Neo chordae tendinae deployment system
Methods and devices for transvascular prosthetic chordae tendinea implantation are disclosed. A catheter is advanced into the left atrium. A helical ventricular anchor subassembly is advanceable through the catheter, having a ventricular suture extending proximally through the catheter. A leaflet anchor subassembly is advanceable through the catheter, having a leaflet suture extending proximally through the catheter. From an atrium side, the leaflet anchor subassembly can be anchored to a superior surface of a mitral valve leaflet and a leaflet anchor can be advanced into the mitral valve leaflet to secure the mitral valve leaflet to the leaflet suture. The ventricular anchor subassembly secures the ventricular anchor to a ventricular wall. The leaflet suture and the ventricle suture may be tensioned and connected by a suture lock to form an artificial chordae.
1. A neo chordae tendinae deployment system, comprising:
a catheter having a proximal end and a distal end;
a helical ventricular anchor subassembly extendable through the catheter, having a ventricular suture extending proximally through the catheter; and
a leaflet anchor deployment subassembly extendable through the catheter, having a radially enlargeable leaflet anchor within the subassembly and having a leaflet suture extending proximally through the catheter.
2. The neo chordae tendinae deployment system as in claim 1 , wherein the radially enlargeable leaflet anchor comprises a pledget.
3. The neo chordae tendinae deployment system as in claim 2 , wherein the pledget is transformable from an elongate strip configuration to a radially enlarged, axially shortened configuration by proximal retraction of the suture.
4. The neo chordae tendinae deployment system as in claim 1 , wherein the radially enlargeable leaflet anchor comprises the leaflet suture positioned between two sheets of material.
5. The neo chordae tendinae deployment system as in claim 1 wherein the radially enlargeable leaflet anchor is carried within a needle having a sharpened end for piercing the leaflet.
6. The neo chordae tendinae deployment system as in claim 5 , wherein the leaflet anchor deployment subassembly comprises an elongate tube having a distal end and a central lumen, and a leaflet connector on the distal end.
7. The neo chordae tendinae deployment system as in claim 6 , wherein the leaflet connector comprises a helical leaflet anchor.
8. The neo chordae tendinae deployment system as in claim 7 , wherein the needle is axially movable with respect to the helical leaflet anchor.
9. The neo chordae tendinae deployment system as in claim 1 further comprising a suture locking subassembly, advanceable through the catheter and configured to connect the ventricular suture to the leaflet suture.
10. The neo chordae tendinae deployment system as in claim 1 , wherein the ventricular anchor subassembly comprises an outer tubular sheath having a rotatable anchor driver extending therethrough and a helical ventricular anchor removably carried by the anchor driver.
11. The neo chordae tendinae deployment system as in claim 10 , further comprising a hub between the anchor driver and the helical ventricular anchor.
12. The neo chordae tendinae deployment system as in claim 10 , further comprising a suture lock guide on a proximal end of the ventricular anchor.
13. The neo chordae tendinae deployment system as in claim 12 , wherein the suture lock guide comprises a proximally extending tubular sleeve configured to receive a suture lock.
14. The neo chordae tendinae deployment system as in claim 13 , further comprising a radiopaque marker carried by the suture lock guide.
15. The neo chordae tendinae deployment system as in claim 10 , further comprising a core wire extending axially through the helical anchor.
16. The neo chordae tendinae deployment system as in claim 15 , further comprising a tissue depth indicator carried by the core wire.
17. The neo chordae tendinae deployment system as in claim 16 , further comprising a spring to bias the depth indicator in the distal direction.
18. The neo chordae tendinae deployment system as in claim 1 , wherein the catheter is dimensioned to simultaneously receive the leaflet anchor deployment subassembly and the ventricular suture therethrough.
19. The neo chordae tendinae deployment system as in claim 18 , further comprising a suture lock delivery subassembly.
20. The neo chordae tendinae deployment system as in claim 19 , wherein the suture lock delivery subassembly is configured to advance a suture lock simultaneously along the leaflet suture and the ventricular suture.