Methods and apparatus for cardiac valve repair

A method for immobilizing two valve leaflets in a cardiac valve, said method comprising:

• providing a leaflet capture catheter having at least three grasping prongs;
• capturing a first valve leaflet between a first pair of prongs;
• and
• capturing a second valve leaflet between a second pair of prongs.

A method for repairing an atrioventricular valve, said method comprising:

• accessing a patient's vasculature remote from the heart;
• advancing an interventional tool through the vasculature to a ventricle;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole,
• wherein the tissue structure comprises the chordae and the engaging step comprises linking opposed chordae together.

A method for repairing an atrioventricular valve, said method comprising:

• accessing a patient's vasculature remote from the heart;
• advancing an interventional tool through the vasculature to a ventricle;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole,
• wherein the tissue structure comprises the chordae and the engaging step comprises shortening the chordae which comprises mechanically plicating the chordae.

A method for repairing an atrioventricular valve, said method comprising:

• accessing a patient's vasculature remote from the heart;
• advancing an interventional tool through the vasculature to a ventricle;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole,
• wherein the tissue structure comprises papillary muscles and the engaging step comprises capturing and drawing opposed points of the papillary muscles together.

A method for repairing an atrioventricular valve, said method comprising:

• accessing a patient's vasculature remote from the heart;
• advancing an interventional tool through the vasculature to a ventricle;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole,
• wherein valve action is stopped temporarily by raising the pressure in the ventricle above pressure in the atrium during diastole.

A method for repairing an atrioventricular valve, said method comprising:

• accessing a patient's vasculature remote from the heart;
• advancing an interventional tool through the vasculature to a ventricle;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole,
• wherein valve action is stopped temporarily by mechanically restraining the leaflets.

A method for repairing a mitral valve, said method comprising:

• accessing a patient's vasculature remote from the heart, wherein accessing comprises accessing a vena cava by entering through an access location in the inferior vena cava, the superior vena cava, a femoral vein, or an internal jugular vein, wherein accessing further comprises placing a guide catheter from the access location to a right atrium, through an interatrial septum, and into a left atrium, wherein an interventional tool is passed through the guide catheter;
• coupling the guide catheter to the interatrial septum to stabilize the guide catheter;
• advancing the interventional tool through the vasculature to a ventricle, wherein advancing comprises passing the interventional tool from the access location into the right atrium, passing the tool through the interatrial septum into a left atrium, and approaching the mitral valve from above;
• and engaging the tool against a tissue structure which forms or supports the mitral valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole.

A method for repairing a mitral valve, said method comprising:

• accessing a patient's vasculature remote from the heart, wherein accessing comprises accessing a vena cava by entering through an access location in the inferior vena cava, the superior vena cava, a femoral vein, or an internal jugular vein, wherein accessing further comprises placing a guide catheter from the access location to a right, atrium, through an interatrial septum, and into a left atrium, and engaging a distal structure on the guide catheter against the mitral valve, tissue surrounding the mitral valve, or an internal surface of the left atrium, wherein an interventional tool is passed through the guide catheter;
• advancing the interventional tool through the vasculature to a ventricle, wherein advancing comprises passing the interventional tool from the access location into the right atrium, passing the tool through the interatrial septum into a left atrium, and approaching the mitral valve from above;
• and
• engaging the tool against a tissue structure which forms or supports the mitral valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole.

A method for repairing a mitral valve, said method comprising:

• accessing a patient's vasculature remote from the heart, wherein accessing comprises accessing the aortic arch and wherein accessing further comprises placing a guide catheter from the access location through an aortic valve into a left ventricle, and engaging a distal structure of the guide catheter against the mitral valve, mitral valve chordae, papillary muscles, or an internal surface of the left ventricle, wherein an interventional tool is advanced through the guide catheter;
• advancing the interventional tool through the vasculature to a ventricle, wherein advancing comprises passing the interventional tool through the aortic valve into the left ventricle and approaching the mitral valve from below;
• and
• engaging the tool against a tissue structure which forms or supports the atrioventricular valve, wherein the tool modifies the tissue structure in a manner that reduces leakage through the valve during ventricular systole.