US20040167539A1 — Mitral and tricuspid valve repair

Claim 1

Independent Claim 60 words

1 . A kit comprising a cardiac catheter and a leaflet fastener applicator, said cardiac catheter having suitable dimensions for deployment and insertion into a human heart in the vicinity of the mitral or tricuspid valve, said leaflet fastener applicator having a size allowing insertion through said cardiac catheter and being capable of holding portions of opposing heart valve leaflets.

Claim 2

Dependent Claim 60 words

1 . A kit comprising a cardiac catheter and a leaflet fastener applicator, said cardiac catheter having suitable dimensions for deployment and insertion into a human heart in the vicinity of the mitral or tricuspid valve, said leaflet fastener applicator having a size allowing insertion through said cardiac catheter and being capable of holding portions of opposing heart valve leaflets.

Claim 3

Dependent Claim 38 words

2 . The kit of claim 1 wherein said fastener applicator comprises opposing jaws, one of said jaws having a site for holding a tack and the second of said jaws having a site for holding a cap.

Claim 4

Dependent Claim 14 words

3 . The kit of claim 1 wherein said fastener applicator comprises a stapler.

Claim 5

Dependent Claim 21 words

4 . The kit of claim 1 wherein said fastener applicator comprises a needle and suture, which passes through a leaflet.

Claim 6

Dependent Claim 28 words

5 . The kit of claim 1 wherein said fastener applicator comprises sets of opposing arms where each set has suitable dimensions for holding a heart valve leaflet.

Claim 7

Dependent Claim 14 words

6 . The kit of claim 1 wherein said fastener applicator comprises a ring.

Claim 8

Dependent Claim 31 words

7 . The kit of claim 1 wherein said fastener applicator comprises a clip button including a first element with spikes and a second element that clips onto said first element.

Claim 9

Dependent Claim 58 words

8 . The kit of claim 1 further comprising a gripper, said gripper including a tube having a proximal end and a distal end, opposing gripper arms at said distal end of said tube, and an actuator at said proximal end of said tube such that motion of said actuator changes the relative position of said gripper arms.

Claim 10

Dependent Claim 26 words

9 . The kit of claim 1 further comprising a gripper, said gripper having a suitable opening for the application of suction to a heart valve.

Claim 11

Dependent Claim 21 words

10 . The kit of claim 1 further comprising instructions describing use of said cardiac catheter and said leaflet fastener applicator.

Claim 12

Dependent Claim 51 words

11 . A method of repairing a valve of a beating heart, said method comprising: a) inserting the distal end of a catheter into the heart to provide access to said valve; and b) fastening together portions of leaflets of said valve using a leaflet fastener applicator inserted through said catheter.

Claim 13

Dependent Claim 51 words

11 . A method of repairing a valve of a beating heart, said method comprising: a) inserting the distal end of a catheter into the heart to provide access to said valve; and b) fastening together portions of leaflets of said valve using a leaflet fastener applicator inserted through said catheter.

Claim 14

Dependent Claim 22 words

12 . The method of claim 11 wherein the catheter is inserted through an opening in the wall of said beating heart.

Claim 15

Dependent Claim 21 words

13 . The method of claim 11 wherein the catheter is introduced into the heart by way of a blood vessel.

Claim 16

Dependent Claim 23 words

14 . The method of claim 11 wherein said fastening of said opposing leaflets comprises placement of a sharp projection through said leaflets.

Claim 17

Dependent Claim 19 words

15 . The method of claim 11 wherein said fastening of said leaflets comprises suturing together said opposing leaflets.

Claim 18

Dependent Claim 20 words

16 . The method of claim 11 further comprising gripping said leaflets with a gripper prior to fastening said leaflets.

Claim 19

Dependent Claim 55 words

17 . The method of claim 16 wherein said gripper comprise a tube having a proximal end and a distal end, opposing gripper arms at said distal end of said tube, and an actuator at said proximal end of said tube such that motion of said actuator change the relative position of said gripper arms.

Claim 20

Dependent Claim 23 words

18 . The method of claim 16 wherein said gripper has a suitable opening for the application of suction to a heart valve.

Claim 21

Dependent Claim 29 words

19 . The method of claim 11 further comprising inserting a wire through said wall of said heart to initiate an opening through which said cardiac catheter is inserted.

Claim 22

Dependent Claim 24 words

20 . The method of claim 11 further comprising making an incision in the wall of the heart for said insertion of said catheter.

Claim 23

Dependent Claim 62 words

21 . A device comprising a catheter and a leaflet fastener applicator, said catheter having a proximal end, a distal end and suitable dimensions for insertion into a heart, said leaflet fastener applicator passing through said catheter such that an actuating element projects from said proximal end of said catheter while a fastening element projects from said distal end of said catheter.

Claim 24

Dependent Claim 62 words

21 . A device comprising a catheter and a leaflet fastener applicator, said catheter having a proximal end, a distal end and suitable dimensions for insertion into a heart, said leaflet fastener applicator passing through said catheter such that an actuating element projects from said proximal end of said catheter while a fastening element projects from said distal end of said catheter.

Claim 25

Dependent Claim 26 words

22 . The device of claim 21 wherein said actuating element comprises a length of suture extending to said distal end of said leaflet fastener applicator.

Claim 26

Dependent Claim 21 words

23 . The device of claim 21 wherein said actuating element comprises a lever that controls the delivery of a fastener.

Claim 27

Dependent Claim 42 words

24 . The device of claim 21 further comprising a gripper inserted through said cardiac catheter such that gripping appendages project from said distal end and an actuating element projects from said proximal end, where said actuating element controls said gripping appendages.

Claim 28

Dependent Claim 35 words

25 . A heart valve leaflet fastener comprising two pairs of arms, each pair having a suitable size for fastening heart valve leaflets and said two pairs of arms capable of fastening two adjacent leaflets.

Claim 29

Dependent Claim 35 words

25 . A heart valve leaflet fastener comprising two pairs of arms, each pair having a suitable size for fastening heart valve leaflets and said two pairs of arms capable of fastening two adjacent leaflets.

Claim 30

Dependent Claim 36 words

26 . The heart valve leaflet fastener of claim 26 wherein said arms flex relative to a central core, and wherein said fastener has a locked position where each said pair of arms meet under tension.

Claim 31

Dependent Claim 25 words

27 . The heart valve leaflet fastener of claim 26 wherein one of said arms of each pair includes a projection for piercing a leaflet.

Claim 32

Dependent Claim 26 words

28 . A heart valve gripper/fastener applicator comprising a gripper and a fastener applicator wherein said gripper and said fastener applicator extend from a single shaft.

Claim 33

Dependent Claim 26 words

28 . A heart valve gripper/fastener applicator comprising a gripper and a fastener applicator wherein said gripper and said fastener applicator extend from a single shaft.

Claim 34

Dependent Claim 14 words

29 . The gripper/fastener of claim 28 wherein said gripper comprises two opposing jaws.

Claim 35

Dependent Claim 38 words

30 . The gripper/fastener of claim 28 wherein said fastener comprises two opposing jaws, one of said jaws having a site for holding a tack and the second of said jaws having a site for holding a cap.

Claim 36

Dependent Claim 36 words

31 . A heart valve leaflet fastener applicator comprising two opposing jaws, one of said jaws having a site for holding a tack and the second of said jaws having a site for holding a cap.

Claim 37

Dependent Claim 36 words

31 . A heart valve leaflet fastener applicator comprising two opposing jaws, one of said jaws having a site for holding a tack and the second of said jaws having a site for holding a cap.

Claim 38

Dependent Claim 41 words

32 . The heart valve leaflet fastener applicator of claim 31 wherein said jaw having a site for holding a tack further comprises a slot wherein a tack can be shifted to a position opposite said site for holding a cap.

Claim 39

Dependent Claim 42 words

33 . A gripper comprising a plunger that slides over an inner shaft and arms having suitable dimensions for gripping heart valve leaflets, said plunger slides such that interaction of heart valve leaflets with said plunger directs said leaflets toward said arms.

Claim 40

Dependent Claim 42 words

33 . A gripper comprising a plunger that slides over an inner shaft and arms having suitable dimensions for gripping heart valve leaflets, said plunger slides such that interaction of heart valve leaflets with said plunger directs said leaflets toward said arms.

Claim 41

Dependent Claim 20 words

34 . The gripper of claim 33 wherein said plunger is a balloon plunger that can be inflated and deflated.

Claim 42

Dependent Claim 89 words

35 . A fastener applicator comprising a first shaft, a first portion of a button clip having a sharp projection for piercing a heart valve leaflet, a second shaft that slides over said first shaft, and a second portion of said button clip having an opening to engage the projection of said first portion of said button clip, said second portion of said button clip sliding over said first shaft and not over said second shaft such that second shaft can direct said second portion toward said first portion.

Claim 43

Dependent Claim 89 words

35 . A fastener applicator comprising a first shaft, a first portion of a button clip having a sharp projection for piercing a heart valve leaflet, a second shaft that slides over said first shaft, and a second portion of said button clip having an opening to engage the projection of said first portion of said button clip, said second portion of said button clip sliding over said first shaft and not over said second shaft such that second shaft can direct said second portion toward said first portion.

Mitral and tricuspid valve repair

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