Tensioning device and methods for use

Abstract

A tensioning device is provided comprising a locking device. The locking device comprises a locking enclosure comprising a groove and a locking pin comprising teeth. The tensioning device further comprises a suture comprising first and second portions. The first and second portions of the suture and the locking pin are positioned within the groove of the locking enclosure and the locking pin is movable within the groove between a first, outer position in which the teeth are disengaged from the suture so that the locking device is movable along the first and second portions of the suture and a second, inner position in which the teeth are engaged with the suture so that the locking device is not movable along the suture. Methods for treating mitral valve regurgitation are also provided.

1 . A tensioning device for forming a suture loop comprising:
 a locking enclosure comprising a groove configured to receive two or more portions of suture within the locking enclosure: and   a locking pin moveable within the groove between a first, outer position and a second, inner position, the locking pin having one or more teeth extending from a surface of the locking pin to engage the two or more portions of suture received in the groove so that the tensioning device is not movable relative to the two or more portions of suture when the locking pin is in the second, inner position;   wherein when the locking pin is in the first, outer position, the teeth of the locking pin do not engage the two or more portions of suture and the tensioning device can move relative to the two or more portions of suture.   
     
     
         2 . The tensioning device of  claim 1 , wherein the locking enclosure further comprises a post and the locking pin further comprises a channel, wherein the post is engageable with the channel to couple the locking enclosure and locking pin together and permit relative movement between the locking enclosure and locking pin along the channel. 
     
     
         3 . The tensioning device of  claim 1 , wherein the locking pin further comprises a post and the locking enclosure further comprises a channel, wherein the post is engageable with the channel to couple the locking enclosure and locking pin and permit relative movement between the locking enclosure and locking pin along the channel. 
     
     
         4 . The tensioning device of  claim 3 , wherein the locking enclosure further comprises a flange at a distal end of the locking enclosure. 
     
     
         5 . A method for treating mitral valve regurgitation comprising:
 forming a loop of suture around a mitral valve annulus;   coupling the suture with a locking device comprising a locking enclosure and a locking pin comprising teeth by passing first and second ends of the suture through the locking enclosure and inserting the locking pin into the locking enclosure;   adjusting tension of the suture to reduce mitral valve annulus size by moving the locking device along the suture; and   locking tension of the suture around the mitral valve annulus by moving the pin from an outer position in which the teeth are disengaged from the suture and the locking device is movable along the suture to an inner position in which the teeth are engaged with the suture and the locking device is not movable along the suture.   
     
     
         6 . The method according to  claim 5 , further comprising:
 holding the locking pin in the outer position by ensnaring the locking pin with a snare of a snare catheter;   pulling the snare to pull the locking pin to the outer position; and   clamping the snare in place to keep the ensnared locking pin in the outer position.   
     
     
         7 . The method according to  claim 6 , wherein the snare catheter comprises a tube with an end and the locking enclosure comprises a flange and wherein the method further comprises advancing the locking device within the tube until the flange abuts the end of the tube. 
     
     
         8 . The method according to  claim 7 , wherein adjusting the tension of the suture by moving the locking device along the suture comprises pushing the snare catheter to move the locking device proximally along the suture to increase tension. 
     
     
         9 . The method according to  claim 7 , wherein adjusting the tension of the suture by moving the locking device along the suture further comprises pulling the snare catheter to move the locking device distally along the suture to decrease tension. 
     
     
         10 . A locking device for securing two portions of suture together, the locking device comprising:
 an enclosure having an internal cavity and a distal opening at a distal end of the enclosure;   a moveable member having a distal end, the moveable member being positioned at least partially within the internal cavity and being moveable within the cavity between a first position and a second position; and   a snare member having a loop that extends from the distal end of the moveable member, the loop extending at least partially out of the distal opening of the enclosure;   wherein an effective diameter of the loop is the portion of the loop that extends out of the opening, and the effective diameter of the loop when the moveable member is in the first position is smaller than the effective diameter of the loop when the moveable member is in the second position.   
     
     
         11 . The locking device of  claim 10 , wherein the effective diameter of the loop when the moveable member is in the first position is smaller than the combined diameter of two portions of suture that are to be secured by the locking device. 
     
     
         12 . The locking device of  claim 10 , further comprising a biasing member that extends from the moveable member and at least partly engages the enclosure to restrict movement of the moveable member from the first position to the second position. 
     
     
         13 . The locking device of  claim 12 , wherein the biasing member comprises one or more curved Nitinol arms. 
     
     
         14 . The locking device of  claim 13 , wherein the moveable member further comprises an internal cavity and a portion of a handle member is moveable mounted within the internal cavity, and
 wherein by moving the handle member in the distal direction, the portion of the handle member in the internal cavity releases the biasing member and permits movement of the moveable member from the first position to the second position.   
     
     
         15 . A method for treating mitral valve regurgitation comprising:
 forming a loop of suture around a mitral valve annulus;   positioning two portions of the suture through a loop of a snare member, the snare member extending from a distal opening in an enclosure and mounted to a distal end of a moveable member mounted at least partially within a cavity of the enclosure;   adjusting tension of the suture to reduce mitral valve annulus size by moving the loop of the snare member along the suture; and   locking tension of the suture around the mitral valve annulus by moving the moveable member within the cavity and causing a portion of the loop to move into the enclosure through the distal opening, thereby reducing an effective diameter of the portion of the loop that extends out of the distal opening.   
     
     
         16 . The method according to  claim 15 , wherein adjusting the tension of the suture by moving the locking device along the suture comprises pushing the snare catheter to move the locking device proximally along the suture to increase the tension of the suture. 
     
     
         17 . The method according to  claim 15 , wherein adjusting the tension of the suture by moving the locking device along the suture further comprises pulling the snare catheter to move the locking device distally along the suture to decrease the tension of the suture. 
     
     
         18 . The method according to  claim 15 , wherein the enclosure comprises a flange at a distal end of the enclosure.