Apparatus and method for delivering fasteners during valve replacement

Abstract

A fastener delivery tool includes a loading chamber for receiving a fastener having a pair of tines overlapping one another to define a loop in a parent or relaxed state. A retaining member retains the fastener in the loading chamber. The fastener delivery tool also includes a tongue, pusher member, and an ejection track communicating with the loading chamber. An actuator causes the tongue to move to engage the tines of the fastener to transform the fastener from the relaxed state to a constrained state defining a U-shape. The actuator also causes the pusher member to release the retaining member and advance the fastener down the ejection track in the constrained state. The tool also includes a trigger for ejecting the fastener completely from the ejection track. The fastener may be used to secure a prosthetic heart valve or components thereof into surrounding tissue, e.g., within a tissue annulus.

Description

FIELD OF THE INVENTION [0001] The invention relates generally to apparatus and methods for fastening devices to tissue or other devices, and, more particularly, to apparatus and methods for delivering fasteners during heart valve replacement, placement of other prostheses, or repair of body organs in general and vascular surgery, such as wound closure, anastomosis, hernia repair, and grafting procedures for aneurysm repair. BACKGROUND [0002] Prosthetic heart valves have been used to replace defective human valves in patients. A prosthetic valve generally includes a sewing ring or suture cuff that may be attached to and / or extend around a valve member. The sewing ring may be made from a biocompatible fabric and / or other material through which a needle and suture may pass. The sewing ring may be part of a single piece prosthetic valve, or may be part of a multiple piece prosthetic valve assembly. [0003] In a typical aortic valve replacement procedure, the aorta may be incised and the ...

AI Technical Summary

Benefits of technology

[0012] In still another embodiment, a fastener delivery tool is provided that includes a staging area or section in which a plurality of fasteners are loaded. The fasteners may be loaded individually or within a cartridge. Multiple fasteners may be loaded into the tool, thereby permitting the user to eject or “fire” multiple fasteners successively without having to reload between ejections.

Problems solved by technology

This procedure is time consuming as doctors often use three to ten knots per suture.

During heart valve replacement procedures, the patient may be on cardiopulmonary bypass (CPB), which may reduce the patient's oxygen level and / or create non-physiological blood flow dynamics.

The longer a patient is on CPB, the greater the risk for long-term or even permanent health damage.

Existing suturing techniques extend the duration of CPB and, consequently, increase the health risks due to the patient.

Sewing rings can also be tedious and time consuming to secure to a valve orifice.

To assemble multiple component heart valves, for example, one component has to be sewn into another in vivo, resulting in a complex and time consuming process.

The complexity of the procedure also provides a greater opportunity for mistakes and requires a patient to be on cardiopulmonary bypass for a lengthy period.

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