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 . A method comprising
 providing a 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,   deploying the first catheter in a left atrium of a heart,   deploying the second catheter in a great cardiac vein adjacent a posterior annulus of a mitral valve,   magnetically coupling the distal opening of the first catheter in the left atrium to the distal opening of the second catheter within the great cardiac vein,   penetrating tissue between the magnetically coupled distal openings, and   passing a guide wire through the penetrated tissue from the guide lumen of one of the first and second catheters into the guide lumen of the other one of the first and second catheters.   
     
     
         2 . A method according to  claim 1   wherein the first catheter is deployed through a first vascular access site,   wherein the second catheter is deployed through a second vascular access site different than the first vascular access site, and   wherein passing the guide wire includes passing the guide wire entirely through the guide lumens of the both first and catheters so that the guide wire extends through an intravascular path from the first vascular access site to the second vascular access site.   
     
     
         3 . A method according to  claim 2   further including withdrawing the first and second catheters over the guide wire.   
     
     
         4 . A method according to  claim 1   wherein the first catheter is deployed through a first vascular access site over a first guide wire,   wherein the second catheter is deployed through a second vascular access site different than the first vascular access site and over a second guide wire, and   wherein passing the guide wire includes passing the first guide wire at least partially into the guide lumen of second catheter.   
     
     
         5 . A method according to  claim 4   further including withdrawing the first catheter over the first guide wire, and withdrawing the second catheter over the second guide wire.   
     
     
         6 . A method according to  claim 1   wherein penetrating tissue includes passing a cutting tool through the guide lumen of the first catheter.   
     
     
         7 . A method according to  claim 1   wherein penetrating tissue includes passing a cutting tool through the guide lumen of the second catheter.   
     
     
         8 . A method according to  claim 1   wherein penetrating tissue includes providing a cutting tool having an interior lumen, and passing the cutting tool through the guide lumen of one of the first and second catheters, and   wherein passing the guide wire comprises passing the guide wire through the interior lumen of the tool into the guide lumen of the other one of the first and second catheters.   
     
     
         9 . A method according to  claim 1   wherein penetrating tissue includes providing a guide wire including a distal element operative to penetrate tissue, and passing the guide wire through the guide lumen of one of the first and second catheters to penetrate tissue, and   wherein passing the guide wire comprises continuing to pass the guide wire with the distal element through the penetrated tissue into the guide lumen of the other one of the first and second catheters.