Method and apparatus for percutaneous delivery and deployment of a cardiac valve prosthesis
Catheter apparatuses and methods are provided for repairing heart valves, particularly mitral valves. The method includes providing a catheter having an elongate, flexible body, with a proximal end and a distal end. The distal end can be transluminally advanced from the left atrium through the mitral valve. A distal anchor zone or portion coupled with the proximal end can extend and along the left ventricular outflow tract into the ascending aorta. A valve repair device is deployed to permanently connect leaflets at a mid-section of a mitral valve while permitting medial and lateral portions of the natural leaflets to open and close. The catheter apparatuses may be positionable using a steering device. The valve repair device detachably connects the distal and proximal ends of the catheter. The valve repair device can be detached using low profile devices actuatable from the proximal or distal ends, e.g., at a venous or arterial access site.
1. A mitral valve prosthesis, comprising:
an elongate arcuate body having a proximal end and a distal end, wherein the distal end comprises a distal interface adapted to reversibly couple with a delivery catheter while the proximal end remains coupled to a proximal portion of the delivery catheter;
a base disposed between the proximal and distal ends of the elongate arcuate body;
an arcuate anterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position;
an arcuate posterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position; and
a control surface disposed on the base and interacting with one of the anterior and posterior leaflet grasping elements to open the anterior or posterior leaflet grasping element respectively, the control surface disposed between the anterior or posterior leaflet grasping elements when the prostheses is in a closed configuration,
wherein the arcuate anterior leaflet grasping element is configured to be actuated independently of the arcuate posterior leaflet grasping element.
2. The mitral valve prosthesis of claim 1 , wherein when the posterior leaflet grasping element is in the closed position the posterior leaflet grasping element is received in a space at least partially bounded by the base.
3. The mitral valve prosthesis of claim 1 , wherein a lumen and a hydraulic actuator are disposed in the base for actuating at least one of the anterior and posterior leaflet grasping elements.
4. The mitral valve prosthesis of claim 1 , further comprising a control member channel disposed on a proximal face of the base for engaging a guidewire or push element.
5. The mitral valve prosthesis of claim 1 , wherein the control surface on the base is a first control surface having a first profile and further comprising a second profile disposed on a surface of one of the anterior and posterior grasping elements, the first and second profiles being axially displaceable relative to each other between a first position in which the first and second profiles cause the grasping element upon which the second profile is disposed to move laterally relative to the base and a second position in which the first and second profiles are aligned to allow the grasping element upon which the second profile is disposed to move laterally toward the base.
6. The mitral valve prosthesis of claim 5 , wherein in the first position, the first and second profiles are out-of-phase and in the second position the first and second profiles are in-phase.
7. The mitral valve prosthesis of claim 5 , wherein in the first position, the first and second profiles are un-nested and in the second position the first and second profiles are nested.
8. A mitral valve prosthesis, comprising:
an elongate arcuate body having a proximal end and a distal end, wherein the distal end comprises a distal interface adapted to reversibly couple with a delivery catheter;
a base disposed between the proximal and distal ends of the elongate arcuate body;
an arcuate anterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position;
an arcuate posterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position; and
a control surface disposed on the base and interacting with one of the anterior and posterior leaflet grasping elements to open the anterior or posterior leaflet grasping element respectively, the control surface disposed between the anterior or posterior leaflet grasping elements when the prostheses is in a closed configuration,
wherein the arcuate anterior leaflet grasping element is configured to be actuated independently of the arcuate posterior leaflet grasping element, wherein the base includes a hydraulic channel configured to slideably receive a portion of at least one of the anterior and posterior grasping elements.
9. The mitral valve prosthesis of claim 8 , wherein at least one of the anterior and posterior grasping elements comprises a control member disposed in the hydraulic channel, a grasping face, and an elastically deformable region coupled with the grasping face and the control member.
10. The mitral valve prosthesis of claim 9 , wherein the control surface deflects the grasping face laterally upon sliding of the control member in the hydraulic channel.
11. The mitral valve prosthesis of claim 10 , wherein the elastically deformable region stores strain energy when the grasping face is deflected and releases the strain energy to urge the grasping face against the base.
12. A mitral valve prosthesis, comprising:
an elongate arcuate body having a proximal end and a distal end, wherein the distal end comprises a distal interface adapted to reversibly couple with a delivery catheter;
a base disposed between the proximal and distal ends of the elongate arcuate body;
an arcuate anterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position;
an arcuate posterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position; and
a control surface disposed on the base and interacting with one of the anterior and posterior leaflet grasping elements to open the anterior or posterior leaflet grasping element respectively, the control surface disposed between the anterior or posterior leaflet grasping elements when the prostheses is in a closed configuration,
wherein the arcuate anterior leaflet grasping element is configured to be actuated independently of the arcuate posterior leaflet grasping element, wherein the base further comprises a first lumen and a second lumen distinct from the first lumen, a control member of the arcuate anterior leaflet grasping element disposed within the first lumen, a control member of the arcuate posterior leaflet grasping element disposed within the second lumen.
13. A mitral valve prosthesis, comprising:
an elongate arcuate body having a proximal end and a distal end, the distal end comprising a distal interface configured to de-couple from a distal portion of a delivery catheter system while the proximal end remains coupled to a proximal portion of the delivery catheter system;
a base disposed between the proximal and distal ends of the elongate arcuate body, the base comprising a first lumen and a second lumen;
an arcuate anterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position, the arcuate anterior leaflet grasping element comprising a first control member disposed within the first lumen and a first control surface disposed outside of the first lumen, the first control surface facing toward the base;
an arcuate posterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position, the arcuate posterior leaflet grasping element comprising a second control member disposed within the second lumen and a second control surface disposed outside of the second lumen, the second control surface facing toward the base; and
a base control surface disposed on the base and interacting with at least one of the first and second control surfaces to open the anterior or posterior leaflet grasping elements.
14. The mitral valve prosthesis of claim 13 , wherein the arcuate anterior leaflet grasping element is configured to be actuated independently of the arcuate posterior leaflet grasping element.
15. The mitral valve prosthesis of claim 13 , wherein the arcuate anterior leaflet grasping element is configured to move away from the base as the first control surface slides distally past the base control surface.
16. A mitral valve prosthesis, comprising:
an elongate arcuate body having a proximal end and a distal end, wherein the distal end comprises a distal interface adapted to reversibly couple with a delivery catheter;
a base disposed between the proximal and distal ends of the elongate arcuate body;
an arcuate anterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate anterior leaflet grasping element being movable between an open position and a closed position;
an arcuate posterior leaflet grasping element articulated at the distal end of the elongate arcuate body, the arcuate posterior leaflet grasping element being movable between an open position and a closed position; and
a control surface disposed on the base and interacting with one of the anterior and posterior leaflet grasping elements to open the anterior or posterior leaflet grasping element respectively, the control surface disposed between the anterior or posterior leaflet grasping elements when the prostheses is in a closed configuration,
wherein the arcuate anterior leaflet grasping element is configured to be actuated independently of the arcuate posterior leaflet grasping element, wherein the arcuate anterior leaflet grasping element comprises a first control member disposed within a first lumen of the base and a first control surface disposed outside of the first lumen, the first control surface facing toward the control surface disposed on the base.
17. The mitral valve prosthesis of claim 16 , wherein the arcuate anterior leaflet grasping element is configured to move away from the base as the first control surface slides distally past the control surface disposed on the base.