Annuloplasty sizers for minimally invasive procedures

Abstract

A sizing plate for sizing a native valve annulus in a patient's heart for either valve replacement or repair during a minimally invasive surgical procedure is shown and described. The sizing plate is generally shaped such that it corresponds to the shape of the native valve annulus. Additionally, a thickness of the sizing plate is such that it can be inserted through a space between the ribs of the patient during the procedure. The sizing plate includes two keyways extending though the plate separated by a bridge. The keyways are sized and shaped such that they are adapted to be engaged by a minimally invasive surgical tool such as a laparoscopic grasper. The keyways in conjunction with the bridge facilitate manipulation of the sizing plate by the grasper from an external location.

1 . A sizing plate for sizing a native valve annulus in a patient's heart during a minimally invasive mitral valve replacement or repair procedure, the sizing plate comprising:
 an upper surface and a lower surface defining a thickness of the sizing plate between the upper and lower surfaces;   first and second keyways extending through the sizing plate from the upper planar surface to the lower planar surface of the sizing plate; and   a bridge member between the first and second keyways configured to be engaged by a laparascopic grasping tool.   
     
     
         2 . The sizing plate according to  claim 1 , wherein the sizing plate is generally D-shaped. 
     
     
         3 . The sizing plate according to  claim 1 , wherein the sizing plate has a shape generally corresponding to a shape of an anterior leaflet of a native mitral valve. 
     
     
         4 . The sizing plate according to  claim 1 , wherein the bridge member comprises a bar coupled to the sizing plate. 
     
     
         5 . The sizing plate according to  claim 1 , wherein at least a portion of the sizing plate is radiopaque. 
     
     
         6 . The sizing plate according to  claim 1 , wherein the first and second keyways have a trapezoidal shape. 
     
     
         7 . The sizing plate according to  claim 1 , wherein the sizing plate is generally D-shaped having a major dimension and a minor dimension, and wherein the bridge is oriented substantially parallel to the major dimension. 
     
     
         8 . The sizing plate according to  claim 1 , further comprising an aperture extending through the upper and lower surfaces disposed near a lower edge of the sizing plate. 
     
     
         9 . The sizing plate according to  claim 1 , wherein the thickness of the sizing plate defined between the upper planar surface and the lower planar surface is such that the sizing plate is adapted to be inserted through a space between a patient's ribs when the sizing plate is oriented on an edge. 
     
     
         10 . A kit for sizing a native valve annulus in a patient's heart during a minimally invasive mitral valve replacement or repair procedure, the kit comprising:
 a plurality of sizing plates of differing size for sizing the native valve annulus, each sizing plate having a shape generally corresponding to a shape of an anterior leaflet of the native mitral valve and having a major dimension and a minor dimension, wherein at least one of the major dimension and the minor dimension varies among the plurality of sizing plates, each sizing plate further including:   an upper planar surface and a lower planar surface defining a thickness of the sizing plate between the upper and lower planar surfaces;   first and second keyways extending through the sizing plate from the upper planar surface to the lower planar surface of the sizing plate; and   a bridge between the first and second keyways configured to be engaged by a laprascopic grasping tool.   
     
     
         11 . The kit according to  claim 10 , wherein the bridge of each sizing plate is oriented substantially parallel to the major dimension. 
     
     
         12 . The kit according to  claim 10 , further comprising a grasping tool. 
     
     
         13 . The kit according to  claim 10 , wherein each sizing plate is generally D-shaped. 
     
     
         14 . The kit according to  claim 10 , wherein the first and second keyways of each sizing plate have a trapezoidal shape. 
     
     
         15 . The kit according to  claim 10 , wherein each of the sizing plates further comprises at least one aperture disposed near a lower edge of the sizing plate. 
     
     
         16 . The kit according to  claim 10 , wherein the thickness of each of the sizing plates is such that the sizing plate is adapted to be inserted through a space between a patient's ribs when the sizing plate is oriented on an edge. 
     
     
         17 . A method of sizing a native valve annulus during a minimally invasive mitral valve repair or replacement procedure comprising:
 a) creating a surgical access port in an intercostals space in a patient's body;   b) exposing the native valve annulus;   c) inserting a first sizing plate through the surgical access port, the first sizing plate including: an upper surface and a lower surface defining a thickness of the sizing plate; first and second keyways extending through the sizing plate from the upper planar surface to the lower planar surface of the sizing plate; and a bridge member between the first and second keyways configured to be engaged by a laparoscopic grasping tool;   d) engaging the bridge of the sizing plate using a laparoscopic grasping tool inserted through the surgical access port;   e) positioning the sizing plate in the valve annulus;   f) comparing the major and minor dimensions and the shape of the sizing plate to a major and a minor dimension and shape of an anterior leaflet of the mitral valve; and   g) determining the major and minor dimensions and shape of the anterior leaflet of the mitral valve.   
     
     
         18 . The method according to  claim 17 , further comprising the steps of: removing the first sizing plate from the patient's body; inserting a second sizing plate through the surgical access port, the second sizing plate comprising a major dimension and a minor dimension and a shape generally corresponding to the shape of an anterior leaflet of the native mitral valve; an upper planar surface and a lower planar surface defining a thickness of the sizing plate; and a first keyway and a second keyway to facilitate engagement of a grasping tool with the sizing plate, the first and second keyways generally centered on the sizing plate and extending through the sizing plate from the upper planar surface to the lower planar surface of the sizing plate; and repeating steps c)-g). 
     
     
         19 . The method according to  claim 17 , further comprising the step of temporarily suspending the first sizing plate through the access port. 
     
     
         20 . The method according to  claim 17 , further comprising the step of orienting the first sizing plate on an edge when inserting the first sizing plate through the surgical access port.