Devices, systems, and methods for treating heart failure
The present teachings provide devices and methods for percutaneously removing internal tissue. Specifically, one aspect of the present teachings provides a tissue incising element with a sharp cutting edge and a longitudinal lumen and a tissue stabilizer slidably disposed within the longitudinal lumen of the tissue incising element. The tissue incising element has a deployed configuration during tissue cutting and a small collapsed configuration during the percutaneous delivery and removal. The tissue stabilizer includes a tissue supporting/gripping element configured to support tissue during incising and capture the removed tissue.
1. A transseptal tissue coring device comprising a cutting edge and a supporting surface, each of which comprises a delivery profile and a deployed profile;
wherein at least one dimension of the cutting edge in the deployed profile is up to 400% of that in the delivery profile; and
the cutting edge in the deployed profile is capable of applying a force against the supporting surface in the deployed profile to cut tissues; and
the supporting surface is derived from a tubular body having a proximal end, a distal end, and a plurality of slits extending substantially from the proximal end to the distal end;
wherein the deployed supporting surface is substantially parallel to a surface formed by the deployed cutting edge and is greater than the dimension of the deployed cutting edge.
2. The transseptal tissue coring device of claim 1 , wherein the at least one dimension of the cutting edge in the deployed profile is about 4 mm.
3. The transseptal tissue coring device of claim 1 , wherein at least one dimension of the cutting edge in the delivery profile is greater than that of the supporting surface in the delivery profile.
4. The transseptal tissue coring device of claim 1 , wherein the cutting edge comprises a plurality of flaps.
5. The transseptal tissue coring device of claim 1 , wherein the supporting surface comprises one or more supporting struts.
6. The transseptal tissue coring device of claim 1 , wherein each of the slits is parallel to the longitudinal axis of the tubular body.
7. The transseptal tissue coring device of claim 1 , wherein each the slits is spiral along the tubular body.
8. The transseptal tissue coring device of claim 1 , wherein the device is configured to percutaneously remove internal tissue.
9. The transseptal tissue coring device of claim 8 , wherein the internal tissue is from the atrial septum.
10. A transseptal tissue coring device comprising:
a tissue incising element comprising a proximal end, a distal end, a longitudinal lumen extending from the proximal end to the distal end, and a sharp edge at the distal end, and
a tissue stabilizer comprising an elongated body, a distal portion, and a plurality of tissue supporting struts formed by a plurality of slits along the elongated body of the distal portion of the tissue stabilizer, wherein the tissue supporting struts form a supporting surface, wherein the supporting surface is substantially parallel to a surface formed by the sharp edge of the tissue incising element; and
is greater than the dimension of the sharp edge of the tissue incising element.
11. The transseptal tissue coring device of claim 10 , wherein each of the tissue supporting struts comprises a fixed end attaching to the elongated body and a free end extending radially away from the elongated body of the tissue stabilizer.
12. The transseptal tissue coring device of claim 10 , wherein the tissue stabilizer comprises a delivery profile and a deployed profile and the tissue stabilizer is slidably disposed within the longitudinal lumen of the tissue incising element in its delivery profile.
13. The transseptal tissue coring device of claim 12 , wherein the tissue supporting struts are stowed radially along the elongated body of the tissue stabilizer in the delivery profile.
14. The transseptal tissue coring device of claim 12 , wherein the tissue supporting struts expand radially outward forming the supporting surface in the deployed profile.
15. A method of percutaneously removing tissue from the heart comprising:
providing a transseptal tissue coring device according to claim 10 ;
advancing the transseptal tissue coring device to a proximity of the atrial septum, expanding the tissue supporting struts of the tissue stabilizer radially and
positioning the tissue stabilizer against the atrial septum inside the left atrium,
positioning the tissue incising element against the atrial septum inside the right atrium,
advancing the tissue incising element distally,
incising tissue from the atrial septum, and
capturing the removed septal tissue inside the transseptal tissue coring device.