公开/公告号

US6629534B1

申请日

2000-04-07

发明名称

Methods and apparatus for cardiac valve repair

解决的技术问题

it would be desirable to provide alternative and additional methods, devices, and systems for performing the repair of mitral and other cardiac valves, particularly the tricuspid valve which is the other atrioventricular valve. Such methods, devices, and systems should preferably not require open chest access and be capable of being performed endovascularly, i.e., using devices which are advanced to the heart from a point in the patient's vasculature remote from the heart. Still more preferably, the methods, devices, and systems should not require that the heart be bypassed, although the methods, devices, and systems should be useful with patients who are bypassed and/or whose heart may be temporarily stopped by drugs or other techniques.

技术方案

The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

相关附图

公开/公告号

US7563267B2

申请日

2003-05-19

发明名称

Fixation device and methods for engaging tissue

解决的技术问题

 it would be desirable to provide alternative and additional methods, devices, and systems for performing the repair of mitral and other cardiac valves. Such methods, devices, and systems should preferably not require open chest access and be capable of being performed either endovascularly, i.e., using devices which are advanced to the heart from a point in the patient's vasculature remote from the heart or by a minimally invasive approach. Further, such devices and systems should provide features which allow repositioning and optional removal of a fixation device prior to fixation to ensure optimal placement. Still more preferably, the methods, devices, and systems would be useful for repair of tissues in the body other than heart valves.

技术方案

The invention provides devices, systems and methods for tissue approximation and repair at treatment sites. The devices, systems and methods of the invention will find use in a variety of therapeutic procedures, including endovascular, minimally-invasive, and open surgical procedures, and can be used in various anatomical regions, including the abdomen, thorax, cardiovascular system, heart, intestinal tract, stomach, urinary tract, bladder, lung, and other organs, vessels, and tissues. The invention is particularly useful in those procedures requiring minimally-invasive or endovascular access to remote tissue locations, where the instruments utilized must negotiate long, narrow, and tortuous pathways to the treatment site. In addition, many of the devices and systems of the invention are adapted to be reversible and removable from the patient at any point without interference with or trauma to internal tissues.

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公开/公告号

US7666204B2

申请日

2003-05-19

发明名称

Multi-catheter steerable guiding system and methods of use

解决的技术问题

 it would be desirable to provide an access or guiding system having an adjustable distal end which is capable of being positioned within a target body cavity in a desired orientation. The system should have a large lumen diameter to accommodate the passage of a variety of devices, should have good wall strength to avoid kinking or collapse when bent around tight curves, and should have good column, tensile, and torsional strength to avoid deformation when the devices are passed through the lumen and torqued or translated. The steering mechanisms should provide for a high degree of controlled deflection at the distal end of the system but should not take up significant lumen area to allow for passage of interventional devices. Further, the system should be positionable in a manner which allows compound curves to be formed, for example curvature within more than one plane.

技术方案

Devices, systems, methods and kits are provided for endoscopically accessing a body cavity and providing a directed pathway toward a target tissue within the cavity. The directed pathway is provided by a multi-catheter guiding system which is positioned in a desired configuration, generally directed toward the target tissue. Interventional devices may then be passed through the guiding system to the target tissue. Depending on the location of the target tissue and the desired angle of approach, the guiding system may be required to maintain one or more curves in one or more planes to properly direct the interventional devices. The multi-catheter guiding system of the present invention comprises an outer guiding catheter and a coaxially positioned inner guiding catheter, each of which independently form curvatures so that together the curves properly direct the interventional device.

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公开/公告号

US7608091B2

申请日

2003-07-03

发明名称

Methods and apparatus for cardiac valve repair

解决的技术问题

 it would be desirable to provide alternative and additional methods, devices, and systems for performing the repair of mitral and other cardiac valves, particularly the tricuspid valve which is the other atrioventricular valve. Such methods, devices, and systems should preferably not require open chest access and be capable of being performed endovascularly, i.e., using devices which are advanced to the heart from a point in the patient's vasculature remote from the heart. Still more preferably, the methods, devices, and systems should not require that the heart be bypassed, although the methods, devices, and systems should be useful with patients who are bypassed and/or whose heart may be temporarily stopped by drugs or other techniques. 

技术方案

The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

相关附图

公开/公告号

US10828042B2

申请日

2003-05-19

发明名称

Fixation devices, systems and methods for engaging tissue

解决的技术问题

  it would be desirable to provide alternative and additional methods, devices, and systems for performing the repair of mitral and other cardiac valves. Such methods, devices, and systems should preferably not require open chest access and be capable of being performed either endovascularly, i.e., using devices which are advanced to the heart from a point in the patient's vasculature remote from the heart or by a minimally invasive approach. Further, such devices and systems should provide features which allow repositioning and optional removal of a fixation device prior to fixation to ensure optimal placement. Still more preferably, the methods, devices, and systems would be useful for repair of tissues in the body other than heart valves.

技术方案

System for fixation of leaflets of a heart valve including a delivery catheter having an elongated shaft, a proximal end portion and a distal end portion configured to be positioned proximate native leaflets of a heart valve from a remote vascular access point, the delivery catheter further includes a rotatable actuator rod having a threaded fastener at a distal end thereof, and a fixation device releasably coupled by a threaded connection to the threaded fastener of the actuator rod. The fixation device includes a first arm moveable between a closed position and an open position, a second arm moveable between a closed position and an open position. The fixation device further includes a first gripping element movable relative to the first arm in the open position, the first gripping element biased toward the first arm to capture a first leaflet of the heart valve therebetween, and a second gripping element movable relative to the second arm in the open position, the second gripping element biased toward the second arm to capture a second leaflet of the heart valve therebetween. The first gripping element and the second gripping element each includes a plurality of barbs extending therefrom, the plurality of barbs of each of the first gripping element and the second gripping element being aligned transversely in at least one row. The fixation device further includes a covering disposed on each of the first gripping element and the second gripping element, wherein the plurality of barbs of the first gripping element and the second gripping element, respectively, protrude through the covering.

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公开/公告号

CN102395331B

申请日

2009-12-15

发明名称

用于可植入的固定设备的分离机构

解决的技术问题

希望的是提供用于执行二尖瓣和其他心脏瓣膜修复的替代和额外的方法、设备和系统。优选地，这种方法、设备和系统宜不要求开放的胸部路径，并能够血管内执行或者通过微创方法执行，血管内执行即使用从患者远离心脏的脉管推进到心脏的设备来执行。此外，这些设备和系统应该提供允许在固定之前重新定位和随意移除固定设备的特征，以确保最佳布置。这种设备还应该容易输送和部署。更优选地，该方法、设备和系统将用于修复心脏瓣膜以外的身体组织。

技术方案

本发明提供用于组织接近和在治疗部位进行修复的设备、系统和方法。本发明的设备、系统和方法能够应用在各种治疗手术中，包括血管内、微创和开放式外科手术，并且能够用在各种解剖区域，包括腹部、胸腔、心血管系统、心脏、肠道、胃、尿道、膀胱、肺和其他器官、血管和组织。本发明在那些需要到达远处组织位置的微创或者血管内通路的手术特别有用，其中使用的器械必须通过长的、狭窄且弯曲的路径到达治疗部位。另外，本发明的很多设备和系统适于被倒转并从患者的任何位置处移除，而不与内部组织干涉或损伤内部组织。

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