121 results about "Chordae tendineae" patented technology

The invention includes a novel method and system to achieve leaflet coaptation in a cardiac valve percutaneously by creation of neochordae to prolapsing valve segments. This technique is especially useful in cases of ruptured chordae, but may be utilized in any segment of prolapsing leaflet. The technique described herein has the additional advantage of being adjustable in the beating heart. This allows tailoring of leaflet coaptation height under various loading conditions using image-guidance, such as echocardiography. This offers an additional distinct advantage over conventional open-surgery placement of artificial chordae. In traditional open surgical valve repair, chord length must be estimated in the arrested heart and may or may not be correct once the patient is weaned from cardiopulmonary bypass. The technique described below also allows for placement of multiple artificial chordae, as dictated by the patient's pathophysiology.

Methods and apparatus for mitral valve repair are disclosed herein where the posterior mitral leaflet is supported or buttressed in a frozen or immobile position to facilitate the proper coaptation of the leaflets. An implantable apparatus may be advanced and positioned intravascularly beneath the posterior leaflet of the mitral valve. The apparatus may include one or more individual balloon members, each of which may be optionally configured with supporting integrated structures. A magnet chain catheter may be positioned within the coronary sinus and adjacent to the mitral valve to magnetically secure the apparatus in position beneath the posterior mitral leaflet. Alternatively, a split-ring device may be placed about the chordae tendineae supporting the mitral valve such that the ring slides along the chordae tendineae alternately against the mitral leaflet and towards the papillary muscles during systole and diastole.

An apparatus for replacing the native chordae of a heart valve having at least two leaflets includes a prosthetic chordae assembly configured to extend from a papillary muscle to one of the at least two valve leaflets of the heart valve. The prosthetic chordae assembly has first and second end portions, and a middle portion extending therebetween. The prosthetic chordae assembly further includes a plurality of loop members interconnected at the first end portion for suturing to the papillary muscle. The middle portion is formed by two generally parallel strands of each of the loop members, and the second end portion is formed by an arcuate junction of the two strands of each of the loop members. The arcuate junctions are spaced apart and each of the junctions provides an independent location for attaching to one of the at least two valve leaflets of the heart valve.

Apparatus (20) is provided for treating mitral valve regurgitation, including a band (30) having distal and proximal ends, the band (30) adapted to be placed: around between 90 and 270 degrees of a mitral valve (58), including around at least a portion of a posterior cusp (56) of the valve (58), in a space defined by (a) a ventricular wall (70), (b) a ventricular surface of the posterior cusp (56) in a vicinity of an annulus (60) of the mitral valve (58), and (c) a plurality of third-order chordae tendineae (74). The apparatus (20) further includes distal and proximal coupling elements (32, 34), coupled to the band (30) at the distal and proximal ends thereof, respectively, and adapted to be coupled to a first chorda tendinea and a second chorda tendinea, respectively, each of the first and second chordae tendineae selected from the group consisting of: one of the plurality of third-order chordae tendineae (74), and a first-order chorda tendinea that inserts on a commissural cusp (78) of the mitral valve (58). Additional embodiments are also described.

Apparatus (20) is provided for treating mitral valve regurgitation, including a band (30) having distal and proximal ends, the band (30) adapted to be placed: around between 90 and 270 degrees of a mitral valve (58), including around at least a portion of a posterior cusp (56) of the valve (58), in a space defined by (a) a ventricular wall (70), (b) a ventricular surface of the posterior cusp (56) in a vicinity of an annulus (60) of the mitral valve (58), and (c) a plurality of third-order chordae tendineae (74). The apparatus (20) further includes distal and proximal coupling elements (32, 34), coupled to the band (30) at the distal and proximal ends thereof, respectively, and adapted to be coupled to a first chorda tendinea and a second chorda tendinea, respectively, each of the first and second chordae tendineae selected from the group consisting of: one of the plurality of third-order chordae tendineae (74), and a first-order chorda tendinea that inserts on a commissural cusp (78) of the mitral valve (58). Additional embodiments are also described.

A sewing ring (12) has a diameter commensurate with a diameter of a removed mitral valve. Skirts (44, 46) of mesh or net material extend downward from the sewing ring and line the walls of an associated vessel (58). Basal chordae simulating structures (34, 36) in the form of elongated strips of mesh or netting, rods, or the like extend from the skirt to an underside of each of two valve leaflets (14, 16). Marginal chordae simulating structures (30, 32) extend between each leaflet and the basal chordae simulating structure. The sewing ring (12) is stitched to an open end of a vessel and inner ends of the basal chordae simulating structure are stitched or stapled (50, 52) to associated papillary musculature (54, 56). In this manner, the papillary muscles assist in controlling the timing and control of the mitral valve.

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.

Methods and devices for repairing a cardiac valve. A minimally invasive procedure includes creating an access in the apex region of the heart through which one or more instruments may be inserted. The device can implant artificial heart valve chordae tendineae into cardiac valve leaflet tissues to restore proper leaflet function and prevent reperfusion. The device punctures the apex of the heart and travels through the ventricle. The tip of the device rests on the defective valve and punctures the valve leaflet. A suture or a suture / guide wire combination is inserted, securing the top of the leaflet to the apex of the heart. A resilient element or shock absorber mechanism adjacent to the outside of the apex of the heart minimizes the linear travel of the device in response to the beating of the heart or opening / closing of the valve.

A stentless bioprosthetic valve includes at least one piece of biocompatible material comprising a bi-leaflet conduit having a proximal end and a distal end. The proximal end defines a first annulus for suturing to the valve annulus. The conduit includes first and second leaflets that mimic the native leaflets and extend between the conduit ends. The distal end defines a second annulus at which the first and second leaflets terminate. The conduit further includes first and second pairs of prosthetic chordae projecting from the leaflets at the second annulus. One of the first pair of prosthetic chordae extends from the first leaflet and has a distal end for suturing to a papillary muscle and the other of the first pair of prosthetic chordae extends from the first leaflet and has a distal end for suturing to another papillary muscles.

Novel apparatus and minimally invasive methods to treat atrioventricular valve regurgitation that is a result of tethering of chordae attaching atrioventricular valve leaflets to muscles of the heart, such as papillary muscles and muscles in the heart wall, thereby restricting the closure of the leaflets. Catheter embodiments for delivering and positioning chordal severing and elongating instruments are described.

Methods and devices for repairing a cardiac valve. A minimally invasive procedure includes creating an access in the apex region of the heart through which one or more instruments may be inserted. The device can implant artificial heart valve chordae tendineae into cardiac valve leaflet tissues to restore proper leaflet function and prevent reperfusion. The device punctures the apex of the heart and travels through the ventricle. The tip of the device rests on the defective valve and punctures the valve leaflet. A suture or a suture / guide wire combination is inserted, securing the top of the leaflet to the apex of the heart. A resilient element or shock absorber mechanism adjacent to the outside of the apex of the heart minimizes the linear travel of the device in response to the beating of the heart or opening / closing of the valve.

Novel apparatus and minimally invasive methods to treat atrioventricular valve regurgitation that is a result of tethering of chordae attaching atrioventricular valve leaflets to muscles of the heart, such as papillary muscles and muscles in the heart wall, thereby restricting the closure of the leaflets. Catheter embodiments for delivering and positioning chordal severing and elongating instruments are described.

Apparatus and methods are provided for thermally and / or mechanically treating tissue, such as valvular structures, to reconfigure or shrink the tissue in a controlled manner. The apparatus comprises a catheter in communication with an end effector which induces a temperature rise in an annulus of tissue surrounding the leaflets of a valve or in the chordae tendineae sufficient to cause shrinkage, thereby causing the valves to close more tightly. Mechanical clips can also be implanted over the valve either alone or after the thermal treatment. The clips are delivered by a catheter and may be configured to traverse directly over the valve itself or to lie partially over the periphery of the valve to prevent obstruction of the valve channel. The clips can be coated with drugs or a radiopaque coating. The catheter can also incorporate sensors or energy delivery devices, e.g., transducers, on its distal end.

Described herein are devices, methods and kits for assessing and / or enhancing the accessibility of a subvalvular space of a heart, accessing the subvalvular space of the heart (e.g., to provide access for one or more other devices), and / or positioning one or more devices in the subvalvular space of the heart. The devices described herein may, for example, comprise catheters that may be used to manipulate one or more chordae tendineae, diagnostic catheters having different sizes and / or shapes (e.g., different curvatures), guide catheters having different sizes and / or shapes (e.g., different curvatures), and visualization catheters. In some variations, the devices, methods, and / or kits may be used to visualize a target site, such as a subannular groove of a heart valve. In certain variations, the devices, methods, and / or kits may be used to manipulate chordae tendineae to provide additional space in a ventricle of a heart (e.g., enhancing the accessibility of the ventricle).

Described herein are devices, methods and kits for assessing and / or enhancing the accessibility of a subvalvular space of a heart, accessing the subvalvular space of the heart (e.g., to provide access for one or more other devices), and / or positioning one or more devices in the subvalvular space of the heart. The devices described herein may, for example, comprise catheters that may be used to manipulate one or more chordae tendineae, diagnostic catheters having different sizes and / or shapes (e.g., different curvatures), guide catheters having different sizes and / or shapes (e.g., different curvatures), and visualization catheters. In some variations, the devices, methods, and / or kits may be used to visualize a target site, such as a subannular groove of a heart valve. In certain variations, the devices, methods, and / or kits may be used to manipulate chordae tendineae to provide additional space in a ventricle of a heart (e.g., enhancing the accessibility of the ventricle).

Described herein are devices, methods and kits for assessing and / or enhancing the accessibility of a subvalvular space of a heart, accessing the subvalvular space of the heart (e.g., to provide access for one or more other devices), and / or positioning one or more devices in the subvalvular space of the heart. The devices described herein may, for example, comprise catheters that may be used to manipulate one or more chordae tendineae, diagnostic catheters having different sizes and / or shapes (e.g., different curvatures), guide catheters having different sizes and / or shapes (e.g., different curvatures), and visualization catheters. In some variations, the devices, methods, and / or kits may be used to visualize a target site, such as a subannular groove of a heart valve. In certain variations, the devices, methods, and / or kits may be used to manipulate chordae tendineae to provide additional space in a ventricle of a heart (e.g., enhancing the accessibility of the ventricle).

An apparatus for applying liquid pressure to resected tissue may include a fixture, a papillary assembly coupled to the fixture and having first and second spaced apart papillary attachment elements, and a resected mitral valve attached to the fixture. The fixture may have a first chamber, a second chamber, and an internal panel extending between the first and second chambers. The resected mitral valve may be attached to the internal panel and may have a posterior leaflet, an anterior leaflet, and tendinae chordae. The tendinae chordae may each be attached at a first end to the posterior leaflet or the anterior leaflet and at a second end to one of the papillary attachment elements. A first group of the tendinae chordae may be attached to the first papillary attachment element, and a second group of the tendinae chordae may be attached to the second papillary attachment element.

Apparatus comprises: (A) a housing (248), percutaneously deliverable to a heart of a subject, slidable along a guidewire (242), and shaped to define at least one opening (249); (B) a guide member (250), percutaneously deliverable to the heart, percutaneously removable from the subject, couplable to the housing, and having: (i) a distal portion, comprising a chord-engaging element (252), configured to be percutaneously slidably coupled to and decouplable from at least one chordae tendineae (244), and (ii) a proximal portion, comprising a longitudinal element (251); and (C) a deployment tool, configured (i) to be reversibly coupled to a tissue anchor (50,280), (ii) to be slidably coupled to the longitudinal element of the guide member, and (iii) to anchor the tissue anchor to a papillary muscle (254) of the subject. Other embodiments are also described.

The invention discloses artificial chordae tendineae and an artificial chordae tendineae implanting system. The artificial chordae tendineae comprises a flexible chordae tendineae main body, wherein the first end and / or the second end of the chordae tendineae main body are / is connected with a fixing element; and a puncture connecting element is arranged at one side, backing to the chordae tendineae main body, of the fixing element. The artificial chordae tendineae implanting system comprises a clamping device, a puncture device and a pushing device, wherein the pushing device comprises a pushing guide pipe; the puncture device and the clamping device are arranged in different inner cavities of the pushing guide pipe in a penetrating way; the clamping device comprises a clamping push rod, afar end clamp head and a near end clamp head; the near end clamp head is arranged at the far end of the pushing guide pipe; the far end clamp head is arranged at the far end of the clamping push rod;the artificial chordae tendineae is accommodated in the clamping device; the fixing element of the artificial chordae tendineae corresponds to a puncture needle head; the puncture device comprises the puncture needle head and a puncture push rod; the puncture push rod is connected with the near end of the puncture needle head; and the far end of the puncture needle head is a cone-shaped straightsharp end. The artificial chordae tendineae and the puncture needle head form stable connection; the puncture point is small; the injury on valve leaflets is reduced; and the operation time is reduced.

The invention discloses an artificial chordae implantation system provided with a detection device. The artificial chordae implantation system comprises a clamping device, a puncture device, a push device and a detection device, wherein the push device comprises a push catheter; the clamping device comprises a clamping push rod in which an artificial chordae is accommodated as well as a distal clamping head and a proximal clamping head which are cooperated for clamping a valve leaflet; the detection device comprises at least one probe; the probe is movably inserted into the push catheter; a detection outlet is kept in the clamping surface of the proximal clamping head or the distal clamping head, and correspondingly, a probe accommodating cavity, which is opposite to the probe outlet, is kept in the clamping surface of the distal clamping head or the proximal clamping head; and the distal end of the probe is accommodated in the probe accommodating cavity from the probe outlet when thedistal clamping head and the proximal clamping head are closed. According to the artificial chordae implantation system provided by the invention, it can rapidly and accurately detect whether the valve leaflet is clamped between the distal clamping head and the proximal clamping head or not via the detection device of a mechanical structure; the system is simple in structure, simple and convenientto operate and low in surgical risk; and the system can reduce production cost of apparatuses and reduce economic burdens of patients.

The invention relates to a distal anchoring tab for an orthogonally delivered prosthetic mitral valve where the tab is extended using a guide wire to capture native mitral leaflet and / or chordae tissue and withdrawing the guide wire contracts the tab and pins the native tissue against the subannular sidewall of the prosthetic valve.

The invention discloses a mitral chordae sewing machine for implanting the artificial chordae through the minimally invasive technology and a method of the mitral chordae sewing machine in the field of medical apparatus and instruments. The mitral chordae sewing machine comprises a mitral forceps holder, sewing needles and a position detection device, wherein the mitral forceps holder is capable of clamping a mitral leaflet; the mitral forceps holder comprises an operating handle, a support rod and a clamping device of which the front end is opened and closed under the control of the operating handle; the number of the sewing needles is two; each sewing needle is designed to be of a barb structure, and the barb structures are used for hooking the artificial chordae; the position detection device is used for detecting the position, clamped by the mitral forceps holder, of the mitral leaflet; the mitral leaflet can be implanted into a human body through the small incision of left chest, and enters the ventriculus sinister from the apex cordis position to clamp the mitral leaflet; the sewing needles penetrate through the mitral leaflet to hook the artificial chordae, so that a liner is adhered to the mitral leaflet at one side of the atrium sinistrum, and two ends of the artificial chordae are fixed to the apex cordis position. According to the mitral chordae sewing machine and the method of the mitral chordae sewing machine disclosed by the invention, the goal that the artificial chordae is implanted through the minimally invasive technology is achieved, and patients with mitral regurgitation caused by the rupture of the mitral chordae are effectively treated.

The invention discloses a valve repair device. The valve repair device comprises a sealing sheath, a catcher, a puncture needle, an artificial chordae tendineae and a handle, wherein the catcher is arranged at the far end of the sealing sheath and used for catching and fixing a valve cusp, the puncture needle is arranged in the sealing sheath and used for puncturing the caught valve cusp of the catcher, the artificial chordae tendineae punctures into the valve along with the puncture needle and is used for repairing the valve, and the handle is arranged at the near end of the sealing sheath and used for operating the valve repair device.

A prosthetic mitral valve with a frame comprises at least one arm shaped to deploy among a region of chordae tendineae of the native mitral valve to deflect these chords in order to pull the native valve leaflets around the frame to avoid paravalvular leaks. The frame may be made from two parts that are connected by sutures. The prosthetic valve may be deployed by a catherer comprising a deployment clamp attached to the valve frame where the deployment clamp is actuable to induce rotation of the frame.

The invention relates to an A2 clip for a side-delivered prosthetic mitral valve where the A2 clip is extended using a guide wire to capture native mitral leaflet and / or chordae tissue and withdrawing the guide wire contracts the A2 clip and pins the native tissue against the subannular sidewall of the prosthetic valve.

The present invention is directed to a proximal anchoring tab for a side delivered prosthetic mitral valve having an elongated distal tab, where the proximal tab anchors the proximal side of the prosthetic valve using a tab or loop deployed to the A3-P3 (proximal) commissure area of the mitral valve, and wherein the elongated distal tab is extended around the posterior P1-P2 leaflet and / or chordae using a guide wire to capture native mitral leaflet and / or chordae tissue and where withdrawing the guide wire contracts the tab and pins the native posterior tissue against the subannular posterior-side sidewall of the prosthetic valve.

The invention discloses an artificial chordae tendineae device and a threading element and suite. The artificial chordae tendineae device comprises a flexible rope. The flexible rope is an annular rope. A first end, a second end and a third end are formed between the annular rope and the threading element. The second end and the third end are fixedly knotted to first tissue. The third end is fixed on second tissue through a traction element. The connection manner of the artificial chordae tendineae device is achieved through self-knotting in the heart, the threading element penetrates the first tissue in the third end area, pulls the first end and loosens the second end, the threading element returns to an original position, the first end is driven to penetrate the third end, self-knotting is achieved, and chordae tendineae is pulled to be fixed at the second tissue.