Aortic leaflet repair using shock wave applicators

A device for delivering shock waves to treat calcified lesions in a heart valve, comprising:

• an elongated flexible tube carried by a sheath, the tube having a fluid input end, the fluid input end of the tube being located near a proximal end of the sheath, and wherein the tube includes a loop portion, the loop portion being configured to be at least partially accommodated within a cusp of the heart valve, said tube being fillable with a conductive fluid via the fluid input end of the tube;
• an elongated flexible support wire centrally disposed within the tube;
• at least two insulated wires supported by the elongated flexible support wire, the at least two insulated wires being coiled around the elongated flexible support wire;
• and
• at least two electrode pairs included in the at least two insulated wires positioned within the loop portion, each of the electrode pairs comprising a plurality of arc-generating regions formed within interleaved portions of two insulated wires of the at least two insulated wires, the arc-generating regions being devoid of insulation, the at least two electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

A method for delivering shock waves to treat calcified lesions in a heart valve, comprising:

• introducing a shock wave device into a patient's vasculature, the shock wave device comprising an elongated flexible tube carried by a sheath, the tube having a fluid input end, the fluid input end of the tube being located near a proximal end of the sheath, and wherein the tube includes a loop portion, the loop portion being configured to be at least partially accommodated within a cusp of the heart valve, said tube being fillable with a conductive fluid via the fluid input end of the tube;
• and an array of electrode pairs associated with a plurality of wires positioned within the loop portion, said electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses;
• advancing the shock wave device within the vasculature such that the loop portion of the tube is at least partially accommodated with a cusp of the heart valve;
• providing the tube of the shock wave device with conductive fluid;
• and
• activating the voltage source to apply shock waves to treat the calcified lesions.

A device for delivering shock waves to treat calcified lesions in a heart valve, comprising:

• an elongated flexible tube carried by a sheath, the tube having a fluid input end, the fluid input end of the tube being located near a proximal end of the sheath, said tube being fillable with a conductive fluid via the fluid input end of the tube;
• and
• an array of electrode pairs associated with a plurality of wires positioned within the tube, said electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses, wherein the electrode pairs comprises a first electrode pair and a second electrode pair,
• wherein the first electrode pair includes a first arc-generating region of a first wire and at least one second arc-generating region of a second wire, a portion of the first wire being interleaved with a first portion of the second wire, the first wire having an electrical potential that is more positive than that of the second wire, and
• wherein the second electrode pair includes a third arc-generating region of the second wire and at least one fourth arc-generating region of a third wire, a second portion of the second wire being interleaved with a first portion of the third wire, the second wire having an electrical potential that is more positive than that of the third wire.

A device for delivering shock waves to treat calcified lesions in a heart valve comprising:

• an elongated flexible tube carried by a sheath,
• wherein the tube has an open proximal end and a sealed distal end,
• wherein the distal end of the tube is configured to be at least partially accommodated within a cusp of the heart valve, and
• wherein the tube is fillable with a pressurized conductive fluid via the open proximal end of the tube;
• and
• an array of electrode pairs associated with a plurality of wires positioned within the tube, said electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses.

A method for delivering shock waves to treat calcified lesions in a heart valve, comprising:

• introducing a shock wave device into a patient's vasculature, wherein the shock wave device comprises:
• an elongated flexible tube carried by a sheath, wherein the tube includes an open proximal end and a sealed distal end, wherein the distal end of the tube is configured to curl into a loop portion when extended out of the sheath, wherein the loop portion is configured to partially unfold when said tube is filled with a pressurized conductive fluid via the open proximal end of the tube;
• and
• an array of electrode pairs associated with a plurality of wires positioned within the loop portion, said electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses;
• positioning the distal end of the sheath close to but spaced from a cusp of the heart valve;
• extending a portion of the tube out of the sheath such that the distal end of the tube curls into a loop portion and such that the loop portion of the tube is at least partially accommodated within the cusp of the heart valve;
• pressurizing the tube with a pressurized conductive fluid via the open proximal end to partially unfold the loop portion of the tube into a curved portion;
• and
• activating the voltage source to apply shock waves to treat the calcified lesions.

A method for delivering shock waves to treat calcified lesions in a heart valve, comprising:

• introducing a shock wave device into a patient's vasculature, the shock wave device comprising:
• an elongated flexible tube carried by a sheath, the tube having a proximal end and a distal end, wherein the distal end of the tube is configured to be at least partially accommodated within a cusp of the heart valve, and wherein the tube is fillable with a conductive fluid,
• an array of electrode pairs associated with a plurality of wires positioned within the tube, said electrode pairs being electrically connectable to a voltage source and configured to generate shock waves in the conductive fluid in response to voltage pulses, and
• a central anchor extending beyond the distal end of the tube and configured to pass through the leaflets of the heart valves and into the ventricle to stabilize the position of the sheath, wherein the anchor includes a first arm and a second arm, wherein one or more markers are disposed on the first arm in a first configuration and one or more markers are disposed on the second arm in a second configuration;
• advancing the shock wave device within the vasculature such that the central anchor is placed into the ventricle;
• expanding the central anchor;
• based on the marker configurations, determining the locations of the arms;
• based on the determined locations of the arms, positioning the tube such that the distal end of the tube is at least partially accommodated with a first cusp of the heart valve;
• activating the voltage source to apply shock waves to treat the calcified lesions.