Minimally invasive repair of a valve leaflet in a beating heart
A device for performing minimally invasive repair of mitral valve leaflets in a beating heart through the delivery and implantation of artificial chordae tendineae includes a handle for positioning the device into a chest cavity of the patient, a capture assembly adapted to capture a valve leaflet between distal an proximal tip portions, a needle adapted to penetrate the valve leaflet, and a capture confirmation system for verifying capture of the valve leaflet between the distal and proximal tip portions.
1. A method of repairing a heart valve in a beating heart of a patient, comprising:
percutaneously inserting a suture attachment device into a beating heart of a patient;
positioning a capture assembly of the suture attachment device adjacent a valve leaflet of the heart valve;
operating a jaw actuator on a handle assembly of the suture attachment device to longitudinally slide a distal clamping jaw of the capture assembly carrying a suture under tension with respect to a proximal clamping jaw of the capture assembly to create a space between the proximal clamping jaw and the distal clamping jaw;
positioning the capture assembly such that the valve leaflet is in the space between the proximal clamping jaw and the distal clamping jaw;
clamping the valve leaflet between the proximal clamping jaw and the distal clamping jaw; and
operating a needle actuator on the handle assembly to actuate a needle to retrieve the suture carried under tension on the distal clamping jaw across a path of travel of the needle to insert the suture through the valve leaflet.
2. The method of claim 1 , wherein the proximal clamping jaw and distal clamping jaw are each angled relative to a distal end of a generally cylindrical shaft.
3. The method of claim 1 , wherein the capture assembly includes a suture channel that extends around an outer perimeter surface of the capture assembly.
4. The method of claim 1 , wherein the distal clamping jaw is biased towards a closed position with respect to the proximal clamping jaw.
5. The method of claim 1 , wherein the capture assembly further includes a slideable shaft connected to the distal clamping jaw.
6. The method of claim 5 , wherein operating the jaw actuator moves the distal clamping jaw with respect to the proximal clamping jaw by sliding the slideable shaft.
7. The method of claim 6 , wherein operating the jaw actuator moves the distal clamping jaw by longitudinal movement of the jaw actuator.
8. The method of claim 1 , wherein a clamping face of the distal clamping jaw includes a plurality of ridges configured to enhance retention of the leaflet between the distal clamping jaw and the proximal clamping jaw.
9. The method of claim 1 , further comprising confirming capture of a valve leaflet between the proximal clamping jaw and the distal clamping jaw with one or more fiber optic cables extending from the handle assembly to the proximal clamping jaw at one or more openings on a clamping face of the proximal clamping jaw.
10. The method of claim 1 , further comprising a needle release disposed at the handle assembly, the needle release configured to prevent the needle from being inadvertently displaced.
11. A method of repairing a heart valve in a beating heart of a patient, comprising:
percutaneously inserting a suture attachment device into a beating heart of a patient;
positioning a suture attachment assembly of the suture attachment device adjacent a valve leaflet of the heart valve;
operating a jaw actuator on a control handle of the suture attachment device to longitudinally slide a distal clamping jaw of the suture attachment assembly attached to a distal portion of a capture shaft and carrying a suture under tension with respect to a proximal clamping jaw of the suture attachment assembly to create a space between the proximal clamping jaw and the distal clamping jaw;
positioning the suture attachment assembly such that the valve leaflet is in the space between the proximal clamping jaw and the distal clamping jaw;
clamping the valve leaflet between the proximal clamping jaw and the distal clamping jaw; and
operating a needle actuator on the control handle to actuate a needle to retrieve the suture carried under tension on the distal clamping jaw across a path of travel of the needle to insert the suture through the valve leaflet.
12. The method of claim 11 , wherein the proximal clamping jaw and distal clamping jaw are each angled relative to a distal end of a device shaft.
13. The method of claim 11 , wherein the suture attachment assembly includes a suture channel that extends around an outer perimeter surface of the suture attachment assembly.
14. The method of claim 11 , wherein the distal clamping jaw is biased towards a closed position with respect to the proximal clamping jaw.
15. The method of claim 11 , wherein operating the jaw actuator longitudinally slides the capture shaft and the distal clamping jaw by longitudinal movement of the jaw actuator.
16. The method of claim 11 , wherein a clamping face of the distal clamping jaw includes a plurality of ridges configured to enhance retention of the leaflet between the distal clamping jaw and the proximal clamping jaw.
17. The method of claim 11 , further comprising confirming capture of a valve leaflet between the proximal clamping jaw and the distal clamping jaw with one or more fiber optic cables extending from the control handle to one or more openings on a clamping face of the proximal clamping jaw.
18. The method of claim 11 , further comprising a needle selectively slideable within a device shaft with the needle actuator.
19. The method of claim 18 , further comprising a needle release disposed at the control handle, the needle release configured to prevent the needle from being inadvertently displaced.
20. The method of claim 11 , further comprising a suture configured to be retained on the distal clamping jaw for retrieval by the needle and a suture tensioning mechanism disposed at the control handle, the suture tensioning mechanism configured to enable the suture to be retained on the distal clamping jaw under tension.