Devices and methods for heart valve repair

Abstract

Methods and devices provide constriction of a heart valve annulus to treat cardiac valve regurgitation and other conditions. Embodiments typically include a device for attaching a cinching or tightening apparatus to a heart valve annulus to reduce the circumference of the annulus, thus reducing valve regurgitation. Tightening devices may include multiple tethered clips, multiple untethered crimping clips, stabilizing devices, visualization devices, and the like. In one embodiment, a plurality of tethered clips is secured circumferentially to a valve annulus, and the tether coupling the clips is cinched to reduce the circumference of at least a portion of the annulus. Methods and devices may be used in open heart surgical procedures, minimally invasive procedures, catheter-based procedures, and/or procedures on beating hearts or stopped hearts.

1 - 36 . (canceled) 
     
     
         37 : A method of applying a plurality of clips to annular tissue of a heart valve comprising:
 sequentially delivering at least two clips to the annular tissue from a clip applicator, wherein each of the at least two clips is coupled to a tether, and wherein each of the at least two clips is capable of penetrating tissue;
 cinching the tether so that the distance between the at least two clips is shortened; and 
 cutting the tether after it has been cinched. 
   
     
     
         38 : The method of  claim 37  wherein the method is performed minimally invasively. 
     
     
         39 : The method of  claim 37  performed during a beating heart procedure. 
     
     
         40 : The method of  claim 37  performed during an open surgical procedure. 
     
     
         41 : The method of  claim 37  performed during an intravascular procedure. 
     
     
         42 : The method of claim  1  further comprising the step of visualizing the annular tissue. 
     
     
         43 : The method of  claim 42  wherein the heart valve has regurgitant flow and the step of visualizing the annular tissue comprises the step of visualizing the regurgitant flow during the cinching step and selecting an amount of cinching based on a reduction in the regurgitant flow. 
     
     
         44 : The method of  claim 37  wherein at least one of the at least two clips is T-shaped. 
     
     
         45 : A method of applying a plurality of clips to annular tissue of a heart valve to reduce regurgitation comprising:
 sequentially delivering at least two clips to the annular tissue from a clip applicator, wherein each of the at least two clips is capable of penetrating tissue, and wherein each of the at least two clips is deformable so that the upon clip deformation, the clips tighten and reduce a length of the annular tissue and thereby reduce regurgitation.   
     
     
         46 : The method of  claim 45  wherein each of the at least two clips is coupled to a tether and further comprising the step of cinching the tether so that the distance between the at least two clips is shortened.