# US 2014/0194976 A1 · Devices and methods for heart valve repair

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- Number: US 2014/0194976 A1
- Document ID: US20140194976A1
- Status: Published application
- Kind: A1
- Application number: 14/156,347
- Filed: 2014-01-15
- Published: 2014-07-10
- Earliest claimed: 2002-06-13
- Assignees: Guided Delivery Systems, Inc.
- Applicants: Guided Delivery Systems Inc.
- Inventors: Niel F. STARKSEN; John TO
- Web page: https://patentgrep.com/patent/US20140194976A1

## CPC

- A61F 2/2466: {Delivery devices therefor}
- A61B 6/487: {involving fluoroscopy}
- A61B 6/504: {for diagnosis of blood vessels, e.g. by angiography}
- A61B 8/0883: {for diagnosis of the heart}
- A61B 8/12: in body cavities or body tracts, e.g. by using catheters
- A61B 17/00234: {for minimally invasive surgery (A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence)}
- A61B 17/064: Surgical staples, {i.e. penetrating the tissue}
- A61B 17/0682: {for applying U-shaped staples or clamps, e.g. without a forming anvil}
- A61F 2/2445: {Annuloplasty rings in direct contact with the valve annulus}
- A61B 17/0401: {Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors (A61B17/0642 takes precedence; fixation devices for tendons or ligaments A61F2/0811)}
- A61B 2017/00243: {cardiac}
- A61B 2017/00783: {Valvuloplasty}
- A61B 2017/00867: {shape memory effect}
- A61B 2017/0409: {Instruments for applying suture anchors}
- A61B 2017/0414: {having a suture-receiving opening, e.g. lateral opening}
- A61F 2220/0016: with sharp anchoring protrusions, e.g. barbs, pins, spikes
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)

## Abstract

Devices and methods provide enhanced treatment of a cardiac valve annulus. Methods generally involve contacting an anchor delivery device with the valve annulus and releasing a plurality of coupled anchors from the anchor delivery device to secure the anchors to the annulus. Anchors, which in some embodiments are super-elastic or shape memory self-securing anchors, are then drawn together to tighten the annulus. Devices generally include an elongate catheter having a housing at or near the distal end for releasably housing a plurality of coupled anchors. The housing may be flexible, may conform to a valve annulus, and in some embodiments may be coupled with an expandable member to enhance contact of the housing with annular tissue. In one embodiment, self-securing anchors lie approximately flat within the delivery device housing, allowing anchors with relatively large deployed shapes to be housed in and deployed from a relatively narrow delivery device.

## Claims

### Claim at position 1

1-117. (canceled)

### Claim 118

A method of constricting tissue in a heart, the method comprising:
advancing an operational device such that a distal end of the operational device is entirely within a ventricle to contact a length of ventricular tissue located between a left ventricular wall, at least one mitral valve leaflet and at least one chordae tendineae of the heart, wherein the operational device comprises a lumen and a plurality of apertures in communication with the lumen for delivering a plurality of anchors therethrough, wherein contacting the length of tissue comprises simultaneously positioning the plurality of coupled anchors along the length of the tissue; delivering the simultaneously positioned plurality of coupled anchors from the lumen of device through the plurality of apertures to secure the anchors to the tissue; and drawing the anchors together to constrict the tissue.

### Claim 119 (depends on 118)

A method as in claim 118, wherein contacting, delivering and drawing are performed as part of an open heart surgical procedure.

### Claim 120 (depends on 118)

A method as in claim 118, wherein advancing, delivering and drawing are performed without stopping the heart.

### Claim 121 (depends on 118)

A method as in claim 118, wherein advancing, delivering and drawing are performed through one or more minimally invasive incisions.

### Claim 122 (depends on 118)

A method as in claim 118, wherein delivering the plurality of anchors comprises crimping the anchors to secure them to the tissue.

### Claim 123 (depends on 118)

A method as in claim 118, wherein delivering the plurality of anchors comprises driving the anchors out of the operational device using at least one expandable member disposed within the operational device.

### Claim 124 (depends on 118)

A method as in claim 118, wherein drawing the anchors together comprises allowing a self-deforming coupling member coupled with the anchors to deform to constrict the tissue.

### Claim 125 (depends on 118)

A method as in claim 118, further comprising stabilizing the tissue with the anchor delivery device prior to delivering the anchors.

### Claim 126 (depends on 118)

A method as in claim 118, wherein delivering the plurality of anchors from the operational device acts to secure at least one heart valve prosthesis to the tissue.

### Claim 127 (depends on 118)

A method as in claim 118, wherein the operational device is contacted with the length of tissue from within a left ventricle of the heart.

### Claim 128 (depends on 118)

A method as in claim 118, wherein the anchor delivery device is contacted with the length of tissue from within a left atrium of the heart.

### Claim 129 (depends on 118)

A method as in claim 118, wherein advancing, delivering and drawing are performed via intravascular access to the heart.

### Claim 130 (depends on 129)

A method as in claim 129, wherein the method further comprises advancing the operational device through an aorta and into a left ventricle of the heart.

### Claim 131 (depends on 129)

A method as in claim 129, wherein the method further comprises advancing the operational device through a central vein and into a right atrium of the heart, across an interatrial septum, and into a left ventricle of the heart to contact ventricular wall tissue located inferior to an intersection of a left ventricular wall and at least one mitral valve leaflet of the heart.

### Claim 132 (depends on 118)

A method as in claim 118, further comprising deforming a flexible distal portion of the operational device to conform the distal portion to the length of tissue prior to contacting the anchor delivery device with the length of tissue.

### Claim 133 (depends on 121)

A method as in claim 121, further comprising advancing the flexible distal portion within a space between a left ventricular wall, at least one mitral valve leaflet and at least one chordae tendineae of the heart.

### Claim 134 (depends on 118)

A method as in claim 118, wherein drawing the anchors together comprises cinching a tether coupled with the anchors.

### Claim 135 (depends on 134)

A method as in claim 134, further comprising: securing the tether to at least a terminal anchor of the plurality of anchors; and cutting the tether to leave the cinched anchors secured to the tissue.

### Claim 136 (depends on 118)

A method as in claim 118, further comprising visualizing the tissue.

### Claim 137 (depends on 136)

A method as in claim 136, wherein visualizing is performed using a visualization device selected from the group consisting of an ultrasound device, an angioscopic device, a transesophageal echocardiogram device and a fluoroscopic device.