Implant devices, systems, and methods for annulus reduction
An implantable device which shifts between a collapsed configuration and an expanded configuration. The implantable device may be delivered transluminally in a collapsed delivery configuration to a treatment site, whereupon the implantable device may be expanded to a deployment configuration. As the implantable device is expanded to the deployment configuration, the proximal end of the implantable device remains coupled to a delivery and/or deployment device. The implantable device is configured such that while the proximal end may be constrained by being coupled to the delivery device, the distal end is not impeded from expanding to within greater than 90% of its fully expanded configuration when not coupled to the delivery device.
1 . An implantable annuloplasty device configured to reshape a cardiac valve annulus, the implantable annuloplasty device being shiftable between a collapsed configuration and an expanded configuration, the implantable annuloplasty device comprising:
a tubular frame extending about a frame axis and having a proximal end configured to be coupled to a delivery device and a distal end configured to be secured to tissue;
wherein:
the tubular frame has a proximal section adjacent the proximal end of the frame, an anchoring section adjacent the distal end of the frame, and a middle section between the proximal section and the anchoring section;
the proximal section of the tubular frame bows outwardly from the frame axis at least when the implantable annuloplasty device is expanded prior to being implanted;
wherein the proximal section is disposed radially outward of the proximal end of the tubular frame at least when the implantable annuloplasty device is expanded prior to being implanted; and
the anchoring section of the tubular frame extends at an angle relative to the middle section in a direction inwardly towards the frame axis.
2 . The implantable annuloplasty device of claim 1 , wherein a bend is provided adjacent and spaced from the proximal end of the tubular frame to define the proximal section relative to the middle section.
3 . The implantable annuloplasty device of claim 2 , wherein the tubular frame comprises a plurality of struts joined along proximal apices, and the bend is formed adjacent at least one of the proximal apices.
4 . The implantable annuloplasty device of claim 3 , further comprising a slider on the at least one proximal apex, the slider movable along the at least one proximal apex to shift the implantable device between a collapsed configuration and an expanded configuration.
5 . The implantable annuloplasty device of claim 4 , wherein the slider is slidable over the bend.
6 . The implantable annuloplasty device of claim 1 , the tubular frame comprises a plurality of struts joined along proximal apices.
7 . The implantable annuloplasty device of claim 6 , further comprising a slider on at least one of the proximal apices, the slider movable along the at least one proximal apex to shift the implantable device between a collapsed configuration and an expanded configuration.
8 . The implantable annuloplasty device of claim 7 , wherein distal movement of the slider causes the proximal section of the frame to straighten relative to the middle section of the frame.
9 . The implantable device of claim 8 , wherein distal movement of the slider over a bend in the frame separating the proximal section from the middle section causes the proximal section of the frame to straighten relative to the middle section of the frame.
10 . The implantable device of claim 6 , wherein:
a slider screw is held in a window in the at least one proximal apex by one or more bearings;
the slider is movable along the at least one apex upon rotation of the slider screw; and
the slider screw pivots with respect to the at least one apex to pivot the slider with respect to the apex, the slider forming the proximal section of the tubular frame.
11 . The implantable device of claim 10 , wherein the slider forms the proximal section of the frame and is pivotable between a configuration at an angle relative to the middle section of the frame to a configuration substantially aligned with the middle section of the frame.
12 . A delivery system comprising:
a delivery catheter;
a delivery device deliverable through the delivery catheter to a treatment site; and
an implantable annuloplasty device configured to reshape a cardiac valve annulus having a proximal end coupled to the delivery device and a distal end configured to be secured to tissue at the treatment site, the implantable annuloplasty device deliverable through the delivery catheter to the treatment site;
wherein:
the delivery device comprises at least one elongated member;
the implantable annuloplasty device is expandable from a collapsed delivery configuration to an expanded deployment configuration while coupled to the delivery device;
a proximal section of the implantable annuloplasty device adjacent the proximal end of the implantable annuloplasty device remains at a smaller angle with respect to the at least one elongated member of the delivery device than does a middle section of the implantable annuloplasty device extending distally from the proximal section when the implantable annuloplasty device shifts from the collapsed delivery configuration to the expanded deployment configuration while coupled to the delivery device;
wherein the implantable annuloplasty device includes a tubular frame;
wherein an outward bend is provided adjacent and spaced from a proximal end of the tubular frame to form the proximal section of the implantable annuloplasty device;
wherein the outward bend defines a region of the tubular frame that is disposed radially outward of the proximal end of the tubular frame;
wherein an inward bend is provided adjacent and spaced from a distal end of the tubular frame to form an anchoring section of the implantable annuloplasty device and
wherein the tubular frame comprises a plurality of struts joined along proximal apices, and the outward bend is formed adjacent at least one of the proximal apices.
13 . The delivery system of claim 12 , further comprising a slider on the at least one of the proximal apices, the slider movable along the at least one proximal apex to shift the implantable annuloplasty device between a collapsed configuration and an expanded configuration.
14 . The delivery system of claim 13 , wherein the slider is slidable over the outward bend.
15 . The delivery system of claim 12 , wherein:
the tubular frame comprises a plurality of struts joined along proximal apices;
a slider is provided on at least one of the proximal apices, the slider movable along the at least one proximal apex to shift the implantable device between a collapsed configuration and an expanded configuration;
a slider screw is held in a window in the at least one proximal apex by one or more bearings;
the slider is movable along the at least one apex upon rotation of the slider screw; and
the slider screw pivots with respect to the at least one apex to pivot the slider with respect to the apex, the slider forming the proximal section of the tubular frame.
16 . The delivery system of claim 12 , wherein:
an anchoring bend is provided in the frame defining an anchoring section adjacent a distal end of the implantable device; and
the anchoring section extends at a smaller angle with respect to the at least one elongated member of the delivery device than does the middle section of the implantable annuloplasty device.
17 . An implantable annuloplasty device, comprising:
a tubular frame extending about a frame axis and having a proximal end configured to be coupled to a delivery device and a distal end configured to be secured to tissue;
wherein the tubular frame has a middle section, a proximal section extending between the proximal end of the tubular frame and the middle section, and an anchoring section extending between the middle section and the distal end of the tubular frame;
wherein the proximal section of the tubular frame bows outwardly relative to the proximal end of the tubular frame and the middle section; and
wherein the anchoring section of the tubular frame extends radially inward relative to the middle section.
18 . The implantable annuloplasty device of claim 17 , wherein the proximal section includes a plurality of struts extending between the proximal end of the tubular frame and the middle section; and
wherein in a direction extending from the proximal end of the tubular frame to the middle section, the struts bow radially outward.