Method and Devices For Cardiac Valve Annulus Expansion

Abstract

A method and apparatus is disclosed that allows a cardiac surgeon to temporarily and controllably dilate the aortic root using a thin walled spiral cylinder that is irreversibly dilated by an expansion apparatus. Following removal of the reversible expansive apparatus the irreversible dilation member temporarily remains in the expanded aortic root during aortic valve prosthesis placement with the irreversible dilation member at the level of the aortic annulus. Implantation sutures that had been previously placed are tied following the removal of the irreversible dilation member. The apparatus and method may be used to place a sub aortic stent for the treatment of sub aortic stenosis.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side elevation of one embodiment of the aortic root expansion apparatus in the unexpanded condition with the detachable irreversible dilation member in place.

FIG. 2 is an end view of FIG. 1 in the direction of arrow A in FIG. 1

FIG. 3 is an end view of FIG. 1 in the direction of arrow B in FIG. 1

FIG. 4 is side elevation of the preferred embodiment of the aortic root expansion apparatus with the irreversible dilation member absent.

FIG. 5 is an end view of FIG. 4 in the direction of arrow D in FIG. 4

FIG. 6 is an exploded isometric view of the aortic root expansion apparatus of FIG. 1 with the irreversible dilation member absent.

FIG. 7 is a cross-section view of the aortic root expansion apparatus taken along line CC of FIG. 2.

FIG. 8 is a cross-section view of the aortic root expansion apparatus taken along line EE of FIG. 7.

FIG. 9 is a partial cross-section view of the aortic root expansion apparatus taken along line CC of FIG. 2 but in the expanded condition.

FIG. 10 is an end view taken in the direction of arrow F in FIG. 9.

FIG. 11 is a cross-section view taken along line GG of FIG. 9

FIG. 12 is a plan view of one embodiment of the irreversible dilation member in its pre-coiled flat form

FIG. 13 is a plan view of the an alternative embodiment of the irreversible dilation member in its pre-coiled flat form

FIG. 14 is a side view of the irreversible dilation member shown in FIG. 12 in the flat, pre-coiled form

FIG. 15 is an enlarged cross-section taken along line HH of FIG. 12.

FIG. 16 is a side elevation of the irreversible dilation member in its unexpanded form.

FIG. 17 is an end view of the irreversible dilation member in its unexpanded form taken in the direction of arrow I of FIG. 16.

FIG. 18 is an enlarged part end view of the irreversible dilation member in its unexpanded form taken in the direction of arrow I of FIG. 16.

FIG. 19 is an end elevation of irreversible dilation member in an expanded form taken in the direction of arrow I of FIG. 16.

FIG. 20 is a side elevation of an alternative embodiment of the aortic root expansion apparatus in the unexpanded condition with an elastic sheath member in place.

FIG. 21 is an end view taken in the direction of arrow J in FIG. 20.

FIG. 22 is a part cross-section side elevation taken along line KK of FIG. 21 in the unexpanded condition with an elastic sheath member in place.

FIG. 23 is a part cross-section side elevation taken along line KK of FIG. 20 in the expanded condition with an elastic sheath member in place.

Claims

1. A cardiac valve annulus expansion device comprising: an expansion member defining an expansion circumference corresponding to an inner circumference of a cardiac valve annulus; andan actuation member operatively associated with the expansion member wherein actuation of the actuation member causes radial expansion of the expansion circumference.

2. The cardiac valve annulus expansion device of claim 1 wherein actuation of the actuation member selectively causes radial contraction of the expansion circumference.

3. The cardiac valve annulus expansion device of claim 2 further comprising a dilation member operatively associated with the expansion member, the dilation member being expandable from a first diameter corresponding to an inner circumference of a cardiac valve to a second larger diameter.

4. The cardiac valve annulus expansion device of claim 3 wherein expansion of the expansion circumference causes expansion of the dilation circumference.

5. The cardiac valve annulus expansion device of claim 4 further comprising means associated with the dilation member preventing contraction of the dilation circumference.

6. The cardiac valve annulus expansion device of claim 1 wherein the expansion member comprises a mechanical device.

7. The cardiac valve annulus expansion device of claim 1 wherein the expansion member comprises an inflatable balloon.

8. A cardiac valve expansion device comprising: an irreversible dilation member, the irreversible dilation member comprising a band formed into a cylinder of a first diameter and means operatively associated with the band for irreversibly maintaining the band in a second diameter greater than the first diameter;an expansion member defining an expansion circumference receiving an inner diameter of the irreversible dilation member, the expansion circumference corresponding to an inner circumference of a cardiac valve annulus; andan actuator operatively associated with the expansion member to expand the expansion circumference of the irreversible dilation member.

9. The cardiac valve expansion device of claim 8 further comprising the actuator being configured to cause radial contraction of the expansion circumference.

10. The cardiac valve expansion device of claim 8 wherein the second diameter of the irreversible dilation member is selectable from a plurality of diameters greater than the first diamater

11. A method of expanding a cardiac valve annulus comprising: providing a cardiac valve annulus expansion device including an expansion member adjacent to a cardiac valve annulus; andexpanding the expansion member.

12. The method of expanding a cardiac valve annulus of claim 11 further comprising expanding a dilation member in contact with the cardiac valve annulus.

13. The method of expanding a cardiac valve annulus of claim 12 further comprising: contracting the expansion member; andremoving the cardiac valve expansion device from the vicinity of the cardiac valve annulus.

14. A method of cardiac valve replacement surgery comprising: excising a cardiac valve;providing a dilation member in contact with an inner diameter of the cardiac valve annulus;expanding the annular circumference of the dilation member; andreplacing the cardiac valve.

15. The method of claim 14 further comprising the dilation member being irreversible and irreversibly expanding the dilation member.

16. The method of claim 15 further comprising removing the dilation member.

17. The method of claim 15 further comprising leaving the dilation member in the valve annulus to function as a stent.

18. The method of claim 15 further comprising providing an irreversible dilation member in a sub-aortic position, expanding the annular circumference of the dilation member and leaving the dilation member in the sub-aortic position to function as a stent.