Translumenal apparatus, system, and method

Abstract

Methods, apparatus, and systems for altering the configuration of a heart valve. Methods, apparatus, and systems include the use of a cord delivered into the heart by a delivery catheter that can be manipulated by a receiving catheter so as to improve the heart valve function.

1 . A method, comprising:
 positioning a delivery catheter adjacent a fiberous ring surrounding a heart valve;   positioning a receiving catheter adjacent the fiberous ring surrounding the heart valve, the receiving catheter having a coupling device;   passing a first piercing member and a first portion of a cord from the delivery catheter through the fiberous ring;   extending a first capture device from the receiving catheter;   capturing the first piercing member that extends through the fiberous ring with the first capture device;   passing a second piercing member and a second portion of the cord from the delivery catheter through the fiberous ring;   extending a second capture device from the receiving catheter;   capturing the second piercing member that extends through the fiberous ring with the second capture device;   connecting the first portion and the second portion of the cord with the coupling device to form a loop; and   releasing the loop and at least a portion of the coupling device from the receiving catheter.   
     
     
         2 . The method of  claim 1 , where connecting the first portion and the second portion of the cord includes altering a configuration of the heart valve in forming the loop. 
     
     
         3 . The method of  claim 2 , wherein altering the configuration of the heart valve includes constraining an elongate portion of a leaflet of the heart valve perpendicularly to a plane of coaptation for the leaflet. 
     
     
         4 . The method of  claim 2 , wherein altering the configuration of the heart valve includes adjusting tension of the cord; and
 joining portions of the cord at or adjacent a first end and a second end of the cord.   
     
     
         5 . The method of  claim 4 , wherein adjusting tension of the cord applies force to an anterior and posterior portion of the fibrous ring of the heart valve. 
     
     
         6 . The method of  claim 2 , wherein positioning the delivery catheter and the receiving catheter adjacent the heart valve includes positioning the delivery catheter and the receiving catheter adjacent a mitral valve. 
     
     
         7 . The method of  claim 6 , wherein altering the configuration of the heart valve includes altering the configuration of the mitral valve to create a double orifice through an opening of the mitral valve. 
     
     
         8 . The method of  claim 1 , wherein connecting the first portion and the second portion of the cord with the coupling device to form the loop includes adjusting a length of the loop to constrain an elongate portion of a leaflet of the heart valve perpendicularly to a plane of coaptation for the leaflet. 
     
     
         9 . The method of  claim 1 , wherein passing the first piercing member and the first portion of the cord includes passing the first piercing member and the first portion of the cord through a posterior portion of the fibrous ring surrounding the heart valve. 
     
     
         10 . The method of  claim 9 , wherein passing the second piercing member and the second portion of the cord includes passing the second piercing member and the second portion of the cord through an anterior portion of the fibrous ring surrounding the heart valve. 
     
     
         11 . A method, comprising:
 positioning a delivery catheter adjacent a fibrous ring surrounding a heart valve;   positioning a cord between at least a portion of chordae tendineae attached to leaflets of the heart valve with the delivery catheter;   advancing the cord through the fibrous ring surrounding the heart valve; and   modifying a configuration of the heart valve with the cord to induce the leaflets of the heart valve to coapt.   
     
     
         12 . The method of  claim 11 , wherein positioning the delivery catheter further includes:
 positioning the distal end of delivery catheter at a first predetermined location and delivering a first portion of the cord to the first predetermined location; and   positioning the distal end of the delivery catheter at a second predetermined location and delivering a second portion of the cord to the second predetermined location.   
     
     
         13 . The method of  claim 12 , wherein the first predetermined location includes a posterior portion of the fibrous ring, and wherein the second predetermined location includes an anterior portion of the fibrous ring. 
     
     
         14 . The method of  claim 13 , wherein positioning the delivery catheter at the anterior fibrous ring includes moving the delivery catheter between the chordae tendineae. 
     
     
         15 . The method of  claim 14 , wherein moving the delivery catheter between the chordae tendineae further includes adjusting the delivery catheter from the first predetermined location to the second predetermined location using an adjustment member coupled to the delivery catheter. 
     
     
         16 . The method of  claim 11 , wherein advancing the cord includes advancing the cord through an anterior and a posterior portion of the fibrous ring between a first heart chamber and a second heart chamber such that a first portion and a second portion of the cord extend into the first heart chamber. 
     
     
         17 . The method of  claim 16 , wherein modifying further includes:
 positioning a receiving catheter adjacent the fibrous ring surrounding the heart valve in the second heart chamber; and   capturing the first and second portions of the cord with the receiving catheter.   
     
     
         18 . The method of  claim 17 , wherein modifying further includes:
 applying force to the cord through the receiving catheter to modify the configuration of the heart valve; and   connecting the cord with the receiving catheter to form a loop having a closed circumference.