Automated annular plication for mitral valve repair

Abstract

A novel system for performing a heart valve annuloplasty. The system involves the use of a plication band. In one embodiment, the annulus of the valve is reduced by constriction of the plication band itself. More particularly, each plication band enters the tissue at two or more points which are spaced from one other by a distance which is dictated by the geometry of the plication band. Subsequent constriction of the plication band causes these points to move toward each other, thereby constricting the tissue trapped between these points and thus reducing the overall circumference of the valve annulus. In a second embodiment, the annulus of the valve is reduced by linking multiple plication bands to one other, using a linkage construct, and then using a shortening of the length of the linkage construct between each plication band so as to gather the tissue between each plication band, whereby to reduce the overall circumference of the valve annulus.

Description

REFERENCE TO PENDING PRIOR PATENT APPLICATION [0001] This is a continuation-in-part of pending prior U.S. patent application Ser. No. 09 / 888,282, filed Jun. 22, 2001 by John R. Liddicoat et al. for AUTOMATED ANNULAR PLICATION FOR MITRAL VALVE REPAIR. [0002] This patent application also claims benefit of pending prior U.S. Provisional Patent Application Ser. No. 60 / 242,466, filed Oct. 23, 2000 by Richard B. Streeter for MYOBAND. [0003] The aforementioned two patent applications are hereby incorporated herein by reference.BACKGROUND OF THE INVENTION [0004] Mitral valve repair is the procedure of choice to correct mitral regurgitation of all etiologies. With the use of current surgical techniques, between approximately 70% and 95% of regurgitant mitral valves can be repaired. The advantages of mitral valve repair over mitral valve replacement are well-documented. These include better preservation of cardiac function and reduced risk of anticoagulant-related hemorrhage, thromboembolism ...

AI Technical Summary

Benefits of technology

Enables mitral valve repair with reduced morbidity and mortality, extending benefits to patients with poor cardiac function and allowing for smaller incisions and percutaneous approaches, potentially improving left ventricular function and treating congestive heart failure.

Problems solved by technology

This technique can be time-consuming and technically difficult.

It is well-known that cardiopulmonary bypass is associated with significant morbidity and mortality.

To date, however, there are no clinically-applicable techniques for performing mitral valve surgery on a beating heart without the use of a heart-lung machine.

In current practice, all patients judged to be candidates for mitral valve surgery must face the risk of cardiopulmonary bypass and cardiac arrest.

Conversely, other patients (i.e., those with poor cardiac function and other co-morbidities) are frequently denied surgery as the risk associated with cardiopulmonary bypass and cardiac arrest is too high.

Furthermore, it is believed that mitral regurgitation contributes to the deterioration of left ventricular function.

Unfortunately, however, such heart failure patients are at high risk for mitral valve surgery using current techniques.

Therefore, the majority of such patients are not deemed candidates for mitral valve repair using currently available techniques.

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