Delivery devices and methods for heart valve repair
Devices, systems and methods facilitate positioning of a cardiac valve annulus treatment device, thus enhancing treatment of the annulus. Methods generally involve advancing an anchor delivery device through vasculature of the patient to a location in the heart for treating the valve annulus, contacting the anchor delivery device with a length of the valve annulus, delivering a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus, and drawing the anchors together to circumferentially tighten the valve annulus. Devices generally include an elongate catheter having at least one tensioning member and at least one tensioning actuator for deforming a distal portion of the catheter to help it conform to a valve annulus. The catheter device may be used to navigate a subannular space below a mitral valve to facilitate positioning of an anchor delivery device.
1. A cinchable anchor assembly capable of being placed in an arcuate tensioned configuration, the cinchable anchor assembly comprising:
a tether;
a distal anchor comprising an eyelet and two arms joined to the eyelet, wherein the distal anchor is fixedly coupled to the tether at its eyelet;
a first additional anchor comprising an eyelet, two arms joined to the eyelet at a junction, and a belt disposed over the junction, wherein the first additional anchor is proximal to the distal anchor and is slidably coupled to the tether at its eyelet; and
at least one force distributing member positioned along the tether between the distal and first additional anchors such that when the device is in an arcuate tensioned configuration, the at least one force distributing member reduces the force applied to the distal anchor thereby helping prevent pull-out of the distal anchor.
2. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member is axially compressible.
3. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member is axially incompressible.
4. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member is porous.
5. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member has a textured outer surface.
6. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member comprises a woven or braided material.
7. The cinchable anchor assembly of claim 1 , further comprising a second additional anchor comprising an eyelet, two arms joined to the eyelet at a junction, and a belt disposed over the junction, wherein the second additional anchor is proximal to the first additional anchor and is slidably coupled to the tether at its eyelet, and an additional force distributing member positioned along the tether between the first and second additional anchors.
8. The cinchable anchor assembly of claim 1 , further comprising a catheter, wherein the catheter has a side wall having a plurality of openings along a length thereof, wherein each opening is sized for the passage of an anchor therethrough.
9. The cinchable anchor assembly of claim 1 , wherein the distal anchor and the first additional anchor are self-securing anchors.
10. The cinchable anchor assembly of claim 1 , wherein the at least one force distributing member comprises a tubular member.
11. A method for cinching tissue using a cinchable anchor assembly, the method comprising:
securing a cinchable anchor assembly into tissue, the cinchable anchor assembly comprising a tether, a distal anchor fixedly coupled to the tether, a first additional anchor proximal to the distal anchor and slidably coupled to the tether, and at least one force distributing member positioned along the tether between the distal and first additional anchors, wherein the first additional anchor comprises an eyelet, two arms joined to the eyelet at a junction, and a belt disposed over the anchor at the junction, wherein the first additional anchor is coupled to the tether at its eyelet; and
tensioning the tether such that the cinchable anchor assembly assumes an arcuate tensioned configuration where the at least one force distributing member reduces the force applied to the distal anchor thereby helping prevent pull-out of the distal anchor.
12. The method of claim 11 , wherein the at least one force distributing member reduces the resultant force applied to at least one of the distal or first additional anchors when the tether is under longitudinal tension, the resultant force being in the same direction as the pull out force of the anchor.
13. The method of claim 11 , wherein the tissue is heart tissue, and the cinchable anchor assembly is secured to the heart tissue while the heart is beating.
14. The method of claim 11 , wherein the tissue is heart tissue, and the cinchable anchor assembly is secured to the heart tissue while the heart is stopped.
15. The method of claim 11 , wherein the tissue comprises internal ventricular wall tissue of a left ventricle at or adjacent to an intersection of a mitral valve leaflet and the ventricular wall tissue.
16. The method of claim 15 , wherein the distal anchor and the first additional anchor do not penetrate into a left atrium.
17. The method of claim 11 , wherein the distal anchor and the first additional anchor are configured to self-secure into tissue.
18. The method of claim 11 , the at least one force distributing member comprises a tubular member.
19. The method of claim 11 , wherein the at least one force distributing member comprises a woven or braided material.
20. The method of claim 11 , wherein the at least one force distributing member is porous.