TISSUE ANCHORS, SYSTEMS AND METHODS, AND DEVICES
Systems, devices and methods for securing tissue including the annulus of a mitral valve. The systems, devices and methods may employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.
1 . A tissue anchor comprising:
a flexible tensile member; and
a plurality of discrete, flat flexible anchor elements coupled for movement along the flexible tensile member to form an anchor assembly, the flexible tensile member and at least one of the plurality of discrete, flat flexible anchor elements capable of being inserted through tissue and capable of moving between an elongate configuration and a shortened configuration suitable for anchoring against at least one side of the tissue, the anchor assembly having a proximal end portion, a distal end portion, and a compressible intermediate portion between the proximal end portion and the distal end portion;
wherein the anchor elements can slide relative to the flexible tensile member, and the flexible tensile member is capable of being pulled to cause the anchor elements to move relative to the flexible tensile member from the elongate configuration to the shortened configuration.
2 . The tissue anchor of claim 1 , wherein the anchor elements are formed from a material selected from at least one of: natural fibers, synthetic fibers, polymers, metals or combinations thereof.
3 . The tissue anchor of claim 2 , wherein the flexible tensile member further comprises a suture.
4 . The tissue anchor of claim 1 , wherein the flexible tensile member further comprises a suture.
5 . The tissue anchor of claim 1 , further comprising a lock member for retaining the shortened configuration.
6 . The tissue anchor of claim 5 , wherein the lock member further comprises a slip knot in the flexible tensile member.
7 . The tissue anchor of claim 1 , wherein the flexible tensile member extends through multiple locations on each of the anchor elements.
8 . The tissue anchor of claim 1 , wherein the anchor elements are formed from a material that promotes tissue ingrowth.
9 . The tissue anchor of claim 1 , further comprising at least one radiopaque marker on at least one of the anchor elements or the flexible tensile member or both the flexible tensile member and at least one of the anchor elements.
10 . The tissue anchor of claim 9 , further comprising a first radiopaque marker located proximate the proximal end portion when the anchor assembly is in the shortened configuration and a second radiopaque marker located proximate the distal end portion when the anchor assembly is in the shortened configuration.
11 . A tissue anchoring system, comprising:
a delivery catheter including a lumen;
a flexible tensile member; and
a plurality of discrete, flat flexible anchor elements coupled for movement along the flexible tensile member to form an anchor assembly, the anchor assembly received in the lumen of the delivery catheter and the flexible tensile member and at least one of the plurality of discrete, flat flexible anchor elements capable of being extended therefrom and inserted through tissue, the anchor assembly further capable of moving between an elongate configuration and a shortened configuration suitable for anchoring against at least one side of the tissue, the anchor assembly having a proximal end portion, a distal end portion, and a compressible intermediate portion between the proximal end portion and the distal end portion;
wherein the anchor elements can slide relative to the flexible tensile member, and the flexible tensile member is capable of being pulled to cause the anchor elements to move relative to the flexible tensile member from the elongate configuration to the shortened configuration.
12 . The system of claim 11 , further comprising:
a deploying device operatively associated with the delivery catheter and operable to extend the anchor assembly from the delivery catheter.
13 . The system of claim 12 , wherein the deploying device further comprises a deploying member capable of pushing the anchor assembly at least partially out of the lumen of the delivery catheter.
14 . The system of claim 11 , wherein the anchor elements are formed from a material selected from at least one of: natural fibers, synthetic fibers, polymers, metals, or combinations thereof.
15 . The system of claim 11 , wherein the flexible tensile member further comprises a suture.
16 . The system of claim 11 , further comprising a lock member for retaining the shortened configuration.
17 . The system of claim 16 , wherein the lock member further comprises a slip knot in the flexible tensile member.
18 . The system of claim 11 , wherein the flexible tensile member extends through multiple locations on each of the anchor elements.
19 . The system of claim 11 , wherein the anchor elements are formed from a material that promotes tissue ingrowth.
20 . The system of claim 11 , further comprising at least one radiopaque marker on at least one of the anchor elements, or the flexible tensile member, or both the flexible tensile member and at least one of the anchor elements.
21 . The system of claim 11 , further comprising a first radiopaque marker located proximate the proximal end portion when the anchor assembly is in the shortened configuration and a second radiopaque marker located proximate the distal end portion when the anchor assembly is in the shortened configuration.
22 . A method of anchoring tissue with a first anchor assembly comprised of a first plurality of discrete, flat flexible anchor elements, the first anchor assembly having a proximal end portion, a distal end portion, and a compressible intermediate portion located between the proximal and distal end portions and movable between an elongated configuration and a shortened configuration, the method comprising:
inserting at least one of the anchor elements through the tissue, and
pulling a first flexible tensile member coupled for sliding movement relative to the first plurality of discrete, flat flexible anchor elements to draw the proximal and distal end portions of the first anchor assembly toward each other and to compress the intermediate portion into the shortened configuration with the first anchor assembly engaged against the tissue.
23 . The method of claim 22 , wherein the tissue comprises the mitral valve annulus.
24 . The method of claim 22 , further comprising:
engaging the first anchor assembly against opposite sides of the tissue.
25 . The method of claim 22 , further comprising:
inserting a second anchor assembly through the tissue at a location spaced from the first anchor assembly, the second anchor assembly including a second plurality of discrete, flat flexible anchor elements, the second anchor assembly having a proximal end portion, a distal end portion, and a compressible intermediate portion located between the proximal and distal end portions and movable between an elongated configuration and a shortened configuration;
pulling a first end of a second flexible tensile member coupled for sliding movement relative to the second plurality of discrete, flat flexible anchor elements to draw the proximal and distal end portions of the second anchor assembly toward each other and to compress the intermediate portion into the shortened configuration with the second anchor assembly engaged against the tissue;
drawing the first and second anchor assemblies toward each other to plicate the tissue between the first and second anchor assemblies, and locking the first and second anchor assemblies in position relative to each other with the tissue plicated therebetween.
26 . The method of claim 25 , wherein the tissue comprises the mitral valve annulus and drawing the first and second anchor assemblies toward each other plicates annulus tissue between the first and second anchor assemblies.
27 . The method of claim 25 , further comprising:
inserting a third anchor assembly through the tissue at a location spaced from the first anchor assembly, the third anchor assembly including a third plurality of discrete, flat flexible anchor elements, the third anchor assembly having a proximal end portion, a distal end portion, and a compressible intermediate portion located between the proximal and distal end portions and movable between an elongated configuration and a shortened configuration;
pulling a first end of a third flexible tensile member coupled for sliding movement relative to the third plurality of discrete, flat flexible anchor elements to draw the proximal and distal end portions of the third anchor assembly toward each other and to compress the intermediate portion into the shortened configuration with the third anchor assembly engaged against the tissue;
drawing at least two of the first, second and third anchor assemblies toward each other to plicate the tissue therebetween; and
locking the first, second and third anchor assemblies in position relative to each other with the tissue plicated therebetween.
28 . The method of claim 27 , wherein the tissue comprises the mitral valve annulus and drawing at least two of the first, second and third anchor assemblies toward each other plicates annulus tissue between at least the two anchor assemblies.
29 - 39 . (canceled)