Ventricular structure reshaping atrio-ventricular valve

Patent metadata

Field	Value
Publication number	US-12097114-B2
Application number	US-202217932014-A
Country	US
Kind code	B2
Filing date	Sep 14, 2022
Priority date	May 20, 2012
Publication date	Sep 24, 2024
Grant date	Sep 24, 2024

Abstract

Apparatus and methods are described including placing a valve frame within a subject's heart. The valve frame includes a valve frame body that is configured to support the prosthetic valve within the native atrio-ventricular valve, and at least one arm that is configured to extend from a ventricular portion of the valve frame. The at least one arm is deployed among chords of the native atrio-ventricular valve. Subsequently, at least a portion of the valve frame is rotated in a direction in which an interior of the arm faces, such as to modify shapes of the native valve leaflets and the ventricular structures, by recruiting and deflecting at least a portion of the chords. The frame body of the valve frame is then radially expanded, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes. Other applications are also described.

First claim

The invention claimed is:

1. A method for use with a prosthetic valve that is configured to be deployed within a native atrio-ventricular valve of a heart of a mammalian subject, the native atrio-ventricular valve including a valve annulus, native valve leaflets, and ventricular structures including chords, papillary muscles, and ventricular walls, the method comprising:
placing a valve frame within the subject's heart, the valve frame including:
a valve frame body that is configured to support the prosthetic valve within the native atrio-ventricular valve, and that includes an atrial portion and a ventricular portion, and
at least one arm that is configured to extend from the ventricular portion of the valve frame;

subsequently, deploying the at least one arm among the chords of the native atrio-ventricular valve;
subsequently, rotating at least a portion of the valve frame, in a direction in which an interior of the arm faces, such as to modify shapes of the native valve leaflets and the ventricular structures, by recruiting and deflecting at least a portion of the chords; and
subsequently, causing the frame body of the valve frame to radially expand, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes.

2. The method according to claim 1 , wherein deploying the at least one arm among the chords of the native atrio-ventricular valve comprises deploying the at least one arm among the chords of the native atrio-ventricular valve such that the arm defines a curving inner surface that curves, as a radial distance of the arm from the ventricular portion increases, from a relatively more radial orientation of the curved surface to a relatively more circumferential orientation of the curved surface.

3. The method according to claim 1 , further comprising locking the deployed arm into position.

4. The method according to claim 1 , wherein deploying the at least one arm among the chords of the native atrio-ventricular valve comprises deploying the arm such that a chord receiving surface of the arm defines a slope that guides chords into a chord grasping region located between the arm and the ventricular portion, during the rotation of portion of the valve frame.

5. The method according to claim 1 , wherein causing the frame body of the valve frame to radially expand, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes comprises preventing blood flow between the native valve leaflets and the valve frame, at least in the direction passing from a ventricle to an atrium of the heart.

6. The method according to claim 1 , wherein deploying the at least one arm among the chords of the native atrio-ventricular valve comprises deploying the at least one arm among the chords of the native atrio-ventricular valve, even when the portion of the valve frame from which the at least one arm extends is in a radially-compressed state.

7. The method according to claim 1 , further comprising preventing the portion of the chords that are recruited by the arm from exiting the arm, using a protruding member shaped to protrude from the arm.

8. The method according to claim 1 , wherein the native atrio-ventricular valve includes a native mitral valve, and placing the valve frame within the patient's heart comprises placing within a left heart of the patient a valve frame that is configured to support the prosthetic valve within the native mitral valve.

9. The method according to claim 1 , wherein causing the frame body of the valve frame to radially expand, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes comprises using the at least one arm to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes.

10. The method according to claim 1 , wherein causing the frame body of the valve frame to radially expand, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes comprises holding the native valve leaflets between the atrial portion of the valve frame and the at least one arm.

11. The method according to claim 1 , wherein causing the frame body of the valve frame to radially expand, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes comprises causing a cylindrical portion of the valve frame that extends through an annular level of the native atrio-ventricular valve to radially expand toward the at least one arm, such as to hold the native valve leaflets and the ventricular structures at least partially in the modified shapes.

12. The method according to claim 1 , wherein:
rotating at least the portion of the valve frame comprises twisting the native valve leaflets, such that the native valve leaflets are shaped into overlapping configurations with respect to each other, and
causing the frame body of the valve frame to radially expand comprises holding the native valve leaflets in the overlapping configurations with respect to each other.

13. The method according to claim 12 , wherein twisting the native valve leaflets, such that the native valve leaflets are shaped into overlapping configurations with respect to each other comprises sealing commissures between the native valve leaflets by twisting the native valve leaflets into the overlapping configurations with respect to each other.

14. The method according to claim 1 , wherein deploying the at least one arm among the chords of the native atrio-ventricular valve comprises extending the arm radially to a distance sufficient to engage primary and secondary chords of the native atrio-ventricular valve and rotating at least a portion of the valve frame, in a direction in which an interior of the arm faces comprises recruiting and deflecting at least a portion of the primary and secondary chords of the native atrio-ventricular valve.

15. The method according to claim 14 , wherein deploying the at least one arm among the chords of the native atrio-ventricular valve comprises extending the arm radially to a distance sufficient to engage primary, secondary, and tertiary chords of the native atrio-ventricular valve and rotating at least a portion of the valve frame, in a direction in which an interior of the arm faces comprises recruiting and deflecting at least a portion of the primary, secondary, and tertiary chords of the native atrio-ventricular valve.

16. An apparatus for use with a prosthetic valve that is configured to be deployed within a native atrio-ventricular valve of a heart of a mammalian subject, the native atrio-ventricular valve including a valve annulus, native valve leaflets, and ventricular structures including chords and papillary muscles, the apparatus comprising:
a valve frame configured to support the prosthetic valve within the native atrio-ventricular valve, the valve frame comprising:
a frame body comprising:
an atrial portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the atrial portion is disposed on an atrial side of the native atrio-ventricular valve; and
a ventricular portion configured to be positioned such that, when the valve frame is deployed, at least a portion of the ventricular portion is disposed within a ventricle of the subject; and

at least one arm configured to extend from the ventricular portion of the frame body; and

a delivery device configured to:
deliver the valve frame to the native atrio-ventricular valve;
subsequently, deplo

Assignees

• Tel Hashomer Medical Res Infrastructure & Services Ltd

Inventors

• Raanani Ehud
• Orlov Boris
• Harari Boaz
• Meiri Oded
• Rozitsky Lichen

Classifications

• A61F2/243

  Deployment by mechanical expansion · CPC title

• A61F2220/0008

  Fixation appliances for connecting prostheses to the body · CPC title

• A61F2250/006

  modular · CPC title

• A61F2/2457

  Chordae tendineae prostheses · CPC title

• A61F2/2436

  Deployment by retracting a sheath · CPC title