38 results about "Atrioventricular valve" patented technology

An implant for implantation at a native atrioventricular valve of a subject, includes a frame assembly, including a valve frame and an outer frame coupled to each other. The valve frame includes a tubular portion that circumscribes a longitudinal axis of the valve frame so as to define a lumen along the axis, and an upstream support portion including a plurality of arms. Each arm extends radially outward from the tubular portion to engage tissue in the atrium. The outer frame includes a ring that circumscribes the tubular portion, and a plurality of ventricular anchors that extend radially outward from the ring and are configured to anchor the implant to tissue of the ventricle. In an expanded state of the frame assembly, the implant defines a toroidal space between the plurality of ventricular anchors and the upstream support portion. Other embodiments are also described.

Methods and devices for reducing ventricle filling volume are disclosed. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to reduce ventricle filling volume or even blood pressure. When the heart is stimulated in a consistent way to reduce blood pressure, the cardiovascular system may over time adapt to the stimulation and revert back to the higher blood pressure. In some embodiments, the stimulation pattern may be configured to be inconsistent such that the adaptation response of the heart is reduced or even prevented. In some embodiments, an electrical stimulator may be used to stimulate a patient's heart to cause at least a portion of an atrial contraction to occur while the atrioventricular valve is closed. Such an atrial contraction may deposit less blood into the corresponding ventricle than when the atrioventricular valve is opened throughout an atrial contraction.

Systems for replacing the function of a native atrioventricular valve are described. The systems can include a prosthetic heart valve including a self-expanding frame and a plurality of leaflets. The systems can include a delivery catheter having an elongate shaft for advancing the prosthetic heart valve through a patient's vasculature to the native atrioventricular valve, the elongate shaft including a capsule along a distal end portion of the elongate shaft for maintaining the prosthetic heart valve in a compressed state. A tether assembly can extend through the elongate shaft of the delivery catheter and can include loop portions. A release assembly can include a plurality of flexible release tethers that are retractable for removal from the loop portions and thereby allowing the tether assembly to be released from the prosthetic heart valve.

A device for connecting artificial chordae tendineae to the leaflets of an atrioventricular valve, the device comprising: a neochord delivery system comprising a manipulable and pushable catheter that houses a neochord attached to a neochord puncture needle, the catheter being operable to push the puncture needle to puncture and pass the neochord through the papillary muscle of the ventricle; a retriever system comprising a catheter that houses a grasper that is operable to capture the neochord puncture needle after it passes through the papillary muscle and remove the neochord puncture needle and the neochord from the ventricle; and a tissue clamping system comprising a catheter that houses a distal tissue clamp and a proximal tissue clamp that can be deployed to clamp and hold the area of ​​the atrioventricular valve located therebetween so that the area can be punctured by the puncture needle to deliver the neochord through the leaflets and to the papillary muscle.

The present invention discloses a self-expanding atrioventricular valve prosthesis device, comprising: a main body portion, which is a frame structure, and the main body portion is implanted at the native valve annulus of the heart. The main body portion includes an inflow section, an outflow section and a transition section. The inflow section is located at the atrial end, the outflow section is located at the ventricular end, and the transition section is located between the inflow section and the outflow section; it further includes at least one artificial valve leaf, which is fixed to the transition section of the main body portion, and the artificial valve leaf is provided with a connecting portion; it further includes a chordae tendineae portion, one end of which is fixed, and the other end is connected to the artificial valve leaf through the connecting portion. The present invention restricts the movement range of the artificial valve leaf through the chordae tendineae portion, and the connecting portion prevents the chordae tendineae portion from tearing and stress concentration on the valve leaf, thereby increasing the durability of the artificial valve leaf.

The application provides a valve anchoring device, a guide device and a method for anchoring a prosthetic valve, mainly comprising an anchoring structure and a positioning member, wherein the anchoring structure has a first anchoring member and a second anchoring member extending from both sides of a combination member, the positioning member is connectable to the combination member, the combination member passes through a commissure of a leaflet of a heart tissue, the positioning member is positioned at one side of a heart atrioventricular valve adjacent to an atrium, the first anchoring member and the second anchoring member are positioned at one side of the heart atrioventricular valve adjacent to a ventricle, and the first anchoring member and the second anchoring member are cooperatively matched to anchor the prosthetic valve, so that the prosthetic valve is positioned relative to a native valve of the heart tissue. Therefore, the anchoring effect of the prosthetic valve can be improved.

The present application provides a heart valve prosthesis, which has a first end and a second end opposite in a first direction; the heart valve prosthesis comprises a first support body, a second support body and an artificial valve leaflet; the first support body has a first edge and a second edge opposite in a second direction, which is perpendicular to the first direction; the second support body comprises a first segment, which is located on one side of the first support body and has a non-linear configuration; the first segment intersects the first edge at a first intersection point and intersects the second edge at a second intersection point; the second support body is connected with the first support body and allows the first segment to rotate relative to the first support body around a line connecting the first intersection point and the second intersection point; the artificial valve leaflet is connected with the edge of the second support body located on the side close to the first end and the first segment; the heart valve prosthesis has a contracted state and an expanded state; when the heart valve prosthesis switches from the contracted state to the expanded state, the first segment rotates and drives the middle part of the first segment to move in the direction close to the first end, and the distance between the middle part of the first segment and the first support body increases; when the heart valve prosthesis is in the expanded state, the area of the cross section of the artificial valve prosthesis perpendicular to the first direction first increases and then decreases along the first direction. The heart valve prosthesis can replace the native atrioventricular valve and / or the native arterial valve and has a larger effective valve orifice area.

The invention provides a heart implant, a delivery assembly and a heart implant system.The heart implant comprises a valve prosthesis and an anchoring nail, the anchoring nail can nail the valve prosthesis on a native tissue of an atrioventricular valve, on one hand, anchoring of the valve prosthesis in the heart is achieved, the problems of falling, shifting, twisting and the like of the valve prosthesis are avoided, and the heart implant delivery efficiency is improved; on the other hand, the compression of the valve prosthesis on the native tissue of the heart is greatly reduced so as to solve a series of problems such as ventricular structure remodeling caused by the valve prosthesis anchored through radial force, and on the other hand, the fitting gap between the valve prosthesis and the native tissue can be reduced, the sealing performance of the perivalvular is improved, the perivalvular leakage is reduced, and the heart safety is improved. On the other hand, when the valve prosthesis is nailed on the valve ring of the atrioventricular valve through the anchoring nail, the valve prosthesis is allowed to have a small axial height, and therefore the height of the valve prosthesis below the valve is reduced, and blocking of the valve prosthesis to blood entering the ventricular outflow tract is reduced.

A heart valve prosthesis for replacing a native atrioventricular valve of the heart. The prosthesis includes a housing component that is configured to be radially expandable and compressible between a radially compressed state and a radially expanded state to engage structure of the native atrioventricular valve to fix the housing component relative to the native atrioventricular valve. The housing component includes a housing body and an annular sealing element connected to an atrial end of the housing body. The annular sealing element is made of polyester and is reinforced with wire. A valve component is configured to be radially expandable and compressible between a radially compressed state and a radially expanded state within the housing component. The valve component includes a valve body having a valve passage extending therethrough and three leaflets made from pericardium secured to the valve body.

Apparatus for use with an annuloplasty ring (20), and an atrioventricular valve of a heart of a mammalian subject. A plurality of chord-manipulation arms (26) each include a flexible material and a stiffening element (70), the stiffening elements being configured to provide desired shapes to the chord-manipulation arms (26), when the chord-manipulation arms are disposed in non-radially constrained configurations. The chord-manipulation arms (26) are configured to be deployed among chords of the atrioventricular valve, and subsequently, to cause a size of the valve annulus to decrease, by the chord-manipulation arms (26) being rotated such as to twist the native atrioventricular valve and pull the native atrioventricular valve radially inwards. The stiffening elements (70) are configured to be removed from the flexible material of the chord-manipulation arms and / or de-stiffened, such as to facilitate removal of the chord-manipulation arms (26) from among the chords. Other applications are also described.

The invention discloses a guiding sheath tube and a transcatheter atrioventricular valve repair system. The guiding sheath tube comprises a sheath tube body and an operating handle. The sheathing canal body comprises a main body section, a far-end section and a bending adjusting section located between the main body section and the far-end section, and the bending adjusting section comprises a first controllable section and a second controllable section which can be driven to bend. The operating handle comprises a first driving mechanism, a second driving mechanism and a third driving mechanism, the first driving mechanism is used for driving the first controllable section to bend, the second driving mechanism is used for driving the second controllable section to bend, and the third driving mechanism is used for driving the sheathing canal body to rotate. The guide sheath tube and the transcatheter atrioventricular valve repair system are flexible in operation and more suitable for complex atrioventricular valve repair operations.

The invention provides a valve replacement system which is used for replacing a native atrioventricular valve and comprises a butt joint device, an anchoring device and a valve prosthesis. The docking device is configured to be positioned through the anchoring and locking device and provide an accommodating cavity; the anchoring and locking device comprises a plurality of anchoring pieces, a plurality of locking pieces and a plurality of flexible linear pieces, wherein the number of the locking pieces is the same as that of the anchoring pieces, and the number of the flexible linear pieces is the same as that of the anchoring pieces. In the deployment completion state, one end of a linear piece is correspondingly and fixedly connected with an anchoring piece, and the other end of the linear piece penetrates through the butt joint device and then is correspondingly and fixedly connected with a locking piece; at least one anchoring piece is anchored into ventricular tissue, and at least another anchoring piece is anchored into annulus tissue or atrial tissue; the linear piece is tensioned by the anchoring piece and the locking piece which are correspondingly located on the two opposite sides of the butt-joint device, so that the butt-joint device is pressed against the native valve ring to be positioned; the valve prosthesis is arranged in the containing cavity of the butt joint device in a penetrating mode and is reliably fixed by the butt joint device.

A method for treating a patient includes delivering a distal portion of an elongate medical device into a ventricle of a beating closed heart of a subject via a primary skin opening and a secondary puncture, utilizing the distal portion of the elongate medical device to engage a plurality of chordae tendineae extending from a first papillary muscle within the ventricle, at least a first one of the plurality of chordae tendineae attached to a first leaflet of an atrioventricular valve located between the ventricle and an adjacent atrium, and at least a second one of the plurality of chordae tendineae attached to a second leaflet of the atrioventricular valve, approximating the engaged plurality of chordae tendineae to increase an amount of closure possible between the first leaflet and the second leaflet, and locking the plurality of chordae tendineae in their approximated condition.

A method for treating a patient includes delivering a distal portion of an elongate medical device into a ventricle of a beating closed heart of a subject via a primary skin opening and a secondary puncture, utilizing the distal portion of the elongate medical device to engage a plurality of chordae tendineae extending from a first papillary muscle within the ventricle, at least a first one of the plurality of chordae tendineae attached to a first leaflet of an atrioventricular valve located between the ventricle and an adjacent atrium, and at least a second one of the plurality of chordae tendineae attached to a second leaflet of the atrioventricular valve, approximating the engaged plurality of chordae tendineae to increase an amount of closure possible between the first leaflet and the second leaflet, and locking the plurality of chordae tendineae in their approximated condition.

A method and apparatus for treatment of hypertension and heart failure by increasing vagal tone and secretion of endogenous atrial hormones by excitory pacing of the heart atria. Atrial pacing is done during the ventricular refractory period resulting in atrial contraction against closed AV valves, and atrial contraction rate that is higher than the ventricular contraction rate. Pacing results in the increased atrial wall stress. An implantable device is used to monitor ECG and pace the atria in a nonphysiologic manner.

Devices and methods for reducing atrioventricular heart valve regurgitation. Some implementations include a compressible and expandable spacer with a proximal end and a distal end and sized to fit within coapt against the leaflets of the atrioventricular valve to reduce regurgitation therebetween. The spacer has a compressed delivery configuration and a radially expanded implant configuration. Supra-annular anchoring arms connect to the proximal end of the spacer via a malleable central mount extending axially from the spacer. The anchoring arms extend outward from a proximal end of the central mount sufficiently far to reach the atrioventricular annulus. Each anchoring arm terminates in a tissue anchor, wherein the central mount has one or more plastically-deformable components such that a position of the spacer relative to the atrioventricular annulus may be adjusted from leaflet contact therewith.

Method and apparatus for treating prolapse of an atrioventricular valve. An implant (30) is delivered by catheter (32) into the heart, the implant configured to attach to a native chordae tendineae (20) and to shorten the functional length of the native chordae tendineae.

A heart valve prosthesis for replacing a native atrioventricular valve of the heart. The prosthesis includes a housing component that is configured to be radially expandable and compressible between a radially compressed state and a radially expanded state to engage structure of the native atrioventricular valve. The housing component includes a housing body. A valve component is configured to be radially expandable and compressible between a radially compressed state and a radially expanded state within the housing component. The valve component includes a valve body. The valve body has an atrial end that protrudes beyond an atrial end of the housing body and has a diameter that is greater than a diameter of a ventricular end of the valve body such that the atrial end of the valve body expands into an atrium of the heart.

An assembly for the tricuspid orifice of a human heart has an external frame connected to an internal stent carrying a tricuspid valve bioprosthesis and a sealing skirt. The external frame is configured to hold its position in the native tricuspid annulus. The internal stent is connected to the external frame by one or more fixing strands. The sealing skirt covers the interstitial space existing between the external frame and the internal stent. Developments are described which include the use of a deformable region of the frame, various alternative embodiments of the sealing skirt, the use of a frame composed of multiple sub-sections, the use of fixing strands between the stent and the frame and of fixing elements for fixing the assembly to the native tissue, the use of sensors and / or actuators, and also the use of a stent in the inferior vena cava. Method aspects are also described.

A system for replacing the function of a native atrioventricular valve includes a prosthetic heart valve and a steerable delivery catheter. A capsule or sheath is provided along a distal end portion of the delivery catheter to maintain the prosthetic heart valve in a compressed state during advancement through the vascular system. A tether assembly includes an attachment tether adapted to extend through the delivery catheter and pass through an opening in the prosthetic heart valve. A release assembly includes a release tether for securing the attachment tether to the prosthetic heart valve. The release tether is retractable to detach the attachment tether from the prosthetic heart valve. The prosthetic heart valve can be released from the capsule and, while attached to the tether assembly, can expand and operate as a one-way valve. The prosthetic heart valve can then be detached from the tether assembly after confirming proper deployment.

A system for replacing the function of a native atrioventricular valve includes a prosthetic heart valve and a steerable delivery catheter. A balloon or sheath is disposed along the distal portion of the delivery catheter for maintaining the prosthetic heart valve in a compressed state during advancement through the vasculature. The tether assembly extends through the delivery catheter and includes a coupling tether adapted to pass through an opening in the prosthetic heart valve. The release assembly includes a release tether for locking the coupling tether to the prosthetic heart valve. The release tether is retractable for detaching the coupling tether from the prosthetic heart valve. The prosthetic heart valve may be released from the balloon and allowed to expand and operate as a one-way valve while still being attached to the tether assembly. The prosthetic heart valve may then be detached from the tether assembly after confirming proper deployment.

Apparatus and methods are described for use at an atrioventricular valve of a heart of a subject, the atrioventricular valve including a valve annulus, valve leaflets, chords, and papillary muscles. An annuloplasty ring is configured to be implanted on an atrial side of the atrioventricular valve. A plurality of chord-manipulation arms are configured to be deployed among the chords of the atrioventricular valve, and, subsequently, in response to being rotated, to cause a size of the valve annulus to decrease, by twisting the native atrioventricular valve and pulling the native atrioventricular valve radially inwards, by the chord-manipulation arms deflecting the chords. Subsequently, the chord-manipulation arms are configured to provide a counterforce against which the annuloplasty ring can be pushed, during implantation of the annuloplasty ring. Other applications are also described.

The present invention relates to an atrioventricular valve prosthesis that can be implanted in, for example, the heart of a mammal. The heart valve prosthesis comprises a foldable and expandable tubular stent having a lumen, the lumen having, preferably during use of the stent or when fully expanded, an opening cross-sectional area or opening area smaller than the opening area of ​​the natural atrioventricular valve replaced by the heart valve prosthesis. The heart valve prosthesis further comprises an internal valve leaflet positioned within the lumen of the tubular stent that closes the heart valve by abutting against each other, an external valve leaflet that closes against the natural valve leaflet, and at least one fixation suture directly or indirectly connected to the tubular stent. The present invention further relates to a method for manufacturing a heart valve prosthesis and a method for inserting a heart valve prosthesis.

Devices and methods for reducing atrioventricular heart valve regurgitation. Some implementations include a compressible and expandable spacer with a proximal end and a distal end and sized to fit within and to coapt against the leaflets of the atrioventricular valve to reduce regurgitation therebetween. The spacer has a compressed delivery configuration and a radially expanded implant configuration. Supra-annular anchoring arms connect to the proximal end of the spacer via a malleable central mount extending axially from the spacer. The anchoring arms extend outward from a proximal end of the central mount sufficiently far to reach the atrioventricular annulus. Each anchoring arm terminates in a tissue anchor, wherein the central mount has one or more plastically- deformable components such that a position of the spacer relative to the atrioventricular annulus may be adjusted from leaflet contact therewith.

A method for replacing a native atrioventricular heart valve includes inserting a delivery catheter into the heart with a prosthetic apparatus retained in a compressed state inside of the delivery catheter. The prosthetic apparatus includes an annular anchoring member having a mesh structure made of Nitinol and defining a plurality of circumferentially extending rows of cells. A fabric layer is attached to an inner surface of the anchoring member. An annular support member made of Nitinol is disposed within the anchoring member. The support member is attached to the anchoring member with sutures. A prosthetic valve made of biological tissue is disposed within and secured to the support member. The method further includes allowing the prosthetic apparatus to self-expand to a radially expanded state in which the anchoring member contacts tissue of the native atrioventricular valve.

Systems and methods for reducing ventricular filling volume are disclosed.SOLUTION: The stimulation circuit is used to stimulate the patient's heart to reduce ventricular filling volume or blood pressure. When the heart is stimulated to a certain degree to reduce the blood pressure, the cardiovascular system may eventually adapt to the stimulation and return to a higher blood pressure. The stimulation pattern may be inconsistently configured such that an adaptive response of the heart is reduced or prevented, and the stimulation circuitry may be used to stimulate the patient's heart to cause at least a portion of the atrial contraction with the atrioventricular valve closed. Such atrial contraction causes less blood to enter the corresponding ventricle than when the atrioventricular valve is open throughout atrial contraction.SELECTED DRAWING: Figure 9

This application discloses an atrioventricular valve clamping device, comprising a support member, a first clamping member and a second clamping member, a first covering membrane, and a second covering membrane. The first and second clamping members are openable or closed relative to the support member. The first covering membrane is disposed on the support member, and the second covering membrane is disposed on the first and second clamping members and extends between them. The first covering membrane is connected to the second covering membrane. The atrioventricular valve clamping device of this application has advantages such as reduced snagging of chordae tendineae in certain corner areas and reduced thrombus accumulation.

A prosthetic valve includes a valve frame, an outer sealing frame, and leaflets positioned about a flow channel. Each leaflet includes two commissure ends, and a central portion positioned between the commissure ends. The leaflets are attached to form commissure regions at which commissure ends meet. The commissure regions are affixed to the valve frame, which provides openings between the commissure regions. The outer sealing frame is coupled to the valve frame such that (i) the downstream portion is spaced radially outward from the valve frame to engage and seal against the native atrioventricular valve while defining a gap between the downstream portion and the valve frame, and (ii) ventricular blood passes along radially outward facing surfaces of the leaflets and through the openings into the gap in a manner that washes out the downstream portion to reduce thrombus formation. Other implementations are also disclosed.

Coaptation-assist devices (20) are provided for treating a native atrioventricular valve. The coaptation-assist devices (20) include a ventricular anchor (30), which includes one or more wires (35), and which is configured to be positioned in a ventricle; and a neo-leaflet (32), which is supported by the ventricular anchor (30) and is configured to at least partially replace function of a target native leaflet of the native atrioventricular valve by providing a surface of coaptation (34) for one or more opposing native leaflets. In some configurations, the ventricular anchor (30) includes a proximal subannular anchor (54), which includes a digitate anchor (56) that is shaped so as to define a plurality of fingers (60) having a plurality of curved superior peaks (66) that point in a superior direction and engage a subannular surface of the target native leaflet. Other embodiments are also described.

Devices for anchoring catheter systems, such as an atrioventricular heart valve regurgitation reduction system with a coapting element or spacer positioned within the atrioventricular valve leaflets. The spacer may be anchored above the atrioventricular valve with a rail that extends up into the subclavian vein, with tethers that attach to anchors around the annulus, or with a tether that connects to a stent expanded within an adjacent blood flow passage. The spacer may also be anchored below the atrioventricular valve with a rail that terminates in a tissue anchor within the ventricle, with tethers that attach to anchors around ventricle, or with a tether that connects to a stent expanded within an adjacent blood flow passage. The spacer may also be stabilized by a harness extending across the valve annulus or may be self-anchoring with an array of struts that extend into contact with the surrounding tissue.