Transcatheter tissue cutting system
Systems and methods for cutting tissue using a transcatheter approach are disclosed. In some examples, the systems and methods are implemented as part of a delivery system that includes an implant with a support structure and a cutting element coupled to the support structure, such that the cutting element configured to cut tissue.
1 . A delivery system comprising:
a delivery device;
an implant having a support structure, the implant being releasably coupled to the delivery device; and
a tissue cutting system coupled to the delivery device and the implant, the tissue cutting system including a cutting element comprising a wire formed of a conductive material electrically connected to a current source and configured to cut tissue, wherein the wire comprises a first portion and a second portion extending from the first portion,
wherein the first portion of the wire extends through a lumen of the delivery device and the implant and outwardly from a distal tip portion of the delivery device in a distal direction, and
wherein the second portion of the wire extends from a distal end of the first portion of the wire in a proximal direction alongside the delivery device and the implant and then back into the delivery device at a location proximal the distal tip portion of the delivery device.
2 . The delivery system of claim 1 , wherein the first and second portions of the wire form a loop portion that extends radially outward relative to the delivery device, and wherein the loop portion is configured to be adjusted in size by a user.
3 . The delivery system of claim 1 , wherein the cutting element comprises a protective cover extending partially over the wire and rendering at least a portion of the wire inoperable for cutting tissue.
4 . The delivery system of claim 1 , further comprising an outer sheath retractably disposed over at least a portion of the cutting element.
5 . The delivery system of claim 4 , wherein the outer sheath comprises a thermally insulating material.
6 . The delivery system of claim 4 , wherein the outer sheath comprises an electrically insulating material.
7 . The delivery system of claim 4 , wherein the outer sheath comprises an abrasion-resistant material.
8 . The delivery system of claim 1 , wherein the support structure comprises a leaflet frame subcomponent and an anchor frame subcomponent.
9 . The delivery system of claim 8 , wherein the support structure further comprises an interstage flexibly coupling the leaflet frame subcomponent and the anchor frame subcomponent.
10 . The delivery system of claim 9 , wherein the cutting element is coupled to the interstage.
11 . The delivery system of claim 8 , wherein the cutting element extends through a framework of the leaflet frame subcomponent or the anchor frame subcomponent.
12 . The delivery system of claim 1 , wherein the support structure is configured to be self-expanding.
13 . The delivery system of claim 1 , wherein the support structure is configured to assume a collapsed, delivery configuration and an expanded, deployed configuration.
14 . The delivery system of claim 1 , wherein the cutting element is configured to cut tissue when the implant is in a deployed configuration.
15 . The delivery system of claim 14 , wherein the cutting element is configured to be uncoupled from the delivery system or the implant.
16 . The delivery system of claim 1 , wherein the delivery device comprises shaft defining the lumen through which the first portion of the wire extends, wherein the implant is mounted around the shaft such that the first portion and the second portion of the wire form a loop that extends through and alongside the implant.
17 . A method of delivering an implant to a treatment site, the method comprising:
positioning the implant at the treatment site with a delivery device; and
cutting tissue at the treatment site with a cutting element that is coupled to the delivery device and the implant, wherein the cutting element comprises a first portion and a second portion extending from the first portion,
wherein the first portion of the cutting element extends through a lumen of the delivery device and the implant and then distally from an opening in a distal tip portion of the delivery device, and
wherein the second portion of the cutting element curves from a distal end of the first portion of the cutting element in a proximal direction alongside the delivery device and the implant and back into the delivery device.
18 . The method of claim 17 , wherein the first and second portions of the cutting element define a loop portion, and wherein the method further comprises adjusting a size of the loop portion prior to cutting the tissue.
19 . The method of claim 17 , further comprising:
uncoupling the cutting element from the implant after the tissue is cut, and removing the cutting element from the treatment site.
20 . The method of claim 17 , further comprising:
deploying the implant at the treatment site, wherein the tissue is cut at least one of prior to, during, or following deploying the implant.
21 . A method for treating a human patient with a diagnosed condition or disease associated with valve insufficiency or valve failure of a native valve, the method comprising implanting the implant of claim 1 , the implant being a prosthetic valve, the prosthetic valve being implanted at or adjacent to a location associated with the native valve.