Device and method of treating heart valve malfunction

Abstract

An assembly and method for treating heart valve malfunction typically including treating of mitral regurgitation wherein an instrument assembly includes an elongated chord movably disposed within an introductory sheath and including an anchor secured to a distal end thereof. An attendant method includes concurrently introducing the sheath and the chord into the heart chamber through an exterior wall and penetrating and passing the sheath and the chord through the anterior mitral valve leaflet. The sheath and the chord are then extended transversely across the heart chamber and the distal end of the chord is anchored to an opposing portion of the heart wall. The sheath is then withdrawn back along the length of the anchored chord and through the anterior mitral valve leaflet and a securing member connects the proximal end of the chord to the valve leaflet. The chord is secured between the valve leaflet and the opposing heart wall under sufficient tension to maintain an intended positioning of the valve leaflet to overcome mitral regurgitation.

1 . An instrument assembly for treating heart valve malfunction, said instrument assembly comprising:
 at least one elongated chord and an introductory sheath, said sheath at least initially disposed in enclosing relation to said one chord and movable with said chord and along the length thereof,   said sheath and said one chord cooperatively structured to concurrently enter the heart chamber through the heart wall and penetrate and pass through a predetermined heart valve leaflet,   an anchor connected to a distal end of said one chord and disposable into an anchored relation with the heart wall substantially oppositely disposed to the predetermined valve leaflet,   a securing assembly connectable to a proximal extremity of said one chord in an interconnecting position between said one chord and the predetermined valve leaflet, and   said anchored relation of said anchor and said interconnecting position of said securing assembly collectively defining an operative length of one said chord within the heart chamber and a tensioning of the predetermined valve leaflet sufficient to restrict prolapsing of the predetermined valve leaflet, by said one chord.   
     
     
         2 . An instrument assembly as recited in  claim 1  wherein said interconnecting position comprises said securing assembly disposed in securing relation between said proximal extremity of said one chord and an exterior surface exposed to the left atrium of the predetermined valve leaflet. 
     
     
         3 . An instrument assembly as recited in  claim 1  wherein the predetermined valve leaflet comprises a prolapsing one of the anterior mitral valve leaflet and posterior mitral valve leaflet. 
     
     
         4 . An instrument assembly as recited in  claim 1  wherein said securing assembly comprises a securing member movably mounted on and extendable along the length of said one chord into said interconnecting position. 
     
     
         5 . An instrument assembly as recited in  claim 4  wherein said securing assembly further comprises a sleeve connected to said securing member, said sleeve concentrically mounted on and positionable along the length of said one chord with said securing member into said interconnecting position. 
     
     
         6 . An instrument assembly as recited in  claim 5  wherein said interconnecting position further comprises said sleeve disposed through the predetermined valve leaflet concurrently to said securing member being disposed in securing relation between said proximal extremity of said one chord and the predetermined valve leaflet. 
     
     
         7 . An instrument assembly as recited in  claim 1  wherein said anchor comprises an outer extremity comprising a configuration sufficient to penetrate the opposing heart wall portion. 
     
     
         8 . An instrument assembly as recited in  claim 7  wherein said outer extremity is disposable in penetrating relation to the predetermined valve leaflet prior to a chord securing relation with the opposing heart wall portion. 
     
     
         9 . An instrument assembly as recited in  claim 7  wherein said sheath comprises an open distal end dimensioned to facilitate disposition of said anchor into a penetrating orientation to the predetermined valve leaflet and subsequently, the opposing heart wall portion. 
     
     
         10 . An instrument assembly as recited in claim wherein said anchor comprises a gripping structure disposed laterally outward from said outer extremity of said anchor; said gripping structure structured to define a secure connection of said anchor with the opposing heart wall portion. 
     
     
         11 . An instrument assembly as recited in  claim 10  wherein said gripping structure is expandable radially outward from said outer extremity of said anchor. 
     
     
         12 . An instrument assembly as recited in claim wherein said anchor comprises a gripping structure disposed laterally outward from said outer extremity of said anchor; said gripping structure structured to define a secure connection of said anchor with the opposing heart wall. 
     
     
         13 . A method of treating mitral valve regurgitation using the instrument assembly as recited in  claim 1 , the method comprising:
 introducing the sheath and at least one chord into the chamber of the heart through the atrium wall thereof;   passing the sheath and one chord substantially concurrently through at least one mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber,   extending the sheath and one chord transversely across the left ventricle and securing the anchor into an anchored relation with a substantially opposing portion of the ventricular wall of the heart,   withdrawing the sheath back along the length of the anchored one chord from the ventricular wall and back through the one mitral valve leaflet, and   securing the securing assembly along the length of the one chord into an interconnecting position between a proximal extremity of the one chord and the one mitral valve leaflet.   
     
     
         14 . A method as recited in  claim 13  disposing the securing assembly along the length of the one chord into the interconnecting position with an exterior of the one mitral valve leaflet which is exposed to the left atrium. 
     
     
         15 . A method as recited in  claim 13  comprising passing the sheath and one chord substantially concurrently through the anterior mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber. 
     
     
         16 . A method as recited in  claim 13  comprising passing the sheath and one chord substantially concurrently through the posterior mitral valve leaflet in the siege of prolapse and there from into the left ventricle of the heart chamber. 
     
     
         17 . A method as recited in  claim 13  comprising disconnecting a remaining distal portion of the one chord, extending between the securing assembly and the atrium wall, subsequently to securing the securing assembly in the interconnecting position. 
     
     
         18 . A method of treating heart valve malfunction comprising:
 passing an instrument into the heart chamber and into penetrating relation to a predetermined valve leaflet under the siege of prolapse,   passing the instrument through the predetermined valve leaflet,   extending at least one chord of the instrument from the predetermined valve leaflet across the heart chamber into anchored relation with a portion of the heart wall substantially opposing the predetermined valve leaflet,   withdrawing a sheath of the instrument back along a length of the anchored one chord from the opposing portion of the heart wall and back through the predetermined valve leaflet, and   securing a corresponding proximal extremity of the one chord to the predetermined valve leaflet.   
     
     
         19 . A method as recited in  claim 18  comprising disposing an anchor of the instrument into a griping orientation when in the anchored relation with the opposing portion of the heart wall. 
     
     
         20 . A method as recited in  claim 19  further comprising expanding the anchor into the gripping orientation with the opposing portion of the heart wall. 
     
     
         21 . A method as recited in  claim 19  further comprising defining the gripping orientation of the anchor portion as a penetrating engagement with an interior portion of the ventricular wall. 
     
     
         22 . A method as recited in  claim 21  further comprising tensioning the one chord between the ventricular wall and the predetermined valve leaflet by securing the corresponding proximal extremity of the one chord to an exterior of the predetermined valve leaflet. 
     
     
         23 . A method as recited in  claim 18  further comprising establishing an operative length of said one chord between the predetermined valve leaflet and the opposing portion of the heart wall to define a tensioning of the predetermined valve leaflet sufficient to restrict prolapsing of the predetermined valve leaflet, by the one chord. 
     
     
         24 . A method as recited in  claim 18  comprising treating mitral valve regurgitation by entering the heart through the atrial wall into the left atrium and penetrating the predetermined mitral valve leaflet under the siege of prolapse with a distal portion of the one chord and passing the one chord through the mitral valve leaflet and transversely across the left ventricle and disposing an anchor, secured to the distal end of the one chord, into anchored relation with an oppositely disposed portion of the ventricular wall. 
     
     
         25 . A method as recited in  claim 24  comprising positioning the anchor into a gripping orientation on the interior of the heart chamber by penetrating interior portions of the ventricular wall. 
     
     
         26 . A method as recited in  claim 25  further defining the gripping orientation by expanding the anchor into penetrating engagement with the interior portions of the papillary muscle of the ventricular wall. 
     
     
         27 . A method as recited in  claim 24  further comprising tensioning the one chord between the penetrated portion of the ventricular wall and the one mitral valve leaflet by securing a proximal extremity of the one chord to the one mitral valve leaflet. 
     
     
         28 . A method as recited in  claim 27  further comprising establishing an operative length of said one chord between the predetermined mitral valve leaflet and penetrated portion of the ventricular wall to define a tensioning of the predetermine valve leaflet sufficient to restrict prolapsing of the predetermined mitral valve leaflet, by the one chord.