| 摘要 |
An apparatus for cinching an anatomic passage (e.g., the annulus of the mitral valve or another cardiac valve) includes a cinching cord, slotted anchors, and corresponding sliding members disposed in the slots of the anchors. The sliding members are held captive within the slots by a protrusion on one side of the slot and by the presence of the cinching cord in apertures of the sliding members on the other side of the slot, because the cinching cord passes through the aperture in each of the sliding members. In some embodiments, at least one sleeve of material that accepts tissue ingrowth is disposed over the cinching cord. A closed loop of cord may also be used in place of the cinching cord in alternative embodiments, so that subsequent to implantation, the closed loop of cord prevents the anatomic annulus from expanding. |
| 主权项 |
1. An apparatus for cinching an annulus of a cardiac valve, the annulus having an initial circumference, the apparatus comprising:
at least four anchors, each of the anchors having a pointy distal end and a proximal end, wherein each of the anchors has a slot that runs in a proximal-to-distal direction, and wherein each of the anchors is configured for implantation into tissue in a distal direction and is also configured to resist extraction from the tissue in a proximal direction subsequent to implantation; at least four sliding members, each of the sliding members being disposed in a slot of a respective one of the anchors, with a first portion of the sliding member extending out of the slot in a first direction and a second portion of the sliding member extending out of the slot in a second direction, wherein the sliding member and the slot are configured so that the anchor can slide in a distal direction with respect to the sliding member, wherein each of the sliding members has at least one protrusion on the first portion of the sliding member configured to prevent the sliding member from passing through the slot in the second direction, and wherein the second portion of each of the sliding members has an aperture; and a cinching cord having a distal loop portion, the distal loop portion having a first end region a second end region, the cinching cord having a first proximal portion connected to the first end region and a second proximal portion connected to the second end region, wherein the distal loop portion of the cinching cord passes through the aperture in each of the sliding members, wherein each of the apertures retains the distal loop portion of the cinching cord within the aperture such that the presence of the distal loop portion of the cinching cord in the aperture prevents the sliding member from passing through the slot in the first direction, and wherein the anchors and sliding members are distributed around the distal loop portion of the cinching cord at positions configured to facilitate implantation of the anchors into the annulus or into leaflets of the cardiac valve adjacent to the annulus with the first end region positioned next to the second end region, so that subsequent to implantation, pulling both the first proximal portion and the second proximal portion in a proximal direction while the first end region is held next to the second end region will reduce the circumference of the annulus. |
