Reconfiguring Heart Features

Abstract

Among other things, a heart tissue support has gripping elements, each element having a free end that is sharp enough to penetrate heart tissue when pushed against the tissue, and a feature to resist withdrawal from the tissue after the sharp free end has penetrated the tissue. Among other things, the shape of a heart valve annulus is corrected in a catheter laboratory by orienting a tip of a catheter holding a heart tissue support that has gripping elements at the valve annulus, applying a radial force from the catheter against the annulus by opening a structure at the tip of the catheter, and while the structure is opened, forcing the support onto the annulus. Among other things, the shape of a heart valve annulus is corrected during a surgical procedure by pushing a heart tissue support that has gripping elements onto the annulus.

1 - 30 . (canceled) 
     
     
         31 . A method comprising:
 correcting the shape of a heart valve annulus in a catheter laboratory by orienting a tip of a catheter holding a heart tissue support that has gripping elements at the valve annulus, applying a radial force from the catheter against the annulus by opening a structure at the tip of the catheter, and while the structure is opened, forcing the support onto the valve annulus.   
     
     
         32 . A method comprising:
 correcting the shape of a heart valve annulus during a surgical procedure by pushing a heart tissue support that has gripping elements onto the valve annulus.   
     
     
         33 . A method comprising
 attaching, to different sized heart valve annuli in different patients, supports that can be expanded in preparation for attachment and allowed to contract to a common relaxed, non-expanded native size when they are in place on the annuli, and   reducing the sizes of at least some of the in-place supports to be smaller than the common relaxed non-expanded native size, to accommodate the different sized heart valve annuli of different patients.   
     
     
         34 . (canceled) 
     
     
         35 . A method comprising:
 pushing a support onto a region of heart tissue to cause only a portion of a number of small grippers on the support to embed themselves and be retained in the tissue, the portion being sufficient to attach the support securely to the heart tissue.   
     
     
         36 - 44 . (canceled) 
     
     
         45 . The method of  claim 31  comprising causing the support to conform to a delivery configuration for attachment to the valve annulus. 
     
     
         46 . The method of  claim 31  in which forcing the support onto the valve annulus comprises applying a force to the catheter in a direction axial to the annulus. 
     
     
         47 . The method of  claim 31  in which forcing the support onto the valve annulus causes a tapered surface of the tip of the catheter to engage the valve annulus. 
     
     
         48 . The method of  claim 31  comprising sheathing the support before the tip of the catheter is placed in a vicinity of the valve annulus, and unsheathing the support in the vicinity of the valve annulus. 
     
     
         49 . The method of  claim 31  comprising retracting the tip of the catheter from the heart valve. 
     
     
         50 . The method of  claim 49  in which retracting comprises releasing the support. 
     
     
         51 . The method of  claim 49  in which releasing the support comprises breaking a connection between the support and the tip of the catheter. 
     
     
         52 . The method of  claim 32  comprising causing the heart tissue support to conform to a delivery configuration for attachment to the valve annulus. 
     
     
         53 . The method of  claim 32  in which pushing the support onto the valve annulus comprises applying a force to the support in a direction axial to the annulus. 
     
     
         54 . The method of  claim 32  comprising causing some of the gripping elements to pierce tissue of the valve annulus. 
     
     
         55 . The method of  claim 32  comprising permitting the support to contract into a long-term configuration. 
     
     
         56 . The method of  claim 33  in which the common relaxed non-expanded native size corresponds to a diameter of a delivery head of a delivery tool used to attach the supports. 
     
     
         57 . The method of  claim 33  in which reducing the sizes of at least some of the in-place supports comprises allowing the supports to contract to respective long-term configurations. 
     
     
         58 . The method of  claim 33  comprising attaching at least some of the supports in a catheter laboratory. 
     
     
         59 . The method of  claim 35  comprising causing the support to conform to a delivery configuration for attachment to the heart tissue. 
     
     
         60 . The method of  claim 35  comprising sheathing the support before the support is placed in a vicinity of the region of heart tissue and unsheathing the support in the vicinity of the region of heart tissue.