[go: up one dir, main page]

WO2007100268B1 - Catheter based mitral valve repair method and apparatus - Google Patents

Catheter based mitral valve repair method and apparatus

Info

Publication number
WO2007100268B1
WO2007100268B1 PCT/RS2007/000006 RS2007000006W WO2007100268B1 WO 2007100268 B1 WO2007100268 B1 WO 2007100268B1 RS 2007000006 W RS2007000006 W RS 2007000006W WO 2007100268 B1 WO2007100268 B1 WO 2007100268B1
Authority
WO
WIPO (PCT)
Prior art keywords
leaflet
suture
assembly
anchor
cords
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/RS2007/000006
Other languages
French (fr)
Other versions
WO2007100268A3 (en
WO2007100268A2 (en
Inventor
Uros Babic
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Priority to EP07709280A priority Critical patent/EP2023822A2/en
Publication of WO2007100268A2 publication Critical patent/WO2007100268A2/en
Anticipated expiration legal-status Critical
Publication of WO2007100268A3 publication Critical patent/WO2007100268A3/en
Publication of WO2007100268B1 publication Critical patent/WO2007100268B1/en
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0482—Needle or suture guides
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
    • A61F2/2457—Chordae tendineae prostheses
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00778—Operations on blood vessels
    • A61B2017/00783—Valvuloplasty
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0404—Buttons
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0406—Pledgets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0409—Instruments for applying suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0474—Knot pushers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0469—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery
    • A61B2017/0477—Suturing instruments for use in minimally invasive surgery, e.g. endoscopic surgery with pre-tied sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/04—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials
    • A61B2017/0496—Surgical instruments, devices or methods for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
    • A61F2/2463—Implants forming part of the valve leaflets

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Veterinary Medicine (AREA)
  • Animal Behavior & Ethology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Cardiology (AREA)
  • Medical Informatics (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Rheumatology (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

Method and devices including novel suture composition, catheter type suture transporters, pushers -and tying instruments, implant-pledget for anchoring onto the mitral leaflet, myocardial free wall entry site occluder, and technique for catheter based treatment of mitral regurgitation are presented. In one embodiment, a leaflet tension apparatus is implanted to adjust the systolic leaflet amplitude excursion. A continuous guiding suture track is created from the direct left ventricular puncture site through one or two puncture sites of the leaflet (1114) via the transseptal catheter and femoral vein; a pledget-implant (84) is apposed onto the exteriorized distal (venous) suture end via its integrated suture part and is anchored onto the atrial leaflet surface (11141) by retracting the guiding suture from the epicardial end. Silicon tube (70) is interposed between the leaflet and the free myocardial wall (1113) covering the implant's integrated sutures (841) which are directed through the free myocardial wall oclluder (90) and secured to its epicardial segment by an adjustable knot (9021x841) so as to keep the leaflet at the wanted distance during systole whilst the valve opening remains unhindered.

Claims

AMENDED CLAIMS received by the International Bureau on 27 August 2008 (27.08.2008)
Claims
An assembly for repair of mitral valve comprising: a leaflet anchor (84) with attached cords (841), a myocardial free wall anchor (90) with attached locking loop knot (90212) , a stabilisation tube (70) which is interposed between the said myocardial wall anchor and the target leaflet wherein the said tube covers longitudinally the said cords, wherein the said leaflet is sandwiched between the said leaflet anchor and the said tube in which way the said leaflet is fastened to the said leaflet anchor without knotting, wherein the said cords are secured to the exterior of the said cardiac wall anchor with said locking loop knot wherein the tension length of the said assembly is adjusted outside the heart. An assembly of claim 1, wherein the said leaflet anchor (84) is formed of a biocompatible polymer pledget having attached cords (341) formed of the surgical suture loop having docking connectors (842) integrated into the ends of the said suture loop. A device of claim 2 wherein said connectors are formed of metallic
"stent like" spiral which enables docldng onto different guiding tracks by manual compression, wherein said connectors have a small compressed profile that enables passage and transportation through cardiovascular cathetars and/ or sheaths which enables percutaneous application of the assembly of claim 1.
4. An assembly of claim 1 wherein the said myocardial wall anchor (90) is formed of two solid biocompatible polymer discs, smaller internal (endocardial) (901) and larger external (epicardial) (902), interconnected with a central part (903) made of resilient sponge of biocompatible polymer reinforced with a suture mash, wherein a preformed locking loop knot (90212) made of separate surgical suture length is attached to the external disc of the said myocardial wall anchor.
5. An assembly of claim 1 wherein the said stabilization tube (70) is made of elastic biocompatible polymer wherein the said tube has a small outer diameter to allow its transportation through the cardiovascular sheaths and an inner lumen large enough to accept passage of two or more said cords (841) of claim 2.
PCT/RS2007/000006 2006-03-02 2007-02-26 Catheter based mitral valve repair method and apparatus Ceased WO2007100268A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP07709280A EP2023822A2 (en) 2006-03-02 2007-02-26 Catheter based mitral valve repair method and apparatus

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
RSP-06/0147 2006-03-02
RSP20060147 2006-03-02

Publications (3)

Publication Number Publication Date
WO2007100268A2 WO2007100268A2 (en) 2007-09-07
WO2007100268A3 WO2007100268A3 (en) 2008-10-02
WO2007100268B1 true WO2007100268B1 (en) 2008-11-13

Family

ID=38459455

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/RS2007/000006 Ceased WO2007100268A2 (en) 2006-03-02 2007-02-26 Catheter based mitral valve repair method and apparatus

Country Status (3)

Country Link
EP (1) EP2023822A2 (en)
RS (1) RS20060147A (en)
WO (1) WO2007100268A2 (en)

Families Citing this family (33)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3120811A3 (en) * 2009-09-17 2017-04-19 Abbott Vascular Methods, systems and devices for cardiac valve repair
EP2723277B1 (en) * 2011-06-27 2018-05-30 University of Maryland, Baltimore Transapical mitral valve repair device
US9681864B1 (en) 2014-01-03 2017-06-20 Harpoon Medical, Inc. Method and apparatus for transapical procedures on a mitral valve
WO2016126699A1 (en) 2015-02-02 2016-08-11 On-X Life Technologies, Inc. Rapid deployment artificial chordae tendinae system
EP3753498B1 (en) 2015-10-02 2023-12-06 Harpoon Medical, Inc. Distal anchor apparatus for mitral valve repair
CA2999513C (en) 2015-10-02 2022-03-22 Harpoon Medical, Inc. Distal anchor apparatus and methods for mitral valve repair
WO2017066888A1 (en) * 2015-10-21 2017-04-27 Coremedic Ag Medical implant and method for heart valve repair
JP7002466B2 (en) 2015-12-30 2022-01-20 パイプライン メディカル テクノロジーズ，インコーポレイティド Mitral valve binding
US10624743B2 (en) 2016-04-22 2020-04-21 Edwards Lifesciences Corporation Beating-heart mitral valve chordae replacement
WO2017210434A1 (en) 2016-06-01 2017-12-07 On-X Life Technologies, Inc. Pull-through chordae tendineae system
US9877833B1 (en) 2016-12-30 2018-01-30 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US11083580B2 (en) 2016-12-30 2021-08-10 Pipeline Medical Technologies, Inc. Method of securing a leaflet anchor to a mitral valve leaflet
US12472062B2 (en) 2016-12-30 2025-11-18 Pipeline Medical Technologies, Inc. Method and apparatus for mitral valve chord repair
US10925731B2 (en) 2016-12-30 2021-02-23 Pipeline Medical Technologies, Inc. Method and apparatus for transvascular implantation of neo chordae tendinae
US10765515B2 (en) 2017-04-06 2020-09-08 University Of Maryland, Baltimore Distal anchor apparatus and methods for mitral valve repair
CA3065223C (en) 2017-06-19 2024-05-07 Harpoon Medical, Inc. Method and apparatus for cardiac procedures
CR20200141A (en) 2017-10-24 2020-08-27 Univ Maryland Method and apparatus for cardiac procedures
US10709443B2 (en) * 2018-03-01 2020-07-14 Durastat Llc Devices and methods for suture placement
CN110269725B (en) * 2018-03-15 2022-07-26 杭州德晋医疗科技有限公司 Artificial chordae tendineae capable of being developed
US11517435B2 (en) 2018-05-04 2022-12-06 Edwards Lifesciences Corporation Ring-based prosthetic cardiac valve
EP3796876B1 (en) 2018-05-22 2022-07-27 Boston Scientific Scimed, Inc. Percutaneous papillary muscle relocation
US11224418B2 (en) 2018-06-15 2022-01-18 Edwards Lifesciences Corporation Papillary muscle approximation pads
CN108904102B (en) * 2018-07-19 2023-12-12 上海诺强医疗科技有限公司 Transcatheter mitral valve systole system and method of use thereof
EP3893810A4 (en) 2018-12-12 2022-12-14 Pipeline Medical Technologies, Inc. METHOD AND DEVICE FOR REPAIRING MITRAL VALVE TENDONS
EP3923826A2 (en) 2019-02-12 2021-12-22 Edwards Lifesciences Corporation Controlled tissue anchor spacing
CN114430674B (en) * 2019-07-04 2025-08-29 堤乐哈修门医学研究基础建设及服务有限公司 Chordal replacement devices and methods
CN113729885B (en) * 2019-12-02 2023-01-20 北京领健医疗科技有限公司 Puncture needle, coupler, guide device and repair instrument
CN115666412A (en) 2020-04-22 2023-01-31 爱德华兹生命科学公司 Controlled suture tensioning
JP7701390B2 (en) 2020-06-17 2025-07-01 パイプライン メディカル テクノロジーズ， インコーポレイテッド Methods and devices for mitral valve chordae repair
US12029413B2 (en) * 2020-06-30 2024-07-09 Neurotect LLC Knotless sutures and anchoring clip for knotless sutures
WO2022055923A1 (en) 2020-09-10 2022-03-17 Edwards Lifesciences Corporation Closing tissue openings
CN114652364B (en) * 2020-12-23 2024-09-20 杭州德晋医疗科技有限公司 Implant, transcatheter wire locking device and wire locking method
US12458498B2 (en) 2021-02-10 2025-11-04 Edwards Lifesciences Corporation Implanting grafts to valve leaflets for cardiac procedures

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6260552B1 (en) * 1998-07-29 2001-07-17 Myocor, Inc. Transventricular implant tools and devices

Also Published As

Publication number Publication date
EP2023822A2 (en) 2009-02-18
WO2007100268A3 (en) 2008-10-02
RS20060147A (en) 2008-04-04
WO2007100268A2 (en) 2007-09-07

Similar Documents

Publication Publication Date Title
WO2007100268B1 (en) Catheter based mitral valve repair method and apparatus
US20250339268A1 (en) Systems for placing a coapting member between valvular leaflets
JP7365392B2 (en) mitral valve shackles
US9131928B2 (en) Elongated body for deployment in a heart
US7695510B2 (en) Annuloplasty device having shape-adjusting tension filaments
US7316706B2 (en) Tensioning device, system, and method for treating mitral valve regurgitation
US9636223B2 (en) Systems and methods for placing a coapting member between valvular leaflets
US9763781B2 (en) Inflatable transcatheter intracardiac devices and methods for treating incompetent atrioventricular valves
US9060858B2 (en) Methods, systems and devices for cardiac valve repair
US7955384B2 (en) Coronary sinus approach for repair of mitral valve regurgitation
EP3238663B1 (en) Devices and systems for reshaping a heart valve annulus
JP5371440B2 (en) Papillary muscle position control device, system and method
US8470028B2 (en) Methods, systems and devices for cardiac valve repair
US20130030522A1 (en) Devices and methods for heart treatments
WO2009081396A2 (en) Methods and devices for treatment of a heart
US20040210240A1 (en) Method and repair device for treating mitral valve insufficiency
EP1865888A1 (en) Devices, systems, and methods for reshaping a heart valve annulus
WO2009038725A1 (en) Devices, systems, and methods for reshaping heart valve annulus, including the use of magnetic tools
JP2008534084A (en) Apparatus, system, and method for reshaping a heart valve annulus
HK1242556B (en) Devices and systems for reshaping a heart valve annulus

Legal Events

Date Code Title Description
NENP Non-entry into the national phase in:

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 2007709280

Country of ref document: EP

121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 07709280

Country of ref document: EP

Kind code of ref document: A2