Valve cutter
A cardiac valve cutter of the present disclosure has a flexible housing with a central lumen for receiving a guide wire. A high-speed cutting blade is disposed within the housing near an edge of the housing. A trough cut into a side of the housing exposes a portion of the cutting blade so that the cutting blade can cut valve tissue. Two pusher wires are disposed on an opposite side of the housing from the cutting blade. Troughs cut into the side of the housing form openings from which the pusher wires can extend. The pusher wires are staggered with respect to one another in the longitudinal direction. When the pusher wires are advanced, they extend outwardly from the troughs and can be used to stabilize the cutter at the cardiac valve and push the cutting blade against the valve on the opposite side.
1. A device for cutting cardiac valve, the device comprising:
a housing comprising a single lumen adapted to receive a guide wire, the housing comprising an exterior wall;
a high speed cutting blade disposed within the housing near the exterior wall of the housing;
a motor configured to effectuate motion of the high speed cutting blade;
an elongated cutout in the exterior wall adjacent to the cutting blade, the
elongated cutout forming a cutting trough through which the cutting blade is accessible;
a first pusher wire and a second pusher wire disposed within the housing near the exterior wall of the housing, on an opposite side of the housing from the cutting trough, the first pusher wire and the second pusher wire each extendable through the exterior wall via a pusher wire trough associated with each of the first pusher wire and the second pusher wire, the pusher wire troughs comprising elongated cutouts in the exterior wall, the pusher wire troughs spaced apart from one another longitudinally such that when the first pusher wire and the second pusher wire are extended from the pusher wire troughs, a valley is formed between the first pusher wire and the second pusher wire.
2. The device of claim 1 , wherein the cutting blade comprises a high speed reciprocating saw blade.
3. The device of claim 1 , further comprising a proximal pressure port disposed upwardly from the cutting blade and a distal pressure port disposed downwardly from the cutting blade.
4. The device of claim 1 , further comprising a proximal pressure wire disposed upwardly from the cutting blade and a distal pressure wire disposed downwardly from the cutting blade.
5. The device of claim 1 , wherein the pusher wires are affixed at a bottom end of the pusher wire troughs and advancing the pusher wires from an upper end of the device causes the pusher wires to bow out from the pusher wire troughs.
6. The device of claim 1 , wherein the housing comprises a tapered distal tip.
7. The device of claim 1 , further comprising a substantially cylindrical upper portion and a substantially oval middle portion with a first transition portion transitioning the substantially cylindrical upper portion to the substantially oval middle portion, wherein the cutting trough and the pusher wire troughs each are disposed within the substantially oval middle portion.
8. The device of claim 7 , further comprising a substantially cylindrical lower portion with a second transition portion transitioning the substantially oval middle portion to the substantially cylindrical lower portion.
9. The device of claim 7 , wherein the cutting trough is disposed along a short side of the substantially oval middle portion and the pusher wire troughs are disposed along an opposite short side of the substantially oval middle portion.
10. The device of claim 7 , wherein opposed longitudinal edges of the cutting trough are disposed inwardly from the cutting blade.