Soft body tissue remodeling methods and apparatus

Patent metadata

Field	Value
Publication number	US-9492277-B2
Application number	US-21534105-A
Country	US
Kind code	B2
Filing date	Aug 30, 2005
Priority date	Aug 30, 2005
Publication date	Nov 15, 2016
Grant date	Nov 15, 2016

Abstract

Soft body tissue structure can be remodeled by shortening the distance between first and second portions of that tissue structure. First and second anchor structures are respectively implanted in the first and second portions of the tissue structure. These anchor structures are linked by a linking structure, the length of which between the anchor structures can be shortened to pull the tissue structure portions toward one another. Each of the anchor structures may include two screw structures that are driven into the associated tissue structure portion transverse to the linking structure and with a spacer between the two screws. The entire prosthesis can be implanted percutaneously if desired. An illustrative use of the prosthesis is to shorten the annulus of a patient's mitral valve, with at least a portion of the prosthesis implanted in the patient's coronary sinus.

First claim

The invention claimed is:

1. A prosthesis for reducing distance between first and second portions of soft body tissue structure comprising:
a first anchor structure for inserting into soft tissue, the first anchor structure including first and second screw structures threaded into the first portion of the tissue structure with a first substantially rigid spacer structure for maintaining a space between the first and second screw structures, one of the first and second screw structures including a hollow, helical screw portion, a hollow head portion forming a hollow cylinder with a flange extending radially from a proximal end of the cylinder, and an annular collar fitted around an outside of the head portion so that the screw structure is rotatable about a longitudinal axis relative to the collar, the flange being too large to pass through the collar;
a second anchor structure for inserting into soft tissue, the second anchor structure including third and fourth screw structures threaded into the second portion of the tissue structure with a second substantially rigid spacer structure for maintaining a space between the third and fourth screw structures; and
linking structure between the first and second anchor structures,
wherein the first and second screw structures are located along a first axis defined by the linking structure and the third and fourth screw structures are located along a second axis defined by the linking structure, and the space between the first and second screw structures is approximately equal to a length of the first substantially rigid spacer structure and the space between the third and fourth screw structures is approximately equal to a length of the second substantially rigid spacer structure, and wherein the head portion includes a plurality of T-shaped recesses that receive portions of a screw driving apparatus to releasably hold the screw portion on the screw driving apparatus, the T-shaped recesses having a wider portion positioned proximate the hollow helical screw portion, the T-shaped recesses being longitudinally aligned with the hollow head portion, the T-shaped recesses being spaced around a circumference of the hollow head portion, and the T-shaped recesses being accessible from a hollow interior of the hollow head portion.

2. The prosthesis defined in claim 1 wherein the first and second screw structures are threaded into the first portion of the tissue structure transverse to a longitudinal axis of an adjacent portion of the linking structure.

3. The prosthesis defined in claim 2 wherein the third and fourth screw structures are threaded into the second portion of the tissue structure transverse to a longitudinal axis of an adjacent portion of the linking structure.

4. The prosthesis defined in claim 1 further comprising means for maintaining a selectable length of the linking structure between the first and second anchor structures.

5. The prosthesis defined in claim 4 wherein the means for maintaining comprises:
a clamp structure for selectively clamping onto the linking structure.

6. The prosthesis defined in claim 5 wherein the clamp structure clamps the linking structure adjacent to the fourth screw structure.

7. The prosthesis defined in claim 4 wherein the means for maintaining is deployable to select and maintain any length of the linking structure between the first and second anchor structures within a range of such lengths.

8. The prosthesis defined in claim 7 wherein the means for maintaining has a pre-deployment state in which it permits the length of the linking structure between the first and second anchor structures to be increased or decreased.

9. The prosthesis defined in claim 1 wherein the head portion traps the collar against tissue into which the screw portion is threaded.

10. The prosthesis defined in claim 9 wherein the collar includes structure for engaging the linking structure.

11. The prosthesis defined in claim 10 wherein the structure for engaging holds the collar at a fixed location on the linking structure.

12. The prosthesis defined in claim 10 wherein the structure for engaging allows the collar to slide along the linking structure.

13. The prosthesis of claim 10 , wherein the structure for engaging the linking structure is a capturing ring and the linking structure passes loosely through the ring.

14. The prosthesis defined in claim 1 wherein the first substantially rigid spacer structure is slidable along the linking structure.

15. The prosthesis defined in claim 14 wherein the second substantially rigid spacer structure is slidable along the linking member.

16. The prosthesis defined in claim 1 wherein the linking structure is flexible.

17. The prosthesis of claim 1 , wherein the linking structure passes through an eyelet on at least one screw structure.

18. The prosthesis of claim 1 , wherein the liking structure includes a proximal enlargement.

19. The prosthesis of claim 18 , wherein the proximal enlargement is radio-opaque.

20. The prosthesis of claim 1 , wherein the linking structure includes one or more radio-opaque markers.

21. The prosthesis of claim 1 , wherein the linking structure forms part of an electrical conductor.

22. The prosthesis of claim 1 , wherein the one of the first and second screw structures includes a sharply pointed distal tip, a plurality of helical turns that connect the distal tip to the head portion, the plurality of helical turns having at least one anticlinal barb to resist unthreading of the screw structure from tissue.

23. The prosthesis of claim 1 , wherein the collar comprises a plurality of recesses for releasably securing the collar to an implanting apparatus.

24. The prosthesis of claim 1 , further comprising the screw driving apparatus, the screw driving apparatus including a hollow cylindrical proximal portion and a plurality of distally extending T-shaped portions that are sized and shaped to fit into the T-shaped recesses, the T-shaped portions being resiliently biased to deflect inwardly, towards one another.

25. The prosthesis of claim 24 , further comprising a collar holder, the collar holder including a hollow cylindrical proximal portion and a plurality of distally extending fingers, wherein the hollow cylindrical proximal portion fits concentrically around the screw driving apparatus.

26. A prosthesis for adjusting a distance between a first portion and a second portion of soft body tissue, the prosthesis comprising:
a first anchor assembly for inserting into soft tissue, the first anchor assembly including a first pair of spaced apart rotatable tissue screws having hollow, helical threads and arranged for rotatable insertion into the first portion of soft body tissue, a hollow head portion forming a hollow cylinder with flange extending radially from a proximal end of the cylinder, and an annular collar fitted around an outside of the head portion so that the screw structure is rotatable about a longitudinal axis relative to the collar, the flange being too large to pass through the collar;
a second anchor assembly for inserting into soft tissue, the second anchor assembly including a second pair of spaced apart rotatable tissue screws having helical threads and arranged for rotatable insertion into the second portion of soft body tissue;
a first spacer disposed between the first pair of rotatable tissue screws and a second spacer disposed between the second pai

Assignees

• Hindrichs Paul J
• Kruse Steven D
• Krinke Todd A
• Brenzel Michael P
• Zehr Kenton J
• Thompson Paul
• Dale Theodore P
• Costello David M
• Mayo Foundation

Inventors

• Hindrichs Paul J
• Kruse Steven D
• Krinke Todd A
• Brenzel Michael P
• Zehr Kenton J
• Thompson Paul
• Dale Theodore P
• Costello David M

Classifications

• A61B2017/0488

  Instruments for applying suture clamps, clips or locks · CPC title

• A61F2/2451 Primary

  Inserts in the coronary sinus for correcting the valve shape · CPC title

• A61B17/1285

  for minimally invasive surgery · CPC title

• A61B2017/0441

  the shaft being a rigid coil or spiral · CPC title

• A61B2017/0409

  Instruments for applying suture anchors · CPC title