US20030220685A1
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Method and apparatus for catheter-based annuloplasty using local plications
Assignee: Edwards Lifesciences Corp
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Filing: 2001-05-25
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Granted: —
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Expires: 2021-05-25
Abstract
Abstract The present invention relates to a minimally invasive method of performing annuloplasty. According to one aspect of the present invention, a method for performing annuloplasty includes accessing a left ventricle of a heart to provide a discrete plication element to the left ventricle, and engaging the plication element to tissue near a mitral valve of the heart. Engaging the plication element includes causing the plication element to gather a portion of the tissue to create a plication. In one embodiment, accessing the left ventricle of the heart to provide the plication element includes accessing the left ventricle of the heart using a catheter arrangement.
Inventors
- 👤 Edwin Hlavka
- 👤 Jonathan Podmore
- 👤 Paul Spence
Bibliographic Details
Application Number
—
Jurisdiction
US
Data Source
google_patents
Last Synchronized
2026-10-23 05:18
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/02; A61F2/24; A61F2/2442; A61F2/2445; A61F2/2448; A61F2/2466; A61B; A61B17/00; A61B17/00234; A61B2017/00238; A61B2017/00243; A61B17/04; A61B17/0469; A61B2017/048; Y; Y10; Y10S; Y10S623/00; Y10S623/902; Y10S623/904
Claims Analysis
Total Claims: 43
Claim 1
Independent Claim
61 words
1 . A method for performing annuloplasty, the method comprising: accessing a left ventricle of a heart to provide a plication element to the left ventricle; and engaging the plication element to tissue near a mitral valve of the heart, wherein engaging the plication element includes causing the plication element to gather a portion of the tissue to create a plication.
Claim 2
Dependent Claim
61 words
1 . A method for performing annuloplasty, the method comprising: accessing a left ventricle of a heart to provide a plication element to the left ventricle; and engaging the plication element to tissue near a mitral valve of the heart, wherein engaging the plication element includes causing the plication element to gather a portion of the tissue to create a plication.
Claim 3
Dependent Claim
34 words
2 . A method as recited in claim 1 wherein accessing the left ventricle of the heart to provide the plication element includes accessing the left ventricle of the heart with a catheter arrangement.
Claim 4
Dependent Claim
48 words
3 . A method as recited in claim 2 wherein accessing the left ventricle of the heart using the catheter arrangement includes inserting the catheter arrangement into the left ventricle between a plane defined by the mitral valve and a plane associated with papillary muscles of the heart.
Claim 5
Dependent Claim
74 words
4 . A method as recited in claim 2 wherein engaging the plication element to tissue near the mitral valve includes: piercing the tissue using the plication element, wherein piercing the tissue using the plication element causes a first portion of the plication element to be positioned on an atrial side of the mitral valve and a second portion of the plication element to be positioned on a ventricular side of the mitral valve.
Claim 6
Dependent Claim
34 words
5 . A method as recited in claim 4 wherein the catheter is configured to cause the first portion of the plication element to be positioned on the atrial side of the mitral valve.
Claim 7
Dependent Claim
124 words
6 . A method as recited in claim 1 wherein the plication element includes a first bar element and a second bar element, the first bar element and the second bar element being coupled to a thread, the thread further being coupled to a locking mechanism, and wherein engaging the plication element to tissue near the mitral valve includes: inserting the first bar element and the second bar element through the tissue to an atrial side of the mitral valve; and positioning the locking mechanism against the tissue on a ventricular side of the mitral valve, wherein positioning the locking mechanism against the tissue causes the plication to be formed substantially between the first bar element, the second bar element, and the locking mechanism.
Claim 8
Dependent Claim
16 words
7 . A method as recited in claim 6 wherein the locking mechanism includes a pledget.
Claim 9
Dependent Claim
51 words
8 . A method as recited in claim 6 wherein the locking mechanism includes a spring element, the spring element being arranged to cause the locking mechanism to engage, wherein when the locking mechanism engages, the first bar element and the second bar element are brought into contact with the tissue.
Claim 10
Dependent Claim
78 words
9 . A method as recited in claim 6 wherein accessing the left ventricle of the heart to provide the plication element includes accessing the left ventricle of the heart using a catheter arrangement, the catheter arrangement being configured to introduce the first bar element and the second bar element through the tissue to an atrial side of the mitral valve and to position the locking mechanism against the tissue on the ventricular side of the mitral valve.
Claim 11
Dependent Claim
51 words
10 . A method as recited in claim 1 wherein engaging the plication element to tissue near the mitral valve to cause the plication element to gather the portion of the tissue to create the plication includes gathering the portion of the tissue on a ventricular side of the mitral valve
Claim 12
Dependent Claim
27 words
11 . A method as recited in claim 1 wherein the plication element is one selected from the group consisting of a suture structure and a clip.
Claim 13
Dependent Claim
51 words
12 . A method for performing an annuloplasty, comprising: accessing tissue located near the mitral valve of a heart; and creating a first discrete plication in the tissue using a first plication element, the first discrete plication being positioned to cause an arc length of the mitral valve to be reduced.
Claim 14
Dependent Claim
51 words
12 . A method for performing an annuloplasty, comprising: accessing tissue located near the mitral valve of a heart; and creating a first discrete plication in the tissue using a first plication element, the first discrete plication being positioned to cause an arc length of the mitral valve to be reduced.
Claim 15
Dependent Claim
24 words
13 . A method as recited in claim 12 wherein accessing the tissue includes accessing the tissue through a left ventricle of the heart
Claim 16
Dependent Claim
24 words
14 . A method as recited in claim 13 wherein the tissue is accessed through the left ventricle of the heart using a catheter.
Claim 17
Dependent Claim
19 words
15 . A method as recited in claim 14 further including providing the first plication element through the catheter.
Claim 18
Dependent Claim
26 words
16 . A method as recited in claim 15 wherein the catheter is configured to cause the first plication element to create the first discrete plication.
Claim 19
Dependent Claim
40 words
17 . A method as recited in claim 15 wherein creating the first discrete plication in the tissue using the first plication element includes creating the first discrete plication in the tissue using the first plication element and the catheter.
Claim 20
Dependent Claim
43 words
18 . A method as recited in claim 17 wherein the first plication element is a clip element, and creating the first discrete plication in the tissue using the first plication element and the catheter includes engaging the tissue using the clip element.
Claim 21
Dependent Claim
80 words
19 . A method as recited in claim 17 wherein the first plication element is a locking element, the locking element including a first piece and a second piece, and creating the first discrete plication in the tissue using the first plication element and the catheter includes: penetrating the tissue with a part of the first piece and a part of the second piece; and engaging the tissue between the first piece and the second piece of the locking element.
Claim 22
Dependent Claim
121 words
20 . A method as recited in claim 17 wherein the first plication element includes a plurality of bar pieces, a thread, and a lock, the bar pieces and the lock being coupled to the thread, and creating the first discrete plication in the tissue using the first plication element and the catheter includes: penetrating the tissue to position the bar pieces on an atrial side of the tissue; tensioning the thread to position the bar pieces against the atrial side of the tissue; locking the lock against a ventricular side of the tissue, wherein locking the lock against the ventricular side of the tissue causes the first discrete plication to be formed substantially between the bar pieces and the lock.
Claim 23
Dependent Claim
36 words
21 . A method as recited in claim 12 further including: creating a second discrete plication in the tissue using a second plication element, the second plication element being substantially separate from the first plication element.
Claim 24
Dependent Claim
98 words
22 . A system for use in an annuloplasty procedure, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; and a bendable member, wherein the bendable member is movable between a first position for insertion into a left ventricle through the catheter assembly and a second position, the bendable member being configured to create a plication in tissue located near a mitral valve when the bendable member is in the second position.
Claim 25
Dependent Claim
98 words
22 . A system for use in an annuloplasty procedure, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; and a bendable member, wherein the bendable member is movable between a first position for insertion into a left ventricle through the catheter assembly and a second position, the bendable member being configured to create a plication in tissue located near a mitral valve when the bendable member is in the second position.
Claim 26
Dependent Claim
24 words
23 . A system according to claim 22 wherein the first position is a collapsed position and the second position is an extended position.
Claim 27
Dependent Claim
24 words
24 . A system according to claim 22 wherein the first position is an open position and the second position is a closed position.
Claim 28
Dependent Claim
160 words
25 . A system for use in an annuloplasty procedure, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; and a suture structure comprising a first bar member, a second bar member, a thread, and a locking element, the first bar member and the second bar member being coupled to the thread, the locking element being arranged to move over the thread, the catheter assembly being configured to cause the first bar member and the second bar member to penetrate tissue near the mitral valve, the catheter assembly further being configured to move the locking element over the thread into contact with the tissue on a ventricular side of the mitral valve, wherein a plication is created in the tissue substantially between the first bar member, the second bar member, and the locking element.
Claim 29
Dependent Claim
160 words
25 . A system for use in an annuloplasty procedure, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; and a suture structure comprising a first bar member, a second bar member, a thread, and a locking element, the first bar member and the second bar member being coupled to the thread, the locking element being arranged to move over the thread, the catheter assembly being configured to cause the first bar member and the second bar member to penetrate tissue near the mitral valve, the catheter assembly further being configured to move the locking element over the thread into contact with the tissue on a ventricular side of the mitral valve, wherein a plication is created in the tissue substantially between the first bar member, the second bar member, and the locking element.
Claim 30
Dependent Claim
109 words
26 . A system for performing annuloplasty on a mitral valve of a heart, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; a guide element shaped for insertion into the catheter assembly, the guide element having an anchorable feature; and a plication element, the plication element being shaped for insertion over the guide element into the left ventricle substantially below the mitral valve, wherein the plication element is configured to gather tissue of the heart to create a plication in the tissue.
Claim 31
Dependent Claim
109 words
26 . A system for performing annuloplasty on a mitral valve of a heart, the system comprising: a catheter assembly configured for insertion through an aorta of the heart into a left ventricle of the heart to reach a region of the left ventricle substantially below the mitral valve; a guide element shaped for insertion into the catheter assembly, the guide element having an anchorable feature; and a plication element, the plication element being shaped for insertion over the guide element into the left ventricle substantially below the mitral valve, wherein the plication element is configured to gather tissue of the heart to create a plication in the tissue.
Claim 32
Dependent Claim
32 words
27 . A system according to claim 26 wherein the plication element is a suture element, the suture element being configured to create a suture in the tissue to create the plication.
Claim 33
Dependent Claim
29 words
28 . A system according to claim 26 wherein the plication element is a clip element, the clip element being configured to bunch the tissue to create the plication.
Claim 34
Dependent Claim
73 words
29 . A system according to claim 26 wherein the catheter assembly includes a delivery tube and a gutter catheter, the gutter catheter being positioned at least partially within the delivery tube, wherein a portion of the gutter catheter is configured to be positioned substantially within a region of the left ventricle defined between a plane associated with the papillary muscles of the left ventricle and a plane associated with the mitral valve.
Claim 35
Dependent Claim
23 words
30 . A system according to claim 29 wherein the guide element is shaped for insertion into a lumen of the gutter catheter.
Claim 36
Dependent Claim
85 words
31 . A system according to claim 28 wherein the catheter assembly includes a delivery tube and a gutter catheter, the gutter catheter being positioned at least partially within the delivery tube, wherein a portion of the gutter catheter is configured to be positioned substantially within a region of the left ventricle defined between a plane associated with the papillary muscles of the left ventricle, a plane associated with the mitral valve, cordae tendonae of the left ventricle, and a wall of the left ventricle.
Claim 37
Dependent Claim
117 words
32 . A method for performing annuloplasty on a mitral valve of a heart, the method comprising: inserting a first catheter assembly into a left ventricle through an aorta of the heart and an aortic valve of the heart; positioning a guide element along a wall of the left ventricle beneath the mitral valve using the first catheter assembly; positioning a plication element in the left ventricle beneath the mitral valve using a second catheter assembly and the guide element as a guide; and engaging the plication element with tissue near the mitral valve using the second catheter assembly, wherein engaging the plication element with the tissue near the mitral valve creates a plication in the tissue.
Claim 38
Dependent Claim
117 words
32 . A method for performing annuloplasty on a mitral valve of a heart, the method comprising: inserting a first catheter assembly into a left ventricle through an aorta of the heart and an aortic valve of the heart; positioning a guide element along a wall of the left ventricle beneath the mitral valve using the first catheter assembly; positioning a plication element in the left ventricle beneath the mitral valve using a second catheter assembly and the guide element as a guide; and engaging the plication element with tissue near the mitral valve using the second catheter assembly, wherein engaging the plication element with the tissue near the mitral valve creates a plication in the tissue.
Claim 39
Dependent Claim
80 words
33 . A method as recited in claim 32 wherein the first catheter assembly includes a first catheter and a second catheter, the second catheter being located at least partially within the first catheter, the first catheter being arranged to facilitate the positioning of the second catheter along the wall of the left ventricle, and wherein positioning the guide element along the wall includes: inserting the guide element through the second catheter; and anchoring the guide element against the wall.
Claim 40
Dependent Claim
61 words
34 . A method as recited in claim 32 wherein initially positioning the plication element in the left ventricle beneath the mitral valve using the guide element includes: inserting at least one expandable element into the left ventricle; and expanding the expandable element, wherein expanding the expandable element positions the second catheter assembly generally against the tissue near the mitral valve.
Claim 41
Dependent Claim
35 words
35 . A method as recited in claim 32 wherein the plication element with the tissue near the mitral valve includes at least partially penetrating the tissue with the plication element to create the plication.
Claim 42
Dependent Claim
62 words
36 . A method for performing annuloplasty, the method comprising: inserting at least one plication element into a left ventricle of a heart; and engaging said at least one plication element to tissue near a mitral valve of the heart such that the plication element gathers a portion of the tissue to create a plication in the tissue near the mitral valve.
Claim 43
Dependent Claim
62 words
36 . A method for performing annuloplasty, the method comprising: inserting at least one plication element into a left ventricle of a heart; and engaging said at least one plication element to tissue near a mitral valve of the heart such that the plication element gathers a portion of the tissue to create a plication in the tissue near the mitral valve.
References Cited (Backward Citations)
No citation records indexed.
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