Catheter based tissue fastening systems and methods

Abstract

Catheter based systems and methods for securing tissue including the annulus of a mitral valve. The systems and methods employ catheter based techniques and devices to plicate tissue and perform an annuloplasty.

1 . A catheter system for modifying an annulus of a mitral valve of a heart to reduce regurgitation of blood flow through the mitral valve, comprising: 
 a catheter having at least one lumen,    first, second and third fasteners configured for delivery through said lumen and adapted to be secured to the annulus while said catheter is positioned within the heart,    first, second and third flexible tensile members respectively coupled to said first, second and third fasteners, said first, second and third flexible tensile members each having first and second free ends, and    a locking element configured for delivery through said lumen and capable of securing said first, second and third flexible tensile members together after said fasteners are pulled toward one another using said flexible tensile members to plicate tissue along the annulus.    
   
   
       2 . The system of  claim 1 , further comprising a cutting mechanism configured for delivery through said lumen and operative to cut said first, second and third flexible tensile members after said locking element has secured said first, second and third flexible tensile members.  
   
   
       3 . The system of  claim 2 , further comprising: 
 a locking element delivery device capable of being actuated to selectively move the locking element into a locked condition after achieving a desired amount of reduction in the circumferential length of the annulus by pulling on said flexible tensile members.    
   
   
       4 . A catheter system for modifying an annulus of a mitral valve of a heart to reduce regurgitation of blood flow through the mitral valve, comprising: 
 a catheter having at least one lumen,    first, second and third fasteners configured for delivery through said lumen and adapted to be secured to the annulus while said catheter is positioned within the heart,    first, second and third flexible tensile members respectively coupled to said first, second and third fasteners, said first, second and third flexible tensile members each having first and second free ends, said first, second and third flexible tensile members coupled to the respective first, second and third fasteners proximate the first free end of each of the first, second and third flexible tensile members, and    a locking element configured for delivery through said lumen and capable of securing said first, second and third flexible tensile members together after said fasteners are pulled toward one another using said flexible tensile members to plicate tissue along the annulus.    
   
   
       5 . The system of  claim 4 , further comprising a cutting mechanism configured for delivery through said lumen and operative to cut said first, second and third flexible tensile members after said locking element has secured said first, second and third flexible tensile members.  
   
   
       6 . The system of  claim 5 , further comprising: 
 a locking element delivery device capable of being actuated to selectively move the locking element into a locked condition after achieving a desired amount of reduction in the circumferential length of the annulus by pulling on said flexible tensile members.    
   
   
       7 . The system of  claim 4 , wherein said locking element simultaneously receives each of said first, second and third flexible tensile members in a manner allowing said locking element to slide along said first, second and third flexible tensile members to a position at which the plicated condition of the annulus is retained.  
   
   
       8 . A method of reducing regurgitation of blood flow through a mitral valve of a heart, comprising: 
 introducing a catheter into the heart such that a distal end of the catheter is located in the heart proximate the mitral valve,    introducing first, second and third fasteners respectively coupled with first, second and third flexible tensile members through the lumen,    securing the first, second and third fasteners to the annulus of the mitral valve,    tensioning the first, second and third flexible tensile members to plicate the annulus,    delivering a locking element and over the first, second and third flexible tensile members to a position proximate the annulus, and    locking the first, second and third flexible tensile members together to retain the plication of the annulus.    
   
   
       9 . The method of  claim 8 , further comprising: 
 delivering a cutting mechanism over the first, second and third flexible tensile members to a position proximate the annulus, and    cutting the first, second and third flexible tensile members after the locking element has locked the first, second and third flexible tensile members together to retain the plication.    
   
   
       10 . The method of  claim 8 , wherein locking the first, second and third flexible tensile members together further comprises: 
 directing a locking element delivery device over the first, second and third flexible tensile members to a position proximate the annulus, and    selectively actuating the locking element delivery device to move the locking element into a locked condition after achieving a desired amount of plication.    
   
   
       11 . The method of  claim 8 , wherein introducing the first, second and third fasteners through the lumen further comprises: 
 introducing the first, second and third fasteners through the lumen one at a time.    
   
   
       12 . The method of  claim 8 , wherein introducing the first, second and third fasteners through the lumen further comprises: 
 introducing the first, second and third fasteners through the lumen together.