Devices and methods for image-guided percutaneous cardiac valve implantation and repair

Abstract

Devices and methods for ultrasound image-guided percutaneous cardiac valve implantation and repair comprise, in combination, a plurality of devices including but not limited to an ultrasound-image guided catheter, a pericardial sheath, a cardiac valve delivery system and an ascending aortic filter. An image-guided catheter is utilized to introduce via an introducer needle and a guide wire a pericardium portal for permitting entry from the chest wall to inside the pericardial space between the pericardial outer lining and inner lining. The pericardium portal permits the use of ultrasound vision to locate a site proximate the left ventricular apex for introduction of a sheath via a myocardium needle into the left ventricular space at an angle and avoiding any coronaries or vessels. A first delivery system permits placement of at least one aortic filter which collects any emboli, particulate matter, plaque and prevents such matter travelling via the ascending aorta to the brain, causing a stroke. A second delivery system permits placement of an aortic and/or mitral valve replacement or repair using several types of repair tools.

What is claimed is: 
     
         1 . Apparatus for ultrasound image guided percutaneous cardiac valve replacement or repair comprising in combination:
 an image guided catheter for entry via an incision in the chest wall and by ultrasound vision guidance to a site proximate the left ventricular apex of a heart myocardium,   a guide wire for introduction via the image guided catheter into the pericardial space,   a sheath for entry via the guide wire through the chest wall to pass through and into the pericardial space,   a pericardium portal introduced through the sheath into the pericardial space replacing the guide wire.   a pericardium ultrasound transducer deployable from the pericardium portal having an imaging zone of the left ventricle and the ascending aorta,   a myocardial needle delivery system comprising a bendable portion of the pericardium portal and a myocardial needle for puncturing the myocardium at a site proximate the left ventricular apex, and   an aortic valve delivery system for delivery of an aortic valve prosthesis and a further delivery system for delivering at least one aortic filter.   
     
     
         2 . The apparatus of  claim 1  further comprising
 a closure device for closing the punctured myocardium comprising a distal pad and a proximal pad. 
 
     
     
         3 . The apparatus of  claim 1  further comprising
 an aortic filter delivery catheter circumferentially surrounding a guide wire, 
 a prosthetic valve delivery catheter circumferentially surrounding the aortic filter delivery catheter, and 
 a pericardium catheter circumferentially surrounding the prosthetic valve delivery catheter.