve annulus and the delivery device is withdrawn.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, the camera adapted to provide images from within the surgical site in order to guide subsequent remotely operated steps;

remotely 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;

remotely 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;

remotely attaching sutures to tissue proximate the valve annulus, each suture at a location near a center of a corresponding one of a plurality of Valsalva sinuses;

attaching the sutures to the self-expanding prosthetic aortic valve, the self-expanding prosthetic aortic valve including several protrusions, each protrusion adapted to conform to a corresponding Valsalva sinus;

remotely delivering the self-expanding prosthetic valve to the valve annulus through the delivery port using a delivery device, the self-expanding prosthetic valve advancing along the sutures to rotationally locate the self-expanding prosthetic aortic valve relative to the valve annulus such that each protrusion is located within the corresponding Valsalva sinus;

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

remotely withdrawing the delivery device.

2. 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.

3. The method of claim 2, wherein the step of remotely transecting the patient'"'"'s aorta comprises cutting the aorta with the remotely operated cutting device.

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

5. 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.

6. The method of claim 1, wherein at least some of the remotely performed steps are performed by a surgeon manipulating a control device that translates the surgeon'"'"'s hand movements into operational commands for the remotely operated devices.

7. The method of claim 6, wherein the control device also scales the surgeon'"'"'s hand movements.

8. 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, the camera adapted to provide images from within the surgical site in order to guide subsequent remotely operated steps;

remotely 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;

remotely 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;

remotely attaching sutures to tissue proximate the valve annulus, each suture at a location near a center of a corresponding one of a plurality of Valsalva sinuses;

attaching the sutures to the self-expanding prosthetic aortic valve, the self-expanding prosthetic aortic valve including several protrusions, each protrusion adapted to conform to a corresponding Valsalva sinus;

advancing the self-expanding prosthetic valve to the valve annulus through the delivery port using a delivery device, the self-expanding prosthetic valve advancing along the sutures to rotationally locate the self-expanding prosthetic aortic valve relative to the valve annulus such that each protrusion is located within the corresponding Valsalva sinus; and

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

9. The method of claim 8, further comprising a step, after inserting the camera, of remotely transecting the patient'"'"'s aorta to gain access to the native aortic valve.

10. The method of claim 9, wherein the step of remotely transecting the patient'"'"'s aorta comprises cutting the aorta with the remotely operated cutting device.

11. The method of claim 8, further comprising a step of remotely suturing the transected aorta.

12. The method of claim 8, wherein at least some of the remotely performed steps are performed by a surgeon manipulating a control device that translates the surgeon'"'"'s hand movements into operational commands for the remotely operated devices.

13. The method of claim 12, wherein the control device also scales the surgeon'"'"'s hand movements.