WO2018058157A1

WO2018058157A1 - An accessory for assisting with the repair of a mitral valve

Info

Publication number: WO2018058157A1
Application number: PCT/ZA2017/050070
Authority: WO
Inventors: Mervyn Alexander WILLIAMS
Original assignee: Individual
Current assignee: Individual
Priority date: 2016-09-26
Filing date: 2017-09-26
Publication date: 2018-03-29
Anticipated expiration: 2019-03-26
Also published as: ZA201902647B

Abstract

According to the invention there is provided an accessory (10) for assisting with the repair of a mitral valve (12), which accessory includes an upstream stopper member (14) sized, shaped and/or configured, to engage an end portion (16) of a prosthesis (18) on an upstream side of the valve (20), which prosthesis imitates the anatomical characteristics of a chordae tendineae (22) that extends between a papillary muscle (24) and a co-aptation zone (26) of a leaflet (28) of the mitral valve, and to inhibit displacement of the leaflet relative to the prosthesis beyond a desired closed position of the valve.

Description

AN ACCESSORY FOR ASSISTING WITH THE REPAIR OF A MITRAL VALVE

FIELD OF THE INVENTION

The invention relates to an accessory for assisting with the repair of a mitral valve.

SUMMARY OF THE INVENTION

According to the invention there is provided an accessory for assisting with the repair of a mitral valve, which accessory includes: - an upstream stopper member sized, shaped and/or configured, to engage an end portion of a prosthesis on an upstream side of the valve which prosthesis imitates the anatomical characteristics of a chordae tendineae that extends between a papillary muscle and a co-aptation zone of a leaflet of the mitral valve, and to inhibit displacement of the leaflet relative to the prosthesis beyond a desired closed position of the valve.

The accessory may further include a downstream stopper member which may be sized, shaped and/or configured to engage a portion of the prosthesis on a downstream side of the valve to inhibit displacement of the leaflet relative to the prosthesis towards the papillary muscle once the desired length of the prosthesis has been set by the upstream stopper member.

The stopper members may include an engaging portion for engaging the prosthesis and for inhibiting displacement of the leaflet past the stopper member in an engaging condition, and a manipulating portion for allowing a user to manipulate the engaging portion between an open and engaging condition. The engaging portion may be in the form of any one of the group including jaws, pincers and the like. The engaging portion may include tooth formations for facilitating gripping and retaining the prosthesis in position relative the leaflet. It is to be appreciated that the force exerted by the engaging portion on the prosthesis is sufficient so as to retain the prosthesis in position relative the engaging portion without damaging the prosthesis.

The manipulating portion may extend from end regions of the engaging portion. The manipulating portion may be in the form of an elongate member shaped and/or configured to describe any suitable geometrical shape. The manipulating portion may include a biasing means for biasing the engaging portion towards the engaging condition. The biasing means may be provided by bending the elongate member so that the elongate member has an inherent bias towards the engaging condition. Typically, the biasing may be achieved by bending the elongate member so as to describe a generally circular, ovoid, obovate or elliptical path. Alternatively, the biasing means may be in the form of a spring for biasing the engaging portion towards the engaging condition and allowing a user to bias the engaging portion into an open condition.

The stopper members may be manufactured from any suitable resiliently deformable synthetic, plastic or metallic material such as spring steel.

It is to be appreciated that the stopper members may be sized, shaped and/or configured for allowing the assessment of the mitral valve before engaging the stopper members with the prosthesis. BRIEF DESCRIPTION OF THE DRAWINGS

An accessory for assisting with the repair of a mitral valve in accordance with the invention will now be described by way of the following non-limiting examples with reference to the accompanying drawings.

In the drawings: -

Figure 1 shows a schematic of a part of a mitral valve and prosthesis which imitates the anatomical characteristics of a chordae tendineae in an operative condition where the ends of the prosthesis extend through a co-aptation zone of a leaflet of the mitral valve;

Figure 2 shows an enlarged schematic of an accessory in accordance with the invention in an engaged condition on an upstream side of the valve;

Figures 3 to 7 show enlarged sectioned views of the stopper members of the accessory in various stages of operation;

Figure 8a shows a top view of the accessory in an open condition;

Figure 8b shows a top view of the accessory in a closed engaging condition;

Figure 9 shows a schematic overview of a repaired mitral valve; and

Figures 10 - 15 show schematic representations of various embodiments of the accessory in accordance with the invention.

DETAILED DESCRIPTION OF THE INVENTION

Referring now to the drawings, reference 10 generally depicts an accessory for assisting with the repair of a mitral valve 12 in accordance with the invention. The accessory 10 includes an upstream stopper member 14 sized, shaped and configured, to engage an end portion 16 of a prosthesis 18 on an upstream side 20 of the valve 12 which prosthesis 18 imitates the anatomical characteristics of a chordae tendineae 22 that extends between a papillary muscle 24 and a co-aptation zone 26 of a leaflet 28 of the mitral valve 12, and to inhibit displacement of the leaflet 28 relative to the prosthesis 18 beyond a desired closed position of the valve 12.

The accessory 10 further includes a downstream stopper member 30 sized, shaped and configured to engage with a portion of the prosthesis 18 on a downstream side 32 of the valve 12 to inhibit displacement of the leaflet 28 relative to the prosthesis 18 towards the papillary muscle 24 once the desired length of the prosthesis 18 has been set by the upstream stopper member 14.

The stopper members, 14 and 30, include engaging portions in the form of jaws 34 for engaging the prosthesis 18 and for inhibiting displacement of the leaflet 28 past the stopper members, 14 and 30, and a manipulating portion in the form of an elongate member 36 for manipulating the engaging portion 34 between an open and an engaging condition.

The elongate member 36 extends from end regions of the jaws 34 and is of generally obovate shape so as to impart an inherent bias of the jaws towards the engaging condition. As shown in Figures 1 1 and 12, biasing of the jaws 236 and 336 is achieved via the biasing means in the form of springs, 217 and 317 respectively.

In the embodiment shown in Figure 10, an accessory 1 10 in accordance with the invention includes an elongate member 136 having a substantially oval shape. In the embodiment shown in Figure 12, the manipulating portion is defined by a pair of arms 337 biased towards an engaging condition by a spring 317.

In the embodiment shown in Figure 13, an accessory 410 includes an elongate member 436 having a substantially obovate shape.

In the embodiment shown in Figure 14, an accessory 510 having a generally square shape includes jaws 534 which define a channel 535 for receiving the prosthesis 18 therethrough and a retaining zone 539 defined by the accessory 510 for retaining the prosthesis 18 therein.

In the embodiment shown in Figure 15, an accessory 610 having a generally square shape includes generally wedge-shaped jaws 634 which are shaped and configured for wedging the prosthesis 18 therebetween.

In use, a surgeon will thread the prosthesis 18 through the co-aptation zone 26 of the leaflet 28. Once a desired length of the prosthesis 18 has been reached, the surgeon opens the upstream stopper member 14 to grasp the prosthesis and set the length of the prosthesis 18. The surgeon will then test whether the length of the prosthesis 18 is correct and once the correct length has been established, the surgeon will open the downstream stopper 30 on the downstream side of the leaflet 28 and grasp the prosthesis 18 on the downstream side of the leaflet 28. Once the downstream stopper 30 has been placed in position, the surgeon will then remove the upstream stopper 14 in order to be able to tie a surgeon's knot 38 on the upstream side of the mitral valve 12. After the ends of the prosthesis 18 have been tied into a surgeon's knot 38, the surgeon will then remove the downstream stopper 30 and test once again whether the length of the prosthesis 18 is correct so that there are no leakages in the valve. Although only certain embodiments of the invention have been described herein, it will be understood by any person skilled in the art that other modifications, variations, and possibilities of the invention are possible. Such modifications, variations and possibilities are therefore to be considered as falling within the spirit and scope of the invention and hence form part of the invention as herein described and/or exemplified. It is further to be understood that the examples are provided for illustrating the invention further and to assist a person skilled in the art with understanding the invention and is not meant to be construed as unduly limiting the reasonable scope of the invention.

The inventor believes that an accessory 10 for the assisting in repair of the mitral valve 12 in accordance with the invention, may be advantageous in that it provides a simple, elegant and expedient solution in establishing the correct length of a chordae tendineae prosthesis 18 during the repair of a mitral valve.

Claims

1 . An accessory for assisting with the repair of a mitral valve, which accessory includes: - an upstream stopper member sized, shaped and/or configured, to engage an end portion of a prosthesis on an upstream side of the valve which prosthesis imitates the anatomical characteristics of a chordae tendineae that extends between a papillary muscle and a co-aptation zone of a leaflet of the mitral valve, and to inhibit displacement of the leaflet relative to the prosthesis beyond a desired closed position of the valve.

2. An accessory as claimed in claim 1 wherein the accessory further includes a downstream stopper member which is sized, shaped and configured to engage a portion of the prosthesis on a downstream side of the valve to inhibit displacement of the leaflet relative to the prosthesis towards the papillary muscle once the desired length of the prosthesis has been set by the upstream stopper member.

3. An accessory as claimed in claim 1 or 2 wherein the stopper member includes an engaging portion for engaging the prosthesis and for inhibiting displacement of the leaflet past the stopper member in an engaging condition.

4. An accessory as claimed in claim 3 wherein the engaging portion is in the form of any one of the group including jaws, pincers and the like.

5. An accessory as claimed in claim 4 wherein the engaging portion includes tooth formations for facilitating gripping and retaining the prosthesis in position relative the leaflet.

6. An accessory as claimed in any one or more of the claims 3 to 5 wherein the stopper members further include a manipulating portion for manipulating the engaging portion between an open and engaging condition.

7. An accessory as claimed in claim 6 wherein the manipulating portion extends from end regions of the engaging portion.

8. An accessory as claimed in claim 6 or 7 wherein the manipulating portion is in the form of an elongate member which is shaped and configured to describe any suitable geometric shape.

9. An accessory as claimed in any one or more of the claims 6 to 8 wherein the manipulating portion includes a biasing means for biasing the engaging portion towards the engaging condition.

10. An accessory as claimed in claim 9 wherein the biasing means is provided by bending the elongate member so that the elongate member has an inherent bias towards the engaging condition.

1 1 . An accessory as claimed in claim 10 wherein the biasing of the elongate member is achieved by bending the elongate member so as to describe a generally circular, ovoid, obovate or elliptical path.

12. An accessory as claimed in claim 9 wherein the biasing means is in the form of a spring for biasing the engaging portion towards the engaging condition and allowing a user to bias the engaging portion into an open condition.

13. An accessory as claimed in any one or more of the preceding claims wherein the stopper member is manufactured from any suitable resiliently deformable synthetic, plastics or metallic material.

14. An accessory as claimed in claim 13 wherein the stopper members are manufactured from spring steel.

15. An accessory according to the invention, substantially as hereinbefore described or exemplified.

16. An accessory as specifically described with reference to or as illustrated in any one of the accompanying drawings.

17. An accessory, including any new or inventive integer or combination of integers, substantially as herein described.