Medical System For Annuloplasty

Abstract

A medical system is disclosed for treating a defective mitral valve (MV) having an annulus (A). The system has a removable and flexible elongate displacement unit for temporary insertion into a coronary sinus (CS) adjacent the valve, wherein the displacement unit has a delivery state for delivery into said CS, and an activated state to which the displacement unit is temporarily and reversibly transferable from the delivery state. The displacement unit has a proximal reversibly expandable portion, a distal anchoring portion being movable in relation to the proximal expandable portion in a longitudinal direction of the displacement unit to the activated state in which the shape of the annulus is modified to a modified shape (A′); and an annuloplasty device for permanent fixation at the mitral valve annulus by annuloplasty of the valve when the modified shape is obtained.

1 - 20 . (canceled) 
     
     
         21 . Method for treating a defective mitral valve having an annulus, said method comprising:
 inserting a flexible and removable elongate displacement unit in a delivery state into a coronary sinus adjacent said valve,   positioning a distal anchoring portion inside said coronary sinus,   positioning a proximal expandable portion against a tissue wall outside the entrance of said coronary sinus for providing a counter force against said distal anchoring portion,   activating said displacement unit in an activated state whereby said distal anchoring portion is moved in a longitudinal direction of said displacement unit to reduce the distance between said distal anchoring portion and said proximal expandable portion such that the shape of the annulus is modified to a modified shape.   
     
     
         22 . Method according to  claim 21 , comprising
 fixating an annuloplasty device at the mitral valve annulus when said modified shape is obtained, whereby said annuloplasty device comprises a fixation structure that is adapted to retain said modified shape.   
     
     
         23 . Method according to  claim 21 , comprising
 removing said elongate displacement unit after temporary activation in the activated state.   
     
     
         24 . Method according to  claim 21 , wherein the proximal expandable portion is reversibly foldable to an expanded state from a sheath for positioning against the tissue wall. 
     
     
         25 . Method according to  claim 24 , comprising
 expanding an expandable structure of the proximal expandable portion on either side of the sheath to spread a force symmetrically against a tissue wall outside the entrance of said coronary sinus.   
     
     
         26 . Method according to  claim 21 , comprising
 pivoting the proximal expandable portion towards the longitudinal direction.   
     
     
         27 . Method according to  claim 24 , comprising
 pivoting first and second expandable portions of the proximal expandable portion in opposite directions of the sheath.   
     
     
         28 . Method according to  claim 27 , comprising
 pivoting first and second expandable wires of the proximal expandable portion in opposite directions of the sheath.   
     
     
         29 . Method according to  claim 21 , comprising
 decreasing a radius of curvature of the displacement unit when the displacement unit is transferred from said delivery state to said activated state.   
     
     
         30 . Method according to  claim 21 , wherein said proximal expandable portion is foldable to an expanded state where said proximal expandable portion has a diameter substantially larger than a diameter of said coronary sinus. 
     
     
         31 . Method according to  claim 21 , wherein said fixation structure comprises a helix-shaped loop structure, the method comprising
 positioning the helix-shaped loop structure on either side of said valve to retain said modified shape of the annulus so that at least a portion of the helix-shaped loop structure conforms to a curvature of said annulus.   
     
     
         32 . Method according to  claim 31 , comprising
 moving at least a portion of the displacement unit an activated shape that at least partly assumes the curvature of said helix-shaped loop structure.   
     
     
         33 . Method according to  claim 21 , comprising
 allowing blood flow through a lumen of the displacement unit, the lumen extending along the longitudinal direction of the displacement unit to improve blood flow through the coronary sinus.   
     
     
         34 . Method according to  claim 21 , comprising
 inflating an inflatable unit of the displacement unit to exert a force on the coronary sinus.   
     
     
         35 . Method according to  claim 21 , comprising
 asymmetrically inflating the inflatable unit of the displacement unit.   
     
     
         36 . Method according to  claim 34 , comprising
 independently inflating a plurality of inflatable units.