Method and apparatus for reducing mitral regurgitation

Abstract

Apparatus for reducing mitral regurgitation, by applying a force to the wall of the coronary sinus so as to force the posterior leaflet anteriorly and thereby reduce mitral regurgitation.

1 . Apparatus for reducing mitral regurgitation, said apparatus comprising: 
 a cinching device comprising a distal anchor, a proximal anchor and a flexible body extending therebetween, said distal anchor being adapted to be positioned distal to the distal end of the coronary sinus and the proximal anchor being adapted to be positioned at the coronary ostium, with the flexible body extending through said coronary sinus between said distal anchor and said proximal anchor, and further wherein at least one of said distal anchor and said proximal anchor is configured for ratcheting action relative to said flexible body, whereby the length of body between said distal anchor and said proximal anchor may be reduced,    whereby when said distal anchor is positioned distal to said distal end of said coronary sinus and said proximal anchor is positioned at said coronary ostium, with the flexible body extending through said coronary sinus between said distal anchor and said proximal anchor, and said body is thereafter cinched so as to reduce the length of body between said distal anchor and said proximal anchor, a force may be exerted on the posterior annulus so as to reduce mitral regurgitation.    
   
   
       2 . Apparatus according to  claim 1  wherein said distal anchor is adapted to be set in the pericardial space adjacent to the distal end of the coronary sinus.  
   
   
       3 . Apparatus according to  claim 1  wherein said distal anchor is adapted to be set in the intervening tissue located between the pericardial space and the distal end of the coronary sinus.  
   
   
       4 . Apparatus according to  claim 1  wherein said proximal anchor comprises a plurality of radial projections formed on said filament and a head having a central opening therein, the size and construction of said radial projections and said central opening being coordinated so as to enable a ratcheting action between said filament and said head.  
   
   
       5 . Apparatus according to  claim 4  wherein said head has a plurality of additional openings therein so as to pass blood therethrough.  
   
   
       6 . Apparatus according to  claim 1  wherein said system further comprises a delivery catheter sized to receive said cinching device.  
   
   
       7 . Apparatus according to  claim 1  wherein said system further comprises a guidewire and a delivery catheter.  
   
   
       8 . Apparatus according to  claim 7  wherein said cinching device comprises a central lumen for receiving said guidewire therein.  
   
   
       9 . Apparatus according to  claim 1  wherein said system further comprises a delivery catheter sized to receive said cinching device, and further wherein said cinching device comprises a sharp tip at its distal end, distal to said distal anchor.  
   
   
       10 . Apparatus according to  claim 1  wherein said distal anchor comprises an inflatable balloon.  
   
   
       11 . A method for reducing mitral regurgitation, said method comprising the steps of: 
 providing a cinching device comprising a distal anchor, a proximal anchor and a flexible body extending therebetween, said distal anchor being adapted to be positioned distal to the distal end of the coronary sinus and the proximal anchor being adapted to be positioned at the coronary ostium, with the flexible body extending through said coronary sinus between said distal anchor and said proximal anchor, and further wherein at least one of said distal anchor and said proximal anchor is configured for ratcheting action relative to said flexible body, whereby the length of body between said distal anchor and said proximal anchor may be reduced;    positioning said distal anchor distal to said distal end of said coronary sinus and positioning said proximal anchor at said coronary ostium, with the flexible body extending through said coronary sinus between said distal anchor and said proximal anchor; and    cinching said body so as to reduce the length of body between said distal anchor and said proximal anchor, whereby a force may be exerted on the posterior annulus so as to reduce mitral regurgitation.    
   
   
       12 . A method according to  claim 11  wherein said distal anchor is set in the pericardial space adjacent to the distal end of the coronary sinus.  
   
   
       13 . A method according to  claim 11  wherein said distal anchor is set in the intervening tissue located between the pericardial space and the distal end of the coronary sinus.  
   
   
       14 . A method according to  claim 11  wherein said proximal anchor comprises a plurality of radial projections formed on said body and a head having a central opening therein, the size and construction of said radial projections and said opening being coordinated so as to enable a ratcheting action between said body and said head, and further wherein cinching said body is achieved by moving said head relative to said body.  
   
   
       15 . A method according to  claim 14  wherein said head has a plurality of openings therein so as to pass blood therethrough.  
   
   
       16 . A method according to  claim 11  wherein said cinching device is carried to the coronary sinus inside a delivery catheter.  
   
   
       17 . A method according to  claim 11  wherein said cinching device is carried to the coronary sinus over a guidewire.  
   
   
       18 . Apparatus according to  claim 1  wherein said distal anchor has an external surface which promotes blood clotting.  
   
   
       19 . Apparatus according to  claim 8  wherein said central lumen collapses upon itself to prevent blood leakage from one chamber to another.  
   
   
       20 . A method according to  claim 11  wherein said distal anchor is set through the myocardium tissue and into the left ventrical adjacent to the distal end of the coronary sinus.