Device, system, and method for transcatheter treatment of valvular regurgitation
Devices are disclosed for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation assistance element for implantation across the mitral valve and an edge to edge device. Methods are disclose for reducing mitral valve regurgitation at low left ventricle pressure and high left ventricle pressure during the cardiac cycle. Devices are disclosed for use in the transcatheter treatment of mitral valve regurgitation, specifically a coaptation assistance element for implantation across the mitral valve with an adaptive coaptation element.
1. A method for treating mal-coaptation of a mitral valve of a heart, the method comprising:
delivering a coaptation assistance element to the mitral valve;
positioning the coaptation assistance element, the coaptation assistance element comprising:
a body comprising a first surface disposed toward a posterior leaflet of the mitral valve and an opposed second surface disposed toward an anterior leaflet of the mitral valve,
wherein the body is bounded by a first lateral edge, a second lateral edge, an inferior edge, and a superior edge, and
wherein the body comprises an implant clip zone extending upward from the inferior edge, wherein the implant clip zone is spaced inward from the first lateral edge and the second lateral edge; and
positioning a single grasping device to interact with the coaptation assistance element, wherein the single grasping device is positioned in an open configuration within the implant clip zone inward from the inferior edge, the first lateral edge, and the second lateral edge, wherein the single grasping device comprises a first prong extending outward from the first surface of the body of the coaptation assistance element when the single grasping device is positioned in the open configuration within the implant clip zone, wherein the single grasping device comprises a second prong extending outward from the second surface of the body of the coaptation assistance element when the single grasping device is positioned in the open configuration within the implant clip zone, wherein the first prong and the second prong are directly connected at a central pivot disposed between the first prong and the second prong of the single grasping device, wherein at least a portion of the body of the coaptation assistance element is in between the first prong and the second prong when the grasping device is positioned in the open configuration within the implant clip zone; and
positioning the single grasping device in a closed configuration within the implant clip zone inward from the inferior edge, the first lateral edge, and the second lateral edge, wherein the first prong of the single grasping device grasps the first surface of the body of the coaptation assistance element when the single grasping device is positioned in the closed configuration within the implant clip zone, wherein the second prong of the grasping device grasps the anterior leaflet against the second surface of the body of the coaptation assistance element when the single grasping device is positioned in the closed configuration within the implant clip zone, wherein at least a portion of the body of the coaptation assistance element is in between the first prong and the second prong when the grasping device is positioned in the closed configuration within the implant clip zone,
wherein the single grasping device does not grasp the posterior leaflet;
wherein the coaptation assistance element and the single grasping device are decoupled such that the single grasping device is delivered to the heart after the coaptation assistance element is delivered to the heart.
2. The method of claim 1 , further comprising a radiopaque marker along the implant clip zone.
3. The method of claim 1 , wherein the coaptation assistance element comprises an implant anterior projection between 7 mm and 40 mm.
4. The method of claim 1 , wherein the coaptation assistance element comprises an implant anterior projection between 10 mm and 30 mm.
5. The method of claim 1 , wherein the coaptation assistance element comprises an implant intercommissural distance between 20 mm and 60 mm.
6. The method of claim 1 , wherein the coaptation assistance element comprises an implant intercommissural distance between 30 mm and 50 mm.
7. The method of claim 1 , wherein the coaptation assistance element comprises an coaptation zone angle between 30 degrees and 90 degrees.
8. The method of claim 1 , wherein the coaptation assistance element comprises an coaptation zone angle approximately 70 degrees.
9. The method of claim 1 , wherein the implant clip zone comprises a membrane configured to be stretched inward from the inferior edge by the single grasping device.
10. The method of claim 9 , wherein the membrane comprises ePTFE and wherein the membrane has a thickness between 0.001 inch and 0.020 inch.
11. The method of claim 1 , wherein positioning the single grasping device in the closed configuration comprises grasping only the anterior leaflet, wherein the coaptation assistance element overlies the posterior leaflet.
12. The method of claim 1 , wherein a coaptation zone angle, an implant anterior projection, or an implant intercommissural distance are designed facilitate coaptation of the anterior leaflet with the coaptation assistance element.
13. The method of claim 1 , wherein when the mitral valve starts to close, the coaptation assistance element is contacting the anterior leaflet with the single grasping device in the closed configuration, thereby reducing mitral valve regurgitation at low ventricle pressure.
14. The method of claim 1 , wherein as a left ventricle pressure is increasing, the pressure on an anterior leaflet and the coaptation assistance element is increased, pushing the coaptation assistance element and the anterior leaflet against each other, thereby increasing the contact between the anterior leaflet and the coaptation assistance element and reducing mitral valve regurgitation at high left ventricle pressure.
15. The method of claim 1 , further comprising selecting the coaptation assistance element from a plurality of coaptation assistance elements having different sizes with respect to a coaptation zone angle, an implant anterior projection, or an implant intercommissural distance to provide optimal coaptation during the cardiac cycle.
16. The method of claim 1 , wherein the single grasping device stretches a membrane of the implant clip zone when positioning the single grasping device in the open configuration.
17. The method of claim 1 , wherein the single grasping device allows the anterior leaflet to continue to open relative to the second surface and close against the second surface on either side of the single grasping device.