MINIMALLY INVASIVE REPAIR OF HEART VALVE LEAFLETS

1 . A method of repairing a heart valve in a beating heart of a patient, comprising:

inserting an external guide catheter through a vein of a patient and into a right atrium of a heart of a patient;

advancing the external guide catheter into a right ventricle of the patient's heart;

inserting an internal guide catheter into the external guide catheter and advancing the internal guide catheter into the right ventricle;

puncturing a septum in the patient's heart to create an opening between the right ventricle and a left ventricle;

advancing the internal guide catheter through the opening in the septum and into the left ventricle;

inserting a deployment catheter through the internal guide catheter and advancing the deployment catheter adjacent a heart valve in the left ventricle; and

deploying a repair device onto the heart valve with the deployment catheter.

2 . The method of claim 1 , further comprising:

advancing a sealing device through the internal guide catheter to the septum; and

positioning the sealing device within the opening in the septum to seal the opening.

3 . The method of claim 1 , wherein the repair device is a suture.

4 . The method of claim 3 , wherein deploying a repair device onto the heart valve with the deployment catheter includes:

capturing a heart valve leaflet with a clamping mechanism of the deployment catheter; and

inserting the suture through the heart valve leaflet with a needle of the deployment catheter.

5 . The method of claim 3 , further comprising:

advancing a sealing device through the internal guide catheter to the septum;

extending the suture through a lumen extending through the sealing device; and

positioning the sealing device within the opening in the septum to seal the opening, such that a proximal end of the suture extends from the heart valve through the septum.

6 . The method of claim 5 , further comprising:

threading the suture through an anchoring device;

advancing the anchoring device through the internal guide catheter to the septum;

interfacing the anchoring device with the sealing device to lock a position of the suture with respect to the sealing device;

advancing a cutting catheter having a cutting tool through the internal guide catheter to the septum; and

cutting the suture in the right ventricle adjacent the sealing device.

7 . The method of claim 5 , further comprising selectively tensioning the suture to have a desired tension through the septum.

8 . The method of claim 7 , wherein the suture tension is maintained by a seal within the sealing element that engages the suture, and further comprising:

releasing the tension on the suture by engaging the seal to cause the seal to release the suture; and

retensioning the suture.

9 . The method of claim 3 , wherein the deployment catheter deploys a plurality of sutures on the valve.

10 . A method comprising:

providing a heart valve repair system, the system including an external guide catheter, an internal guide catheter adapted to be slidably inserted through the external guide catheter, a septal puncture tool and a deployment catheter; and

providing instructions for deploying a repair device onto a heart valve of a beating heart of a patient with the heart valve repair system, the instructions comprising:

inserting the external guide catheter through a vein of the patient and into a right atrium of a heart of the patient;

advancing the external guide catheter into a right ventricle of the patient's heart;

inserting the internal guide catheter into the external guide catheter and advancing the internal guide catheter into the right ventricle;

inserting the septal puncture tool through the internal guide catheter and puncturing a septum of the patient with the septal puncture tool to create an opening through the septum between the right ventricle and a left ventricle;

advancing the internal guide catheter through the opening in the system and into the left ventricle;

inserting the deployment catheter through the internal guide catheter and advancing the deployment catheter adjacent the heart valve; and

deploying a repair device onto the heart valve with the deployment catheter.

11 . The method of claim 10 , wherein providing a heart valve repair system includes providing a sealing device, and the instructions further comprise:

advancing the sealing device through the internal guide catheter to the septum; and

positioning the sealing device within the opening in the septum to seal the opening.

12 . The method of claim 10 , wherein providing a heart valve repair system includes providing a suture as the repair device, wherein deploying a repair device onto the heart valve with the deployment catheter includes:

capturing a heart valve leaflet with a clamping mechanism of the deployment catheter; and

inserting the suture through the heart valve leaflet with a needle of the deployment catheter.

13 . The method of claim 10 , wherein providing a heart valve repair system includes providing a sealing device and providing a suture as the repair device and wherein the instructions further comprise:

advancing the sealing device through the internal guide catheter to the septum;

extending the suture through a lumen extending through the sealing device; and

positioning the sealing device within the opening in the septum to seal the opening, such that a proximal end of the suture extends from the heart valve through the septum.

14 . The method of claim 13 , wherein providing a heart valve repair system includes providing an anchoring device and a cutting catheter having a cutting tool, and the instructions further comprise:

threading the suture through the anchoring device;

advancing the anchoring device through the internal guide catheter to the septum;

interfacing the anchoring device with the sealing device to lock a position of the suture with respect to the sealing device;

advancing the cutting catheter through the internal guide catheter to the septum; and

cutting the suture in the right ventricle adjacent the sealing device with the cutting tool.

15 . The method of claim 14 , wherein the instructions further comprise selectively tensioning the suture to have a desired tension through the septum.

16 . A system comprising:

means for intravenously accessing a right ventricle of a beating heart of a patient;

means for creating an opening through a septum of the patient's heart between the right ventricle and a left ventricle;

means for deploying a repair device onto a heart valve;

means for positioning the means for deploying in the left ventricle; and

means for sealing the opening in the septum.

17 . The system of claim 16 , wherein the means for deploying a repair device includes a means for grasping a heart valve leaflet and a means for inserting a suture through the leaflet.

18 . The system of claim 17 , further comprising means for selectively tensioning the suture through the sealing device.

19 . The system of claim 17 , further comprising means for anchoring the suture at the sealing device.

20 . The system of claim 18 , further comprising means for selectively retensioning the suture.