Atraumatic Adjustment or Replacement of a Device for Treating Valve Regurgitation

Abstract

An epicardial device for reducing or preventing regurgitation of blood through a valve of a heart includes a main body having a segment adapted to apply force to an epicardial surface of the heart. A member that applies counterforce to the force applied by the segment is also provided. A foundation is configured to be anchored to the epicardial surface of the heart. The foundation includes a surface configured with attachment features. The device further includes a surface configured with mating attachment features configured to attach to the attachment features of the foundation. The mating attachment features and attachment features are separable and reattachable to allow repositioning of at least a portion of the device relative to the foundation.

1 . An epicardial device for reducing or preventing regurgitation of blood through a valve of a heart, said device comprising:
 a main body having a segment adapted to apply force to an epicardial surface of the heart;   a member that applies counterforce to said force applied by said segment;   a foundation configured to be anchored to the epicardial surface of the heart, said foundation comprising a surface configured with attachment features; and   said device further comprising a surface configured with mating attachment features configured to attach to said attachment features of said foundation;   wherein said mating attachment features and attachment features are separable and reattachable to allow repositioning of at least a portion of said device relative to said foundation.   
     
     
         2 .- 22 . (canceled) 
     
     
         23 . A method of epicardial treatment of valve regurgitation associated with a valve of a heart of a patient, the method comprising:
 establishing at least one opening in the patient to provide access to the heart;   applying an epicardial force on a location of the heart, while visualizing regurgitation through the valve via visualization apparatus;   varying at least one of the location or the amount of epicardial force applied to identify a target position where valve regurgitation is reduced or eliminated;   marking the target position;   anchoring a foundation to the epicardial surface of the heart to provide a base for fixing an epicardial device thereto; and   fixing the epicardial device to the foundation, wherein said fixing establishes a segment of said device in the target position and wherein said fixing indirectly fixes the epicardial device to the heart.   
     
     
         24 .- 28 . (canceled) 
     
     
         29 . A method of epicardial treatment of mitral valve regurgitation associated with a mitral valve of a heart of a patient, the anatomy of the heart including an aorta, a pulmonary trunk, a superior vena cava, a transverse sinus, a left atrial appendage, and an oblique sinus, the method comprising:
 applying an epicardial force on a posterior location of the heart, while visualizing regurgitation through the valve via visualization apparatus;   varying at least one of the location or the amount of epicardial force applied to identify a target position where mitral valve regurgitation is reduced or eliminated;   marking the target position;   anchoring a foundation to the epicardial surface of the heart at a location having a predefined relationship to the marking;   providing a clip having an anterior segment, an anterior end, a posterior segment, a posterior end and a lateral segment extending between the anterior segment and the posterior segment;   positioning the anterior and posterior segments epicardially on the heart at locations apposite to an annulus of the mitral valve, such that the anterior and posterior segments apply force sufficient to reshape the annulus, wherein the posterior segment is located on the target position;   fixing the clip to the foundation, wherein said fixing maintains the posterior segment in the target position.   
     
     
         30 .- 34 . (canceled)