Pull-through chordae tendineae system
An embodiment includes an artificial chordae tendineae system comprising: a first needle; a flexible first chord coupled to a proximal end portion of the first needle; a first proximal pledget coupled to a proximal end portion of the first chord; a first distal conduit coupled to the first chord between the first proximal pledget and the first needle; wherein: the first distal conduit includes first and second faces; one of the first and second faces includes a first aperture; a sidewall of the first conduit, located between the first and second faces, includes a sidewall aperture that does not directly connect to the first aperture; the sidewall aperture is configured to include a portion of the first chord when the first distal conduit is permanently implanted adjacent tissue but not when the first distal conduit is traversing the tissue before being permanently implanted adjacent the tissue.
1. An artificial chordae tendineae system comprising:
a knot;
a first subassembly including: (a) a first needle; (b) a flexible first chord coupled to the first needle and the knot; and (c) a first conduit coupled to the first chord and located between the knot and the first needle;
a second subassembly including: (a) a second needle; (b) a flexible second chord coupled to the second needle and the knot; and (c) a second conduit coupled to the second chord and located between the knot and the second needle;
a third subassembly including: (a) a third needle; (b) a flexible third chord coupled to the third needle and the knot; and (c) a third conduit coupled to the third chord and located between the knot and the third needle;
wherein: (a) when the first chord is fully extended along a long axis of the first chord the first conduit is a first distance from the knot; (b) when the second chord is fully extended along a long axis of the second chord the second conduit is a second distance from the knot; (c) when the third chord is fully extended along a long axis of the third chord the third conduit is a third distance from the knot, and (d) the first distance is unequal to the second distance and the first distance is unequal to the third distance;
wherein: (a) a long axis of the first conduit is substantially parallel to the long axis of the first chord in a first system orientation; and (b) the first conduit is configured to rotate when permanently deployed into a patient in a second system orientation such that the long axis of the first conduit is not parallel to the long axis of the first chord.
2. The system of claim 1 comprising:
a first obstruction between the first conduit and the first needle;
a second obstruction between the second conduit and the second needle;
wherein each of the first obstruction and the second obstruction includes an outer diameter greater than an outer diameter of the first chord.
3. The system of claim 1 , wherein the first distance is less than the second distance and the first distance is less than the third distance.
4. The system of claim 1 , wherein the first chord is monolithic and passes through the first conduit.
5. The system of claim 1 wherein the first chord is monolithic and passes through the first conduit and the second conduit.
6. The system of claim 1 , wherein a portion of the first conduit is substantially statically coupled to the first chord so the portion of the first conduit does not slide along the first chord by more than 1 mm.
7. The system of claim 1 wherein the first chord includes a first chord material, the first conduit includes a first conduit material, and the second conduit includes a second conduit material that is the same as the first chord material and the first conduit material.
8. The system of claim 1 , wherein:
the first conduit includes first and second end portions;
the first end portion includes a first face comprising a first aperture that includes the first chord;
the second end portion is configured to directly contact the first chord when the system is in the first system orientation but to not directly contact the first chord when the system is in the second system orientation.
9. The system of claim 1 , wherein:
the first conduit includes first and second faces;
one of the first and second faces includes a first aperture;
a sidewall of the first conduit, located between the first and second faces, includes a sidewall aperture that does not directly connect to the first aperture;
the sidewall aperture is configured to include a portion of the first chord when the system is in the second system orientation but not when the system is in the first system orientation.
10. The system of claim 1 , wherein the first distal conduit has a beveled edge to
facilitate traversal of the first distal conduit through tissue.
11. The system of claim 1 , wherein:
the first needle has a first maximum outer diameter;
the first distal conduit has a second maximum outer diameter; and
the first chord has a third maximum outer diameter that is less than (a) the first maximum outer diameter, and (b) the second maximum outer diameter.
12. The system of claim 1 , wherein each of the first, second, and third chords couple to one another via the knot.
13. The system of claim 2 , wherein the first obstruction includes a first additional knot and the second obstruction includes a second additional knot.