Apparatus and method for treating a regurgitant heart valve

Abstract

An apparatus is provided for treating regurgitation of blood flow through a diseased heart valve, which includes an annulus, anterior and posterior valve leaflets, and a subvalvular apparatus. The apparatus includes a substantially annular support member, at least one infra-annular support member securely connected thereto, and at least one anchoring element associated with the at least one infra-annular support member. The at least one anchoring element is configured to securely receive a prosthetic chordae tendineae for attachment to a papillary muscle. The posterior end portion is dimensioned for attachment to a posterior portion of the diseased heart valve annulus. The at least one infra-annular support member is securely connected to the substantially annular support member. The at least one infra-annular support member is dimensioned to extend below at least one of the posterior and anterior valve leaflets and across or behind at least one subvalvular structure.

The following is claimed: 
     
         1 . An apparatus for treating regurgitation of blood flow through a diseased heart valve, the diseased heart valve including an annulus, an anterior valve leaflet, a posterior valve leaflet and a subvalvular apparatus, said apparatus comprising:
 a substantially annular support member having at least a first intermediate portion, a second intermediate portion, and a posterior end portion extending between said first and second intermediate portions, said posterior end portion being dimensioned for attachment to a posterior portion of the annulus of the diseased heart valve;   at least one infra-annular support member securely connected to said substantially annular support member at a first location, said at least one infra-annular support member being dimensioned to extend below at least one of the posterior and anterior valve leaflets and across or behind at least one subvalvular structure; and   at least one anchoring element associated with said at least one infra-annular support member, said at least one anchoring element being configured to securely receive a prosthetic chordae tendineae for attachment to a papillary muscle.   
     
     
         2 . The apparatus of  claim 1 , wherein said at least one anchoring element has a semi-circular shape. 
     
     
         3 . The apparatus of  claim 1 , wherein said at least one anchoring element is indirectly or directly associated with a surface of said at least one infra-annular support member so that an aperture is formed between said surface and a portion of said at least one anchoring element. 
     
     
         4 . The apparatus of  claim 1 , wherein attachment of the prosthetic chordae tendineae between the papillary muscle and said at least one anchor element causes the papillary muscle to move medially and improve cardiac functioning by creating a reverse remodeling of a posterior left ventricular wall, improving valve leaflet coaptation, and reducing tension across the native chordae. 
     
     
         5 . The apparatus of  claim 1 , wherein attachment of the prosthetic chordae tendineae between the papillary muscle and said at least one anchor element stabilizes the position of the papillary muscles and prevents late apical migration of the subvalvular apparatus. 
     
     
         6 . An apparatus for treating regurgitation of blood flow through a diseased heart valve, the diseased heart valve including an annulus, an anterior valve leaflet, a posterior valve leaflet and a subvalvular apparatus, said apparatus comprising:
 a substantially annular support member having at least a first intermediate portion, a second intermediate portion, and a posterior end portion extending between said first and second intermediate portions, said posterior end portion being dimensioned for attachment to a posterior portion of the annulus of the diseased heart valve;   a first infra-annular support member securely connected to said substantially annular support member at a first location;   a second infra-annular support member securely connected to said substantially annular support member at a second location; and   at least one anchoring element associated with one or both of said first and second infra-annular support members, said at least one anchoring element being configured to securely receive a prosthetic chordae tendineae for attachment to a papillary muscle;   wherein said first and second infra-annular support members are dimensioned to extend below at least one of the posterior and anterior valve leaflets and across or behind at least one subvalvular structure.   
     
     
         7 . The apparatus of  claim 6 , wherein said at least one anchoring element has a semi-circular shape. 
     
     
         8 . The apparatus of  claim 6 , wherein at least one of said first and second anchoring elements is indirectly or directly associated with a surface of said at least one infra-annular support member so that an aperture is formed between said surface and a portion of said first and second anchoring elements. 
     
     
         9 . The apparatus of  claim 6 , wherein attachment of the prosthetic chordae tendineae between the papillary muscle and said at least one anchor element causes the papillary muscle to move medially and improve cardiac functioning by creating a reverse remodeling of a posterior left ventricular wall, improving valve leaflet coaptation, and reducing tension across the native chordae. 
     
     
         10 . The apparatus of  claim 6 , wherein attachment of the prosthetic chordae tendineae between the papillary muscle and said at least one anchor element stabilizes the position of the papillary muscles and prevents late apical migration of the subvalvular apparatus. 
     
     
         11 . A method for treating regurgitation of blood flow through a diseased heart valve, the diseased heart valve including an annulus, an anterior valve leaflet, a posterior valve leaflet and a subvalvular apparatus, said method comprising the steps of:
 providing an apparatus comprising a substantially annular support member, at least one infra-annular support member securely connected thereto, and at least one anchoring element associated with the at least one infra-annular support member, the substantially annular support member having at least a first intermediate portion, a second intermediate portion and a posterior end portion extending between the first and second intermediate portions;   attaching the substantially annular support member to the annulus of the diseased heart valve; and   attaching proximal and distal ends of a prosthetic chordae tendineae to the at least one anchoring element and a papillary muscle, respectively;   wherein the substantially annular support member is attached so that the at least one infra-annular support member extends below at least one of the posterior and anterior valve leaflets and across or behind at least one subvalvular structure to prevent or substantially reduce regurgitation of blood flow through the diseased heart valve;   wherein the prosthetic chordae tendineae is attached so that the papillary muscle is caused to move medially and improve cardiac functioning by creating a reverse remodeling of a posterior left ventricular wall, improving valve leaflet coaptation, and reducing tension across the native chordae.   
     
     
         12 . The method of  claim 11 , wherein said providing step further includes providing at least one anchoring element having a semi-circular shape. 
     
     
         13 . The method of  claim 11 , wherein said providing step further comprises providing at least one anchoring element that is indirectly or directly associated with a surface of the at least one infra-annular support member so that an aperture is formed between the surface and a portion of the at least one anchoring element. 
     
     
         14 . The method of  claim 11 , wherein attachment of the prosthetic chordae tendineae between the papillary muscle and the at least one anchor element stabilizes the position of the papillary muscles and prevents late apical migration of the subvalvular apparatus. 
     
     
         15 . The method of  claim 11 , wherein the subject is suffering from Carpentier's type I dysfunction. 
     
     
         16 . The method of  claim 11 , wherein the subject is suffering from Carpentier's type IIIb dysfunction.