Heart valve repair apparatus and methods

Abstract

Valve repair apparatus and methods for ensuring proper coaptation and operation of the leaflets of a heart valve. Main aspects of the disclosure relate to devices including a support member configured for attachment to the heart valve annulus, a post extending from the support member away from the plane of the annulus and a connector coupled with the post and configured for attachment to at least one of the leaflets. The various embodiments may include a replacement heart valve connected with the support member for facilitating full replacement as opposed to near repair of an existing native heart valve. Various other devices include support structure and one or more posts connected to opposite sides of the support structure and extending from one side of the valve annulus to another to modify the shape of the annulus.

1 . An annuloplasty device for repairing a mitral valve, the mitral valve having a valve annulus with an annulus anterior portion and an annulus posterior portion, the annulus posterior portion and the annulus anterior portion defining a mitral valve opening therebetween, the annulus posterior portion having a generally arcuate shape, the mitral valve having an anterior valve leaflet attached to the annulus anterior portion and a posterior valve leaflet attached to the annulus posterior portion, the anterior and posterior leaflets having respective anterior and posterior free margins, the anterior and posterior leaflets movable between a closed systolic configuration in which the free margins are in an approximated spatial relationship, and an open diastolic configuration in which the free margins are spaced apart to allow blood flow through the mitral valve opening generally along a valve-flow axis, the device comprising:
 an anterior section and a posterior section coupled to the anterior section, the posterior and anterior sections divided along a first axis, the annuloplasty device having a maximum width dimension along the first axis, the posterior section having a generally curvilinear shape such that the posterior section is non-planar forming a curved structure with respect to the anterior section when viewed in a direction generally parallel to the first axis, whereby the anterior section of the annuloplasty device is attachable to the annulus anterior portion, and the posterior section of the annuloplasty device is attachable to the annulus posterior portion such that the generally curvilinear shape is retained after attachment of the anterior and posterior sections to the annulus thereby fixing the annulus posterior portion into a non-planar configuration to improve coaptation of the leaflet free margins in the systolic configuration.   
     
     
         2 . The device of  claim 1 , wherein the annuloplasty device posterior section is formed into first and second subsections, the first subsection being asymmetric relative to the second section about a second axis bisecting the annuloplasty device along the first axis, the first and second axes being perpendicular to each other. 
     
     
         3 . The device of  claim 1 , wherein the curvilinear shape includes a bend configured to extend in the direction of normal blood flow along a valve-flow axis. 
     
     
         4 . The device of  claim 1 , wherein the posterior and anterior sections together form a closed ring-shaped member configured to be attached along and in close proximity to the annulus. 
     
     
         5 . The device of  claim 4 , wherein the ring shaped member is substantially “D” shaped when viewed in a direction parallel to the valve-flow axis, and wherein:
 a substantially straight portion of the “D”-shape is attachable to the annulus anterior portion, and 
 a substantially arcuate portion of the “D”-shape is attachable to the annulus posterior portion. 
 
     
     
         6 . The device of  claim 5 , wherein the annuloplasty device posterior section is formed into an asymmetric shape relative to a second axis bisecting the annuloplasty device along the first axis, the first and second axes being perpendicular to each other.