Methods and devices for valve clip excision
A system for excising an implanted clip approximating opposed valve leaflets in a heart valve includes a capture catheter configured to be introduced proximate the valve leaflets on one side of the clip, a transfer catheter configured to be introduced proximate the valve leaflets on another side of the clip, and a cutting tool configured to be deployed between the capture and transfer catheters and to be engaged against tissue of at least one of the valve leaflets and to excise the clip. A removal catheter may optionally be used to remove the clip from the heart.
1. A method for excising a clip approximating an opposed pair of valve leaflets in a heart valve, said method comprising:
introducing a capture catheter into a heart chamber adjacent to the valve leaflets on one side of the clip;
introducing a transfer catheter into the heart chamber adjacent to the valve leaflets on another side of the clip;
deploying a cutting element from the transfer catheter to the capture catheter to place the cutting element against tissue of at least one of the valve leaflets;
engaging the cutting element against the valve leaflet tissue; and
excising the clip from at least one valve leaflet using the cutting member.
2. A method as in claim 1 , wherein the heart chamber is the left atrium and the heart valve is a mitral valve.
3. A method as in claim 1 , wherein the heart chamber is the left ventricle and the heart valve is a mitral valve.
4. A method as in claim 1 , wherein the heart chamber is the right atrium and the heart valve is a tricuspid valve.
5. A method as in claim 1 , wherein the heart chamber is the right ventricle and the heart valve is a tricuspid valve.
6. A method as in claim 1 , wherein deploying the cutting element comprises steering a tip of least one of the capture catheter and the transfer catheter to bring tips of both catheters into proximity.
7. A method as in claim 6 , wherein deploying the cutting member further comprises engaging a magnetic element on the capture catheter against a magnetic element on the cutting member and drawing the cutting member past the valve.
8. A method as in claim 6 , wherein deploying the cutting element further comprises engaging a loop on the capture catheter over a free end on the cutting element and drawing the cutting element past the valve.
9. A method as in claim 6 , wherein deploying the cutting element further comprises bringing a tip of the capture catheter and a tip of the transfer catheter together to form a path past the valve and advancing the cutting element through the path.
10. A method as in claim 1 , wherein the clip is excised from only one valve leaflet.
11. A method as in claim 1 , wherein the clip is excised from both valve leaflets of the opposed pair.
12. A method as in claim 1 , wherein excising the clip from at least one valve leaflet comprises delivering radiofrequency current through the cutting element.
13. A method as in claim 1 , wherein excising the clip from at least one valve leaflet comprises mechanically cutting or abrading the valve tissue with the cutting element.
14. A method as in claim 1 , further comprising introducing a clip removal catheter into the heart chamber and engaging a distal end of the clip removal catheter against the clip while excising the clip from at least one valve leaflet using the cutting element.
15. A method as in claim 1 , further comprising excising the clip from both opposed valve leaflets and removing the clip with a clip removal catheter.
16. A method as in claim 1 , wherein the capture catheter and the transfer catheter are introduced transseptally.
17. A method as in claim 1 , wherein the capture catheter and the transfer catheter are introduced transapically.