Devices and methods for heart valve treatment

Abstract

Devices and methods for improving the function of a valve (e.g., mitral valve) by positioning an implantable device outside and adjacent the heart wall such that the device alters the shape of the heart wall acting on the valve. The implantable device may alter the shape of the heart wall acting on the valve by applying an inward force and/or by circumferential shortening (cinching). The shape change of the heart wall acting on the valve is sufficient to change the function of the valve, and may increase coaptation of the leaflets, for example, to reduce regurgitation.

1 - 113 . (canceled)  
     
     
         114 . A method of reducing the circumference of a mitral valve annulus comprising the steps of: 
 providing a mitral valve reducing device comprising an elongate member;    positioning the elongate member in a first position at a location adjacent the atrioventricular groove and exterior of the vasculature of the heart, wherein in the first position, the elongate member has a first radius of curvature; and    releasing the elongate member in the .atrioventricular groove in a second position wherein in the second position the elongate member has a second radius of curvature less than the first radius of curvature so as to reduce the circumference of the mitral valve annulus.    
     
     
         115 . The method of  claim 114  wherein the step of positioning the elongate member in a first position comprises accessing and navigating the pericardial space.  
     
     
         116 . The method of  claim 114  wherein the step of releasing the elongate member in the atrioventricular groove in a second position comprises bending the elongate member from the first position into the second position.  
     
     
         117 . The method of  claim 116  wherein the step of providing an elongate member comprises providing an elongate member comprising a cinching mechanism; and wherein the step of bending the elongate member comprises actuating the cinching mechanism.  
     
     
         118 . The method of  claim 117  wherein the step of providing an elongate member comprises providing an elongate member having a preferential bending mechanism at a location along a length of the elongate member; and wherein the step of bending the elongate member comprises bending the elongate member at the location.  
     
     
         119 . The method of  claim 114  further comprising the step of increasing tissue adherence to the elongate member.  
     
     
         120 . The method of  claim 119  wherein the step of increasing tissue adherence occurs prior to releasing the elongate member in the atrioventricular groove in the second position.  
     
     
         121 . The method of  claim 119  wherein the step of increasing the tissue adherence comprises: 
 providing a coating on the elongate member to cause a tissue response.    
     
     
         122 . The method of  claim 121  wherein the step of providing a coating comprises providing a coating comprising a tissue growth promoter to cause tissue growth around the elongate member.  
     
     
         123 . A system for reducing the mitral annulus of a heart comprising: 
 a mitral valve reducing device comprising: 
 an elongate member having a first position wherein in the first position, the elongate member has a first radius of curvature, and a second position wherein in the second position the elongate member has a second radius of curvature less than the first radius of curvature; and  
   a delivery system comprising: 
 a catheter configured to access a pericardial space of a heart, adjacent an atrioventricular groove and outside of vasculature of the heart; and  
 a mitral valve reducing device delivery member configured to place the reducing device in the atrioventricular groove.  
   
     
     
         124 . The system of  claim 123  wherein the mitral valve reducing device comprises a cinching mechanism; and wherein the step of bending the elongate member comprises actuating the cinching mechanism.  
     
     
         125 . The system of  claim 123  wherein the mitral valve reducing device comprises a preferential bending mechanism at a location along a length of the elongate member.  
     
     
         126 . A mitral valve reduction device comprising: 
 an elongate member having a first position wherein in the first position, the elongate member has a first radius of curvature, a second position wherein in the second position the elongate member has a second radius of curvature less than the first radius of curvature, and a bending mechanism configured to move the elongate member from the first position to the second position; and    a coating on the elongate member, wherein the coating comprises a tissue response promoter for promoting a tissue response adjacent the elongate member.    
     
     
         127 . The mitral valve reduction device of  claim 126  wherein the coating comprises a tissue growth promoter.  
     
     
         128 . A mitral valve reduction device comprising: 
 an elongate member having a first position wherein in the first position, the elongate member has a first radius of curvature and a second position wherein in the second position the elongate member has a second radius of curvature less than the first radius of curvature; and    an end comprising a tissue engaging element configured to engage the heart within the atrioventricular groove.    
     
     
         129 . The mitral valve reduction device of  claim 128  wherein the tissue engaging element comprises at least one finger member extending from the end of the elongate member.  
     
     
         130 . The mitral valve reduction device of  claim 128  further comprising: 
 a bending mechanism configured to move the elongate member from the first position to the second position.