Transvalvular intraanular band and chordae cutting for ischemic and dilated cardiomyopathy
Mitral valve prolapse and mitral regurgitation can be treating by implanting in the mitral annulus a transvalvular intraannular band. The band is positioned so that it extends transversely across a coaptive edge formed by the closure of the mitral valve leaflets, to inhibit prolapse into the left atrium. At least one marginal chordae is severed, to permit leaflet closure against the band.
1. A method of treating ischemic or dilated cardiomyopathy, comprising the steps of:
providing an intraannular, transvalvular band dimensioned for attachment within the plane of the mitral valve annulus, wherein the band comprises an elongate body having a first end, a second end, and a central portion having a convex arcuate shape, wherein the band does not comprise an annuloplasty ring;
attaching the band within the plane of the annulus such that the arcuate shaped portion of the band extends transversely across coaptive edges formed by the mitral valve leaflets and is convex in the direction of the ventricular side of the plane to support the leaflets and elevate the position of the coaptive edges in the direction of the ventricle during valve closure; and
manipulating at least one marginal chordae to permit leaflet coaption.
2. A method as in claim 1 , wherein the elevate the position step comprises elevating the position of the coaptive edges by at least about 4 mm.
3. A method as in claim 1 , wherein the elevate the position step comprises elevating the position of the coaptive edges by an amount within the range of from about 6 mm to about 12 mm.
4. A method as in claim 1 , wherein the manipulating step comprises severing at least one marginal chordae.
5. A method as in claim 4 , comprising severing at least two marginal chordae.
6. A method as in claim 1 , wherein the manipulating step is accomplished prior to the attaching step.
7. A method as in claim 1 , wherein the manipulating step is accomplished following the attaching step.
8. A method as in claim 1 , wherein the manipulating step is accomplished with a sharpened edge.
9. A method as in claim 1 , wherein the manipulating step comprises applying RF energy.