Hemostasis and flushing method and apparatus for trans-catheter annuloplasty

An outer guide configured for a trans-catheter surgical procedure, the outer guide comprising:

• a proximal handle having a proximal end, a distal end, and a mid-section located between the proximal end and the distal end, wherein the proximal end and mid-section are configured to receive a distal end of an implant loading tool therein;
• a flushing chamber located within the proximal handle;
• a closed distal valve located within the proximal handle distal to the flushing chamber, the distal valve configured to seal against the distal end of the implant loading tool when received therethrough and configured to remain closed when the implant loading tool is not received therethrough;
• an open proximal valve located within the proximal handle proximal to the flushing chamber, the proximal valve configured to seal against the distal end of the implant loading tool when received therethrough and configured to remain open when the implant loading tool is not received therethrough;
• and
• a flushing port located on the proximal handle and in fluid communication with the flushing chamber, thereby allowing fluid to be constantly flushed into the flushing chamber through the flushing port and flow out of the open proximal valve when the implant loading tool is being introduced into the proximal handle to create a bolus of fluid beyond the proximal end of the proximal handle to allow the distal tip of the implant loading tool to make contact with the bolus of fluid before entering the proximal open valve, inhibiting air from being trapped in the outer guide or the implant loading tool.

A bifurcated hemostasis tool comprising:

• a housing having a proximal end and a distal end;
• a single tube extending from the distal end of the housing;
• at least two bores located through the proximal end of the housing, each of the bores converging together and being in fluid communication with the single tube;
• a single hemostasis valve located in each of the bores.

A method of flushing a surgical instrument system and achieving hemostasis, the method comprising;

• providing an outer guide, an inner steerable catheter, an implant loading tool slidably coupled to the inner steerable catheter, and a flushing tool, the outer guide comprising a closed distal valve, an open proximal valve and flushing chamber located therebetween;
• placing the flushing tool over a distal end of the implant loading tool;
• filling the inner steerable catheter, the implant loading tool and the flushing tool with a sterile fluid;
• closing a valve located at a distal end of the flushing tool;
• introducing a sterile fluid into the flushing chamber so that it flows out of the open proximal valve to create a bolus of fluid beyond a proximal end of the outer guide;
• removing the flushing tool from the distal end of implant loading tool;
• and
• introducing the distal tip of the implant loading tool to the bolus of fluid before introducing it through the proximal open valve, thereby inhibiting air from being trapped in the outer guide or the implant loading tool during insertion of the implant loading tool into the outer guide.