Catheter-based tissue remodeling devices and methods
Methods and systems for closing an opening or defect in tissue, closing a lumen or tubular structure, cinching or remodeling a cavity or repairing a valve preferably utilizing a purse string or elastic device. The preferred devices and methods are directed toward catheter-based percutaneous, transvascular techniques used to facilitate placement of the devices within lumens, such as blood vessels, or on or within the heart to perform structural defect repair, such as valvular or ventricular remodeling. In some methods, the catheter is positioned within the right ventricle, wherein the myocardial wall or left ventricle may be accessed through the septal wall to position a device configured to permit reshaping of the ventricle. The device may include a line or a plurality of anchors interconnected by a line. In one arrangement, the line is a coiled member.
1. A system configured to remodel tissue proximate a heart valve, comprising:
a guide catheter sized and configured to be guided through a patient's vasculature to a heart;
a plurality of delivery tubes movable within the guide catheter, the delivery tubes having continuous single-piece distal end portions being advanceable out of a distal end of the guide catheter, the continuous single-piece distal end portions of the delivery tubes terminating in distal tips;
a plurality of tissue anchors releasably carried at the terminal distal tips of the delivery tubes; and
an interconnector connecting the tissue anchors,
wherein the system is configured to advance the plurality of delivery tubes through the guide catheter to deliver the tissue anchors substantially simultaneously and positioned in a generally circular manner proximate the heart valve, and
wherein the tissue anchors are configured to move toward one another and reduce a cross-section dimension of the heart valve via application of tension to the interconnector.
2. The system of claim 1 , wherein the tissue anchors are configured to be positioned adjacent the heart valve to reposition the leaflets of the valve.
3. The system of claim 1 , further comprising an imaging device.
4. The system of claim 3 , wherein the imaging device comprises an echocardiogram, fluoroscopy, or cineangiographic guidance device.
5. The system of claim 1 , wherein the plurality of delivery tubes comprises between 3 and 18 delivery tubes.
6. The system of claim 5 , wherein the plurality of delivery tubes comprises between 8 and 12 delivery tubes.
7. The system of claim 1 , wherein the system is configured to secure the tissue anchors adjacent the valve independently of one another.
8. The system of claim 1 , wherein the tissue anchors comprise shape-memory material.
9. The system of claim 1 , wherein the interconnector is a purse string.
10. A system configured to remodel tissue proximate a heart valve, comprising:
a guide catheter having a distal end sized and configured to be positionable proximate the heart valve;
a plurality of delivery tubes movable within the guide catheter, the delivery tubes having continuous single-piece distal end portions that are advanceable so as to protrude out of the distal end of the guide catheter;
a plurality of tissue anchors releasably carried by the continuous single-piece distal end portions of the delivery tubes; and
an interconnector connecting the tissue anchors,
wherein the system is configured to advance the plurality of delivery tubes through the guide catheter such that continuous single-piece distal end portions of the delivery tubes protrude from the distal end of the guide catheter to deliver the tissue anchors substantially simultaneously proximate the heart valve, and
wherein the tissue anchors are configured to move toward one another and reduce a cross-section dimension of the heart valve via application of tension to the interconnector.
11. The system of claim 10 , further comprising an imaging device.
12. The system of claim 11 , wherein the imaging device comprises an echocardiogram, fluoroscopy, or cineangiographic guidance device.
13. The system of claim 10 , wherein the plurality of delivery tubes comprises between 8 and 12 delivery tubes.
14. The system of claim 10 , wherein the system is configured to secure the tissue anchors adjacent the valve independently of one another.
15. The system of claim 10 , wherein the interconnector is configured to cinch the tissue proximate the heart valve.
16. A system configured to remodel tissue proximate a heart valve, comprising:
a guide catheter sized and configured to be guided through a patient's vasculature to a heart;
a plurality of delivery tubes movable within the guide catheter from a stowed position to a deployed position, in the deployed position the delivery tubes having continuous single-piece distal end that protrude out of a distal end of the guide catheter;
a plurality of tissue anchors releasably carried by the continuous single-piece distal end portions of the delivery tubes; and
an interconnector connecting the tissue anchors,
wherein the system is configured to deliver the tissue anchors substantially simultaneously,
wherein in the stowed position, the tissue anchors are restrained in a generally linear configuration,
wherein in the deployed position, the continuous single-piece distal ends of the delivery tubes are curved so as to allow the tissue anchors to be delivered in a radially outward direction proximate the heart valve, and
wherein the tissue anchors are configured to move toward one another and reduce a cross-section dimension of the heart valve via application of tension to the interconnector.
17. The system of claim 16 , further comprising an imaging device.
18. The system of claim 17 , wherein the imaging device comprises an echocardiogram, fluoroscopy, or cineangiographic guidance device.
19. The system of claim 16 , wherein the plurality of delivery tubes comprise between 8 and 12 delivery tubes.
20. The system of claim 16 , wherein the interconnector is configured to cinch the tissue proximate the heart valve.