Method and apparatus for circulatory valve repair

Abstract

An apparatus for the repair of a cardiovascular valve has leaflets comprising a grasper capable of grabbing and co-apting the leaflets of the valve. In a preferred embodiment the grasper has jaws that grasp and immobilize the leaflets, and then a fastener is inserted to co-apt the leaflets. The apparatus is particularly useful for repairing mitral valves to cure mitral regurgitation.

What is claimed is:  
     
         1 . An apparatus for the repair of a cardiovascular valve having leaflets comprising a grasper capable of grabbing and coapting the leaflets of the valve.  
     
     
         2 . The apparatus of    claim 1   , where the valve to be repaired is a cardiac valve.  
     
     
         3 . The apparatus of    claim 2   , where the valve to be repaired is a mitral heart valve.  
     
     
         4 . The apparatus of    claim 3   , where the patient suffers from mitral regurgitation.  
     
     
         5 . The apparatus of    claim 2   , where the valve to be repaired is an aortic valve.  
     
     
         6 . The apparatus of    claim 5   , wherein the patient suffers from aortic insufficienty.  
     
     
         7 . The apparatus of    claim 1   , which comprises a coaptor to coapt the valve leaflets with a fastener.  
     
     
         8 . The apparatus of    claim 1   , wherein the grasper has a distal end comprising a multiplicity of jaws which are freely movable about a joint to permit a range of motion of said jaws when the apparatus is manipulated by an operator.  
     
     
         9 . The apparatus of    claim 1   , wherein the grasper end is removable from the apparatus.  
     
     
         10 . The apparatus of    claim 9   , wherein the grasper distal end is disposable.  
     
     
         11 . The apparatus of    claim 7   , wherein the coaptor is adjunctive to, and capable of operating in concert with, the grasper distal end.  
     
     
         12 . The apparatus of    claim 7   , wherein the coaptor is separate from the grasper distal end.  
     
     
         13 . The apparatus of    claim 1    which can be inserted percutaneously.  
     
     
         14 . The apparatus of    claim 1   , wherein the grasper is capable of adjusting the leaflets of the valve to obtain optimal coaptation.  
     
     
         15 . The apparatus of    claim 8   , wherein the jaws of the grasper can be independently manipulated to ensure optimal valve leaflet apposition.  
     
     
         16 . An apparatus for the repair of a cardiovascular valve, comprising a grasper having two jaws each having a closure member removably attached thereto wherein each closure member has a proximal end and the grasper also comprises a positioning member that is capable of positioning a binding member around the closure member proximal ends to secure the closure members together to coapt leaflets of the cardiovascular valve.  
     
     
         17 . A method of repairing a heart valve in a patient suffering from regurgitation or insufficiency wherein an apparatus of    claim 1    is inserted into a patient's heart, the grasper is used to grasp and immobilize the leaflets of the valve, and a fastener is inserted to coapt the leaflets.  
     
     
         18 . The method of    claim 17   , wherein the apparatus is inserted into the heart through the chest via a thorascope.  
     
     
         19 . The method of    claim 17   , wherein the apparatus is inserted through the jugular vein.  
     
     
         20 . The method of    claim 17   , wherein the apparatus is inserted through the femoral artery and advanced percutaneously.  
     
     
         21 . The method of    claim 17   , wherein the heart valve is a mitral valve or an aortic valve.  
     
     
         22 . The method of    claim 21   , wherein the heart valve is a mitral valve.  
     
     
         23 . The method of    claim 21   , wherein the heart valve is an aortic valve.  
     
     
         24 . The method of    claim 17    for repairing a mitral valve in a patient suffering from mitral valve regurgitation wherein the leaflets of the mitral valve are grasped and immobilized by jaws of the grasper and a fastener is inserted into the immobilized mitral valve leaflets to coapt the leaflets.  
     
     
         25 . The method of    claim 17    for repairing an aortic valve in a patient suffering from aortic valve insufficiency wherein the leaflets of the aortic valve are grasped and immoblized by jaws of the grasper and a fastener is inserted into the immobolized aortic valve leaflets to coapt the leaflets.  
     
     
         26 . A method of repairing a heart valve in a patient suffering from regurgitation or insufficiency comprising: 
 inserting an apparatus of    claim 1    into a patient's heart;    grasping the leaflets of the heart valve;    immobilizing said leaflets of the heart valve;    inserting a fastener into the patient's heart in proximity to the grasped valve leaflets;    coapting the leaflets of the said heart valve together by affixing the fastener; and    removing the grasper while leaving the fastener in place.    
     
     
         27 . The method of    claim 26   , wherein the patient suffers from mitral regurgitation and a mitral valve is repaired.  
     
     
         28 . The method of    claim 26   , wherein the patient suffers from aortic insufficiency and an aortic valve is repaired.