Apparatus and method for heart valve repair
A device for transcatheter gathering of tissue of a heart valve leaflet may include an elongated tube extending in a longitudinal direction and a capture tool moveable in the elongated tube between a retracted position and an extended position. The elongated tube may have at least one slot extending generally in the longitudinal direction from a distal end of the elongated tube. The at least one slot may have an open end at the distal end of the elongated tube and a closed end remote therefrom. The capture tool may be operable to gather tissue of the heart valve leaflet into the at least one slot. The gathered tissue may have a pleated configuration.
1. A device for transcatheter gathering of tissue of a heart valve leaflet, comprising:
an elongated tube extending in a longitudinal direction and having a circumferential wall and at least one slot extending through the wall and extending generally in the longitudinal direction from a distal end of the elongated tube, the at least one slot having an open end at the distal end of the elongated tube and a closed end remote therefrom;
a capture tool moveable in the elongated tube between a retracted position and an extended position, the capture tool being operable to gather tissue of the heart valve leaflet into the at least one slot, such that the gathered tissue has a pleated configuration;
a tissue securing component disposed within the elongated tube and adapted to be applied to the gathered tissue for holding the gathered tissue in the pleated configuration, the tissue securing component comprising a clip arrangeable in a partially-open condition within the elongated tube and biased to contract to a clamping condition when deployed from the elongated tube; and
retention elements adapted to hold the clip in the partially-open condition, the retention elements including hooks adapted to engage with recesses at opposed ends of the clip.
2. The device of claim 1 , wherein a distal end of the capture tool has a hook shape.
3. The device of claim 2 , wherein the capture tool includes a grasping wire slidably disposed in a containment tube, and a distal portion of the grasping wire is adapted to change from a linear shape to the hook shape when the distal portion of the grasping wire is extended out from the containment tube.
4. The device of claim 3 , wherein the grasping wire is partially or entirely made from a shape-memory material.
5. The device of claim 1 , further comprising an operating handle having an actuating member adapted to control movement of the capture tool between the retracted and extended positions.
6. The device of claim 1 , wherein at least a portion of the at least one slot has a generally U-shaped configuration.
7. The device of claim 6 , wherein the elongated tube has at least one pair of opposed angled portions, each pair of opposed angled portions extending between the distal end of the elongated tube and sidewalls of a corresponding one of the at least one slot, each pair of angled portions forming at least a portion of a substantially V-shaped opening leading to the at least one slot.
8. The device of claim 1 , wherein the at least one slot includes two slots located substantially opposite one another in a direction perpendicular to the longitudinal direction of the elongated tube.
9. The device of claim 1 , wherein the clip is wholly or partly made of a shape-memory material.
10. The device of claim 1 , further comprising a support shelf slidable within the elongated tube in the longitudinal direction between a retracted position in which a distal end of the support shelf is disposed within the elongated tube and an extended position in which the distal end of the support shelf is disposed beyond the distal end of the elongated tube, the support shelf being adapted to support the clip within the elongated tube.
11. The device of claim 10 , wherein the clip in the partially-open condition has a generally cylindrical shape and defines a longitudinal axis around which the clip extends, the retention elements adapted to hold the clip in the partially-open condition with the longitudinal axis of the clip oriented substantially perpendicular to the longitudinal direction.
12. A device for transcatheter gathering of tissue of a heart valve leaflet, comprising:
an elongated tube extending in a longitudinal direction;
a releasable clip disposed within the elongated tube and adapted to be applied to gathered tissue for holding the gathered tissue in a gathered configuration, the clip being arrangeable in a partially-open condition within the elongated tube and biased to contract to a clamping condition when deployed from the elongated tube, the clip in the partially-open condition having a generally cylindrical shape and defining a longitudinal axis around which the clip extends;
a support shelf slidable within the elongated tube in the longitudinal direction between a retracted position in which a distal end of the support shelf is disposed within the elongated tube and an extended position in which the distal end of the support shelf is disposed beyond a distal end of the elongated tube, the support shelf being adapted to support the clip within the elongated tube; and
a plurality of retention elements slidable within the elongated tube in the longitudinal direction, the retention elements being adapted to hold the clip in the partially-open condition with the longitudinal axis of the clip oriented substantially perpendicular to the longitudinal direction.
13. The device of claim 12 , wherein the retention elements include sutures adapted to engage with apertures at opposed ends of the clip.
14. The device of claim 13 , further comprising cutting tubes disposed around the sutures, the cutting tubes adapted to slide in the longitudinal direction relative to the elongated tube, the cutting tubes each having a sharp distal end adapted to cut through a portion of a corresponding one of the sutures.
15. The device of claim 12 , further comprising a capture tool moveable in the elongated tube between a retracted position and an extended position, the capture tool being operable to draw the tissue of the heart valve leaflet into the elongated tube.
16. The device of claim 12 , wherein the elongated tube has at least one slot extending generally in the longitudinal direction from a distal end of the elongated tube, the at least one slot having an open end at the distal end of the elongated tube and a closed end remote therefrom, the at least one slot adapted to form the gathered tissue into a pleated configuration.
17. The device of claim 12 , wherein the retention elements are slidable between a retracted position in which a distal end of each retention element is disposed within the elongated tube and an extended position in which the distal end of each retention element is disposed beyond the distal end of the elongated tube.