System and method for reducing tricuspid regurgitation
The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices each includes a vascular anchor, an annulus anchor, and at least one tensioning member connecting with the vascular anchor or the annulus anchor. Another aspect of the present teachings provides methods of deploying a vascular anchor at a first treatment location inside the coronary sinus, and deploying an annulus anchor at a second treatment location across the tricuspid annulus. When both the anchors are pulled towards each other, the portion of the annulus between the two anchors is plicated, which improves the coaptation of the tricuspid valve leaflets.
1. A system for reducing a circumference of an annulus of a tricuspid valve of a heart of a subject, the tricuspid valve being disposed between a right atrium and right ventricle of the heart, the heart having a coronary sinus, the system comprising
a first anchor configured to be deployed inside the coronary sinus,
a first tensioning member having a fixed end connecting to the first anchor and a free end, wherein the first tensioning member is configured to apply tension to the first anchor,
a second anchor:
configured to deploy in stages and including a proximal portion, a center portion, and a distal portion that is pivotally coupled to the center portion, and
positionable between a deployed position in which the distal portion is disposed perpendicular to the center portion and a retracted position in which the distal portion is disposed adjacent and parallel to the center portion,
a second tensioning member having a fixed end connecting to the proximal portion of the second anchor, and a free end, wherein the second tensioning member is configured to apply tension to the second anchor,
a lock member,
a first delivery device for delivering the first anchor, the first delivery device comprising a balloon catheter with an annular balloon, wherein the first anchor is collapsible around the balloon, the first delivery device is dimensioned to advance the balloon into the coronary sinus with the first anchor collapsed around the balloon, and inflation of the balloon causes the first anchor to radially expand allowing for engagement with an inner surface of the coronary sinus,
a second anchor delivery device, configured to:
while the second anchor is in the retracted position within the second anchor delivery device, transluminally deliver the second anchor to the right atrium,
drive the distal portion of the second anchor from the right atrium, through the annulus at a site that is across the annulus from the coronary sinus, and into the right ventricle, and
anchor the second anchor at the site such that the second anchor is in the deployed position, the distal portion of the second anchor is seated against a ventricular surface of the annulus, the center portion of the second anchor extends through the annulus, and the proximal portion of the second anchor is disposed in the right atrium, and a lock member delivery device, configured to:
advance the lock member along the first and second tensioning members and into the right atrium while the first anchor is disposed at the coronary sinus and the second anchor is disposed at the site,
facilitate reduction of a distance between the site and the coronary sinus via tensioning of the first and second tensioning members, such that the first and second tensioning members extend toward each other on an atrial side of the tricuspid valve, and
facilitate maintenance of tension in the first and second tensioning members by locking the lock member to the first tensioning member and the second tensioning member in the right atrium.
2. The system of claim 1 , wherein the first anchor comprises an expandable tubular shaped structure having a proximal end and an opposing distal end.
3. The system of claim 2 , wherein the first anchor has a plurality of openings formed therein between the proximal and distal ends and along a longitudinal direction.
4. The system of claim 2 , wherein the first tensioning member is attached to the first anchor at the proximal end thereof.