US 12,133,962 B2
Catheters and manipulators with articulable ends
Nasser Rafiee, Andover, MA (US); Robert J. Lederman, Bethesda, MD (US); Toby Rogers, Bethesda, MD (US); Dursun Korel Yildirim, Bethesda, MD (US); Mai Le Diep, Andover, MA (US); and Koosha Rafiee, Andover, MA (US)
Assigned to Transmural Systems LLC, Andover, MA (US); and United States Department of Health and Human Services, Bethesda, MD (US)
Filed by Transmural Systems LLC, Andover, MA (US); and The UNITED STATES OF AMERICA, as represented by the Secretary, Dept. of Health and Human Srvcs., Bethesda, MD (US)
Filed on Sep. 8, 2019, as Appl. No. 16/563,925.
Application 16/563,925 is a continuation in part of application No. PCT/US2018/048177, filed on Aug. 27, 2018.
Claims priority of provisional application 62/550,347, filed on Aug. 25, 2017.
Claims priority of provisional application 62/567,203, filed on Oct. 2, 2017.
Claims priority of provisional application 62/663,518, filed on Apr. 27, 2018.
Claims priority of provisional application 62/688,378, filed on Jun. 21, 2018.
Claims priority of provisional application 62/712,194, filed on Jul. 30, 2018.
Claims priority of provisional application 62/728,413, filed on Sep. 7, 2018.
Prior Publication US 2020/0001053 A1, Jan. 2, 2020
Int. Cl. A61M 25/09 (2006.01); A61B 18/12 (2006.01); A61B 18/14 (2006.01); A61M 25/01 (2006.01); A61B 18/00 (2006.01)
CPC A61M 25/09025 (2013.01) [A61B 18/12 (2013.01); A61M 25/0105 (2013.01); A61B 2018/00077 (2013.01); A61B 2018/00184 (2013.01); A61B 2018/00279 (2013.01); A61B 2018/00369 (2013.01); A61B 2018/00601 (2013.01); A61B 2018/1213 (2013.01); A61B 2018/126 (2013.01); A61B 2018/141 (2013.01); A61B 2018/1417 (2013.01); A61B 2018/1432 (2013.01); A61M 2025/09133 (2013.01); A61M 2025/09175 (2013.01)] 15 Claims
OG exemplary drawing
 
1. A method of removing cardiac valve tissue, comprising:
providing a tissue dissection and removal catheter, the tissue dissection and removal catheter having a proximal end, a distal end and defining a longitudinal axis along its length, the tissue dissection and removal catheter including:
an outer tubular member having a proximal end, a distal end, and defining an elongate passage therethrough along its length; and
a subassembly slidably disposed in the elongate passage of the outer tubular member, the subassembly including first and second deployable stabilizers, the first and second deployable stabilizers each being configured to expand in lateral width along a direction transverse to the longitudinal axis when unconstrained by the outer tubular member, each said stabilizer defining a curved free distal end that is being configured to be received within a cusp of a respective cardiac valve leaflet, wherein the curved free distal end of each said stabilizer faces along a distal direction such that distal advancement of the subassembly urges the curved free distal end of each stabilizer into a respective cardiac valve cusp;
introducing the tissue dissection and removal catheter into a patient at a target location within a patient's vasculature;
advancing the subassembly along a distal direction toward an underside of a cardiac valve;
individually deploying the first and second deployable stabilizers out of the outer tubular member;
directing the curved free distal end of each said stabilizer into respective first and second cusps of the cardiac valve adjacent a circumferential wall surrounding the cardiac valve to stabilize the position of the valve leaflet dissection and removal catheter with respect to the target location, wherein each said deployable stabilizer stabilizes the subassembly in place without individually grasping cardiac tissue, and further wherein the first and second deployable stabilizers are configured to be slidably and rotatably articulable with respect to each other;
deploying a further tool out of the outer tubular member, the further tool being slidably and rotatably displaceable with respect to the first and second deployable stabilizers; and
removing tissue from the cardiac valve at least in part by using the further tool.