A method of implanting a prosthetic atrioventricular valve into a native atrioventricular valve includes delivering a fixation device to the native valve, and applying the fixation device to engage and approximate free edges of two leaflets of the native valve. After applying the fixation device, the prosthetic valve is delivered to the native valve while the prosthetic valve is in a collapsed condition. The prosthetic valve is then be deployed into the native valve so that the prosthetic valve expands into engagement with the native valve. A transcatheter positioning device for an atrioventricular valve modification device delivery system is also provided. The positioning device comprises a positioning member having an undeployed configuration for delivery of the positioning device to an atrioventricular valve modification device delivery site in the heart of a patient and a deployed configuration for the positioning member to engage and reposition an object in the heart.
A tunable fixation device for fixation of heart valve leaflets includes a central assembly, an arm moveably coupled to the central assembly, and a gripping element moveable relative to the arm to capture a native leaflet therebetween. The arm has a body portion and a wire frame coupled to the body portion. The wire frame has a first and second wire segment, and an interconnection portion interconnecting the first and second wire segments. The interconnection portion is slidingly engaged with the body portion. The first wire segment is configured to deform upon force applied to the second wire segment by sliding movement of the interconnection portion relative to the body portion, and the second wire segment is configured to deform upon force applied to the first wire segment by sliding movement of the interconnection portion relative to the body portion.
A fixation device includes a primary unit having pair of distal elements and a pair of proximal elements, the pair of distal elements and the pair of proximal elements being configured to retain tissue, a secondary reinforcement coupled to the primary unit and transitionable between a first position spaced away from the primary unit and a second position nested about the primary unit, and a deployment shaft configured to actuate the secondary reinforcement between the first position and the second position. A method of treating a native valve includes providing a fixation device including a primary unit having a pair of distal elements and a pair of proximal elements configured to retain tissue, and a secondary reinforcement, and transitioning the secondary reinforcement from a first position to a second position to increase a stiffness of the fixation device.
A fixation device includes a primary unit having pair of distal elements and a pair of proximal elements, the pair of distal elements and the pair of proximal elements being configured to retain tissue, a secondary reinforcement coupled to the primary unit and transitionable between a first position spaced away from the primary unit and a second position nested about the primary unit, and a deployment shaft configured to actuate the secondary reinforcement between the first position and the second position. A method of treating a native valve includes providing a fixation device including a primary unit having a pair of distal elements and a pair of proximal elements configured to retain tissue, and a secondary reinforcement, and transitioning the secondary reinforcement from a first position to a second position to increase a stiffness of the fixation device.
Devices and methods for removing a valve clip which is pre-positioned on a heart leaflet, the valve clip including a delivery catheter having a distal end portion configured to be positioned near a heart valve; a grasping tool deployable from the distal end portion of the delivery catheter, the grasping tool configured to grasp and manipulate a valve clip from an implanted condition to an elongated condition, wherein the valve clip in the elongated condition has an elongated width less than an implanted width of the valve clip in the implanted condition; and a removal tool extendable relative to the distal end portion of the delivery catheter, the removal tool configured to at least partially surround the valve clip in the elongated condition and to remove the valve clip from the heart valve leaflet.
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A mitral valve clip includes a stud, a lock, and two arms. The stud includes a shank, and the lock includes a frame relative to which the stud is translatable and into which the shank extends. The lock is able to prevent movement of the stud relative to the lock in at least one direction by locking engagement of the shank. The two arms are connected to the lock and the stud such that an angle between the arms depends on a location of the stud relative to the lock. The locking engagement of the shank that prevents movement of the stud relative to the lock in the at least one direction is only possible when the angle between the arms is below a predefined locking threshold.
A system for securing tissue includes a fixation device and a piezoelectric sensing system. The fixation device includes a center portion and a first clamp extending from the center portion. The first clamp is comprised of a first proximal element and a first distal element. The piezoelectric sensing system includes a first piezoelectric sensor coupled to one of the first distal element, the first proximal element, and the center portion. A signal processing unit of the sensing system includes a power source and a signal processing module. The signal processing module is configured to receive signals from the first piezoelectric sensor corresponding to a parameter associated with pressure, process the received signals, and generate an output signal indicative of the parameter. An interface is configured to couple the first piezoelectric sensor to the signal processing unit for transmitting the signals from the first piezoelectric sensor to the signal processing unit.
A fixation device for fixation of heart valve leaflets includes a central assembly and an arm moveably coupled to the central assembly. The arm includes a body portion having a first end and a second end and a longitudinal axis defined therebetween. The body portion has opposing body lateral sides, each body lateral side extending between the first end and the second end. Further, the body portion has a body portion width defined between the opposing body lateral sides. The fixation device further includes a size adapter attached to the arm, the size adapter having a maximum undeformed arm lateral cross-dimension defined between outer lateral edges of the size adapter. The ratio between the body portion width and the maximum undeformed arm lateral cross-dimension is at least about 1:1.8 to about 1:2.2. The fixation device further includes at least one gripping element.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A fixation device includes a center assembly and first and second clamps extending outwardly from the center assembly. Each clamp includes an anchor member and a gripper disposed opposite the anchor member. The gripper includes an indicator arm and a retention arm. The indicator arm and retention arm are independently moveable between a raised position and an engagement position. The retention arm has a length greater than a length of the indicator arm.
A fixation device includes a first distal element and a first proximal element. The first distal element and first proximal element each have a first end and a second end and are moveable relative to each other. First and second electrodes are coupled to either the first distal element or the first proximal element between the first and second ends thereof. The electrodes at least partially form a circuit. The circuit is an open circuit generating a first impedance response when tissue contacts the first electrode and not the second electrode. The circuit is a closed circuit generating a second impedance response when tissue contacts the first and second electrode. The first impedance response has a first impedance value greater than a second impedance value of the second impedance response.
A fixation device includes a first proximal element and a first distal element. The first proximal element has a gridded frame disposed between a first end portion and a second end portion and a plurality of frictional elements. The gridded frame has a plurality of axial struts and a plurality of transverse struts intersecting the axial struts to define a plurality of openings. At least some of the frictional elements extend from at least some of the transverse struts. The first distal element is disposed in opposition to the first proximal element and has a cavity disposed between a first end portion and a second end portion thereof. The cavity is configured to receive at least a portion of the gridded frame.
A system for implanting two or more implants into a heart of a patient may include a multi-device steerable guide catheter ("MDSGC"), a transcatheter edge-to-edge repair ("TEER") implant delivery device, and an additional implant delivery device for implanting an additional medical device. The additional medical device may be a collapsible and expandable prosthetic transcatheter aortic valve repair ("TAVR") device or a collapsible and expandable left atrial appendage ("LAA") occluder device. The MDSGC may have a first handle and may be steerable, the TEER delivery device may have a second handle, and the additional delivery device may have an additional handle. The system may include a fixation device to capture native heart valve leaflets therebetween as part of a TEER procedure. The TEER delivery device and the additional delivery device may each have a catheter sized and shaped to pass through an interior of a catheter of the MDSGC.
The present disclosure relates to repair devices and methods for repair of regurgitant tricuspid valves. A repair method includes positioning a repair device at a tricuspid valve in a collapsed configuration. The repair device includes a proximal disk and a distal disk joined by a neck section. The distal disk is deployed by passing it from the collapsed state to an expanded configuration on a first side of the tricuspid valve. The proximal disk is then deployed by passing it from the collapsed state to an expanded configuration on a second side of the tricuspid valve so as to grasp all three tricuspid valve leaflets between the deployed distal disk and the deployed proximal disk.
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
15.
Opposing Disk Device For Grasping Cardiac Valve Tissue
The present disclosure relates to repair devices and methods for repair of regurgitant tricuspid valves. A repair method includes positioning a repair device at a tricuspid valve in a collapsed configuration. The repair device includes a proximal disk and a distal disk joined by a neck section. The distal disk is deployed by passing it from the collapsed state to an expanded configuration on a first side of the tricuspid valve. The proximal disk is then deployed by passing it from the collapsed state to an expanded configuration on a second side of the tricuspid valve so as to grasp all three tricuspid valve leaflets between the deployed distal disk and the deployed proximal disk.
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
16.
Device and Procedure for Mitral Valve Clip Removal and Subsequent Delivery of a Transcatheter Mitral Valve Implantation
Devices, systems and methods for removal of a mitral valve clip and subsequent delivery of a mitral valve implantation in a mitral valve replacement procedure. A modular port accessory device having a distal connector configured to be compatible with corresponding connectors on an existing therapeutic device, wherein the port accessory can be selectively attached to a proximal end portion connector of a proximal end portion of a catheter assembly of an existing therapeutic device. The catheter assembly is introduced to a target site within the patient's anatomy, and remains in place throughout a multistep therapeutic procedure for use with other therapeutic devices, all while allowing hemostasis to be controlled during use ad interchange of multiple therapeutic devices.
The present disclosure relates to delivery systems for delivering and deploying interventional devices to a targeted area within a body, such as delivering a replacement heart valve to a targeted heart valve. A delivery device includes a steerable catheter and a replacement valve delivery system positioned within the steerable catheter and configured to be translatable within the steerable catheter. The steerable catheter includes one or more control wires running from a distal end of the catheter to a handle at the proximal end of the catheter. Each control wire is coupled to a control of the handle such that manipulation of the control provides deflection and control of the steerable catheter.
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61F 2/48 - Moyens d'actionnement ou de commande, p. ex. de l'extérieur du corps, commande de sphincters
A61F 2/95 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes
A61F 2/966 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure avec un mouvement longitudinal relatif entre la gaine extérieure et la prothèse, p. ex. utilisant une tige poussoir
A61F 2/97 - Instruments spécialement adaptés pour insérer ou retirer les stents ou les endoprothèses déployables couvertes possédant une gaine extérieure la gaine extérieure pouvant être fendue
A61M 25/01 - Introduction, guidage, avance, mise en place ou maintien en position des cathéters
18.
MITRAL VALVE FIXATION DEVICE REMOVAL DEVICES AND METHODS
Procedures may be performed on the heart after the installation of a mitral valve fixation device. In order to prepare the heart for such procedures, the fixation device may be removed or disabled in minimally invasive ways (e.g., through an endovascular procedure), without requiring open access to the heart. The fixation device may be partitioned so that one portion may remain attached to each leaflet of the mitral valve. In another example, the leaflets may be cut along the edges of the distal element(s) of the fixation device, so as to cut the fixation device from the leaflet(s). Systems and devices for performing such procedures endovascularly are disclosed. Fixation devices with improved access to a release harness are also disclosed.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A delivery system includes a delivery catheter that is releasably coupled to a fixation device and a delivery handle that is coupled to the delivery catheter. A lock control assembly of the delivery handle has a releasable lock line handle operable to lock and unlock components of the fixation device. The lock line handle has a shaft body and a lever arm that respectively define first and second openings. A lock line extending from the fixation device and through the delivery catheter has a first end portion fixedly coupled to the lock line handle and a second end portion that extends through the first and second openings. The lock line is free to move through the openings when the lever arm is in a first position and is secured when the lever arm is in a second position.
Medical delivery system for accessing a tricuspid valve via an inferior vena cava, including an outer guide catheter, an inner guide catheter and an interventional catheter. The first deflection portion of the outer guide catheter is steerable to define a first outer-guide-catheter curve and the second deflection portion of the outer guide catheter is steerable to define a second outer-guide-catheter curve and the first deflection portion of the inner guide catheter is steerable to define a first inner-guide-catheter curve.
Devices and methods for use in a cardiac valve repair procedure, particularly a tricuspid valve repair procedure. An interventional clip device includes a pair of distal elements rotatably joined to a coupling member, and a pair of proximal elements resiliently biased toward the distal elements to grasp tissue therebetween. The proximal elements include a plurality of adjustable tines moveable between a retracted configuration and an open configuration to avoid damage to tissue prior to engagement while allowing tines to enhance gripping to targeted tissue when open. A delivery system enables delivery of an interventional clip to a targeted cardiac valve, and includes a support structure for maintaining position relative to the cardiac valve.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A system for excising an implanted clip approximating opposed valve leaflets in a heart valve includes a capture catheter configured to be introduced proximate the valve leaflets on one side of the clip, a transfer catheter configured to be introduced proximate the valve leaflets on another side of the clip, and a cutting tool configured to be deployed between the capture and transfer catheters and to be engaged against tissue of at least one of the valve leaflets and to excise the clip. A removal catheter may optionally be used to remove the clip from the heart.
A61B 17/10 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour poser ou retirer les clamps pour blessuresChargeurs de clamps pour blessures
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
Devices, systems and methods are provided for stabilizing and grasping tissues such as valve leaflets, assessing the grasp of these tissues, approximating and fixating the tissues, and assessing the fixation of the tissues to treat cardiac valve regurgitation, particularly mitral valve regurgitation.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A fixation device includes a first distal element and a gripping device. The gripping device including a base section, a first bend feature, and a first proximal element. The first bend feature defining a first hinge axis. The first proximal element extending from the first bend feature and having a first section, a second section, and a first hinge disposed between the first section and the second section and defining a second hinge axis. The second section having a plurality of frictional elements extending therefrom and being rotatable about the second hinge axis between a first configuration and a second configuration.
A fixation device includes first and second distal elements and first and second proximal elements. The first and second proximal elements include a first elongate arm and a second elongate arm, respectively. The first and second elongate arms each include first and second side edges and plurality of frictional elements defining a plurality notches in the first and second side edges. The first and second proximal elements also each include first and second guard rails extending adjacent to and along the first and second side edges, respectively.
A fixation device includes first and second distal elements and first and second proximal elements. The first and second proximal elements include a first elongate arm and a second elongate arm, respectively. The first and second elongate arms each include first and second side edges and plurality of frictional elements defining a plurality notches in the first and second side edges. The first and second proximal elements also each include first and second guard rails extending adjacent to and along the first and second side edges, respectively.
A delivery system includes a delivery catheter that is releasably coupled to a fixation device and a delivery handle that is coupled to the delivery catheter. A lock control assembly of the delivery handle has a releasable lock line handle operable to lock and unlock components of the fixation device. The lock line handle has a shaft body and a lever arm that respectively define first and second openings. A lock line extending from the fixation device and through the delivery catheter has a first end portion fixedly coupled to the lock line handle and a second end portion that extends through the first and second openings. The lock line is free to move through the openings when the lever arm is in a first position and is secured when the lever arm is in a second position.
An implantable fixation device includes fixation elements and gripping elements for fixating tissue. A stud is coupled to the fixation elements and is configured such that movement of the stud moves the fixation elements within a range of positions. A binding plate is configured to engage the stud to arrest its movement and to disengage the stud to allow its movement. A biasing element engages the binding plate and biases the binding plate into engagement with the stud. A harness with a single foot is engaged to the binding plate is configured such that tensioning the harness moves the binding plate in opposition to the bias of the biasing element so as to release the binding plate from the stud. Releasing tension on the harness returns the binding plate into engagement with the stud and secures the fixation elements in one position within the range of positions.
An implantable fixation device includes fixation elements and gripping elements for fixating tissue. A stud is coupled to the fixation elements and is configured such that movement of the stud moves the fixation elements within a range of positions. A binding plate is configured to engage the stud to arrest its movement and to disengage the stud to allow its movement. A biasing element engages the binding plate and biases the binding plate into engagement with the stud. A harness with a single foot is engaged to the binding plate is configured such that tensioning the harness moves the binding plate in opposition to the bias of the biasing element so as to release the binding plate from the stud. Releasing tension on the harness returns the binding plate into engagement with the stud and secures the fixation elements in one position within the range of positions.
A fixation device includes a first proximal element and a first distal element. The first proximal element has a gridded frame disposed between a first end portion and a second end portion and a plurality frictional elements. The gridded frame has a plurality of axial struts and a plurality of transverse struts intersecting the axial struts to define a plurality of openings. At least some of the frictional elements extend from at least some of the transverse struts. The first distal element is disposed in opposition to the first proximal element and has a cavity disposed between a first end portion and a second end portion thereof. The cavity is configured to receive at least a portion of the gridded frame.
A system for cutting leaflet tissue at a cardiac valve may comprise a guide catheter having a proximal end and a distal end, wherein the distal end of the guide catheter is steerable to a position above a cardiac valve. The system may also include a handle coupled to the proximal end of the guide catheter, the handle comprising at least one control configured to steer the guide catheter to the position above the cardiac valve. Finally, the system may comprise a cutting mechanism routable through the guide catheter and able to be positioned at the distal end of the guide catheter, the cutting mechanism configured to cut a portion of leaflet tissue of the cardiac valve.
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
32.
Catheter Assembly With Coaptation Aid And Methods For Valve Repair
Catheter assembly with a coaptation aid for repair of leaflets of a heart valve includes an elongate catheter shaft adapted to be positioned transvascularly proximate a heart valve and a lever coupled to the catheter shaft. The lever has a hinge to transition the lever between an elongate delivery configuration generally aligned longitudinally with the catheter shaft and a deployed configuration extending transversely from the catheter shaft. The lever also includes an atraumatic tip at a distal end thereof and adapted to contact a distal side of a native leaflet of the heart valve when the catheter shaft is positioned proximate the heart valve and the lever is in the deployed configuration, and an actuation assembly coupled to the lever to remotely transition the lever between the delivery configuration and the deployed configuration. Method for fixation of native leaflets of a heart valve using the catheter assembly also disclosed.
An integrated imaging and device deployment platform and method may include a catheter, at least one imaging unit, at least one deployment unit, and at least one device configured to be deployed by the at least one deployment unit. The integrated imaging and device deployment platform facilitates improved navigation and deployment of a therapeutic or medical device by providing the at least one imaging unit proximate the deployment unit. Information generated from the at least one imaging unit may be utilized with additional imaging modalities to provide improved imaging and delivery of devices while reducing use of X-ray radiation and contrast injection.
A61B 8/00 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
Fixation device for engaging tissue including a pair of fixation elements moveable between a closed position and an open position. The fixation device further includes a pair of gripping elements each moveable with a respective fixation element and disposed in opposition to at least a portion of the respective fixation element to capture tissue therebetween. The fixation device further includes a central portion operatively connected to each gripping element at a respective central portion-gripping element interface. The central portion has at least one distal end and a width “W1” proximate the distal end. Each of the gripping elements has a free end opposite its respective central portion-gripping element interface and a length “L1” defined between the respective central portion-gripping element interface and the free end. The length L1 fixation elements is at least about three times the width W1.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
An integrated imaging and device deployment platform and method may include a catheter, at least one imaging unit, at least one deployment unit, and at least one device configured to be deployed by the at least one deployment unit. The integrated imaging and device deployment platform facilitates improved navigation and deployment of a therapeutic or medical device by providing the at least one imaging unit proximate the deployment unit. Information generated from the at least one imaging unit may be utilized with additional imaging modalities to provide improved imaging and delivery of devices while reducing use of X-ray radiation and contrast injection.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
Procedures may be performed on the heart after the installation of a mitral valve fixation device. In order to prepare the heart for such procedures, the fixation device may be removed or disabled in minimally invasive ways (e.g., through an endovascular procedure), without requiring open access to the heart. The fixation device may be partitioned so that one portion may remain attached to each leaflet of the mitral valve. In another example, the leaflets may be cut along the edges of the distal element(s) of the fixation device, so as to cut the fixation device from the leaflet(s). Systems and devices for performing such procedures endovascularly are disclosed. Fixation devices with improved access to a release harness are also disclosed.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
Procedures may be performed on the heart after the installation of a mitral valve fixation device. In order to prepare the heart for such procedures, the fixation device may be removed or disabled in minimally invasive ways (e.g., through an endovascular procedure), without requiring open access to the heart. The fixation device may be partitioned so that one portion may remain attached to each leaflet of the mitral valve. In another example, the leaflets may be cut along the edges of the distal element(s) of the fixation device, so as to cut the fixation device from the leaflet(s). Systems and devices for performing such procedures endovascularly are disclosed. Fixation devices with improved access to a release harness are also disclosed.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A fixation device includes a central assembly and an arm moveably coupled to the central assembly. The arm includes a body portion having a first end and a second end. The second end is moveable between a closed position and an open position. The body portion also includes opposing body lateral sides each extending between the first end and the second end and a body portion width defined between the opposing body lateral sides. The arm further includes first and second nondeformable wing extensions each extending laterally from a respective lateral side and having a lateral outer edge. A maximum arm width of the arm is defined between the outer lateral edge of the first wing extension and the outer lateral edge of the second wing extension. The fixation device further includes a gripping element moveable relative to the arm to capture a native leaflet therebetween.
A fixation system includes a delivery device, a fixation device, and an optical coherence tomography (OCT) catheter. The delivery device includes a shaft that defines a lumen. The fixation device includes a first clamp, a second clamp, and a center portion. The center portion is releasably connected to a distal end of the shaft of the delivery device, and the first and second clamps define respective first and second lateral extents of the fixation device. The OCT catheter includes an imaging probe that comprises a first end, a second end, and a first lens assembly that is disposed at the second end of the imaging probe. In an assembled condition of the fixation system, the imaging probe extends through the lumen and out from the second end of the shaft such that the lens assembly is positioned between the first and second lateral extents of the fixation device.
A fixation system includes a delivery device, a fixation device, and an optical coherence tomography (OCT) catheter. The delivery device includes a shaft that defines a lumen. The fixation device includes a first clamp, a second clamp, and a center portion. The center portion is releasably connected to a distal end of the shaft of the delivery device, and the first and second clamps define respective first and second lateral extents of the fixation device. The OCT catheter includes an imaging probe that comprises a first end, a second end, and a first lens assembly that is disposed at the second end of the imaging probe. In an assembled condition of the fixation system, the imaging probe extends through the lumen and out from the second end of the shaft such that the lens assembly is positioned between the first and second lateral extents of the fixation device.
A tissue gripping device is formed from a shape-memory material, and has a base section, a first arm, and a second arm disposed opposite the first arm, each arm having a first end coupled to the base section and a free end extending from the base section. The arms of the tissue gripping device are configured to resiliently flex toward a relaxed configuration in a distal direction as the tissue gripping device is moved from a pre-deployed configuration toward a deployed configuration. The tissue gripping device is usable in a method for gripping tissue. The method includes positioning the tissue gripping device near target tissue and moving the tissue gripping device from a pre-deployed configuration toward a deployed configuration in order to grip the target tissue.
A fixation device for fixation of tissue includes a central element defining a central axis. The fixation device also includes a distal portion that includes an arm coupled to the central element and a leg operatively coupled to the arm. The arm is moveable to a selected position between a fully open position and a fully closed position. The leg is configured to move the arm to the selected position. The arm includes a contact portion for engaging tissue. The distal portion also includes a flexure portion configured to enable the contact portion in the selected position to move within a flex angle range between an undeformed contact portion angle relative to the central axis and a flexed contact portion angle relative to the central axis. The fixation device further includes at least one gripping element moveable relative to the at least one arm to capture tissue therebetween.
System for fixation of native leaflets of a heart valve including an implantable fixation device including a center portion defining a longitudinal axis. The implantable fixation device further includes a first distal assembly having a first distal strut pivotally-coupled with the center portion and a first distal element pivotally-coupled with the first distal strut. The first distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a second distal assembly having a second distal strut pivotally-coupled with the center portion and a second distal element pivotally-coupled with the second distal strut. The second distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a locking mechanism configured to lock the first distal assembly and second distal assembly in a selected locked position between the closed position and the extended position.
Fixation device for fixation of leaflets of a heart valve includes a central assembly and at least one arm moveably coupled relative to the central assembly. The at least one arm includes a deformable frame having a first end and a second end and a longitudinal axis defined therebetween, the second end being moveable between a closed position and an open position. The deformable frame further includes first and second deformable flex portions, each flex portion extending along a respective lateral side of the deformable frame and having a deformed condition and an undeformed condition, and each flex portion having an outer lateral edge. The at least one arm has a maximum deformed arm lateral cross-dimension with the flex portions in the deformed condition.
Stabilizer for a medical delivery system is provided, wherein the medical delivery system has at least two portions translatable relative each other. The stabilizer includes a base and a sled coupled to the base. The sled includes a distal arm including a distal attachment for receiving a first portion of the medical delivery system, and a proximal arm including a proximal attachment for receiving a second portion of the medical delivery system. The sled is translatable relative to the base and the proximal attachment is translatable relative to the proximal arm.
A61B 1/00 - Instruments pour procéder à l'examen médical de l'intérieur des cavités ou des conduits du corps par inspection visuelle ou photographique, p. ex. endoscopesDispositions pour l'éclairage dans ces instruments
Medical device delivery system including a catheter, handle, lock line handle, and lock line. The catheter includes a proximal end portion and a distal end portion. The handle is coupled to the proximal end portion of the catheter. The lock line handle is releasably coupled to the handle and actuatable between a lock position and an unlock position. The lock line includes a first end portion fixedly coupled to the lock line handle, a second end portion releasably coupled to the lock line handle, and an intermediate portion configured to be releasably coupled to the medical implant disposed proximate the distal end portion of the catheter. Actuating the lock line handle from the lock position toward the unlock position increases tension on the lock line, and actuating the lock line handle from the unlock position toward the lock position decreases tension on the lock line.
An interventional tool includes an outer sheath, a steerable sleeve disposed within the outer sheath and translatable relative thereto, an inner conduit disposed within the steerable sleeve and translatable relative thereto, and a stiffness-varying element disposed within the outer sheath and configured and arranged to transition the interventional tool between a first state having a first stiffness and a second state having a second stiffness, the first stiffness being greater than the second stiffness.
An interventional tool includes an outer sheath, a steerable sleeve disposed within the outer sheath and translatable relative thereto, an inner conduit disposed within the steerable sleeve and translatable relative thereto, and a stiffness-varying element disposed within the outer sheath and configured and arranged to transition the interventional tool between a first state having a first stiffness and a second state having a second stiffness, the first stiffness being greater than the second stiffness.
Fixation system for fixation of leaflets of a heart valve including an implantable fixation device having a first arm and a second arm, a first proximal element moveable relative to the first arm between a first position and a second position, and a second proximal element moveable relative to the second arm between a first position and a second position. The fixation system includes a delivery device having a catheter, a first proximal element line and a second proximal element line, and a handle having a first and second proximal element line handles coupled to the first proximal element line and the second proximal element line, respectively. The handle can include an interlock moveable between an unlocked position and a locked position.
A system configured to cut leaflet tissue at a cardiac valve may comprise a guide catheter and a cutting mechanism routable through the guide catheter. The cutting mechanism includes a cutting arm and a plurality of grasping arms rotatably coupled to the cutting arm. The grasping arms are connected to the cutting arm via a central hinge and are actuatable between a closed position against the cutting arm and an open position where the grasping arms extend laterally away from the cutting arm by rotating about the hinge. Targeted cardiac leaflet tissue may be grasped between the cutting arm and the grasping arms and cut by a cutting element that is attached to or extends through the cutting arm.
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
51.
CLIP DELIVERY CATHETER WITH HELICAL MULTI-LUMEN EXTRUSION FOR IMPROVED GRIPPER ACTUATION AND METHODS OF MAKING AND USING SAME
An interventional tool includes a delivery catheter defining a central lumen and a plurality of peripheral lumens, at least one of the plurality of peripheral lumens defining a helical path along a portion of the delivery catheter, and at least one line disposed within the at least one of the plurality of peripheral lumens, the at least one line being configured to actuate a medical device.
Fixation device for fixation of heart valve leaflets includes an elongate central member defining a longitudinal axis of the fixation device and first and second arms rotatable about at least one arm hinge point between an open position and a closed position. The fixation device further includes a first gripping element rotatable about a first gripping element axis of rotation to capture a first leaflet of a heart valve between the first gripping element and the first arm, and a second gripping element rotatable about a second gripping element axis of rotation to capture a second leaflet of a heart valve between the second gripping element and the second arm. At least one of the first gripping element axis of rotation and the second gripping element axis of rotation is variably offset from the arm hinge point by an axis offset distance defined along the longitudinal axis.
An interventional tool includes a delivery catheter defining a central lumen and a plurality of peripheral lumens, at least one of the plurality of peripheral lumens defining a helical path along a portion of the delivery catheter, and at least one line disposed within the at least one of the plurality of peripheral lumens, the at least one line being configured to actuate a medical device.
A fastening system and a deployment system for controlling translation and rotation of a deployment device are presented. A fastening system may comprise one or more components configured for arresting or restricting translation of a delivery catheter of a medical device, including a mitral valve fixation device such as the MitraClip®. A deployment system may comprise one or more components configured for locking rotation of a crimping cam to a slider to control deployment of a mitral valve fixation device.
The present disclosure relates to repair devices configured for use in fixing or approximating tissues, such as cardiac valve tissues and particularly the leaflets of a regurgitant mitral valve. The repair device includes a shaft, a pair of proximal elements pivotally coupled to the shaft and extending from the shaft, and a pair of distal elements pivotally coupled to the shaft and extending from the shaft. The proximal and distal elements are configured so that targeted tissue can be grasped therebetween. The distal elements and/or the proximal elements include adjustable arms that can be extended and retracted to adjust the length of the gripping elements to provide more effective grasping of targeted tissues.
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
According to one aspect, a mitral valve clip is introduced using a delivery system. The clip includes two arms at an angle relative to one another and a lock that prevents widening of the angle when the angle is below a locking threshold value, wherein the lock is in a passively disengaged state when the angle is above the locking threshold value. The lock is manually disengaged and the angle is expanded to a leaflet capture starting angle. The lock is returned to the passively disengaged state after the angle is expanded to the leaflet capture starting angle. The leaflets of a mitral valve are captured while the lock remains in the passively disengaged state. The clip is closed to a final closure angle by narrowing the angle while the leaflets are trapped. The lock transitions to an engaged state when the angle falls below the locking threshold value.
Methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. A delivery device for staged deployment of an implantable device to a target area. The delivery device includes a deployment handle and one or more lock lines extending from the deployment handle through the catheter to the implantable device, the one or ore lock lines being configured to engage with the implantable device to allow locking of the implantable device.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 90/50 - Supports pour instruments chirurgicaux, p. ex. bras articulés
Techniques are provided for candidate risk assessment for a mitral TEER procedure. A set of candidate anatomical features corresponding to a candidate for a mitral transcatheter edge-to-edge repair (TEER) procedure is received. A candidate feature vector based on the set of candidate anatomical features is generated. A classification engine is applied to the candidate feature vector, wherein the classification engine is trained to evaluate mitral TEER outcome. An outcome metric corresponding to a predicted mitral TEER success or a predicted mitral TEER failure for the candidate based on applying the classification engine is provided.
G16H 20/40 - TIC spécialement adaptées aux thérapies ou aux plans d’amélioration de la santé, p. ex. pour manier les prescriptions, orienter la thérapie ou surveiller l’observance par les patients concernant des thérapies mécaniques, la radiothérapie ou des thérapies invasives, p. ex. la chirurgie, la thérapie laser, la dialyse ou l’acuponcture
G16H 50/20 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le diagnostic assisté par ordinateur, p. ex. basé sur des systèmes experts médicaux
G16H 50/30 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le calcul des indices de santéTIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour l’évaluation des risques pour la santé d’une personne
G16H 50/70 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour extraire des données médicales, p. ex. pour analyser les cas antérieurs d’autres patients
59.
CANDIDATE RISK ASSESSMENT FOR A MITRAL TRANSCATHETER EDGE-TO-EDGE REPAIR PROCEDURE
Techniques are provided for candidate risk assessment for a mitral TEER procedure. A set of candidate anatomical features corresponding to a candidate for a mitral transcatheter edge-to-edge repair (TEER) procedure is received. A candidate feature vector based on the set of candidate anatomical features is generated. A classification engine is applied to the candidate feature vector, wherein the classification engine is trained to evaluate mitral TEER outcome. An outcome metric corresponding to a predicted mitral TEER success or a predicted mitral TEER failure for the candidate based on applying the classification engine is provided.
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
G16H 50/30 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour le calcul des indices de santéTIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour l’évaluation des risques pour la santé d’une personne
G16H 50/70 - TIC spécialement adaptées au diagnostic médical, à la simulation médicale ou à l’extraction de données médicalesTIC spécialement adaptées à la détection, au suivi ou à la modélisation d’épidémies ou de pandémies pour extraire des données médicales, p. ex. pour analyser les cas antérieurs d’autres patients
A61B 5/02 - Détection, mesure ou enregistrement en vue de l'évaluation du système cardio-vasculaire, p. ex. mesure du pouls, du rythme cardiaque, de la pression sanguine ou du débit sanguin
A fixation device for fixation of heart valve leaflets includes a central assembly and first and second arms each pivotally coupled to the central assembly. Each of the first and second arms include a trunk portion having a first end, a second end, and a longitudinal axis extending therebetween. The trunk portion has opposing lateral sides each extending between the first and second ends. Each of the first and second arms further include a coupling portion extending from the first end of the trunk portion. The coupling portion includes a pair of extension elements symmetrical about the longitudinal axis, and configured to be coupled to the central assembly for pivotal movement of the trunk portion relative the central assembly. The fixation device further includes first and second gripping elements each moveable relative to the first and second arms, respectively, to capture native leaflet tissue therebetween.
A fixation device for fixation of heart valve leaflets includes a central assembly and an arm moveably coupled to the central assembly. The arm includes a body portion having a first end and a second end and a longitudinal axis defined therebetween. The body portion has opposing body lateral sides, each body lateral side extending between the first end and the second end. Further, the body portion has a body portion width defined between the opposing body lateral sides. The fixation device further includes a size adapter attached to the arm, the size adapter having a maximum undeformed arm lateral cross-dimension defined between outer lateral edges of the size adapter. The ratio between the body portion width and the maximum undeformed arm lateral cross-dimension is at least about 1:1.8 to about 1:2.2. The fixation device further includes at least one gripping element.
A tunable fixation device for fixation of heart valve leaflets includes a central assembly, an arm moveably coupled to the central assembly, and a gripping element moveable relative to the arm to capture a native leaflet therebetween. The arm has a body portion and a wire frame coupled to the body portion. The wire frame has a first and second wire segment, and an interconnection portion interconnecting the first and second wire segments. The interconnection portion is slidingly engaged with the body portion. The first wire segment is configured to deform upon force applied to the second wire segment by sliding movement of the interconnection portion relative to the body portion, and the second wire segment is configured to deform upon force applied to the first wire segment by sliding movement of the interconnection portion relative to the body portion.
A tunable fixation device for fixation of heart valve leaflets includes a central assembly, an arm moveably coupled to the central assembly, and a gripping element moveable relative to the arm to capture a native leaflet therebetween. The arm has a body portion and a wire frame coupled to the body portion. The wire frame has a first and second wire segment, and an interconnection portion interconnecting the first and second wire segments. The interconnection portion is slidingly engaged with the body portion. The first wire segment is configured to deform upon force applied to the second wire segment by sliding movement of the interconnection portion relative to the body portion, and the second wire segment is configured to deform upon force applied to the first wire segment by sliding movement of the interconnection portion relative to the body portion.
A heart valve repair clip includes a stud, two arms operatively coupled to the stud and capable of transitioning between an open condition and a closed condition, and includes an indicator coupled to each of the two arms and moveable relative thereto.
Fixation system for engaging tissue of a patient including an implantable fixation device having a first arm and a second arm, a first proximal element, a second proximal element, and a coupling member. The system includes a delivery device having a catheter, a shaft extending through the at least one lumen of the catheter, a first proximal element actuator and a second proximal element actuator. The second end portions of the first proximal element actuator and second proximal element actuator can be coupled to at least one of the shaft and the coupling member.
Catheter assembly with a coaptation aid for repair of leaflets of a heart valve includes an elongate catheter shaft adapted to be positioned transvascularly proximate a heart valve and a lever coupled to the catheter shaft. The lever has a hinge to transition the lever between an elongate delivery configuration generally aligned longitudinally with the catheter shaft and a deployed configuration extending transversely from the catheter shaft. The lever also includes an atraumatic tip at a distal end thereof and adapted to contact a distal side of a native leaflet of the heart valve when the catheter shaft is positioned proximate the heart valve and the lever is in the deployed configuration, and an actuation assembly coupled to the lever to remotely transition the lever between the delivery configuration and the deployed configuration. Method for fixation of native leaflets of a heart valve using the catheter assembly also disclosed.
Devices and methods for removing a valve clip which is pre-positioned on a heart leaflet, the valve clip including a delivery catheter having a distal end portion configured to be positioned near a heart valve; a grasping tool deployable from the distal end portion of the delivery catheter, the grasping tool configured to grasp and manipulate a valve clip from an implanted condition to an elongated condition, wherein the valve clip in the elongated condition has an elongated width less than an implanted width of the valve clip in the implanted condition; and a removal tool extendable relative to the distal end portion of the delivery catheter, the removal tool configured to at least partially surround the valve clip in the elongated condition and to remove the valve clip from the heart valve leaflet.
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A transapical removal device that can be deployed in a catheter procedure to capture for removal or alteration a mitral valve clip or heart tissue, such as the anterior leaflet of the mitral valve, and methods of use are disclosed. The removal device includes a delivery catheter configured to be deployed near a mitral valve using a guide catheter. The delivery catheter has a snare head at the distal end, which assumes a collapsed state during movement of the delivery catheter through the guide catheter and deployed state for capturing a mitral valve clip or anterior leaflet. The snare head has one or more ablation delivery catheters configured to ablate tissue surrounding the pre-positioned mitral valve clip or anterior leaflet. In some arrangements within the scope of the present disclosure, the removal device includes a deployment mechanism for deploying a new transcatheter valve into the mitral valve.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/221 - Dispositifs de préhension des calculs en forme de boucles ou de paniers
A61B 17/50 - Instruments pour retirer les corps étrangers du corps humain
A61B 18/02 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par refroidissement, p. ex. techniques cryogéniques
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A tissue gripping device is formed from a shape-memory material, and has a base section, a first arm, and a second arm disposed opposite the first arm, each arm having a first end coupled to the base section and a free end extending from the base section. The arms of the tissue gripping device are configured to resiliently flex toward a relaxed configuration in a distal direction as the tissue gripping device is moved from a pre-deployed configuration toward a deployed configuration. The tissue gripping device is usable in a method for gripping tissue. The method includes positioning the tissue gripping device near target tissue and moving the tissue gripping device from a pre-deployed configuration toward a deployed configuration in order to grip the target tissue.
Medical device delivery system including a catheter, handle, lock line handle, and lock line. The catheter includes a proximal end portion and a distal end portion. The handle is coupled to the proximal end portion of the catheter. The lock line handle is releasably coupled to the handle and actuatable between a lock position and an unlock position. The lock line includes a first end portion fixedly coupled to the lock line handle, a second end portion releasably coupled to the lock line handle, and an intermediate portion configured to be releasably coupled to the medical implant disposed proximate the distal end portion of the catheter. Actuating the lock line handle from the lock position toward the unlock position increases tension on the lock line, and actuating the lock line handle from the unlock position toward the lock position decreases tension on the lock line.
Fixation device for fixation of leaflets of a heart valve includes a central assembly and at least one arm moveably coupled to the central assembly. The at least one arm includes a body portion having a first end and a second end and a longitudinal axis defined therebetween, the second end being moveable between a closed position and an open position, the body portion having opposing body lateral sides, each body lateral side extending between the first end and the second end, the body portion having a body portion width defined between the opposing body lateral sides. The at least one arm further includes first and second nondeformable wing extensions, each wing extension extending laterally from a respective lateral side, each wing extension having a lateral outer edge, wherein a maximum arm width is defined between the outer lateral edge of the first wing extension and the outer lateral edge of the second wing extension. The fixation device further includes at least one gripping element moveable relative to the at least one arm to capture a native leaflet therebetween.
Systems and methods for separating native heart valve leaflets attached together by a fixation device. Systems including an elongate shaft having a proximal end portion, a distal end portion and a longitudinal axis extending therebetween, the elongate shaft configured for transvascular delivery of the distal end portion to a native heart valve. At least one arm extending from the distal end portion, and a cutter disposed along at least one of the distal end portion and the at least one arm. The at least one arm is configured to extend through an orifice defined between native heart valve leaflets attached together by a fixation device to position the cutter against one of the native heart valve leaflets adjacent the fixation device, the cutter configured to cut through native heart valve leaflet tissue.
A61B 18/12 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage en faisant passer des courants à travers les tissus à chauffer, p. ex. des courants à haute fréquence
A61B 18/16 - Électrodes neutres ou passives pour mise à la terre
Medical delivery system for accessing a tricuspid valve via an inferior vena cava, including an outer guide catheter, an inner guide catheter and an interventional catheter. The first deflection portion of the outer guide catheter is steerable to define a first outer-guide-catheter curve and the second deflection portion of the outer guide catheter is steerable to define a second outer-guide-catheter curve and the first deflection portion of the inner guide catheter is steerable to define a first inner-guide-catheter curve.
A mitral valve clip includes a stud, a lock, and two arms. The stud includes a shank, and the lock includes a frame relative to which the stud is translatable and into which the shank extends. The lock is able to prevent movement of the stud relative to the lock in at least one direction by locking engagement of the shank. The two arms are connected to the lock and the stud such that an angle between the arms depends on a location of the stud relative to the lock. The locking engagement of the shank that prevents movement of the stud relative to the lock in the at least one direction is only possible when the angle between the arms is below a predefined locking threshold.
Systems and methods for augmenting image data during heart valve repair procedures, such as transcatheter mitral valve repair (TMVr) or transcatheter tricuspid valve repair (TTVr). Image data may be obtained from an imaging device, and may be output to a display with one or more reference markers overlaid on the image data to simplify the visual data. Image data may be augmented or replaced with the reference markers. In some cases, reference markers may provide information about objects that are difficult to see in the image data. In other cases, the reference markers may provide clinical recommendations or feedback.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
A61B 34/20 - Systèmes de navigation chirurgicaleDispositifs pour le suivi ou le guidage d'instruments chirurgicaux, p. ex. pour la stéréotaxie sans cadre
76.
VALVE REPAIR CLIP WITH AUTOMATIC LOCKING MECHANISM ACTIVATION
A mitral valve clip includes a stud, a lock, and two arms. The stud includes a shank, and the lock includes a frame relative to which the stud is translatable and into which the shank extends. The lock is able to prevent movement of the stud relative to the lock in at least one direction by locking engagement of the shank. The two arms are connected to the lock and the stud such that an angle between the arms depends on a location of the stud relative to the lock. The locking engagement of the shank that prevents movement of the stud relative to the lock in the at least one direction is only possible when the angle between the arms is below a predefined locking threshold.
Fixation device for fixation of leaflets of a heart valve includes an elongate central member defining a longitudinal axis of the fixation device and first and second arms rotatable about at least one arm hinge point between an open position and a closed position. The fixation device further includes a first gripping element rotatable about a first gripping element axis of rotation to capture a first leaflet of a heart valve between the first gripping element and the first arm. The fixation device further includes a second gripping element rotatable about a second gripping element axis of rotation to capture a second leaflet of a heart valve between the second gripping element and the second arm. At least one of the first gripping element axis of rotation and the second gripping element axis of rotation is variably offset from the arm hinge point by an axis offset distance defined along the longitudinal axis.
Systems and methods for augmenting image data during heart valve repair procedures, such as transcatheter mitral valve repair (TMVr) or transcatheter tricuspid valve repair (TTVr). Image data may be obtained from an imaging device, and may be output to a display with one or more reference markers overlaid on the image data to simplify the visual data. Image data may be augmented or replaced with the reference markers. In some cases, reference markers may provide information about objects that are difficult to see in the image data. In other cases, the reference markers may provide clinical recommendations or feedback.
Systems and methods for separating native heart valve leaflets attached together by a fixation device. The system has elongate shaft including a proximal end portion, a distal end portion and a longitudinal axis extending therebetween. The elongate shaft is configured for transvascular delivery of the distal end portion to a native heart valve. A balloon is disposed at the distal end portion of the elongate shaft, and the balloon is inflatable from a collapsed condition to an inflated condition. At least one snare lumen extends along at least a portion of the balloon, the at least one snare lumen having an exit port defined therein. A snare is deployable through the exit port from a delivery position within the at least one snare lumen to an extended position extending beyond the exit port. The snare in the extended position is configured to capture the fixation device.
Fixation device for fixation of leaflets of a heart valve, the fixation device including a central element defining a central axis. The fixation device further includes a distal portion including at least one arm coupled to the central element, wherein the at least one arm is moveable to a selected position between a fully open position and a fully closed position. The distal portion further includes at least one leg operatively coupled to the at least one arm and configured to move the at least one arm to the selected position between the fully open position and the fully closed position. The at least one arm includes a contact portion configured to engage native heart valve tissue, the contact portion defining a contact portion axis. The distal portion includes a flexure portion configured to enable the contact portion in the selected position to move within a flex angle range between an undeformed contact portion angle relative to the central axis and a flexed contact portion angle relative to the central axis. The flexed contact portion angle is greater than the undeformed contact portion angle. The flex angle range is about 10 degrees to about 45 degrees. The fixation device further includes at least one gripping element moveable relative to the at least one arm to capture a native leaflet therebetween.
Devices, systems and methods are provided for stabilizing and grasping tissues such as valve leaflets, assessing the grasp of these tissues, approximating and fixating the tissues, and assessing the fixation of the tissues to treat cardiac valve regurgitation, particularly mitral valve regurgitation.
A61B 17/04 - Instruments, dispositifs ou procédés chirurgicaux pour refermer les plaies ou les maintenir ferméesAccessoires utilisés en liaison avec ces opérations pour la suture des plaiesSupports ou emballages pour aiguilles ou matériaux de suture
Devices, systems and methods are provided for stabilizing and grasping tissues such as valve leaflets, assessing the grasp of these tissues, approximating and fixating the tissues, and assessing the fixation of the tissues to treat cardiac valve regurgitation, particularly mitral valve regurgitation.
A61B 17/12 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/29 - Pinces pour la chirurgie faiblement invasive
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
83.
SYSTEMS, APPARATUSES, AND METHODS FOR REMOVING A MEDICAL IMPLANT FROM CARDIAC TISSUE
An implant removal device having an elongate body having a proximal end and a distal end, the elongate body being resiliently flexible and configured to transmit torque from the proximal end to the distal end with a predetermined turning ratio, and a capturing structure extending distally from the distal end and having a capture region, the capturing structure being configured to selectively center a deployed implant in relation to a longitudinal axis of the elongate body and the capture region to aid with capture and subsequent removal.
An implant removal device having an elongate body having a proximal end and a distal end, the elongate body being resiliently flexible and configured to transmit torque from the proximal end to the distal end with a predetermined turning ratio, and a capture structure extending distally from the distal end and having a capture region, the capture structure being configured to selectively center a deployed implant in relation to a longitudinal axis of the elongate body and the capture region to aid with capture and subsequent removal.
An implant removal device having an elongate body having a proximal end and a distal end, the elongate body being resiliently flexible and configured to transmit torque from the proximal end to the distal end with a predetermined turning ratio, and a capture structure extending distally from the distal end and having a capture region, the capture structure being configured to selectively center a deployed implant in relation to a longitudinal axis of the elongate body and the capture region to aid with capture and subsequent removal.
A61B 17/221 - Dispositifs de préhension des calculs en forme de boucles ou de paniers
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
86.
SYSTEMS AND APPARATUSES FOR REMOVING A MEDICAL IMPLANT FROM CARDIAC TISSUE
An implant removal device having an elongate body having a proximal end and a distal end, the elongate body being resiliently flexible and configured to transmit torque from the proximal end to the distal end with a predetermined turning ratio, and a capturing structure extending distally from the distal end and having a capture region, the capturing structure being configured to selectively center a deployed implant in relation to a longitudinal axis of the elongate body and the capture region to aid with capture and subsequent removal.
System for fixation of native leaflets of a heart valve including an implantable fixation device including a center portion defining a longitudinal axis. The implantable fixation device further includes a first distal assembly having a first distal strut pivotally-coupled with the center portion and a first distal element pivotally-coupled with the first distal strut. The first distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a second distal assembly having a second distal strut pivotally-coupled with the center portion and a second distal element pivotally-coupled with the second distal strut. The second distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a locking mechanism configured to lock the first distal assembly and second distal assembly in a selected locked position between the closed position and the extended position.
System for fixation of native leaflets of a heart valve including an implantable fixation device including a center portion defining a longitudinal axis. The implantable fixation device further includes a first distal assembly having a first distal strut pivotally-coupled with the center portion and a first distal element pivotally-coupled with the first distal strut. The first distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a second distal assembly having a second distal strut pivotally-coupled with the center portion and a second distal element pivotally-coupled with the second distal strut. The second distal assembly is configured to move between a closed position and an extended position. The implantable fixation device further includes a locking mechanism configured to lock the first distal assembly and second distal assembly in a selected locked position between the closed position and the extended position.
Devices, systems and methods for removal of a mitral valve clip and subsequent delivery of a mitral valve implantation in a mitral valve replacement procedure. A modular port accessory device having a distal connector configured to be compatible with corresponding connectors on an existing therapeutic device, wherein the port accessory can be selectively attached to a proximal end portion connector of a proximal end portion of a catheter assembly of an existing therapeutic device. The catheter assembly is introduced to a target site within the patient's anatomy, and remains in place throughout a multistep therapeutic procedure for use with other therapeutic devices, all while allowing hemostasis to be controlled during use ad interchange of multiple therapeutic devices.
Devices, systems and methods for removal of a mitral valve clip and subsequent delivery of a mitral valve implantation in a mitral valve replacement procedure. A modular port accessory device having a distal connector configured to be compatible with corresponding connectors on an existing therapeutic device, wherein the port accessory can be selectively attached to a proximal end portion connector of a proximal end portion of a catheter assembly of an existing therapeutic device. The catheter assembly is introduced to a target site within the patient's anatomy, and remains in place throughout a multistep therapeutic procedure for use with other therapeutic devices, all while allowing hemostasis to be controlled during use ad interchange of multiple therapeutic devices.
An interventional device for cutting tissue at a targeted cardiac valve, such as a mitral valve. The interventional device includes a catheter having a proximal end and a distal end. A cutting mechanism is positionable at the distal end, such as by routing the cutting mechanism through the catheter to position it at the distal end. The cutting mechanism includes one or more cutting elements configured for cutting valve tissue when engaged against the tissue. A handle is coupled to the proximal end of the catheter and includes one or more controls for actuating the cutting mechanism.
A61B 18/24 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par application de radiations électromagnétiques, p. ex. de micro-ondes en utilisant des lasers le faisceau étant dirigé le long, ou à l'intérieur d'un conduit flexible, p. ex. d'une fibre optiquePièces à main à cet effet avec un cathéter
A61B 17/22 - Instruments pour comprimer les ulcères ou similaires placés sur les organes internes du corpsInstruments pour curer les cavités des organes du corps, p. ex. des osInstruments, dispositifs ou procédés chirurgicaux pour l'élimination ou la destruction invasives des calculs utilisant des vibrations mécaniquesInstruments, dispositifs ou procédés chirurgicaux pour l'élimination non prévue ailleurs des obstructions dans les vaisseaux sanguins
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
An integrated imaging and device deployment platform and method may include a catheter, at least one imaging unit, at least one deployment unit, and at least one device configured to be deployed by the at least one deployment unit. The integrated imaging and device deployment platform facilitates improved navigation and deployment of a therapeutic or medical device by providing the at least one imaging unit proximate the deployment unit. Information generated from the at least one imaging unit may be utilized with additional imaging modalities to provide improved imaging and delivery of devices while reducing use of X-ray radiation and contrast injection.
A61B 8/00 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
An integrated imaging and device deployment platform and method may include a catheter, at least one imaging unit, at least one deployment unit, and at least one device configured to be deployed by the at least one deployment unit. The integrated imaging and device deployment platform facilitates improved navigation and deployment of a therapeutic or medical device by providing the at least one imaging unit proximate the deployment unit. Information generated from the at least one imaging unit may be utilized with additional imaging modalities to provide improved imaging and delivery of devices while reducing use of X-ray radiation and contrast injection.
A61B 8/12 - Diagnostic utilisant des ondes ultrasonores, sonores ou infrasonores dans des cavités ou des conduits du corps, p. ex. en utilisant des cathéters
A61B 90/00 - Instruments, outillage ou accessoires spécialement adaptés à la chirurgie ou au diagnostic non couverts par l'un des groupes , p. ex. pour le traitement de la luxation ou pour la protection de bords de blessures
A61B 5/00 - Mesure servant à établir un diagnostic Identification des individus
A61M 25/01 - Introduction, guidage, avance, mise en place ou maintien en position des cathéters
Methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. A delivery device for staged deployment of an implantable device to a target area. The delivery device includes a deployment handle and one or more lock lines extending from the deployment handle through the catheter to the implantable device, the one or more lock lines being configured to engage with the implantable device to allow locking of the implantable device.
A61B 17/00 - Instruments, dispositifs ou procédés chirurgicaux
A61B 17/122 - Clamps ou pinces, p. ex. pour le cordon ombilical
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 90/50 - Supports pour instruments chirurgicaux, p. ex. bras articulés
A61M 25/01 - Introduction, guidage, avance, mise en place ou maintien en position des cathéters
The present disclosure relates to repair devices and methods for repair of regurgitant tricuspid valves. A repair method includes positioning a repair device at a tricuspid valve in a collapsed configuration. The repair device includes a proximal grasping assembly movable between a first position and a second position and a distal grasping assembly movable between a third position and a fourth position. An actuator rod operatively connected to each of the proximal grasping assembly and the distal grasping assembly so that distal movement of the actuator rod moves the proximal grasping assembly proximally and the distal grasping assembly distally.
A fastening system and a deployment system for controlling translation and rotation of a deployment device are presented. A fastening system may comprise one or more components configured for arresting or restricting translation of a delivery catheter of a medical device, including a mitral valve fixation device such as the MitraClip®. A deployment system may comprise one or more components configured for locking rotation of a crimping cam to a slider to control deployment of a mitral valve fixation device.
A fastening system and a deployment system for controlling translation and rotation of a deployment device are presented. A fastening system may comprise one or more components configured for arresting or restricting translation of a delivery catheter of a medical device, including a mitral valve fixation device. A deployment system may comprise one or more components configured for locking rotation of a crimping cam to a slider to control deployment of a mitral valve fixation device.
A system configured to cut leaflet tissue at a cardiac valve may comprise a guide catheter having a proximal end and a distal end, wherein the distal end of the guide catheter is steerable to a position above a cardiac valve. The system may also include a hook catheter having a proximal end and a distal end, the hook catheter configured to extend from the distal end of the guide catheter through a first orifice of the cardiac valve. Further, the system may comprise a cutting mechanism extending from the hook catheter, the cutting mechanism configured to cut a portion of leaflet tissue of the cardiac valve. Finally, the system may include a handle coupled to the proximal end of the guide catheter, the handle comprising at least one control operatively connected to the cutting mechanism.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A61B 18/08 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci par chauffage à l'aide de sondes chauffées électriquement
A61M 25/01 - Introduction, guidage, avance, mise en place ou maintien en position des cathéters
A system configured to detach an interventional implant from a cardiac valve includes a guide catheter and a capture mechanism routable through the guide catheter. The capture mechanism comprises a capture hypotube with a container portion/space configured to receive an interventional implant connected to cardiac valve tissue. The capture mechanism also includes a cutting arm axially moveable relative to the capture hypotube. The capture hypotube and the cutting arm each include cutting elements that are brought together upon actuation of the cutting arm to thereby cut the cardiac valve tissue surrounding the interventional implant to free the implant from the cardiac valve.
A61B 17/128 - Instruments, dispositifs ou procédés chirurgicaux pour ligaturer ou comprimer par un autre moyen les parties tubulaires du corps, p. ex. les vaisseaux sanguins ou le cordon ombilical pour appliquer ou enlever les clamps ou les pinces
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
A system configured to cut leaflet tissue at a cardiac valve may comprise a guide catheter and a cutting mechanism routable through the guide catheter. The cutting mechanism includes a cutting arm and a plurality of grasping arms rotatably coupled to the cutting arm. The grasping arms are connected to the cutting arm via a central hinge and are actuatable between a closed position against the cutting arm and an open position where the grasping arms extend laterally away from the cutting arm by rotating about the hinge. Targeted cardiac leaflet tissue may be grasped between the cutting arm and the grasping arms and cut by a cutting element that is attached to or extends through the cutting arm.
A61B 18/00 - Instruments, dispositifs ou procédés chirurgicaux pour transférer des formes non mécaniques d'énergie vers le corps ou à partir de celui-ci
