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. A method of inserting an annuloplasty device, comprising:
(1) placing a first holding element into a coronary sinus of a heart;
(2) connecting one or more connecting elements to the first holding element;
(3) pulling at least one of the one or more connecting elements to increase mitral valve leaflet coaptation;
(4) placing a second holding element at the level of the mitro-aortic junction and fibrous trigon of the heart below the aortic valve and connecting the one or more connecting elements to the second holding element.
2. The method of claim 1 , wherein the step of connecting one or more connecting elements to the first holding element comprises placing one or more connecting elements through the mitro-aortic junction of the heart.
3. The method of claim 1 , wherein the step of connecting the one or more connecting elements to the first holding element comprises:
piercing the left ventricle outflow tract at the level of fibrous trigon with a first connecting element;
extending the first connecting element across a valve area towards the posterior mitral annulus of the heart;
piercing the mitral annulus and the coronary sinus with the first connecting element and connecting the first connecting element to the first holding element.
4. The method of claim 1 , wherein one of the one or more connecting elements is placed in the left ventricle outflow tract at the level of the fibrous trigon, below the aortic valve using endovascular techniques.
5. The method of claim 1 , wherein at least one of the one or more connecting elements changes its profile during a cardiac cycle to prevent mitral leaflet damage due to impingement of one or more mitral valve leaflets on the at least one connecting element during ventricular systole.
6. The method of claim 1 , wherein at least one of the one or more connecting elements changes its profile during a cardiac cycle and does not block blood flow from atrium to ventricle.
7. The method of claim 1 , further comprising adjusting the length of one of the one or more connecting elements.
8. The method of claim 7 , wherein the step of adjusting the length of one of the one or more connecting elements is performed during a selected one of an initial procedure to install the annuplasty device and a later procedure after the initial procedure is completed.