Heart valve repair and replacement
Apparatuses and methods are disclosed for performing a procedure on a heart valve in which a loop of material ( 160 ) is configured to contact at least a portion of the annulus or the leaflets of a valve. A plurality of anchors ( 16 ) are distributed about the loop and configured for implantation into the annulus or the leaflets in a forward direction. The anchors are configured to resist extraction in a backwards direction. A plurality of linking members ( 150 ) are affixed to the loop of material and at least a portion of each linking member passes through a slot ( 17 ) in a respective anchor so that the linking members can slide with respect to the slots. The anchors are then implanted into the annulus or the leaflets. The loop can then be used to retain a replacement valve or to cinch the annulus. A number of particularly advantageous anchor configurations are also disclosed.
1. An apparatus for performing a procedure on a heart valve, the heart valve having an annulus and leaflets, the apparatus comprising:
a tissue engaging member including
(a) a loop of material configured to contact at least a portion of the annulus or the leaflets when the loop of material is deployed,
(b) a plurality of anchors, each of the plurality of anchors having a pointy front end and a back end, each of the plurality of anchors having An elongated slot, the elongated slot having a direction of elongation that runs in a front-to-back direction, wherein the front ends of the plurality of anchors are configured for implantation into the annulus or the leaflets in a forward direction and wherein the plurality of anchors are configured so that subsequent to implantation, the plurality of anchors resist extraction from the annulus or the leaflets in a backwards direction, wherein the plurality of anchors are arranged with respect to the loop of material so that when the loop of material is deployed the plurality of anchors are distributed about the loop of material with the front ends of the plurality of anchors facing the annulus or the leaflets, and
(c) a plurality of linking members that are affixed to the loop of material, at least a portion of each of the linking members passing through the slot in a respective anchor, wherein each of the linking members is configured to slide with respect to the slot in the respective anchor in the front-to-back direction.
2. The apparatus of claim 1 , wherein each of the linking members comprises a strip of material that passes through the slot in the respective anchor.
3. The apparatus of claim 2 , wherein the strip of material is connected to the loop of material through at least one intermediate member.
4. The apparatus of claim 1 , wherein the linking members are disposed inside the loop.
5. The apparatus of claim 1 , wherein the linking members are disposed outside the loop.
6. The apparatus of claim 1 , wherein the loop of material comprises a closed loop.
7. The apparatus of claim 1 , further comprising means for implanting the plurality of anchors into the annulus or the leaflets so that the tissue engaging member becomes affixed to the annulus or the leaflets.
8. The apparatus of claim 1 , further comprising a plurality of compressed springs configured to, respectively, implant the plurality of anchors into the annulus or the leaflets so that the tissue engaging member becomes affixed to the annulus or the leaflets.
9. The apparatus of claim 1 , further comprising a plurality of pull wires configured to, respectively, implant the plurality of anchors into the annulus or the leaflets so that the tissue engaging member becomes affixed to the annulus or the leaflets.
10. The apparatus of claim 1 , further comprising a plurality of anchor launchers configured to, respectively, implant the plurality of anchors into the annulus or the leaflets so that the tissue engaging member becomes affixed to the annulus or the leaflets.
11. The apparatus of claim 1 , further comprising a plurality of springs, wherein each spring is arranged with respect to a respective one of the plurality of anchors so that when the spring expands from a compressed state to an expanded state, the spring drives the respective anchor into the annulus or the leaflets.
12. The apparatus of claim 11 , further comprising a plurality of actuators, wherein each of the actuators is movable between (a) a first position in which the actuator holds a respective spring in the compressed state and (b) a second position in which the actuator permits the respective spring to expand to the expanded state.