Treatment catheter system
A treatment catheter system for treatment of a heart valve includes a circumferential valve tissue structure and an elongate catheter member, and has an inner lumen, proximal and distal end portions. The system includes a catching component which can be positioned at the distal end portion of the catheter member to be non-separable from the catheter member. An outer member extends circumferentially around the catheter member. The circumferential valve tissue structure is correspondingly arranged between the catheter member and the outer member. A catching mechanism reduces a radial distance between the catheter member and the outer member to catch the valve tissue between the outer member and the catheter member via a catching opening to immobilize and treat the caught valve tissue on the distal end portion of the catheter member.
1. A treatment catheter system for treatment of a bloodstream valve having a circumferential valve tissue structure, comprising
an elongate catheter member to be disposed at the interior of the circumferential valve tissue structure and to be removed therefrom after treatment, the elongate catheter member extending along a longitudinal axis and having an inner lumen and proximal and distal end portions, the elongate catheter member comprising
a catching component that is formed by a cage and is or can be positioned at the distal end portion of the elongate catheter member and is non-separable from the elongate catheter member at least when being positioned at the distal end portion of the elongate catheter member, and that at least when being positioned at the distal end portion of the elongate catheter member comprises a lateral groove provided as a circumferential groove formed in an outer circumferential surface of the cage, the lateral groove extending transverse to the longitudinal axis and opening to a lateral outer side so as to form a lateral catching opening,
an elongate flexible outer member to be disposed at the exterior of the valve structure at a level of the lateral groove, the elongate flexible outer member being capable of at least partially extending circumferentially around the catheter member with valve tissue of the circumferential valve tissue structure being correspondingly circumferentially arranged between the elongate catheter member and the elongate flexible outer member, and
a catching mechanism operable to reduce a radial distance between the elongate catheter member and the elongate flexible outer member so as to catch at least part of the valve tissue between the outer member and the elongate catheter member within the lateral groove via the catching opening to thereby immobilize the caught valve tissue on the distal end portion of the elongate catheter member.
2. The treatment catheter system according to claim 1 , wherein the catching component is moveable relative to the elongate catheter member and can be forwarded and retracted or otherwise exposed via the inner lumen of the elongate catheter member.
3. The treatment catheter system according to claim 1 , wherein the catching component is integrally formed with the elongate catheter member at the distal end portion of the elongate catheter member.
4. The treatment catheter system according to claim 1 , wherein the cage is provided to be radially compressible and expandable so that it can be accommodated within the inner lumen of the elongate catheter member in a radially compressed condition and can be expanded or self-expands at the distal end portion of the elongate catheter member.
5. The treatment catheter system according to claim 4 , wherein the wires are connected to each other by a substantially non-compressible front body having a rounded outer side and having an outer diameter slightly larger than an inner cross-sectional diameter of the lumen of the elongate catheter member to be able to provide a plug for closing a frontal end opening of the inner lumen of the elongate catheter member.
6. The treatment catheter system according to claim 1 , wherein the cage is formed by a plurality of elongate wires substantially extending along the longitudinal axis of the elongate catheter member and being angularly spaced around the longitudinal axis of the elongate catheter member, the elongate wires each comprise a radially and inwardly bended bending portion, the bending portions forming the lateral groove.
7. The treatment catheter system according to claim 6 , wherein each wire is provided in and moveable relative to a sheath which is provided in the lumen of the elongate catheter member and moveable relative to the elongate catheter member.
8. The treatment catheter system according to claim 1 , wherein the catching component comprises a blunt front part.
9. The treatment catheter system according to claim 1 , further comprising an elongate flexible perforation component which can be forwarded through the inner lumen of the elongate catheter member to the distal end portion of the elongate catheter member and which is operable such as to provide a perforation through the valve tissue caught in the lateral groove or through valve tissue adjacent to the caught valve tissue.
10. The treatment catheter system according to claim 9 , wherein the perforation component is formed by a needle which is provided and arranged such as to be forwarded into the lateral groove.
11. The treatment catheter system according to claim 9 , further comprising an anchor component which can be forwarded through the inner lumen of the elongate catheter member and can be placed within the caught valve tissue or within adjacent valve tissue, wherein
the perforation component is hollow, and
the anchor component is provided such that it can be forwarded through the perforation component to the distal end portion of the elongate catheter member.
12. The treatment catheter system according to claim 1 , further comprising an anchor component which can be forwarded through the inner lumen of the elongate catheter member and can be placed within the caught valve tissue or within adjacent valve tissue.
13. The treatment catheter system according to claim 12 , further comprising a chord attached to the anchor component.
14. The treatment catheter system according to claim 1 , further comprising a medical drug supplying component which is provided such that it can be forwarded through the inner lumen of the elongate catheter member to the distal end portion of the elongate catheter member and such that it can forward a medical drug to the caught valve tissue or the adjacent valve tissue.
15. The treatment catheter system according to claim 14 , further comprising an elongate flexible perforation component which can be forwarded through the inner lumen of the elongate catheter member to the distal end portion of the elongate catheter member and which is operable such as to provide a perforation through the valve tissue caught in the lateral groove or through valve tissue adjacent to the caught valve tissue, wherein
the perforation component is hollow, and
the medical drug supplying component is provided such that it can be forwarded to the distal end portion of the elongate catheter member through the perforation component.
16. The treatment catheter system according to claim 1 , further comprising marker members fixedly attached on the catheter member and the elongate flexible outer member, wherein the marker members are made from a material different than the material of the elongate catheter member and outer member respectively, to allow identifying relative positions and orientations of the elongate catheter member and the elongate flexible outer member using material-sensitive imaging techniques.
17. The treatment catheter system according to claim 1 , wherein
the catching component and the elongate flexible outer member each comprise an electrode which is electrically connected to an electric energy source, and
the electrodes of the catching component and the elongate flexible outer member selectively produce an electric field between each other using electric energy supplied from the energy source to open holes in cell membranes of the valve tissue.
18. The treatment catheter system according to claim 1 , wherein the catching component is provided with an artificial heart valve.
19. The treatment catheter system according to claim 1 , wherein
the elongate flexible outer member is provided with a prosthesis having an inner lumen that at least partially receives the elongate flexible outer member to be slideable along a longitudinal direction of the elongate flexible outer member, and
the prosthesis is configured to be fixated to the bloodstream valve.
20. The treatment catheter system according to claim 19 , wherein
the prosthesis has an outer cross-sectional diameter that is defined in a radial direction of a longitudinal axis of the prosthesis, that is smaller than a width of the lateral groove in a direction of the longitudinal axis of the elongate catheter member.
21. A method for surgical treatment of a bloodstream valve having a circumferential valve tissue structure, the method comprising:
advancing the treatment catheter system according to claim 1 into a vicinity of the bloodstream valve;
placing the lateral groove of the catheter member in an interior of the circumferential valve tissue structure;
placing the elongate outer member at least partially around an outside of the circumferential tissue structure at an axial level, with respect to the longitudinal axis, of the lateral groove;
reducing a distance between the elongate outer member and the lateral groove so as to at least partially force tissue of the circumferential valve tissue structure into the lateral groove; and
removing the catheter member and the elongate outer member from the patient.
22. A treatment catheter system for treatment of a bloodstream valve having a circumferential valve tissue structure, comprising
an elongate catheter member to be disposed at the interior of the circumferential valve tissue structure and to be removed therefrom after treatment, the elongate catheter member extending along a longitudinal axis and having an inner lumen and proximal and distal end portions, the elongate catheter member comprising
a catching component that is provided with an artificial heart valve and is or can be positioned at the distal end portion of the elongate catheter member and is non-separable from the elongate catheter member at least when being positioned at the distal end portion of the elongate catheter member, and that at least when being positioned at the distal end portion of the elongate catheter member comprises a lateral groove that extends transverse to the longitudinal axis and that opens to a lateral outer side so as to form a lateral catching opening,
an elongate flexible outer member to be disposed at the exterior of the valve structure at a level of the lateral groove, the elongate flexible outer member being capable of at least partially extending circumferentially around the catheter member with valve tissue of the circumferential valve tissue structure being correspondingly circumferentially arranged between the elongate catheter member and the elongate flexible outer member, and
a catching mechanism operable to reduce a radial distance between the elongate catheter member and the elongate flexible outer member so as to catch at least part of the valve tissue between the outer member and the elongate catheter member within the lateral groove via the catching opening to thereby immobilize the caught valve tissue on the distal end portion of the elongate catheter member.
23. The treatment catheter system according to claim 22 , wherein the catching component is formed by a tubular sleeve having a lateral cutout extending in a transverse direction of the longitudinal axis of the elongate catheter member and forming the lateral groove.
24. A method for surgical treatment of a bloodstream valve comprising a circumferential valve tissue structure of a patient using the treatment catheter system according to claim 22 , the method comprising
placing the lateral groove of the catheter member in an interior of the circumferential valve tissue structure,
placing the elongate outer member at least partially around an outside of the circumferential tissue structure at an axial level, with respect to the longitudinal axis, of the lateral groove,
reducing a distance between the elongate outer member and the lateral groove so as to at least partially force tissue of the circumferential valve tissue structure into the lateral groove, and
removing the catheter member and the elongate outer member from the patient.
25. The method according to claim 24 , wherein
the blood stream valve is a mitral valve connecting a ventricular chamber with an atrial chamber and having a valve annulus and the circumferential valve tissue structure on a side of the ventricular chamber, and wherein
placing the lateral groove comprises placing the lateral groove in the ventricular chamber close to the annulus.
26. The method according to claim 25 , wherein
the ventricular-chamber and the atrial chamber define an axial direction therebetween, wherein
the treatment catheter system further comprises a prosthesis having an inner lumen at least partially receiving the elongate outer member, and wherein
reducing the distance comprises forcing at least a part of the prosthesis into the lateral groove, and wherein
the method further comprises moving the lateral groove in an axial direction of the valve towards the annulus so that the prosthesis is in close contact with the annulus, and
fixing the prosthesis to the annulus.