Annuloplasty rings and methods for heart valve repair
An annuloplasty ring, configured for implantation in the annulus of a heart valve, comprising multiple segments each of which are geometrically shaped from a three dimensional perspective to conform to the anatomic shape of the valve annulus. In one embodiment, at least one of the multiple segments of the annuloplasty ring is configured to facilitate a reduction of tension on heart valve tissue and eliminate a substantial portion of potential pressure or force that may be applied to the atrio-ventricular node by the annuloplasty ring when inserted into a heart valve. In another embodiment, at least one of the multiple segments of the annuloplasty ring are configured to include an assembly that facilitates selective adjustment of a segment's respective length and/or shape. The adjustment of the length of one of the ring segment's results in an adjustment of at least one angle between at least one set of other ring segments, thereby causing an adjustment to the geometric characteristics of the ring.
1. A tricuspid annuloplasty ring configured for implantation in a tricuspid valve annulus having an anterior annulus section, a septal annulus section and a posterior annulus section, the annuloplasty ring comprising:
a triangular shaped continuous body having an anterior segment, a septal segment and a posterior segment, wherein each of the anterior, septal and posterior segments are geometrically shaped to conform to the anatomic shape of the anterior, septal and posterior sections of tricuspid valve annulus, wherein at least one of the anterior segment, the septal segment, and the posterior segment comprises a plurality of sub-segments, wherein a one of the plurality of sub-segments is detachable to create a triangular shaped discontinuous body to facilitate implantation, the triangular shaped continuous body having a first connection between the anterior segment and the septal segment, a second connection between the septal segment and the posterior segment, and a third connection between the anterior segment and the posterior segment, triangular shaped continuous body being flexible at at least one of the first connection, the second connection, and the third connection and rigid elsewhere,
wherein the ring further comprises an adjustment device attached to the ring, wherein the adjustment device comprises:
a gearbox; and
at least one flexible wire, wherein the at least one flexible wire connects the gearbox to the at least one of the flexible connections.
2. The tricuspid annuloplasty ring of claim 1 wherein the anterior, septal and posterior segments of the annuloplasty ring vary in length and curvature when compared to each other.
3. The tricuspid annuloplasty ring of claim 2 wherein the septal segment of the annuloplasty ring is longer than the posterior segment of the annuloplasty ring and the anterior segment of the annuloplasty ring is longer than the posterior segment of the annuloplasty ring.
4. The tricuspid annuloplasty ring of claim 3 wherein the septal segment extends from a posterior-septal commissure to an anterior-septal commissure, the anterior segment extends from the anterior-septal commissure to an anterior-posterior commissure and the posterior segment extends from the anterior-posterior commissure to the posterior-septal commissure.
5. The tricuspid annuloplasty ring of claim 1 wherein the annuloplasty ring has a defined edge comprising an optimal geometric configuration of exterior portions of the anterior, septal and posterior segments.
6. The tricuspid annuloplasty ring of claim 1 wherein a curvature of the anterior segment of the annuloplasty ring is greater than the curvature of the septal and posterior segments of the annuloplasty ring, wherein:
a two lowest points of the anterior segment are located at a posterior-septal commissure of the tricuspid valve and an anterior-septal commissure of the tricuspid valve; and
a zenith of the ring is midway between the two lowest points on the anterior segment.
7. The tricuspid annuloplasty ring of claim 1 wherein the septal segment is configured such that a lowest point of the septal segment corresponds to the septal-anterior commissure and a highest point of the septal segment corresponds to the anterior-posterior commissure.
8. The tricuspid annuloplasty ring of claim 1 wherein the posterior segment is configured such that the lowest point on the posterior segment corresponds to a septal-posterior commissure and the highest point on the posterior segment corresponds to an anterior-posterior commissure.
9. The tricuspid annuloplasty ring of claim 1 has an inner circumferential shape such that projection of the ring onto a planar surface depicts a scalar triangle with unequal edges, wherein the geometric shape of the septal segment of the ring corresponds to the geometric shape of the septal segment of the tricuspid valve annulus, the geometric shape of the anterior segment of the ring corresponds to the geometric shape of the anterior segment of the tricuspid valve annulus and the geometric shape of the posterior segment of the ring corresponds to the geometric shape of the posterior segment of the tricuspid valve annulus.
10. The tricuspid annuloplasty ring of claim 1 wherein the at least one of the plurality of flexible segments comprises molded silicone and the at least one of the plurality of rigid segments comprises metal.
11. The tricuspid annuloplasty ring of claim 1 , wherein the gearbox comprises a rotatable shaft connected to the at least one flexible wire, wherein actuating the gearbox rotates the shaft and adjusts a length of the at least one flexible wire between the shaft and the at least one of the flexible connections, such that an adjusted length of the at least one flexible wire initiates a deflection in the at least one of the flexible connections.
12. The tricuspid annuloplasty ring of claim 11 , wherein the at least one of the flexible connections is a fixed length.