Tools, systems, and methods for remodeling tissue

Abstract

A tool for remodeling a tissue annulus includes an elongate handle and a reshaping element on a distal end of the handle. The reshaping element may be directable between a first configuration to facilitate direction through a tissue annulus, and a second curved configuration to remodel tissue adjacent the tissue annulus. The tool may be used for treating a tissue annulus within a patient's heart, e.g., by introducing the reshaping element through the tissue annulus, and manipulating the tool to reshape the tissue annulus substantially to a contour of the reshaping element. The reshaping element may support the tissue while a prosthesis is secured to the tissue annulus, or the reshaping element may itself be secured to the tissue annulus and released from the tool.

1 - 10 . (canceled) 
     
     
         11 . A tool for treating a tissue annulus, comprising:
 an elongate handle including a proximal end and a distal end; and   a reshaping element on the distal end terminating in a distal tip and having a shape to remodel tissue adjacent a tissue annulus.   
     
     
         12 . The tool of  claim 11 , wherein the distal tip has an atraumatic shape. 
     
     
         13 . The tool of claim  1 , wherein the reshaping element is directable between a first configuration to facilitate direction through a tissue annulus, and a second curved configuration to remodel tissue adjacent the tissue annulus. 
     
     
         14 . The tool of  claim 13 , wherein the reshaping element defines a portion of a circle in the second configuration. 
     
     
         15 . The tool of  claim 13 , further comprising an actuator on the proximal end of the handle coupled to the reshaping element for directing the reshaping element between the first and second configurations. 
     
     
         16 . The tool of  claim 15 , further comprising an actuator member extending from the proximal end of the handle to the distal tip, the actuator coupled to the actuator member for pulling the actuator member to cause the reshaping element to be directed from the first configuration to the second configuration. 
     
     
         17 . The tool of  claim 16 , wherein the reshaping element comprises a plurality of segments defining a passage, the actuator member received through the passage and fixed to the distal tip such that pulling the actuator member causes the plurality of segments to compress to direct the reshaping element from the first configuration to the second configuration. 
     
     
         18 . The tool of  claim 17 , wherein the plurality of segments comprise at least one of cylinders, balls, and coil segments. 
     
     
         19 . The tool of  claim 13 , wherein the reshaping element is flexible in the first configuration to facilitate introduction through a tissue annulus. 
     
     
         20 . The tool of  claim 11 , wherein the reshaping element is releasable from the handle. 
     
     
         21 . The tool of  claim 20 , wherein the reshaping element is at least partially covered with fabric. 
     
     
         22 . The tool of  claim 20 , further comprising an actuator on the proximal end of the handle for releasing the reshaping element from the handle. 
     
     
         23 . A system for treating a tissue annulus, comprising:
 a tool comprising an elongate handle including a proximal end, a distal end, and a reshaping element extending from the distal end and terminating in a distal tip, the reshaping element having a shape to remodel tissue adjacent a tissue annulus; and   a plurality of fasteners receivable through tissue adjacent the tissue annulus.   
     
     
         24 . The system of  claim 23 , further comprising a tool for delivering the fasteners into tissue adjacent the tissue annulus. 
     
     
         25 . (canceled) 
     
     
         26 . The system of  claim 24 , wherein the fasteners are configured for securing the reshaping element on the tool to tissue adjacent the tissue annulus, and wherein the reshaping element is releasable from the handle. 
     
     
         27 . The system of  claim 23 , further comprising a prosthesis configured for supporting the tissue annulus, the fasteners being receivable through the prosthesis for securing the prosthesis to tissue adjacent the tissue annulus. 
     
     
         28 . The system of  claim 27 , wherein the prosthesis has at least one of an annular shape and a “C” shape. 
     
     
         29 . The system of  claim 23 , wherein the reshaping element is directable between a first configuration to facilitate direction through a tissue annulus, and a second curved configuration to remodel tissue adjacent the tissue annulus. 
     
     
         30 . The system of  claim 29 , further comprising:
 an actuator on the proximal end of the handle coupled to the reshaping element for directing the reshaping element between the first and second configurations; and   an actuator member extending from the proximal end of the handle to the distal tip, the actuator coupled to the actuator member for pulling the actuator member to cause the reshaping element to be directed from the first configuration to the second configuration.   
     
     
         31 . A method for treating a tissue annulus within a patient's heart, comprising:
 introducing a distal end of a remodeling tool through the tissue annulus; and   reshaping the tissue annulus substantially to a contour of the tool distal end.   
     
     
         32 - 37 . (canceled)