Apparatus and method to reshape geometry of diseased heart valve
Devices and methods are disclosed for treating mitral valve regurgitation that include members that assist the valve in closing during the cardiac cycle. Such devices may include members configured to alter the shape of mitral valve annulus. In certain embodiments, one or more wires may be anchored on one extremity to an element positioned along the posterior part of the mitral annulus, in the coronary sinus, and on another extremity to an element along the anterior part of the mitral annulus, fibrous trigon. The reshaping of the mitral annulus may be accomplished by pulling the wire or wires. Reducing the length of the wire or wires may provide the displacement of the posterior leaflets towards the anterior, thereby increasing the coaptation surface for the valve leaflets and reducing the regurgitation.
1. An annuloplasty device, comprising:
a first holding element configured to be located in a coronary sinus of a heart, the first holding element having a length;
a second holding element configured to be located in a fibrous trigon of the heart; and
a connecting element for connecting the first holding element and the second holding element, an end of the connecting element being assembled with the first holding element at a location along the length of the first holding element into a single element; and
wherein the device further comprises a wire, and wherein a free end of the connecting element is adapted to be connected to said wire.
2. The device of claim 1 , wherein the connecting element is configured to cross a valve area on an atrial side of the heart.
3. The device of claim 1 , wherein the first and second holding elements and the connecting element are configured to be deployed into the heart using endovascular techniques.
4. The device of claim 1 , wherein the connecting element is configured to change its profile during a cardiac cycle to prevent mitral leaflets damage due to impingement of one or more mitral valve leaflets on the connecting element configured to change its profile during ventricular systole.
5. The device of claim 1 , wherein the connecting element is configured to change its profile during a cardiac cycle not to block blood flow from atrium to ventricle.
6. The device of claim 1 , wherein the second holding element is adapted for locking the wire over the second holding element.
7. A method of inserting the annuloplasty device of claim 1 in the heart, the method comprising:
connecting the first holding element to the connecting element;
placing the first holding element connected to the connecting element into the coronary sinus of the heart;
connecting the connecting element to the second holding element placed at a level of a mitro-aortic junction and fibrous trigon of the heart; and
pulling the connecting element to increase mitral valve leaflets coaptation.
8. The method of claim 7 , wherein the method further comprises:
piercing a coronary sinus of the heart with the first holding element connected to the connecting element avoiding a circonflex artery of the heart;
extending the connecting element across a valve area towards the fibrous trigon on an atrial side of a mitral valve;
piercing a left ventricle outflow tract at a level of the fibrous trigon;
pulling the connecting element to increase mitral valve leaflets coaptation; and
connecting the connecting element to the second holding element.
9. The method of claim 7 , wherein the connecting element is placed in a left ventricle outflow tract at a level of the fibrous trigon, below an aortic valve using endovascular techniques.
10. The method of claim 7 , wherein the connecting element changes its profile during a cardiac cycle to prevent mitral leaflet damage due to impingement of one or more mitral valve leaflets on the connecting element during ventricular systole.
11. The method of claim 7 , wherein the connecting element changes its profile during a cardiac cycle and does not block blood flow from atrium to ventricle.