Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools

Abstract

Implants or systems of implants and methods apply a selected force vector or a selected combination of force vectors within or across the left atrium, which allow mitral valve leaflets to better coapt. The implants or systems of implants and methods make possible rapid deployment, facile endovascular delivery, and full intra-atrial retrievability. The implants or systems of implants and methods also make use of strong fluoroscopic landmarks. The implants or systems of implants and methods make use of an adjustable implant and a fixed length implant. The implants or systems of implants and methods may also utilize a bridge stop to secure the implant, and the methods of implantation employ various tools.

1 . An implant system comprising 
 a first catheter,    a second catheter,    the first and second catheters each including a guide lumen having a distal opening, and    magnetic or ferromagnetic materials placed adjacent the distal openings of both guide lumens, the magnetic or ferromagnetic materials being sized and configured to magnetically couple the distal opening of the first catheter to the distal opening of the second catheter in an alignment that accommodates passage of an operative component between the guide lumens of the first and second catheters.    
     
     
         2 . A system according to  claim 1   wherein the first catheter includes an elongated shaft having a distal end, and a head carried at the distal end in which the distal opening is formed, the head including the magnetic or ferromagnetic material.    
     
     
         3 . A system according to  claim 2   wherein the head includes a distal magnetic portion, a center magnetic portion and a proximal magnetic portion.    
     
     
         4 . A system according to  claim 3   wherein the distal magnetic portion has a first end and a second end, the first end having a first magnetic polarity and the second end having a second opposite magnetic polarity;    the center magnetic portion has a first end and a second end, the first end having a first magnetic polarity and the second end having a second opposite magnetic polarity;    the proximal magnetic portion has a first end and a second end, the first end having a first magnetic polarity and the second end having a second opposite magnetic polarity; and    the magnetic polarity of the first ends of the distal magnetic portion, the center magnetic portion and the proximal magnetic portion is the same.    
     
     
         5 . A system according to  claim 4   wherein the distal magnetic portion is arranged such that the first end is adjacent the center magnetic portion; and    the proximal magnetic portion is arranged such that the first end is adjacent the center magnetic portion.    
     
     
         6 . A system according to  claim 5   wherein the head includes opposite first and second side surfaces,    wherein the distal opening is formed on the first side surface of the head, and    wherein the center magnetic portion is arranged such that the first end is located on the first side surface of the head.    
     
     
         7 . A system according to  claim 6   wherein the second catheter includes an elongated shaft having a distal end, and a head carried at the distal end in which the distal opening is formed, the head including the magnetic or ferromagnetic material.    
     
     
         8 . A system according to  claim 7   wherein the second catheter magnetic portion has a first end with a first magnetic polarity and a second end with a second opposite magnetic polarity, the magnetic portion arranged such that the second end adjacent the distal end of the second catheter.    
     
     
         9 . A system according to  claim 8   wherein the magnetic polarity of the first end of the second catheter magnetic portion is the same as the magnetic polarity of the first end of the center magnetic portion.    
     
     
         10 . A system according to  claim 1   wherein the operative component comprises a first guide wire.    
     
     
         11 . A system according to  claim 10   wherein the first guide wire has a first stretched configuration and a second unstretched configuration.    
     
     
         12 . A system according to  claim 11   wherein the first guide wire is configured to adopt a coiled configuration when the first guide wire is in its unstretched configuration.    
     
     
         13 . A system according to  claim 10   wherein the first catheter distal opening includes a ramped portion, said ramped portion being sized and configured to guide the first guide wire into the second catheter distal opening.    
     
     
         14 . A system according to  claim 10   wherein the second catheter distal opening is formed with a funnel, said funnel being sized and configured to receive the first guide wire from the first catheter distal opening.    
     
     
         15 . A system according to  claim 9   wherein the distal end of the first catheter head is sized and configured for rotation relative to the elongated shaft.    
     
     
         16 . A system according to  claim 15   wherein a first retaining structure is coupled to the first catheter head and a second retaining structure is coupled to the elongated shaft, the first retaining structure being engagable with the second structure to limit the rotation of the first catheter head relative to the elongated shaft.    
     
     
         17 . A system according to  claim 16  wherein the first retaining structure comprises a pin and the second retaining structure comprises a plate including a partial circumferential slot.  
     
     
         18 . An implant system comprising 
 a first catheter,    a second catheter,    the first and second catheters each including a guide lumen having a distal opening,    magnetic or ferromagnetic materials placed adjacent the distal openings of both guide lumens, the magnetic or ferromagnetic materials being sized and configured to magnetically couple the distal opening of the first catheter to the distal opening of the second catheter in an alignment that accommodates passage of an operative component between the guide lumens of the first and second catheters, and    a region of at least one of the first and second catheters adjacent the magnetic or ferromagnetic materials being sized and configured for rotation during the magnetic coupling.    
     
     
         19 . A method comprising 
 providing an implant system as defined in  claim 1 ,    deploying the first and second catheters,    magnetically coupling the distal opening of the first catheter to the distal opening of the second catheter, and    passing a operative component between the guide lumens of the first and second catheters.    
     
     
         20 . A method comprising 
 providing an implant system as defined in  claim 18 ,    deploying the first and second catheters,    magnetically coupling the distal opening of the first catheter to the distal opening of the second catheter, and    passing a operative component between the guide lumens of the first and second catheters.