Axially-shortening prosthetic valve

• US 9,788,941 B2
• Filed: 02/19/2015
• Issued: 10/17/2017
• Est. Priority Date: 03/10/2010
• Status: Active Grant

• Current Assignee: Cardiovalve Ltd.
• Original Assignee: Mitraltech Ltd.
• Inventors: Hacohen, Gil
• Primary Examiner(s): Woznicki, Jacqueline
• Application Number:
  US14/626,267
• Publication Number:
  US 20150157457A1
• Time in Patent Office: 971 Days
• Field of Search: 623 21- 219
• 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 2017/00243 cardiac
• 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 2017/0464 for soft tissue
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61F 2/2409 Support rings therefor, e.g. for connecting valves to tissue annuloplasty rings A61F2/2442
• CPC Class Codes: A61F 2/2418 Scaffolds therefor, e.g. support stents
• CPC Class Codes: A61F 2/2427 Devices for manipulating or deploying heart valves during implantation
• CPC Class Codes: A61F 2/2436 Deployment by retracting a sheath
• CPC Class Codes: A61F 2/2457 Chordae tendineae prostheses
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/005 Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0054 V-shaped
• CPC Class Codes: A61F 2230/0078 hyperboloidal
• CPC Class Codes: A61F 2250/0063 Nested prosthetic parts

Abstract

Apparatus and methods are described including a prosthetic atrioventricular valve (10) for coupling to a native atrioventricular valve (12). The prosthetic valve includes a support frame (20) and a covering (22), which at least partially covers the support frame. The support frame and the covering are shaped so as to define a downstream skirt (24). A plurality of prosthetic leaflets (40) are coupled to at least one element selected from the group consisting of: the support frame and the covering. An elongated anchoring member (152) is positioned around the downstream skirt in a subvalvular space (150), such that the anchoring member presses native leaflets (30) of the native valve against the downstream skirt, thereby anchoring the prosthetic valve to the native valve. Other applications are also described.

Claims

1. A method for use at an atrioventricular valve disposed between an atrium and a ventricle of a heart of a subject, the method comprising:

transluminally advancing a catheter to the heart;

via the catheter, advancing to the heart a prosthetic valve including;

an upstream annular skirt,

a downstream skirt having a first portion and a second portion, the first portion defining a lumen therethrough, and the second portion defining a plurality of anchoring arms that are coupled to the second portion, and

a plurality of prosthetic leaflets attached to the first portion and disposed within the lumen;

expanding the upstream annular skirt in the atrium and expanding the anchoring arms in the ventricle such that the anchoring arms extend radially outward and toward the upstream skirt; and

subsequently, squeezing tissue of the atrioventricular valve between the upstream annular skirt and the anchoring arms by causing the second portion to slide longitudinally along the outside of the first portion and with respect to the prosthetic leaflets, such that the anchoring arms move longitudinally toward the upstream skirt.

2. The method according to claim 1, wherein expanding the anchoring arms in the ventricle such that the anchoring arms extend radially outward and toward the upstream skirt comprises extending the anchoring arms in the ventricle such that the anchoring arms extend from a downstream portion of the downstream skirt.

3. The method according to claim 2, wherein extending the anchoring arms in the ventricle such that the anchoring arms extend from a downstream portion of the downstream skirt comprises extending the anchoring arms in the ventricle such that the anchoring arms extend from a downstream end of the downstream skirt.

4. The method according to claim 1, wherein causing the second portion to slide longitudinally along the outside of the first portion comprises causing the prosthetic valve to move from an extended, unlocked state into a contracted, locked state.

5. The method according to claim 1, wherein the downstream skirt defines a plurality of ratchet teeth, and causing the second portion to slide longitudinally along the outside of the first portion comprises causing mating between ratchet teeth of the plurality of ratchet teeth.

6. The method according to claim 1, wherein the upstream annular skirt includes a plurality of skirt arms, and expanding the upstream support portion in the atrium comprises expanding the upstream support portion in the atrium such that the plurality of skirt arms extend radially outward.

7. The method according to claim 6, wherein each skirt arm is aligned with a respective one of the anchoring arms, and causing the second portion to slide longitudinally along the outside of the first portion comprises causing each skirt arm to become closer to its respective one of the anchoring arms.

8. The method according to claim 1, wherein causing the second portion to slide longitudinally along the outside of the first portion comprises using a tool to apply (i) an upstream force to the downstream skirt, and (ii) a downstream force to the upstream skirt.

9. The method according to claim 8, further comprising expanding an upstream adapter of the tool, and expanding a downstream adapter of the tool, wherein using a tool to apply the upstream force and the downstream force comprises (i) using the downstream adapter to apply the upstream force to the downstream skirt, and (ii) using the upstream adapter to apply the downstream force to the upstream skirt.

10. The method according to claim 4, wherein the method further comprises, subsequently to expanding the upstream annular skirt in the atrium and expanding the anchoring arms in the ventricle, transluminally advancing the tool to the prosthetic valve.

11. The method according to claim 10, wherein transluminally advancing the tool to the prosthetic valve comprises transluminally advancing the downstream adapter through the lumen of the first portion.