Apparatuses and methods for cutting a tissue bridge and/or removing a heart valve clip or suture

A method for excising and removing a clip or suture attached to a heart valve, the clip or suture forming a tissue bridge in said heart valve, the method comprising the following steps:

• placing a purse string suture at a previously determined site along the left ventricular epicardial surface to correspond with a planned incision;
• making an incision in the heart muscle within the borders of the purse string;
• introducing at least two guidewires through said incision into a heart and locating each of at least two guidewires on opposite sides of a tissue bridge formed in a heart valve by a clip or suture, said at least two guidewires providing a navigation passageway for guiding a tissue removal apparatus to the tissue bridge for purposes of removing said tissue bridge;
• providing a tissue removal apparatus comprising an elongated shaft having at least two guidewire lumens extending therethrough to receive each of said at least two guidewires, said tissue removal apparatus comprising:
• (1) an elongated shaft having a clamping member disposed at the distal end of the shaft for gripping said tissue bridge;
• (2) a blade disposed at the distal end of the shaft for cutting said tissue bridge;
• and
• (3) a containment member for capturing an removing said tissue bridge following cutting of said tissue bridge;
• inserting the proximal end of each of said at least two guidewires into said guidewire lumens of said tissue removal apparatus;
• opening said incision and moving said tissue removal apparatus along said guidewires into proximity of said tissue bridge;
• securing said tissue removal apparatus to said tissue bridge with said clamping member;
• cutting said tissue bridge with said blade;
• and
• removing said tissue bridge including said clip or suture with said containment member.

An apparatus for cutting a tissue bridge in a heart valve, the apparatus comprising:

• an elongated shaft having a proximal end and a distal end;
• a handle attached to the proximal end of the shaft;
• at least one blade disposed at the distal end of the shaft;
• a blade cover removably mounted at the distal end of the shaft, said cover configured to be controllably moved from a closed position which covers the blade, to an open position which exposes said blade to facilitate cutting of said tissue bridge;
• a blade cover actuating member attached to said handle, said actuating member coupled to said blade cover for actuating the cover to move from a closed position to an open position;
• a stabilizing member retractably mounted at the distal end of the shaft, said stabilizing member configured to be controllably moved from a closed position which retracts said stabilizing member to configuration approximating the diameter of the shaft, to an open position which extends said stabilizing member outwardly from the distal end of the shaft to engage heart tissue adjacent the tissue bridge to stabilize the distal end of the blade during cutting of said tissue bridge;
• and
• a stabilizing member actuating member attached to said handle, said actuating member coupled to said stabilizing member for actuating said stabilizing member to move from a closed position to an open position.