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.

1 . Apparatus for effecting a desired geometric change the annulus of a heart valve and limiting mitral leaflet prolapse, said apparatus comprising: 
 first and second plication bands, each said plication band comprising: 
 first and second legs each having a first end, said first ends of said first and second legs having a tissue piercing configuration; and  
 a bridge having first and second ends, said first end of said bridge being connected to said first leg and said second end of said bridge being connected to said second leg such that said first ends of said first and second legs are separated by a first given distance;  
 said bridge being configured such that when said first ends of said first and second legs have pierced tissue at said first given distance, said bridge may be deformed so as to cause said first ends of said first and second legs to move toward one another so as to thereafter be separated by a second, shorter given distance, whereby said first and second legs gather together the pierced tissue to effect a desired geometric change in the annulus of the heart valve; and  
   a linking construct connected to said first and second plication bands.    
   
   
       2 . A method for effecting a desired geometric change the annulus of a heart valve and limiting mitral leaflet prolapse, said method comprising the steps of: 
 providing apparatus for effecting a desired geometric change in the annulus of a heart valve, said apparatus comprising: 
 first and second plication bands, each said plication band comprising: 
 first and second legs each having a first end, said first ends of said first and second legs having a tissue piercing configuration; and  
 a bridge having first and second ends, said first end of said bridge being connected to said first leg and said second end of said bridge being connected to said second leg such that said first ends of said first and second legs are separated by a first given distance;  
 said bridge being configured such that when said first ends of said first and second legs have pierced tissue at said first given distance, said bridge may be deformed so as to cause said first ends of said first and second legs to move toward one another so as to thereafter be separated by a second, shorter given distance, whereby said first and second legs gather together the pierced tissue to effect a desired geometric change in the annulus of the heart valve; and  
 
 a linking construct connected to said first and second plication bands;  
   deploying said first plication band in tissue, and deploying said second plication band in tissue such that said linking construct extends across the mouth of the valve and draws the two portions of tissue together, thereby limiting leaflet prolapse.