Tissue Anchors and Percutaneous Tricuspid Valve Repair Using A Tissue Anchor

Abstract

The present teachings provide devices and methods of treating a tricuspid valve regurgitation. Specifically, one aspect of the present teachings provides devices and methods of identifying a suitable location on the tricuspid annulus, placing a wire across the tricuspid annulus at such an identified location, deploying a tissue anchor across such an identified location, deploying two or more tissue anchors and coupling the tissue anchors with a flexible tensioning member, and applying tension to a flexible tensioning member that is coupled with the two or more tissue anchors, plicating tissues between each pair of the two or more tissue anchors, and reducing the circumference of the tricuspid annuls. As a result, a regurgitation jet is reduced or eliminated.

We claim: 
     
         1 . A method comprising:
 locating a first location near a heart valve annulus;   deploying a distal portion of a first tissue anchor across the heart valve annulus at the first location;   deploying a proximal portion of the first tissue anchor at the first location;   locating a second location near the heart valve annulus;   deploying a distal portion of a second tissue anchor across the heart valve annulus at the second location;   deploying a proximal portion of the second tissue anchor at the second location;
 wherein the first tissue anchor and the second tissue anchor are connected with a continuous portion of a flexible tensioning member; and 
   changing the distance between the first and second tissue anchors.   
     
     
         2 . The method of  claim 1 , wherein at least one of the first and the second locations is on a tricuspid annulus. 
     
     
         3 . The method of  claim 2  comprising advancing a locating wire across the tricuspid annulus. 
     
     
         4 . The method of  claim 3  wherein the locating wire crosses the tricuspid annulus from right atrium to right ventricle. 
     
     
         5 . The method of  claim 3  wherein the locating wire crosses the tricuspid annulus from right ventricle to right atrium. 
     
     
         6 . The method of  claim 5  comprising capturing and pulling a distal end of the locating wire outside of the body. 
     
     
         7 . The method of  claim 3  comprising advancing a tissue anchor delivery catheter through the wire to the first location. 
     
     
         8 . The method of  claim 1 , wherein the locating of the second location is after the deployment of the first tissue anchor. 
     
     
         9 . The method of  claim 1 , wherein the locating of the second location is prior to the deployment of the first tissue anchor. 
     
     
         10 . A method comprising:
 positioning a tissue anchor delivery catheter at a first location near a heart valve annulus, wherein the tissue anchor delivery catheter carries a plurality of tissue anchor;   advancing a distal portion of a first tissue anchor outside of the tissue anchor delivery catheter across the annulus of the heart valve at the first location;   deploying the distal portion of the first tissue anchor;   advancing a proximal portion of the first tissue anchor outside of the tissue anchor delivery catheter at the first location;   deploying the proximal portion of the first tissue anchor;   positioning the tissue anchor delivery catheter at a second location near the heart valve annulus,   advancing a distal portion of a second tissue anchor outside of the tissue anchor delivery catheter across the annulus of the heart valve at the second location;   deploying the distal portion of the second tissue anchor;   advancing a proximal portion of the second tissue anchor outside of the tissue anchor delivery catheter at the second location;   deploying the proximal portion of the second tissue anchor;
 wherein the first and second tissue anchors are connected with a continuous portion of a flexible tensioning member; and 
 reducing the distance between the first and second tissue anchors. 
   
     
     
         11 . The method of  claim 10 , wherein the distal portions of the first and second tissue anchors are advanced outside of the tissue anchor delivery catheter by a delivery system pulling on the distal portions of the first and second tissue anchors. 
     
     
         12 . The method of  claim 10 , wherein the distal portion of the first and second tissue anchor is deployed inside the right atrium. 
     
     
         13 . The method of  claim 10 , wherein the distal portion of the first and second tissue anchor is deployed inside the right ventricle. 
     
     
         14 . The method of  claim 10  further comprising locking the distance between the first and second tissue anchors 
     
     
         15 . A chain of tissue anchors configured to be deployed adjacent to each other across a heart valve annulus, comprising
 at least two tissue anchors, wherein each tissue anchor has a first end, a second end, and an anchor body in between having an elongated delivery configuration, a shortened deployed configuration;   a continuous tensioning member threading though the first end of a first tissue anchor, extending along the anchor body, threading through the second end of the first tissue anchor, then continue further threading through the first end of a second tissue anchor, extending along the anchor body of the second tissue anchor and threading through the second end of the second tissue anchor;   wherein the tensioning member comprises a first end configured to prevent the first end of the tensioning member from sliding through the first end of the first tissue anchor;   wherein the tensioning member further comprise a second end, wherein upon applying tension to the second end of the tensioning member, the anchor body transitions from its elongated profile to shortened profile.   
     
     
         16 . The chain of tissue anchors of  claim 15 , wherein when the anchor body transitions from its elongated profile to shortened profile, the distance between the first end and the second end of the tissue anchor shortens. 
     
     
         17 . The chain of tissue anchors of  claim 15 , wherein when the anchor body transitions from its elongated profile to shortened profile by folding, curving, or bending. 
     
     
         18 . The chain of tissue anchors of  claim 15  is configured to be deployed across a heart valve annulus. 
     
     
         19 . The chain of tissue anchors of  claim 18 , wherein when a plurality of tissue anchors deployed across the heart valve annulus, the entire tensioning member remains at the same side of the annulus. 
     
     
         20 . The chain of tissue anchors of  claim 15 , wherein upon applying tension to the second end of the tensioning member, the distance between the first tissue anchor and the second anchor are reduced.