Systems and methods for treating regurgitating cardiac valves
The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to medical devices, systems and methods to treat a regurgitating cardiac valve, including, for example a tricuspid or mitral valve.
1. A medical device, comprising:
an elongate tether comprising a flexible middle portion and substantially rigid proximal and distal portions;
an anchor disposed along a distal end of the tether and configured to engage a tissue wall of a right ventricle of a patient; and
a plug slidably disposed along a proximal segment of the flexible middle portion.
2. The medical device of claim 1 , wherein the flexible middle portion is slotted.
3. The medical device of claim 1 , wherein the substantially rigid proximal and distal portions are not slotted.
4. The medical device of claim 1 , wherein the flexible middle portion of the elongate tether is heat-set.
5. The medical device of claim 1 , wherein the elongate tether includes a sufficient length to extend from the tissue wall of the right ventricle into the right atrium.
6. The medical device of claim 1 , wherein the tether is configured to substantially center the proximal segment of the flexible middle portion across the tricuspid valve of a patient.
7. The medical device of claim 5 , wherein the plug is configured to slide distally along the proximal segment of the middle portion when the right ventricle is in the diastole phase of the cardiac cycle, and the plug is configured to slide proximally along the proximal segment of the middle portion when the right ventricle is in the systole phase of the cardiac cycle.
8. The medical device of claim 1 , wherein the proximal segment of the flexible middle portion is defined by first and second O-rings.
9. The medical device of claim 1 , wherein the plug, when in a deployed configuration, includes a varying outer diameter proximal portion and a constant outer diameter distal portion.
10. The medical device of claim 1 , wherein one or more leaflets of the tricuspid valve contact an outer surface of the plug when the right-ventricle is in the systole phase of the cardiac cycle.
11. The medical device of claim 1 , wherein the plug does not contact any portion of the tricuspid valve when the right ventricle is in the diastole phase of the cardiac cycle.
12. The medical device of claim 1 , wherein the anchor includes one or more retention members configured to move from a first configuration to a second configuration.
13. The medical device of claim 12 , wherein the one or more retention members extend beyond the distal end of the tether in the first configuration, and at least a portion of the one or more retentions members extends over a segment of the rigid distal portion in the second configuration.
14. A plug, comprising:
a central spine defining a lumen therethrough configured to slidably receive a tether;
a framework extending over the central spine; and
an impermeable cover disposed around the framework;
wherein the plug is configured to move from a first configuration to a second configuration; and
wherein the framework, when in the second configuration, includes a varying outer diameter proximal portion and a constant outer diameter distal portion.
15. The plug of claim 14 , wherein framework comprises:
at least one strut extending over the central spine; and
a tine extending inward from a distal end of each of the at least one struts;
wherein a distal end of each tine is configured to be attached to the central spine.
16. The plug of claim 15 , wherein:
the central spine and framework are formed from a shape memory tube; and
wherein the at least one strut and the tine are formed as a plurality of cuts formed within in a first portion of the tube and folded back over a second portion of the tube.
17. The plug of claim 14 , wherein the constant outer diameter distal portion of the plug, when in the second configuration, is configured to contact one or more leaflets of the tricuspid valve when in the systole phase of the cardiac cycle.
18. The plug of claim 14 , wherein the plug is configured, when in the first configuration, to be slidably received within a lumen of a steerable delivery catheter.
19. A system, comprising:
a medical device slidably disposed within a lumen of a steerable delivery catheter, the medical device comprising:
an elongate tether comprising a flexible middle portion and substantially rigid proximal and distal portions;
an anchor disposed in a first configuration along a distal end of the tether; and
a plug disposed in a first configuration along a proximal segment of the flexible middle portion and slidable along the elongate tether; and
a push rod slidably disposed within the lumen of the steerable delivery catheter and proximal to the medical device.
20. The system of claim 19 , wherein the anchor and the plug are configured to move from the first configuration to a second configuration when removed from constraint within the lumen of the steerable delivery catheter.