Systems and methods for heart valve repair

1 . A system for transcatheter heart valve repair, comprising:

a sheath defining a lumen;

at least two clip assemblies comprising:

a first elongate member slidably disposed within the lumen of the sheath;

a first clip releasably coupled to, and selectively detachable from, the first elongate member, wherein the first clip comprises a ventricular jaw and an atrial jaw, wherein the ventricular jaw and the atrial jaw of the first clip are each individually deployable to a respective position for approximation of the first clip on a first leaflet portion of the heart valve;

a second elongate member slidably disposed within the lumen of the sheath and unconnected to the first elongate member such that the first and second elongate members are extendable out from the lumen toward the heart valve separately from each other;

a second clip that is separate from and unconnected to the first clip, wherein the second clip is releasably coupled to, and selectively detachable from, the second elongate member, wherein the second clip comprises a ventricular jaw and an atrial jaw, wherein the ventricular jaw and the atrial jaw of the second clip are each individually deployable to a respective position for approximation of the second clip on a second leaflet portion of the heart valve; and

a locking mechanism configured to slide along the first elongate member and the second elongate member and to couple and lock together the first and second clips.

2 . The system of claim 1 , wherein the at least two clip assemblies comprises three of the clip assemblies.

3 . The system of claim 1 , wherein the at least two clip assemblies comprises four of the clip assemblies.

4 . The system of claim 1 , wherein each ventricular jaw has a first width and a first length, and each atrial jaw has a second width and second length, wherein the first width and the second width are different.

5 . The system of claim 1 , wherein each ventricular jaw has a first width and a first length, and each atrial jaw has a second width and second length, wherein the first length and the second length are different.

6 . The system of claim 1 , wherein each ventricular jaw comprises a first plurality of teeth on an interior portion thereof for engaging the first leaflet portion of the heart valve and each atrial jaw comprises a second plurality of teeth on an interior portion thereof for engaging the second leaflet portion of the heart valve.

7 . The system of claim 6 , wherein the first plurality of teeth is different from the second plurality of teeth.

8 . The system of claim 1 , wherein the locking mechanism is configured to couple and lock together the first and second clips of the at least two clip assemblies in situ, and not until the first clip is approximated on the first leaflet portion and the second clip is approximated on the second leaflet portion.

9 . The system of claim 8 , wherein the locking mechanism comprises a coupler to lock the first and second clips together.

10 . The system of claim 9 , wherein the coupler allows the first and second clips to be attached such that complete inversion of the leaflets is achieved.

11 . The system of claim 9 , wherein the coupler allows the first and second clips to be attached such that 50% inversion of the leaflets is achieved.

12 . The system of claim 9 , wherein the coupler allows the first and second clips to be attached such that 0-10% inversion of the leaflets is achieved.

13 . The system of claim 9 , wherein the coupler comprises a hinge mechanism.

14 . The system of claim 9 , wherein the coupler defines a plurality of slots to grasp the first and second clips in a plurality of positions.

15 . The system of claim 9 , wherein the coupler is flexible to grasp the first and second clips in a plurality of positions.

16 . A method for heart valve repair, comprising:

inserting a sheath into a chamber of a heart of a patient, wherein the sheath defines a lumen;

providing at least two clip assemblies comprising:

a first elongate member slidably disposed within the lumen of the sheath;

a first clip releasably coupled to, and selectively detachable from, the first elongate member, wherein the first clip comprises a ventricular jaw and an atrial jaw, wherein the ventricular jaw and the atrial jaw of the first clip are each individually deployable to a respective position for approximation of the first clip on a first leaflet portion of the heart valve;

a second elongate member slidably disposed within the lumen of the sheath and unconnected to the first elongate member such that the first and second elongate members are extendable out from the lumen toward the heart valve separately from each other;

a second clip that is separate from and unconnected to the first clip, wherein the second clip is releasably coupled to, and selectively detachable from, the second elongate member, wherein the second clip comprises a ventricular jaw and an atrial jaw, wherein the ventricular jaw and the atrial jaw of the second clip are each individually deployable to a respective position for approximation of the second clip on a second leaflet portion of the heart valve; and

individually extending the first elongate member and the first clip of the at least two clip assemblies from an end of the sheath toward the heart valve;

clipping the first leaflet portion of the heart valve with the first clip of the at least two clip assemblies by individually deploying the ventricular jaw and the atrial jaw of the first clip such that the first leaflet portion is approximated between the ventricular jaw and the atrial jaw of the first clip;

individually extending the second elongate member and the second clip of the at least two clip assemblies from an end of the sheath toward the heart valve; and

clipping the second leaflet portion of the heart valve with the second clip of the at least two clip assemblies by individually deploying the ventricular jaw and the atrial jaw of the second clip such that the second leaflet portion is approximated between the ventricular jaw and the atrial jaw of the second clip.

17 . The method of claim 16 , further comprising clipping a third leaflet portion of the heart valve with a third clip of the at least two clip assemblies.

18 . The method of claim 17 , further comprising securing the first clip, the second clip, and the third clip together by advancing a locking mechanism along the elongate member of each clip assembly and into engagement with each of the first clip, the second clip, and the third clip.

19 . The method of claim 16 , further comprising:

providing a locking mechanism;

after the clipping of the first and second leaflet portions, advancing the locking mechanism along the first elongate member and the second elongate member; and

locking the first clip and the second clip together by engaging the locking mechanism onto the first clip and the second clip.

20 . The method of claim 19 , further comprising, after locking the first clip and the second clip together, individually uncoupling the first elongate member from the first clip and the second elongate member from the second clip.

21 . The method of claim 16 , wherein the chamber is a left atrium.

22 . The method of claim 16 , wherein the heart valve is a mitral valve.

23 . The method of claim 16 , wherein the heart valve is a tricuspid valve.