Apparatus and method for heart valve repair
A device 10 for gathering tissue in a patient includes an elongated catheter 14 and a capture assembly 13 at a distal portion of the catheter. The capture assembly has a closed side 18 and a door 20 rotatable between an open condition and a closed condition. The closed side 18 of the capture assembly 13 and the door 20 in the closed condition may collectively define a tissue capturing compartment 19. Movement of the door 20 from the open condition to the closed condition adjacent the tissue may capture a portion 44 of the tissue in the tissue capturing compartment 19. A clip may then be applied from the capture assembly 13 to the captured tissue 44 to hold the tissue substantially in a gathered configuration.
1. A method of gathering tissue in a patient, the method comprising:
inserting an elongated device into the patient to a position adjacent the tissue, the device including a capture assembly having a closed side and a door rotatable between an open condition and a closed condition, the closed side and the door in the closed condition collectively defining a tissue capturing compartment, the device including a clip coupled to the door and biased to move the door to the closed condition, the capture assembly includes a spring element coupled at the door and biased to move the door to the closed condition;
moving the door from the closed condition to the open condition and engaging the door against the tissue;
closing the door against the tissue to capture a portion of the tissue inside the tissue capturing compartment, the captured tissue being formed into a gathered configuration, the door being moved to the closed condition by the bias of the clip and the spring element; and
applying the clip from the capture assembly to the captured tissue so as to hold the captured tissue substantially in the gathered configuration by releasing the clip from engagement with the door.
2. The method as claimed in claim 1 , wherein the tissue is a heart valve leaflet.
3. The method as claimed in claim 1 , wherein the door includes at least one prong projecting therefrom, and the closing step includes grasping the captured tissue with the at least one prong.
4. The method as claimed in claim 1 , wherein the door includes a portion with serrations, and the closing step includes grasping the captured tissue with the serrations.
5. The method as claimed in claim 1 , wherein the device includes a deployment element attached to the door and operable by a user, and the moving step includes pulling the deployment element to rotate the door to the open condition.
6. The method as claimed in claim 1 , wherein the door is a first door, and the capture assembly includes a second door rotatable between open and closed conditions, and the closing step includes closing the first and second doors against the tissue to capture the portion of the tissue inside the tissue capturing compartment.
7. The method as claimed in claim 1 , wherein the clip is biased toward a closed condition and is engaged with the door so that moving the door to the open condition moves the clip to an open condition, and the applying step includes releasing the clip from engagement with the door, whereby the clip moves from the open condition to the closed condition.
8. The method as claimed in claim 7 , wherein the device includes an actuating rod movable relative to the at least one clip, and the applying step includes moving the actuating rod to contact the at least one clip and releasing the at least one clip for application to the captured tissue.
9. A device for gathering tissue in a patient, the device comprising:
an elongated catheter having a proximal portion and a distal portion; and
a capture assembly at the distal portion of the catheter, the capture assembly including a closed side and a door rotatable between an open condition and a closed condition, the closed side and the door in the closed condition collectively defining a tissue capturing compartment,
the door being operable to capture a portion of the tissue in a gathered configuration within the tissue capturing compartment;
a clip releasably held in the tissue capturing compartment and adapted to be applied to the captured tissue for holding the captured tissue in the gathered configuration, the clip being coupled to the door and biased to move the door to the closed condition; and
a spring element coupled at the door and biased to move the door to the closed condition.
10. The device as claimed in claim 9 , wherein the door has one edge rotatably connected to the closed side of the capture assembly and a free edge opposite the one edge, the free edge including at least one prong projecting therefrom.
11. The device as claimed in claim 9 , wherein the door has one edge rotatably connected to the closed side of the capture assembly and a free edge opposite the one edge, the free edge including a plurality of serrations.
12. The device as claimed in claim 9 , further comprising a deployment element attached to the door and extending through the elongated catheter.
13. The device as claimed in claim 9 , wherein the door is a first door, and the capture assembly includes a second door rotatable between open and closed conditions, the first and second doors being operable to capture the portion of the tissue in the gathered configuration within the tissue capturing compartment.
14. The device as claimed in claim 9 , wherein the clip is biased toward a closed condition and is engaged with the door so that moving the door to the open condition moves the clip to an open condition.
15. The device as claimed in claim 14 , wherein the clip has a first end and a second end, and the door includes a slot, the first end of the clip being engaged in the slot.
16. The device as claimed in claim 15 , wherein movement of the door to the open condition creates a biasing force in the clip tending to move the door to the closed condition.
17. A device as for gathering tissue in a patient, the device comprising:
an elongated catheter having a proximal portion and a distal portion;
a capture assembly at the distal portion of the catheter, the capture assembly including a closed side and a door rotatable between an open condition and a closed condition, the closed side and the door in the closed condition collectively defining a tissue capturing compartment, the door being operable to capture a portion of the tissue in a gathered configuration within the tissue capturing compartment;
a clip releasably held in the tissue capturing compartment and adapted to be applied to the captured tissue for holding the captured tissue in the gathered configuration; and
an actuating rod slidably disposed in the tissue capturing compartment, the actuating rod having a laterally projecting bump, and the clip being at least partially held in a travel path of the bump, whereby movement of the bump through the travel path causes the bump to release the clip for application to the captured tissue.
18. The device as claimed in claim 17 , wherein the bump has an oval cross-section, and a portion of the actuating rod adjacent the bump has a round cross-section that is smaller than the oval cross-section in at least one direction.