Deployment techniques for annuloplasty ring and over-wire rotation tool

Patent metadata

Field	Value
Publication number	US-10548729-B2
Application number	US-201715474632-A
Country	US
Kind code	B2
Filing date	Mar 30, 2017
Priority date	May 4, 2009
Publication date	Feb 4, 2020
Grant date	Feb 4, 2020

Abstract

An implant structure includes a contracting mechanism, including a rotatable structure for contracting the implant structure, and a locking mechanism. A rotation tool is configured to engage and rotate the rotatable structure. A longitudinal guide member is removably coupled to the contracting mechanism, configured to guide the rotation tool to the rotatable structure, and includes a distal force applicator. The rotation tool is axially moveable with respect to the guide member. The contracting mechanism is arranged such that the locking mechanism is (a) unlocked when the guide member is coupled to the contracting mechanism in a first state, thereby allowing the rotatable structure to rotate, and (b) locked when (i) the guide member is coupled to the contracting mechanism in a second state, thereby restricting the rotation of the rotatable structure, and (ii) the guide member is not coupled to the contracting mechanism, thereby restricting the rotation of the rotatable structure.

First claim

The invention claimed is:

1. An apparatus comprising:
an implant structure, which comprises a contracting mechanism, which comprises (a) a rotatable structure, arranged such that rotation of the rotatable structure contracts the implant structure, and (b) a locking mechanism;
a rotation tool, which is configured to engage the rotatable structure, and to rotate the rotatable structure in response to a rotational force applied to the rotation tool; and
a longitudinal guide member, which is (a) removably coupled to the contracting mechanism, (b) configured to guide the rotation tool to the rotatable structure, and (c) comprises a distal force applicator,
wherein the rotation tool and the longitudinal guide member are arranged such that the rotation tool is axially moveable with respect to the longitudinal guide member, and
wherein the contracting mechanism is arranged such that:
the locking mechanism is unlocked when the longitudinal guide member is coupled to the contracting mechanism in a first state, thereby allowing the rotatable structure to rotate,
the locking mechanism is locked when the longitudinal guide member is coupled to the contracting mechanism in a second state, thereby restricting the rotation of the rotatable structure, and
the locking mechanism is locked when the longitudinal guide member is not coupled to the contracting mechanism, thereby restricting the rotation of the rotatable structure.

2. The apparatus according to claim 1 , wherein the contracting mechanism is arranged such that:
when in the first state, the longitudinal guide member is coupled to the contracting mechanism at a first level of distal advancement with respect to the contracting mechanism, thereby allowing the rotatable structure to rotate, and
when in the second state, the longitudinal guide member is coupled to the contracting mechanism at a second level of distal advancement with respect to the contracting mechanism, thereby restricting the rotation of the rotatable structure, the second level of distal advancement being less than the first level of distal advancement.

3. The apparatus according to claim 2 , wherein the rotation tool comprises one or more tubes that are configured to pass over the longitudinal guide member, such that the longitudinal guide member is radially within the one or more tubes.

4. The apparatus according to claim 2 , wherein an upper surface of the rotatable structure is shaped so as to define a threaded opening, and wherein a distal portion of the longitudinal guide member is shaped so as to define a screw thread that is removably screwed into the threaded opening.

5. The apparatus according to claim 4 , wherein, when the longitudinal guide member is coupled to the contracting mechanism at the second level of distal advancement, the distal portion of the longitudinal guide member is in a state of being partially unscrewed from the threaded opening.

6. The apparatus according to claim 4 , wherein the distal force applicator extends distally beyond the screw thread, and is configured to unlock the locking mechanism when the longitudinal guide member is coupled to the contracting mechanism at the first level of distal advancement.

7. The apparatus according to claim 2 ,
wherein the locking mechanism is shaped to provide a protrusion and a depressible portion,
wherein a lower surface of the rotatable structure is shaped to define one or more recesses, and
wherein the contracting mechanism is arranged such that:
when the longitudinal guide member is coupled to the contracting mechanism at the second level of distal advancement or the longitudinal guide member is not coupled to the contracting mechanism, the protrusion is positioned with one of the recesses, thereby locking the locking mechanism, and
when the longitudinal guide member is coupled to the contracting mechanism at the first level of distal advancement, the force applicator pushes against the depressible portion, thereby freeing the protrusion from the recess and unlocking the locking mechanism.

8. The apparatus according to claim 2 , wherein the rotatable structure comprises a spool.

9. The apparatus according to claim 8 ,
wherein the locking mechanism is shaped to provide a protrusion and a depressible portion,
wherein a lower surface of the spool is shaped to define one or more recesses, and
wherein the contracting mechanism is arranged such that:
when the longitudinal guide member is coupled to the contracting mechanism at the second level of distal advancement or the longitudinal guide member is not coupled to the contracting mechanism, the protrusion is positioned with one of the recesses, thereby locking the locking mechanism, and
when the longitudinal guide member is coupled to the contracting mechanism at the first level of distal advancement, the force applicator pushes against the depressible portion, thereby freeing the protrusion from the recess and unlocking the locking mechanism.

10. The apparatus according to claim 2 , wherein the longitudinal guide member has a diameter of between 0.1 and 1 mm.

11. The apparatus according to claim 2 , wherein the contracting mechanism comprises a housing that houses the rotatable structure, and wherein the contracting mechanism is arranged such that when unlocked, the locking mechanism allows the rotatable structure to rotate with respect to the housing.

12. The apparatus according to claim 2 , wherein the implant structure further comprises a flexible elongated contracting member separate and distinct from the longitudinal guide member, and wherein the contracting mechanism is configured to contract the implant structure by pulling on the contracting member.

13. The apparatus according to claim 12 ,
wherein the rotatable structure comprises a spool,
wherein the contracting member has a first portion wound around the spool, and a second portion that extends at least along a portion of the implant structure,
wherein the spool is arranged such that the rotation of the spool contracts the implant structure by winding the contracting member around the spool, and
wherein the rotation tool is configured to increase a number of times the contracting member is wound around the spool by rotating the rotatable structure in response to the rotational force applied to the rotation tool.

14. The apparatus according to claim 1 , wherein an upper surface of the rotatable structure is shaped so as to define a threaded opening, and wherein a distal portion of the longitudinal guide member is shaped so as to define a screw thread that is removably screwed into the threaded opening.

15. The apparatus according to claim 1 ,
wherein the locking mechanism is shaped to provide a protrusion and a depressible portion,
wherein a lower surface of the rotatable structure is shaped to define one or more recesses, and
wherein the contracting mechanism is arranged such that:
when the longitudinal guide member is coupled to the contracting mechanism in the second state or the longitudinal guide member is not coupled to the contracting mechanism, the protrusion is positioned with one of the recesses, thereby locking the locking mechanism, and
when the longitudinal guide member is coupled to the contracting mechanism in the first state, the force applicator pushes against the depressible portion, thereby freeing the protrusion from the recess and unlocking the locking mechanism.

16. The apparatus according to claim 1 , wherein the implant structure comprises a sleeve.

17. The apparatus according to claim 1 , wherein the implant structure comprises

Assignees

• Valtech Cardio Ltd

Inventors

• Zipory Yuval
• Cabiri Oz
• Gross Yossi
• Hammer Tal
• Gross Amir
• Maisano Francesco
• Miller Eran
• Weitzman Yoseph
• Ayvazian Aram

Classifications

• A61B2017/0414

  having a suture-receiving opening, e.g. lateral opening · CPC title

• A61F2/2445

  Annuloplasty rings in direct contact with the valve annulus · CPC title

• A61B2017/0409

  Instruments for applying suture anchors · CPC title

• A61B17/0401 Primary

  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 title

• A61F2220/0016

  with sharp anchoring protrusions, e.g. barbs, pins, spikes · CPC title