Apparatus and method for delivering fasteners during valve replacement

Abstract

A fastener delivery tool includes a loading chamber for receiving a fastener having a pair of tines overlapping one another to define a loop in a parent or relaxed state. A retaining member retains the fastener in the loading chamber. The fastener delivery tool also includes a tongue, pusher member, and an ejection track communicating with the loading chamber. An actuator causes the tongue to move to engage the tines of the fastener to transform the fastener from the relaxed state to a constrained state defining a U-shape. The actuator also causes the pusher member to release the retaining member and advance the fastener down the ejection track in the constrained state. The tool also includes a trigger for ejecting the fastener completely from the ejection track. The fastener may be used to secure a prosthetic heart valve or components thereof into surrounding tissue, e.g., within a tissue annulus.

1 . A fastener delivery tool, comprising: 
 a loading chamber for receiving a fastener having a plurality of tines in a relaxed state;    a releasable retaining member for limiting movement of the fastener within the loading chamber;    an ejection track communicating with the loading chamber;    a handle including an actuator;    a tongue and a pusher member coupled to the actuator, activation of the actuator advancing the tongue to engage the tines so as to transform the fastener from the relaxed state to a constrained state and advancing the pusher member to advance the fastener from the loading chamber down the ejection track.    
   
   
       2 . The fastener delivery tool of  claim 1 , further comprising a trigger for ejecting the fastener distally from the ejection track.  
   
   
       3 . The fastener delivery tool of  claim 1 , wherein, in the relaxed state, the tines of the fastener overlap one another to define a loop, the retaining member being received in the loop for limiting movement of the fastener, and, in the constrained state, the fastener comprises a U-shape.  
   
   
       4 . The fastener delivery tool of  claim 3 , wherein the ejection track comprises side walls for constraining the fastener in the U-shape as the fastener is advanced down the ejection track.  
   
   
       5 . The fastener delivery tool of  claim 4 , wherein the tines are exposed distally beyond the ejection track when the actuator is activated without ejecting the fastener completely from the ejection track.  
   
   
       6 . The fastener delivery tool of  claim 1 , wherein the retaining member comprises a movable release pin.  
   
   
       7 . The fastener delivery tool of  claim 6 , wherein the release pin is coupled to at least one of the tongue and the pusher member such that the release pin releases the fastener after the actuator is activated.  
   
   
       8 . The fastener delivery tool of  claim 1 , further comprising a staging section including a plurality of fasteners disposed therein.  
   
   
       9 . The fastener delivery tool of  claim 8 , wherein the plurality of fasteners are carried by a cartridge receivable in the staging section.  
   
   
       10 . The fastener delivery tool of  claim 1 , the retaining member being releasable upon engagement with a cam located on the pusher member.  
   
   
       11 . The fastener delivery tool of  claim 1 , wherein the fastener includes two tines that overlap one another in the relaxed state.  
   
   
       12 . A fastener delivery tool, comprising: 
 a loading chamber for receiving at least one fastener having a pair of tines overlapping one another in a relaxed state, the loading chamber including a release pin on which said at least one fastener is loaded;    an ejection track communicating with the loading chamber; and    an actuator coupled to a tongue and a pusher member, activation of the actuator causing the tongue to engage the plurality of tines to transform the fastener from the relaxed state to a constrained state and causing the pusher member to advance the fastener in the constrained state from the loading chamber down the ejection track.    
   
   
       13 . The fastener delivery tool of  claim 12 , wherein the at least one fastener has a U-shape in the constrained state.  
   
   
       14 . The fastener delivery tool of  claim 12 , further comprising a trigger for ejecting the at least one fastener from the ejection track.  
   
   
       15 . A method for delivering a fastener, comprising: 
 restraining a fastener within a delivery tool using a retaining member, the fastener comprising a pair of tines;    advancing a tongue in the delivery tool relative to the restrained fastener to transform the fastener from a relaxed state to a constrained state;    releasing the fastener from the retaining member while the fastener is in the constrained state;    advancing the fastener in the constrained state distally within the delivery tool; and    ejecting the fastener from the delivery tool.    
   
   
       16 . The method of  claim 15 , wherein the delivery tool carries a plurality of fasteners therein.  
   
   
       17 . The method of  claim 16 , further comprising loading a cartridge into the delivery tool, the cartridge carrying the plurality of fasteners.  
   
   
       18 . The method of  claim 15 , wherein the tongue and fastener are advanced successively upon activating an actuator.  
   
   
       19 . The method of  claim 15 , wherein the constrained state comprises a U-shaped fastener.  
   
   
       20 . The method of  claim 15 , further comprising depressing a trigger on the delivery tool to eject the fastener completely from the delivery tool.  
   
   
       21 . The method of  claim 15 , wherein the fastener is advanced distally within the delivery tool in the constrained state by depressing a lever on the delivery tool.  
   
   
       22 . A method for securing a heart valve prosthesis within a tissue annulus, comprising: 
 restraining a fastener within a delivery tool using a retaining member;    advancing a tongue in the delivery tool relative to the restrained fastener to transform the fastener from a relaxed state to a constrained state;    releasing the fastener from the retaining member while the fastener is in the constrained state;    advancing the fastener in the constrained state distally within the delivery tool; and    ejecting the fastener from the delivery tool through a component of a heart valve prosthesis into the tissue annulus.    
   
   
       23 . The method of  claim 22 , wherein the fastener includes a pair of tines that overlap in the relaxed state to define a loop, the retaining member being received in the loop to restrain the fastener.  
   
   
       24 . The method of  claim 23 , wherein the tongue is received in the loop such that, as the tongue is advanced, the tongue moves the tines into a U-shape in the constrained state.  
   
   
       25 . The method of  claim 22 , wherein the fastener resiliently moves towards the relaxed state after the fastener is ejected from the from the delivery tool to capture tissue between the tines.