Method and apparatus for percutaneous delivery and deployment of a cardiovascular prosthesis

Patent metadata

Field	Value
Publication number	US-2016008129-A1
Application number	US-201414771707-A
Country	US
Kind code	A1
Filing date	Mar 6, 2014
Priority date	Mar 7, 2013
Publication date	Jan 14, 2016
Grant date	—

Abstract

Catheter apparatuses and methods are provided for repairing heart valves, particularly mitral valves. The method includes providing a catheter having an elongate, flexible body, with a proximal end and a distal end. The distal end can be transluminally advanced from the left atrium through the mitral valve and along the left ventricular outflow tract into the ascending aorta. A valve repair device is deployed to permanently connect leaflets at a mid-section of a mitral valve while permitting medial and lateral portions of the natural leaflets to open and close. The valve repair device detachably connects the distal and proximal ends of the catheter.

First claim

1 . A method of performing a procedure in the heart, comprising:
providing a catheter having an elongate flexible body, a proximal end, a distal end, and a procedure zone, spaced proximally apart from the distal end, proximal and distal portion of the catheter being separable from the procedure zone; advancing the catheter antegrade through the mitral valve, through the aortic valve and into the aorta, such that the procedure zone is positioned upstream from the aortic valve; performing a procedure from the procedure zone; separating at least one of the proximal portion and the distal portion from the procedure zone; and separately removing the proximal and distal ends of the catheter from the patient.

2 . (canceled)

3 . (canceled)

4 . A method of performing a procedure in the heart as in claim 1 , wherein the procedure zone comprises a fastening device configured to opening carried by the catheter.

5 . A method of performing a procedure in the heart as in claim 4 , wherein the fastening device is configured to capture adjacent edges of the valve to create a double orifice in the valve.

6 . A method of performing a procedure in the heart as in claim 5 , wherein the fastening device comprises a clip having proximal and distal portions detachably coupled to the proximal and distal portions of the catheter.

7 . A method of performing a procedure in the heart as in claim 1 , further comprising transluminally advancing the catheter through the intra atrial septum prior to the advancing step.

8 . (canceled)

9 . A method of performing a procedure in the heart as in claim 2 , additionally comprising the steps of positioning a flow directed catheter through the mitral valve, through the aortic valve and into the aorta, advancing a guidewire through the flow directed catheter, and removing the flow directed catheter.

10 . (canceled)

11 . (canceled)

12 . A method of performing a procedure in the heart as in claim 1 , wherein the advancing step comprises advancing the catheter to position the procedure zone within a flow path between the mitral valve and the aortic valve.

13 . A method of performing a procedure in the heart as in claim 1 , wherein the procedure zone comprises an opening carried by the catheter.

14 . A method of performing a procedure in the heart as in claim 2 , wherein the opening comprises an opening in a side wall of the catheter.

15 . A method of performing a procedure in the heart as in claim 2 , wherein the catheter comprises an outer tubular wall having a central lumen, and an inner elongate flexible body extendable through the central lumen, and the procedure zone comprises an opening at a distal end of the outer tubular wall.

16 . (canceled)

17 . A method of performing a procedure in the heart as in claim 1 , wherein the procedure comprises an atrioventricular valve repair.

18 . A method of performing a procedure in the heart as in claim 1 , wherein the procedure comprises grasping at least one leaflet of the mitral valve.

19 . A method of performing a procedure in the heart as in claim 1 , wherein the procedure comprises attaching the anterior leaflet of the mitral valve to the posterior leaflet of the mitral valve.

20 . A method of orienting a first and second tissue grasper with respect to the mitral valve, comprising:
providing a catheter having an elongate, flexible body, with a proximal end, a distal end and first and second tissue graspers spaced apart from the distal end; transluminally advancing the distal end from the left atrium through the mitral valve and along the left ventricular outflow tract into the ascending aorta, whereby the first and second tissue graspers are adjacent a central zone of the mitral valve; and drawing the distal end of the catheter out of a peripheral artery.

21 . (canceled)

22 . A method as in claim 20 , further comprising an extending step comprising advancing the first tissue grasper from a first position in which a longitudinal axis of the tissue grasper extends generally parallel with the flexible body, to a second position in which the axis is inclined with respect to the flexible body.

23 . (canceled)

24 . A method as in claim 20 , further comprising actuating a distal interface to separate a distal portion of the catheter including the distal end from the tissue graspers.

25 . A method as in claim 24 , further comprising actuating a proximal interface to separate a proximal portion of the catheter including the distal end from the tissue graspers.

26 . A method of repairing a mitral valve, comprising:
providing a catheter having an elongate, flexible body, with a proximal end and a distal end; transluminally advancing the distal end from the left atrium through the mitral valve and along the left ventricular outflow tract into the ascending aorta; deploying a valve repair device to permanently connect leaflets at a mid-section of a mitral valve while permitting medial and lateral portions of the natural leaflets to open and close; wherein the valve repair device detachably connects the distal and proximal ends of the catheter.

27 . A method of repairing as in claim 26 , wherein the deploying step comprises positioning elements on atrial and ventricular sides of at least one of the anterior and posterior leaflets.

28 . A method of repairing as in claim 23 , wherein the deploying step comprises applying suction to the leaflet.

Assignees

• Cedars Sinai Medical Center

Inventors

• Siegel Robert James

Classifications

• A61B2017/00473

  Distal part, e.g. tip or head (A61B2017/00464 takes precedence) · CPC title

• A61B2017/00292

  mounted on or guided by flexible, e.g. catheter-like, means · CPC title

• A61B2017/00243

  cardiac · CPC title

• A61F2/2427 Primary

  Devices for manipulating or deploying heart valves during implantation · CPC title

• A61B17/00234

  for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence) · CPC title