CN110650711A - 瓣膜锚定件和安装方法 - Google Patents
瓣膜锚定件和安装方法 Download PDFInfo
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Abstract
描述了用于将假体瓣膜固定至天然瓣环的锚定装置和方法。锚定装置可以是与假体瓣膜分开的可扩张元件,锚定装置首先被推进到瓣环并被部署,然后,可扩张的假体瓣膜被推进到瓣环内并被部署。这两个元件的组合可以向瓣膜小叶施加夹持力,夹持力使假体瓣膜保持在适当的位置。锚定装置可具有下部或心室部以及上部或心房部。锚定装置可包括一个或多个小叶夹持部。夹持部之间的一个、两个或更多个直立的垂直柱可以在瓣膜连合向上延伸并支撑上部,上部可以包括一个或多个用于防止泄漏的结构。
Description
相关申请的交叉引用
本申请要求保护于2017年5月22日提交的美国临时申请号62/509,278的权益。该申请通过引用其整体并入本文。
技术领域
本发明涉及修复或置换天然瓣膜,包括用于将假体瓣膜锚定或对接(docking)在天然瓣膜上的装置以及相应的安装方法。
背景技术
心脏是具有四个泵送腔室的中空肌肉器官,所述四个泵送腔室由四个心脏瓣膜隔开:主动脉瓣、二尖瓣(mitral或bicuspid)、三尖瓣和肺动脉瓣。心脏瓣膜由被称为瓣环的致密纤维环、和附接到瓣环的挠性组织小叶或尖(cusps)组成。
先天性、炎性、或感染性病况可致使心脏瓣膜不太有效。这样的病况最终可导致严重的心血管损害(cardiovascular compromise)或死亡。多年来,针对这样的病症的确定的治疗是在心脏直视手术期间的外科修复或瓣膜的置换,即在患者进行心肺转流术时将假体瓣膜缝合于适当位置。这样的手术是耗时的、危险的并且易于出现并发症。
较小侵入性的经血管和经心尖(transapical)技术可用于在心脏搏动同时非体外循环(off-pump)地引入和植入假体心脏瓣膜。例如,假体瓣膜可以以折绉的(crimped)状态被安装在挠性导管的端部上,并且被推进通过患者的血管,直到瓣膜到达植入部位。然后可使在导管尖端处的瓣膜在缺陷性天然瓣膜部位处扩张至其功能尺寸,如通过使球囊(瓣膜安装于其上)膨胀。可替代地,瓣膜可具回弹的、自扩张的支架或框架,当它从导管远端处的递送鞘被推进时,所述支架或框架将瓣膜扩张至它的功能尺寸。这些都是无缝线技术,其可以大大减少程序时间。
无缝线瓣膜的一个问题是瓣膜移位(migration)的可能性。例如,当部署主动脉假体瓣时,100-200mmHg的压强会立即加载在主动脉瓣上。压强乘以瓣膜表面积会在假体瓣膜上产生相当大的负载力,并可导致朝向主动脉弓的瓣膜移位。
二尖瓣的治疗可能会提出其他的挑战,并且适合于主动脉瓣的方法和器械可能不能很好适合与二尖瓣一起使用。举例来说,二尖瓣包括从瓣膜小叶延伸到心室壁的腱索簇,其可能干扰假体的放置。二尖瓣的形状——不是像主动脉瓣那样是圆形且均匀的——可以是椭圆形或肾样形状,其可能不太适合于支撑圆柱形构型的常规支架。进一步,鉴于主动脉瓣环通常完全被肌肉组织包围,二尖瓣环可以仅由外(后)壁上的肌肉组织束缚。二尖瓣环的前侧被邻近左心室流出道(“LVOT”)的薄管壁束缚,所述左心室流出道必须保持打开以允许血液进入到主动脉中。结果,支架型固定可能不适合于二尖瓣,因为天然瓣膜的前侧具有不足的径向强度并且可能扭曲,从而有左心室流出道闭塞的风险。此外,二尖瓣疾病通常伴随着(或归因于)天然瓣环和/或左心室的逐渐增大。因此,当瓣环的尺寸和形状改变时,依赖于与天然瓣环的径向接合或针对天然瓣环的向外压缩的治疗方法可能会失效。
尽管有某些进步,但是仍然需要将假体心脏瓣膜植入到二尖瓣环的改进的方法、***和器械。
发明内容
该发明内容意在提供实例,而无意以任何方式限制本发明的范围。例如,除非权利要求明确地叙述了特征,否则该发明内容的实例中包括的任何特征都不是权利要求所要求的。同样,这里和本申请其他地方描述的特征可以通过多种方式被组合。
本申请公开了用于将假体心脏瓣膜固定至天然心脏瓣环的锚定装置和方法的实施方式。锚定装置可以是与心脏瓣膜假体分开的可扩张元件,其可以首先被推进至天然瓣环并被部署,之后,可扩张心脏瓣膜假体可以被推进至天然瓣环和/或锚定装置内并被部署。锚定装置和心脏瓣膜假体的组合可以向心脏瓣膜小叶施加夹持力,夹持力将假体心脏瓣膜保持在适当的位置。
锚定装置可具有下部(例如,可布置(disposable)/可定位在左心室中的心室部)和上部(例如,可布置/可定位在左心房中的心房部)。下部可以包括一个或多个小叶夹持部,例如,两个彼此相对的小叶夹持部,其径向定位在天然瓣膜小叶的外部(outside)。夹持部之间的一个、两个或多个直立的垂直柱可以在瓣膜连合处向上延伸并支撑上部,上部可以包括一个或多个用于防止泄漏的结构。
本文的锚定装置可以用于将假体瓣膜固定在天然瓣膜(例如,心房和心室之间的天然瓣膜,如二尖瓣或三尖瓣)处。锚定装置可包括下部或心室部以及上部或心房部。下部或心室部可以是在上部或心房部的下方。下部或心室部可以具有围绕垂直轴线的可扩张管状主体,并且可以包括支柱(例如,起伏的(undulating)支柱)。管状主体可限定一个、两个、三个或更多个小叶夹持部(例如,彼此相对的两个小叶夹持部)。每个可以被至少一个向上延伸的峰(peak)限定。在下部或心室部或峰的相对侧上(例如,在两个小叶夹持部之间)也可以存在向下的谷(valley)。锚定装置可被配置以接收和/或任选地包括在锚定装置内扩张的可扩张的假体瓣膜。
锚定装置可进一步包括一个或多个直立的垂直柱,例如,在起伏的支柱的每个谷处开始并向上延伸超过两个小叶夹持部的峰的最大高度并终止在上部或心房部中的直立的垂直柱。垂直柱可以围绕锚定装置的圆周彼此小于180°设置(located)(例如,如果仅使用两个柱,则它们可以但不需要间隔180°)。上部或心房部可以包括被附接到垂直柱的顶端的多孔材料的环形圈。多孔材料的环形圈可以选自聚酯织物、多孔聚合物材料、ePTFE、泡沫、其他材料、或前述的一些或全部。上部或心房部可在每个垂直柱的末端包括一对Y形支柱,这对Y形支柱可以任选地包括覆盖物。心房部可在每个垂直柱的末端包括线圈(wirering),线圈可以任选地包括覆盖物。
夹持部可各自包括至少两个峰和在其间的一个谷。夹持部可以被(例如,用织物、涂层、聚合物材料和/或其他材料)覆盖。
每个支柱可以具有各种相同或不同的形状。作为一个实例,每个支柱可以包括起伏的S形,并且以渐近方式在峰和谷处的各端处终止。支柱还可以限定正弦曲线(sinusoidal)图案。
下部或心室部可包括一个或多个一体形成的向下延伸的腿(legs),腿终止于谷的下方的卡扣中,以便于锚定装置的操纵和部署。腿可各自从夹持部的峰中的一个向下延伸。在一个实施方式中,有三个腿和三个卡扣。卡扣可以形成具有穿过其中的孔的正方形或矩形或其他形状。
也可以使用本文其他地方描述的附加部件和/或组件。
本文中的方法(例如,心脏不停跳方法(beating heart method))可以用于将假体瓣膜固定在天然瓣膜(例如,在心房和心室之间的天然瓣膜)处。天然瓣膜具有天然小叶(以及任选地,在心室中附接的索(chordae))、和在天然瓣膜的天然瓣环处的小叶之间的连合(commissures)。方法可以包括将锚定装置推进至天然瓣膜,该装置具有下(例如心室)部和上(例如心房)部。下部或心室部可具有围绕垂直轴线的可扩张管状主体,可扩张管状主体包括起伏的支柱。
在一个实施方式中,管状主体具有彼此相对的两个小叶夹持部。两个小叶夹持部各自被两个小叶夹持部之间的至少一个峰和两个谷限定。锚定装置进一步包括两个直立的垂直柱,每个垂直柱在起伏的支柱的单独的谷处开始并向上延伸超过两个小叶夹持部的峰的最大高度并终止在上部或心房部中。锚定装置支柱可以是镍钛诺,并且每个夹持部可以具有至少两个峰和在其间的一个谷。夹持部可以被织物覆盖。
心房部可以以多种方式形成。例如,心房部可包括管状泡沫构件。心房部还可在每个垂直柱的末端处包括一对Y形支柱。横跨每对Y形支柱可包括织物覆盖物。任选地,心房部在每个垂直柱的末端包括线圈。横跨线圈可包括覆盖物。
方法还可包括使装置的下部或心室部在瓣环下方(例如在心室中)扩张,并将两个小叶夹持部径向地定位在天然小叶的各自小叶外部。方法还可以包括定位直立柱,使得它们在瓣膜连合处向上突出(例如在两个瓣膜连合处的两个直立柱)并支撑天然瓣环上方(例如在心房中)的上部或心房部。
方法还可以包括使可扩张的假体瓣膜推进到天然小叶内,并且使可扩张的假体瓣膜扩张以压缩天然小叶向外抵靠在装置的小叶夹持部上。任选地,可以使用一个进入或递送***或两个单独的进入或递送***来部署锚定装置和假体瓣膜。
也可以使用本文其他地方描述的附加步骤,并且方法的步骤可以重新排序。
用于将假体瓣膜固定在天然瓣膜处的***可包括可扩张/可皱缩的(collapsible)锚定装置,可扩张/可皱缩的锚定装置具有在第二部分或上部下方的第一部分或下部,第一部分或下部具有围绕垂直轴线的可扩张管状主体并且包括支柱(例如,起伏的支柱等),管状主体限定被至少一个向上延伸的峰限定的小叶夹持部,其中在与至少一个小叶夹持部邻近的第一部分或下部上存在向下的谷,装置进一步包括直立的垂直柱,垂直柱在向下的谷处开始并向上延伸超过小叶夹持部的至少一个峰的最大高度并终止在第二部分或上部中。
***还可包括一个或多个附加的小叶夹持部(例如,第二小叶夹持部)。小叶夹持部可以被向上延伸的至少一个峰或多于一个的峰限定。在一个实施方式中,夹持部各自包括至少两个峰和在其间的一个谷。小叶夹持部(一个或多个)可以被织物覆盖。
支柱可以采用各种形状和构型。在一个实施方式中,装置包括起伏的支柱,并且每个起伏的支柱具有S形并且以渐近方式终止在峰和谷处的各端处。
***可以包括一个或多个附加的垂直柱(例如,第二个直立的垂直柱)。在一个实施方式中,垂直柱在第二个向下的谷处开始并且向上延伸超过小叶夹持部的至少一个峰的最大高度并终止在第二部分或上部中。垂直柱可以围绕锚定装置的圆周彼此小于180°设置。当天然连合不彼此间隔180°设置时(例如在二尖瓣中安装时),这可能是有益的。
下部可以包括一个或多个一体形成的向下延伸的腿,腿终止于谷的下方卡扣中,以便于锚定装置的操纵和部署。在一个实施方式中,腿中的至少一个从小叶夹持部的至少一个峰向下延伸。在一个实施方式中,存在三个向下延伸的腿和卡扣。卡扣可以形成具有穿过其中的孔的正方形或矩形或其他形状。
第二部分或上部可包括被附接到垂直柱的顶端的多孔材料的环形圈。多孔材料的环形圈可以选自聚酯织物、多孔聚合物材料、ePTFE、和泡沫或其他材料。第二或上部可以在每个垂直柱的末端处包括一对Y形支柱。可横跨每对Y形支柱包括织物覆盖物。第二部分或上部可以在每个垂直柱的末端处包括线圈。可横跨线圈包括织物覆盖物。
***还可包括可扩张的假体心脏瓣膜,其可在锚定装置内扩张。
还可以使用本文其他地方描述的附加部件和/或组件。
本文中的方法(例如,将假体瓣膜固定在天然瓣膜处的方法)可以包括将锚定装置推进到天然瓣膜。锚定装置可以与本文其他地方描述的其他锚定装置相同或相似。例如,锚定装置可具有第一部分或下部以及第二部分或上部。第一部分或下部可具有围绕垂直轴线的可扩张管状主体,管状主体包括支柱(例如,起伏的支柱)。管状主体可具有一个或多个小叶夹持部。小叶夹持部可以由至少一个峰和与所述至少一个峰邻近的谷限定。锚定装置可进一步包括一个或多个直立的垂直柱。直立的垂直柱可以在起伏的支柱的谷处开始并且向上延伸超过小叶夹持部的至少一个峰的最大高度并终止在第二部分或上部中。锚定装置支柱可以是镍钛诺,并且每个夹持部可以具有一个或多个峰和在其间的谷(例如,至少两个峰和一个谷)。夹持部可以被织物覆盖。
第二部分或上部可包括管状泡沫构件。第二或上部可以在每个垂直柱的末端处包括一对Y形支柱。可以横跨每对Y形支柱使用织物覆盖物。第二部分或上部可以在每个垂直柱的末端处包括线圈,并且可以包括横跨线圈的覆盖物。
方法还可以包括使装置的第一部分或下部在天然瓣膜或天然瓣环下方扩张,并且可以包括将小叶夹持部径向地定位在天然瓣膜的天然小叶的至少一个小叶外部。方法还可以包括定位直立的垂直柱,使得它在天然瓣膜连合处向上突出,并且在天然瓣环或天然瓣膜上方支撑第二部分或上部。
方法还可以包括使可扩张的假体瓣膜推进至天然小叶内,并且使假体瓣膜扩张以将至少一个小叶压缩向外抵靠在小叶夹持部上。
方法可以包括使用相同的进入***或递送***来部署锚定装置和假体瓣膜,或者使用两个单独的进入***。
也可以使用本文其他地方描述的附加步骤,并且方法的步骤可以重新排序。
通过以下结合附图的详细描述,本发明的其他特征和优点将变得明显,附图通过实例的方式示例了本发明的原理。
附图说明
图1A是从二尖瓣的心房侧看的示意性立体图和左心室的瓣下解剖部位的剖视图;
图1B是指示了常规解剖学特征的常用命名的首字母的二尖瓣小叶的心房平面图;
图1C是二尖瓣小叶和具有解剖学描述符的瓣下结构的平铺图(laid-flatdiagram);
图2A和2B是本申请的具有起伏的心室部和管状防泄漏的心房部的示例性锚定装置的侧视立体图和俯视立体图,而图2C是其分解图;
图3A是类似于图1A的示出了当部署时锚定装置位置的二尖瓣的示意性立体图;
图3B是二尖瓣和所部署的锚定装置的一部分的平铺图;
图3C是类似于图3A的在锚定装置内递送假体心脏瓣膜之后的示意性立体图;
图4A至图4D是可与本文描述的锚定装置一起使用的示例性防泄漏的心房部;
图5是指示了用于本文描述的锚定装置的示例性虚线轮廓的二尖瓣小叶的心房平面图;
图6是被配置为与图5的虚线轮廓相匹配的锚定装置的仅下部或心室部的平面图;
图7是示例性锚定装置的下部或心室部的正视图,在示例性锚定装置上重叠(superimposed)有起伏的虚线;
图8是形状像图7中的起伏的虚线的可替代锚定装置的下部或心室部的正视图;
图9是具有起伏的形状和织物覆盖物的进一步示例性锚定装置的下部或心室部的正视图。
具体实施方式
进行下列描述和附图(其描述和显示某些实施方式)以非限制性方式展示了可用于本公开的各个方面和特征的***、平台、装置、方法等的几种可能的构型。
描述了用于辅助将假体心脏瓣膜植入在天然瓣膜(例如,二尖瓣、三尖瓣等)处的锚定装置。锚定装置可与假体心脏瓣膜分开并在假体心脏瓣膜之前被单独地植入。一旦锚定装置已经被安装在天然瓣膜(例如,二尖瓣等)处,则假体心脏瓣膜就被递送并被耦接到其上。可以使用一个组合的或两个分开的导管、递送***/装置、或进入***/装置来完成这个过程。虽然本文关于二尖瓣给出了实例,但是本文描述的装置、***、方法等的使用不限于与二尖瓣一起使用,而是可以被应用于其他瓣膜(例如主动脉瓣、肺动脉瓣、三尖瓣)或其他位置。
锚定装置可以与各种类型的可扩张瓣膜结合使用,例如,与球囊-可扩张的假体心脏瓣膜(如由加利福尼亚州欧文市的Edwards Lifesciences制作的Edwards SAPIEN 3经导管心脏瓣膜(THV),或如在美国专利号6,730,118中所描述的,其在此通过引用明确地并入本文)结合使用。然而,这些示例性THV不应被解释为限制性的,并且所公开的锚定装置(一个或多个)的实施方式可用于固定通过各种机构递送的多种多样的THV(例如,自扩张心脏瓣膜、其它球囊-扩张心脏瓣膜、可机械扩张心脏瓣膜等等)。术语“可扩张心脏瓣膜”意在包含所有这样的种类。
对于锚定装置(一个或多个)和假体心脏瓣膜,通过身体并进入心脏中的示例性递送途径包括经血管(例如经股动脉)途径、经心尖途径和经主动脉途径等。在经血管的方法中,可以在距心脏相对远的部位处将导管***到脉管***中。锚定装置或假体瓣膜可以以折绉的状态安装在挠性导管的端部上并且通过患者的血管推进,直到瓣膜到达植入部位。然后使在导管尖端处的瓣膜在缺陷性天然瓣膜的部位处扩张至其功能尺寸,如通过使球囊(瓣膜安装在其上)膨胀。
可以使用具有导管或鞘的各种递送或进入***。可以使用一个进入***或递送***用于近乎同时递送、或者使用两个分开的***用于顺序递送来部署锚定装置和假体心脏瓣膜。美国专利号8,439,970中公开了一种适合于在经心尖程序中将假体瓣膜引入到心脏中的一种递送***,该专利通过引用并入本文。在经心尖程序中,将假体瓣膜通过心尖中的外科开口引入到左心室中。类似地,’970专利中的递送***可被用于在经主动脉的程序中将假体瓣膜引入到心脏中。在经主动脉手术中,假体瓣膜通过升主动脉中的外科切口引入到主动脉中(如通过部分J型胸骨切开术或右胸骨旁微型胸廓切开术),且然后通过升主动脉朝向心脏推进。经皮或经导管的递送***也是可能的。
图1A是从二尖瓣200的心房侧看的示意性立体图以及左心室202的瓣下解剖部位的剖视图。二尖瓣200主要包括一对接合小叶——前小叶204和后小叶206,其围绕它们的外边缘被固定到纤维二尖瓣环208。前小叶204和后小叶206的内边缘连接到弦状(string-like)腱索210(向下延伸到左心室202中),并且被栓在从限定左心室腔的肌肉心肌214向上延伸的***肌212处。作为心脏的主要出口泵送腔室,心肌214在心缩期中收缩,其减少腱索210中的张力并准许小叶204、206集合或接合。左心室202内的容积的收缩将血液通过主动脉瓣(未示出)送出并送入到身体中。在心舒期,心肌214向外扩张,在紧张状态下(intension)向下拉动腱索210以帮助打开小叶204、206,并通过二尖瓣200拉动(pulling)血液以填充左心室202的腔。
图1B是二尖瓣200的小叶204、206的心房平面图。周围的二尖瓣环208通常被描述为D形,其具有邻近前小叶204的有些(somewhat)较直侧和邻近后小叶206的较圆侧或凸出侧。小叶被成形使得接合线类似微笑,其近似地与二尖瓣环208的后侧方面(posterioraspect)平行。前小叶204在围绕二尖瓣环208的***方面(peripheral aspect)跨距(span)比后小叶206更小,但是前小叶204具有单个尖突(cusp),尖突具有凸出的自由边缘,自由边缘更远地延伸到由二尖瓣环208限定的孔口中。通常,前小叶204围绕它的***具有三个标记的区域或尖突A1、A2、A3。另一方面,后小叶206典型地被折痕分成围绕其***的三个尖突P1、P2、P3,并且具有通常凹形的自由边缘。两个连合(前连合220和后连合222)通常限定了两个小叶204、206和二尖瓣环208之间的接合线的交点(交叉,相交,intersection)。如将看到的,前连合220和后连合222处的区域可能不是那么清晰,并且有时尖突或小叶在那些点处被限定。
图1C是二尖瓣小叶204、206和具有解剖学描述符的瓣下结构的平铺图。特别地,将前小叶204和后小叶206(以及连合小叶224,如果存在)的自由边缘连接到腱索210,然后到瓣下***肌。存在两条***肌——前外侧和后内侧***肌226、228。从***肌中的每个向上延伸的腱索连接到小叶204、206的部分。在左心室202外部的心壁中还示出了冠状窦230和旋动脉232。
图2A和2B是本申请的示例性锚定装置20的侧面立体图和俯视立体图,锚定装置20具有起伏的下部22(通常称为“心室部”,但可以用于其他位置中)和管状防泄漏的上部24(通常称为“心房部”,但可以用于其他位置中),而图2C是其分解图。
示例的锚定装置20的心室部22包括多个峰30,多个峰30以起伏的方式围绕心室部圆周与相同数量的谷32均匀地交替。在一个示例性实施方式中,有六个相隔60°的峰30,每个与邻近的谷32隔开30°。峰30和谷32期望地位于管状空间中,使得峰30沿着Z轴线被定位在谷32上方,Z轴线通常平行于当装置被植入时通过二尖瓣的血流。
下降和上升的圆周支柱34、36将每两个邻近的峰30和谷32连接起来。更特别地,当沿着轴线Z向下看时,第一圆周支柱34从峰30中的每一个顺时针方向(CW)向下延伸到谷32中的每一个,并且第二圆周支柱36从谷CW向上延伸到下一个峰。圆周支柱34、36通常可以是S形的,具有两个不同的由拐点隔开的曲率。更具体地,支柱34、36中的每个可以以渐近方式终止在其相应的峰和谷处,使得其几乎与垂直的Z轴线对准。看在图2A至2C中的在峰30和谷32之间延伸的圆周支柱34中的一个,第一区段最初在几乎垂直的方向上向下延伸并且具有凹形的向上曲率直到支柱的中点处的拐点为止。从那里,第二区段被凹形向下弯曲,直到其在谷32处几乎垂直的为止。第二圆周支柱36可具有相似或不同的形状。如将要说明的,支柱34、36可被部署成使得它们与天然心脏瓣膜小叶处于直接接触,并且这个S形构型增强了它们夹紧或夹持小叶的广域(wide area)抵靠可扩张心脏瓣膜(被定位在小叶内)的能力。
在图2A至图2C示例的实施方式中,峰30和谷32被设置成相同的形状,并且具有通常平坦的端。任选地,峰30和谷32可以是圆的或更锐利的,并且峰可以是与谷不同的形状。例如,峰30可具有比谷32大的半径,反之亦然。另外地,尽管支柱34、36可以是不对称的,使得峰30看起来比谷32长(反之亦然),但支柱34、36通常是相同的并且在沿Z轴线的中途具有拐点。除了将看到的两个位置处之外,心室部22的起伏形状使锚定装置20能够部分地装配到二尖瓣小叶的外部。
心室部22可以经由一个或多个直立的连合柱40(例如一个、两个、三个或更多个直立的连合柱)连接至心房部24。在示例的实施方式中,如将以下描述的,存在两个柱40,两个柱40彼此直径上对置并且从谷32中的两个向上延伸,该谷32中的两个通常被彼此相对设置并在心室部22的夹持部之间。杆40向上延伸超过峰30的上限(upper extent),并且可以被嵌入并被固定在管状心房部24内。心房部24可包括多孔材料(如聚酯织物、多孔聚合物材料、ePTFE或泡沫)的环形圈。将连合柱40连接到心房部24的手段可以是用粘合剂、缝线、插销(latches)、摩擦等。任选地,柱40可以具有某种倒钩或粗糙度,以实现简单的摩擦保持。更进一步,柱40可以被布覆盖或具有一个或多个眼孔并且被缝合到心房部24。
心室部22可进一步包括一个或多个向下延伸的腿42,其终止于卡扣44,以便于锚定装置20的操纵和部署。在示例的实施方式中,卡扣形成具有穿过其中的孔的正方形或矩形。卡扣44可以与心室部22一体地形成,并且优选地从一个或多个峰30向下延伸。在这点上,术语“一体地形成”是指卡扣44与心室部22的其余部分同质地(homogeneously)形成为单件,或者卡扣以使能够操纵卡扣的方式被固定到心室部22,以操纵内部主体。例如,在卡扣44和心室部22的制造之后,卡扣44可以被焊接到心室部22。
现在参考图3A,示出了锚定装置20被部署在二尖瓣处,其中心室部22在二尖瓣环208下方并且心房部24被设置在瓣环上方。直立的连合柱40连接两个部分,并且在前连合220和后连合222处延伸横跨二尖瓣环208。
图3B是二尖瓣和部署的锚定装置20(其中为了清楚起见,移除了心房部24)的平铺图。如所提及的,除了在两个连合柱40处之外,心室部22的起伏形状使锚定装置20能够部分地装配到二尖瓣小叶204、206的外部。即,心室部22的所有三个峰30均在小叶的外部,而谷32在小叶的内部,其中连合柱40从谷32向上延伸。这样,连合柱40可以在两个瓣膜连合220、222处向上延伸,以将在瓣环上方支撑心房部24。同时,心室部22的大部分位于小叶的外部,以提供锚定件,随后部署的假体瓣膜可被固定抵靠锚定件。在小叶的外部的心室部22的部分限定了锚定装置20的夹持部,并且可以具有如下描述的不同构型。进一步,本文中的各种锚定装置可包括如所示的两个夹持部或另外数量的(例如一个、三个或更多个)的夹持部。心室部22仅在夹持部从谷32上升的意义上“起伏”,连合柱40从谷32突出。再一次,谷32被设置在夹持部之间,连合柱40从谷32突出。
将假体心脏瓣膜固定在左心房234和左心室202之间的二尖瓣200处的,示例性心脏不停跳方法包括使锚定装置20推进至二尖瓣以及使装置的心室部22在左心室中扩张。使用镊子或其他操纵工具,将两个小叶夹持部径向定位在两个小叶204、206中的相应小叶的外部。然后,外科医生将直立柱40定位,使得它们在两个天然瓣膜连合220、222处向上突出,并在左心房中将心房部24支撑在二尖瓣环上方。随后,可扩张的假体心脏瓣膜被推进到二尖瓣小叶204、206内,并被扩张以压缩小叶向外抵靠装置20的两个小叶夹持部。
图3C是类似于图3A的在锚定装置20内假体心脏瓣膜50的递送之后的示意性立体图。如所提及的,假体心脏瓣膜50可向外扩张并且夹住(sandwiches)二尖瓣小叶204、206(抵靠心室部22的夹持部的内表面)。如上所提及,假体心脏瓣膜50可以以各种方式被构造,并且可以包括支撑挠性小叶54(诸如牛心包小叶)的可扩张结构支架或框架52。框架52的顶部边缘可以被部署,使得其终止在锚定装置20内,并且如所示结束在心房部24内。锚定装置20的心室部22具有足够的环向强度(hoop strength),以提供对抗可扩张框架52的强大的向内的反作用力,其转而提供对二尖瓣小叶204、206的充分压缩以将瓣膜50固位在适当位置。然后假体心脏瓣膜50的挠性小叶54正常地起作用并置换天然小叶。
图4A至4D是可与本文描述的锚定装置一起使用的示例性防泄漏的心房部。例如,上面显示的管状心房部24可以用较小的结构替代,该结构可以在天然瓣膜连合220、222处提供各种塞(plug)和/或在连合处向两个二尖瓣小叶204、206施加(exert)夹紧力,在这两种情况下,都帮助减少围绕假体心脏瓣膜50的向上的血液反流(称为“瓣周漏(paravalvular leakage)”)。
例如,图4A示出了形成在垂直柱40的上端上的一对Y形支柱60。支柱60在瓣膜连合220、222的心房侧上延伸并且卷曲围绕以接触二尖瓣小叶204、206的外部范围(outerextents)并朝向彼此给二尖瓣小叶204、206的外部范围加力(urge),因而封闭(closingoff)可能在天然连合处在假体心脏瓣膜50外部形成的任何开口。图4B是类似的结构,其中横跨Y形支柱60增加了小的织物覆盖物62,这进一步帮助封闭任何血液泄漏。
图4C示出了可替代的实施方式,其中在每个柱40的顶部处提供了线圈70。线圈70可以是镍钛诺,并且被成形以在天然瓣膜连合220、222处向二尖瓣小叶204、206施加压缩力,这帮助关闭可能准许泄漏的任何间隙。图4D示出了在每个柱40上的相同的线圈70(具有被固定到其上的网状物或织物覆盖物72)。覆盖物72可以是编织的金属筛或聚合物织物,并且进一步帮助减少瓣周漏。
图5是二尖瓣小叶204、206的心房平面图,其指示了用于本文所描述的锚定装置的示例性圆形虚线轮廓80。可以绘制轮廓80的中心点82、以及通过中心的大致沿二尖瓣环的主轴线定向的水平轴线84。也就是说,二尖瓣环通常呈现为D形或菜豆形、或至少椭圆形,其中较长尺寸(dimension)垂直于较短尺寸。较短尺寸或短轴大致将两个二尖瓣小叶204、206平分(bisects)。由于圆形锚定装置在不规则形状的二尖瓣环内扩张的不匹配,沿着锚定装置的直径的水平轴线84将不太可能与天然瓣膜连合220、222相交。从中心点82通过连合220、222绘制了两条虚线86。由于连接锚定装置的心室和心房部的直立垂直柱必须穿过连合220、222并因此与连合220、222对准,因此它们可以围绕锚定装置从水平轴线84偏移定位,并且特别地沿虚线86定位。
图6是被配置以与图5的虚线轮廓相匹配的锚定装置90的仅心室部的俯视图。锚定装置90可以与如以上描述相同地被构造,使得一系列支柱92限定谷96中间的峰94。如前所述,两个直立柱98在谷96中的两个处向上突出,但是如图5中所示和图6中所代表的,从水平轴线84稍微偏移地被设置。虚线86也被示出并且穿过直立柱98。即,两个直立柱98围绕锚定装置20的圆周彼此小于180°设置。由虚线86与水平轴线84形成的角度限定的每个直立柱98的角偏移(angular offset)期望在约5°和15°之间。换句话说,两个直立柱98围绕锚定装置20的圆周彼此在150°和170°之间被设置。这确保直立柱98与天然瓣膜连合220、222的位置更紧密地重合,从而当锚定装置90被植入时限制二尖瓣环的变形。
图7是示例性锚定装置20的心室部的正视图,在锚定装置20上重叠有起伏的虚线100。虚线100具有正弦曲线形状以示例锚定装置20的支柱的基本起伏。
图8是可替代的锚定装置102的心室部的正视图,可替代的锚定装置102具有形状像图7中的起伏的虚线100的支柱104。在这个构型中,所有峰和谷均具有圆形端,以帮助减少二尖瓣小叶的任何锋利边缘和可能的磨损。
图9是具有起伏的支柱112和织物覆盖物114的进一步可替代的锚定装置110的心室部的正视图。峰和谷的数量被减少到直立柱116所起源的谷之间的一个峰的最小值。这示出了锚定装置110的夹持部的形状的一种极端,并且示例了起伏的含义。即,锚定装置在夹持部和谷之间起伏,直立柱116从谷突出。这使得直立柱116能够被设置在二尖瓣小叶内,从而能够向上延伸到其心房侧。同时,夹持部上升并可以被定位在二尖瓣小叶的外部,用于与假体瓣膜夹持接合。夹持部可仅包括一个峰或向上弯曲、或如图7和8中的多个峰。织物覆盖物114可以横跨多个峰延伸并且帮助避免与腱索缠结。交替的峰和谷准许锚定装置被收缩成较小的直径轮廓,以通过进入管或鞘递送,但是可以构想其他可压缩结构。
虽然已经依据具体变型和示例的附图描述了本发明,但是本发明不限于所描述的变型或附图。关于一个实施方式或变型描述的部件可以在其他实施方式或变型中使用。可以将单独描述的方法进行组合。另外,在上面描述的方法和步骤表明以一定次序发生某些事件的情况下,可以修改某些步骤的次序,并且这种修改是根据本发明的变型进行的。另外,步骤中的某些可以在可能的情况下在平行过程中被同时执行,以及如上所描述被顺序地执行。在不脱离本发明的实质范围的情况下,可以做出许多修改以使特定情况或装置适应本发明的教导。因此,意图是发明不限于本文公开的具体实施方式、和发明的变型存在的范围,变型在本公开的精神之内或等同于权利要求中找到的发明,意图是这个专利也将涵盖这些变型。
Claims (56)
1.用于将假体瓣膜固定在心房和心室之间的天然瓣膜上的锚定装置,包括:
在心房部下方的心室部,所述心室部具有围绕垂直轴线的可扩张管状主体并且包括起伏的支柱,所述管状主体限定彼此相对的两个小叶夹持部,每个小叶夹持部由向上延伸的至少一个峰限定,其中在所述两个小叶夹持部之间的所述心室部的相对侧上存在向下的谷,所述装置进一步包括直立的垂直柱,所述直立的垂直柱在所述起伏的支柱的每个谷处开始并向上延伸超过所述两个小叶夹持部的所述峰的最大高度并终止在所述心房部中。
2.权利要求1所述的锚定装置,其中所述锚定装置支柱是镍钛诺。
3.前述权利要求中任一项所述的锚定装置,其中所述夹持部各自包括至少两个峰和在其间的一个谷。
4.前述权利要求中任一项所述的锚定装置,其中所述夹持部被织物覆盖。
5.前述权利要求中任一项所述的锚定装置,其中每个起伏的支柱具有S形形,并且以渐近方式在峰和谷处的各端处终止。
6.前述权利要求中任一项所述的锚定装置,其中所述起伏的支柱限定正弦曲线图案。
7.前述权利要求中任一项所述的锚定装置,其中所述垂直柱被设置为围绕所述锚定装置的圆周彼此小于180°。
8.前述权利要求中任一项所述的锚定装置,其中所述心室部进一步包括一个或多个一体形成的向下延伸的腿,所述腿终止于所述谷下方的卡扣中,以便于所述锚定装置的操纵和部署。
9.权利要求8所述的锚定装置,其中所述腿各自从所述夹持部的所述峰中的一个向下延伸。
10.权利要求8所述的锚定装置,其中存在三个所述腿和卡扣。
11.权利要求8至10中任一项所述的锚定装置,其中所述卡扣可以形成正方形或矩形,所述正方形或矩形具有从中通过的孔。
12.前述权利要求中任一项所述的锚定装置,其中所述心房部包括被附接到所述垂直柱的顶端的多孔材料的环形圈。
13.权利要求12所述的锚定装置,其中所述多孔材料的环形圈选自聚酯织物、多孔聚合物材料、ePTFE和泡沫。
14.前述权利要求中任一项所述的锚定装置,其中所述心房部在每个垂直柱的末端处包括一对Y形支柱。
15.权利要求14所述的锚定装置,进一步包括横跨每对Y形支柱的织物覆盖物。
16.权利要求1至13中任一项所述的锚定装置,其中所述心房部在每个垂直柱的末端处包括线圈。
17.权利要求16所述的锚定装置,进一步包括横跨所述线圈的织物覆盖物。
18.前述权利要求中任一项所述的锚定装置,进一步包括在所述锚定装置内扩张的可扩张的假体瓣膜。
19.将假体瓣膜固定在心房和心室之间的天然瓣膜处的心脏不停跳方法,所述天然瓣膜具有天然小叶和在所述心室中附接的索、和在所述天然瓣膜的天然瓣环处的所述小叶之间的连合,所述方法包括:
推进锚定装置至所述天然瓣膜,所述装置具有心室部和心房部,所述心室部具有围绕垂直轴线的可扩张管状主体,所述管状主体包括起伏的支柱,所述管状主体具有两个彼此相对的小叶夹持部,每个小叶夹持部由所述两个小叶夹持部之间的至少一个峰和两个谷限定,所述装置进一步包括两个直立的垂直柱,所述两个直立的垂直柱各自在所述起伏的支柱的单独的谷处开始并向上延伸超过所述两个小叶夹持部的所述峰的最大高度并终止在所述心房部中;
使所述装置的所述心室部在所述心室中扩张,并将所述两个小叶夹持部径向地定位在所述天然小叶的各自小叶外部;
定位所述直立柱,使得它们在所述瓣膜连合处向上突出,并在所述心房中在所述天然瓣环上方支撑所述心房部;以及
使可扩张的假体瓣膜推进至所述天然小叶内,并且扩张所述可扩张的假体瓣膜以将所述天然小叶压缩向外抵靠在所述装置的所述小叶夹持部上。
20.权利要求19所述的方法,其中使用一个进入***来部署所述锚定装置和假体瓣膜。
21.权利要求19所述的方法,其中使用两个单独的进入***来部署所述锚定装置和假体瓣膜。
22.权利要求19至21中任一项所述的方法,其中所述锚定装置支柱是镍钛诺,并且每个夹持部可以具有至少两个峰和在其间的一个谷。
23.权利要求19至22中任一项所述的方法,其中所述夹持部被织物覆盖。
24.权利要求19至23中任一项所述的方法,其中所述心房部包括管状泡沫构件。
25.权利要求19至24中任一项所述的方法,其中所述心房部在每个垂直柱的末端处包括一对Y形支柱。
26.权利要求25所述的方法,进一步包括横跨每对Y形支柱的织物覆盖物。
27.权利要求19至26中任一项所述的方法,其中所述心房部在每个垂直柱的末端处包括线圈。
28.权利要求27所述的方法,进一步包括横跨所述线圈的覆盖物。
29.用于将假体瓣膜固定在天然瓣膜处的***,包括:
可扩张/可皱缩的锚定装置,所述可扩张/可皱缩的锚定装置具有在上部下方的下部,所述下部具有围绕垂直轴线的可扩张管状主体并且包括起伏的支柱,所述管状主体限定由向上延伸的至少一个峰限定的小叶夹持部,其中在与至少一个小叶夹持部邻近的所述下部上存在向下的谷,所述装置进一步包括直立的垂直柱,所述直立的垂直柱在向下的谷处开始并向上延伸超过所述小叶夹持部的所述至少一个峰的最大高度并终止在所述上部中。
30.权利要求29所述的***,进一步包括由向上延伸的至少一个峰限定的第二小叶夹持部。
31.权利要求30所述的***,其中所述夹持部各自包括至少两个峰和在其间的一个谷。
32.前述权利要求中任一项所述的锚定装置,其中所述夹持部被织物覆盖。
33.前述权利要求中任一项所述的***,其中每个起伏的支柱具有S形并且以渐近方式在峰和谷处的各端处终止。
34.前述权利要求中任一项所述的***,进一步包括第二直立的垂直柱,所述第二直立的垂直柱在第二向下的谷处开始并且向上延伸超过所述小叶夹持部的所述至少一个峰的最大高度并终止在所述上部中,并且其中所述垂直柱被设置为围绕所述锚定装置的圆周彼此小于180°。
35.前述权利要求中任一项所述的***,其中所述下部进一步包括一个或多个一体形成的向下延伸的腿,所述腿终止于所述谷下方的卡扣中,以便于所述锚定装置的操纵和部署。
36.权利要求35所述的***,其中所述腿中的至少一个从所述小叶夹持部的所述至少一个峰向下延伸。
37.权利要求35所述的***,其中存在三个所述向下延伸的腿和卡扣。
38.权利要求35至37中任一项所述的***,其中所述卡扣形成正方形或矩形,所述正方形或矩形具有从中通过的孔。
39.前述权利要求中任一项所述的***,其中所述上部包括被附接到所述垂直柱的顶端的多孔材料的环形圈。
40.权利要求39所述的***,其中所述多孔材料的环形圈选自聚酯织物、多孔聚合物材料、ePTFE和泡沫。
41.前述权利要求中任一项所述的***,其中所述上部在每个垂直柱的末端包括一对Y形支柱。
42.权利要求41所述的***,进一步包括横跨每对Y形支柱的织物覆盖物。
43.权利要求29至40中任一项所述的***,其中所述上部在每个垂直柱的末端包括线圈。
44.权利要求43所述的***,进一步包括横跨所述线圈的织物覆盖物。
45.前述权利要求中任一项所述的***,进一步包括在所述锚定装置内扩张的可扩张的假体心脏瓣膜。
46.将假体瓣膜固定在天然瓣膜处的方法,包括:
将锚定装置推进到所述天然瓣膜,所述装置具有下部和上部,所述下部具有围绕垂直轴线的可扩张管状主体,所述管状主体包括起伏的支柱,所述管状主体具有由至少一个峰和与所述至少一个峰邻近的谷限定的小叶夹持部,所述装置进一步包括直立的垂直柱,所述直立的垂直柱在所述起伏的支柱的谷处开始并且向上延伸超过所述小叶夹持部的所述至少一个峰的最大高度并终止在所述上部中;
使所述装置的所述下部在所述天然瓣环下方扩张,并且将所述小叶夹持部径向地定位在所述天然瓣膜的天然小叶的至少一个小叶的外部。
47.权利要求46所述的方法,进一步包括定位所述直立的垂直柱,使得所述直立的垂直柱在天然瓣膜连合处向上突出,并且在所述天然瓣膜的天然瓣环上方支撑所述上部。
48.权利要求47所述的方法,进一步包括使可扩张的假体瓣膜推进至所述天然小叶内,并且扩张所述可扩张的假体瓣膜以将所述至少一个小叶压缩向外抵靠在所述小叶夹持部上。
49.权利要求46至48中任一项所述的方法,其中使用一个进入***来部署所述锚定装置和假体瓣膜。
50.权利要求46至48中任一项所述的方法,其中使用两个单独的进入***来部署所述锚定装置和假体瓣膜。
51.权利要求46至50中任一项所述的方法,其中所述锚定装置支柱是镍钛诺,并且每个夹持部包括至少两个峰和在其间的一个谷。
52.权利要求46至51中任一项所述的方法,其中所述夹持部被织物覆盖。
53.权利要求46至52中任一项所述的方法,其中所述上部包括管状泡沫构件。
54.权利要求46至53中任一项所述的方法,其中所述上部在每个垂直柱的末端处包括一对Y形支柱。
55.权利要求54所述的方法,进一步包括横跨每对Y形支柱的织物覆盖物。
56.权利要求46至55中任一项所述的方法,其中所述上部在每个垂直柱的末端包括线圈,并且可以横跨所述线圈包括覆盖物。
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Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN115957047A (zh) * | 2021-11-17 | 2023-04-14 | 北京佰仁医疗科技股份有限公司 | 一种分体式可精准锚定的介入环中瓣*** |
Families Citing this family (25)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8157853B2 (en) * | 2008-01-24 | 2012-04-17 | Medtronic, Inc. | Delivery systems and methods of implantation for prosthetic heart valves |
CN101919751A (zh) | 2009-03-30 | 2010-12-22 | 卡迪万蒂奇医药公司 | 经心尖传送无缝合人工瓣膜的方法和装置 |
EP2967810B1 (en) | 2013-03-14 | 2020-04-22 | Suzhou Jiecheng Medical Technology Co., Ltd. | Embolic protection devices |
US11406497B2 (en) | 2013-03-14 | 2022-08-09 | Jc Medical, Inc. | Heart valve prosthesis |
US11259923B2 (en) | 2013-03-14 | 2022-03-01 | Jc Medical, Inc. | Methods and devices for delivery of a prosthetic valve |
US10357361B2 (en) * | 2016-09-15 | 2019-07-23 | Edwards Lifesciences Corporation | Heart valve pinch devices and delivery systems |
CN209864176U (zh) | 2018-01-07 | 2019-12-31 | 苏州杰成医疗科技有限公司 | 假体心脏瓣膜输送*** |
CN210472336U (zh) | 2018-01-07 | 2020-05-08 | 苏州杰成医疗科技有限公司 | 心脏瓣膜假体 |
WO2019195860A2 (en) | 2018-04-04 | 2019-10-10 | Vdyne, Llc | Devices and methods for anchoring transcatheter heart valve |
US10595994B1 (en) | 2018-09-20 | 2020-03-24 | Vdyne, Llc | Side-delivered transcatheter heart valve replacement |
US11071627B2 (en) | 2018-10-18 | 2021-07-27 | Vdyne, Inc. | Orthogonally delivered transcatheter heart valve frame for valve in valve prosthesis |
US11278437B2 (en) | 2018-12-08 | 2022-03-22 | Vdyne, Inc. | Compression capable annular frames for side delivery of transcatheter heart valve replacement |
US10321995B1 (en) | 2018-09-20 | 2019-06-18 | Vdyne, Llc | Orthogonally delivered transcatheter heart valve replacement |
US11344413B2 (en) | 2018-09-20 | 2022-05-31 | Vdyne, Inc. | Transcatheter deliverable prosthetic heart valves and methods of delivery |
US11109969B2 (en) | 2018-10-22 | 2021-09-07 | Vdyne, Inc. | Guidewire delivery of transcatheter heart valve |
US11253359B2 (en) | 2018-12-20 | 2022-02-22 | Vdyne, Inc. | Proximal tab for side-delivered transcatheter heart valves and methods of delivery |
US11273032B2 (en) | 2019-01-26 | 2022-03-15 | Vdyne, Inc. | Collapsible inner flow control component for side-deliverable transcatheter heart valve prosthesis |
US11185409B2 (en) | 2019-01-26 | 2021-11-30 | Vdyne, Inc. | Collapsible inner flow control component for side-delivered transcatheter heart valve prosthesis |
EP4364706A2 (en) | 2019-03-05 | 2024-05-08 | Vdyne, Inc. | Tricuspid regurgitation control devices for orthogonal transcatheter heart valve prosthesis |
US11173027B2 (en) | 2019-03-14 | 2021-11-16 | Vdyne, Inc. | Side-deliverable transcatheter prosthetic valves and methods for delivering and anchoring the same |
US11076956B2 (en) | 2019-03-14 | 2021-08-03 | Vdyne, Inc. | Proximal, distal, and anterior anchoring tabs for side-delivered transcatheter mitral valve prosthesis |
WO2020227249A1 (en) | 2019-05-04 | 2020-11-12 | Vdyne, Inc. | Cinch device and method for deployment of a side-delivered prosthetic heart valve in a native annulus |
JP2022544707A (ja) | 2019-08-20 | 2022-10-20 | ブイダイン,インコーポレイテッド | 側方送達可能な経カテーテル人工弁の送達及び回収のデバイス及び方法 |
CN114630665A (zh) | 2019-08-26 | 2022-06-14 | 维迪内股份有限公司 | 可侧面输送的经导管假体瓣膜及其输送和锚定方法 |
US11234813B2 (en) | 2020-01-17 | 2022-02-01 | Vdyne, Inc. | Ventricular stability elements for side-deliverable prosthetic heart valves and methods of delivery |
Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008010817A1 (en) * | 2006-07-17 | 2008-01-24 | 3F Therapeutics, Inc. | Minimally invasive valve replacement system |
CN102791223A (zh) * | 2010-03-05 | 2012-11-21 | 爱德华兹生命科学公司 | 小外形心脏瓣膜及递送*** |
CN103153232A (zh) * | 2010-10-21 | 2013-06-12 | 美敦力公司 | 具有低心室型面的二尖瓣假体 |
CN103974674A (zh) * | 2011-10-19 | 2014-08-06 | 托尔福公司 | 人工心脏瓣膜装置、人工二尖瓣和相关***及方法 |
US20150216661A1 (en) * | 2010-07-21 | 2015-08-06 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
US20150328000A1 (en) * | 2014-05-19 | 2015-11-19 | Cardiaq Valve Technologies, Inc. | Replacement mitral valve with annular flap |
CN105101911A (zh) * | 2013-03-15 | 2015-11-25 | 托尔福公司 | 人造心瓣装置、人造二尖瓣以及相关***和方法 |
CN105283149A (zh) * | 2013-03-11 | 2016-01-27 | 内奥瓦斯克迪亚拉公司 | 具有防枢转机构的假体瓣膜 |
US20160051362A1 (en) * | 2014-08-21 | 2016-02-25 | Edwards Lifesciences Corporation | Dual-flange prosthetic valve frame |
US20160143733A1 (en) * | 2009-09-29 | 2016-05-26 | Edwards Lifesciences Cardiaq Llc | Replacement heart valve and method |
WO2016093877A1 (en) * | 2014-12-09 | 2016-06-16 | Cephea Valve Technologies, Inc. | Replacement cardiac valves and methods of use and manufacture |
Family Cites Families (302)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB1127325A (en) | 1965-08-23 | 1968-09-18 | Henry Berry | Improved instrument for inserting artificial heart valves |
US3587115A (en) | 1966-05-04 | 1971-06-28 | Donald P Shiley | Prosthetic sutureless heart valves and implant tools therefor |
US3548417A (en) | 1967-09-05 | 1970-12-22 | Ronnie G Kischer | Heart valve having a flexible wall which rotates between open and closed positions |
USRE30912E (en) | 1968-09-16 | 1982-04-27 | Hancock Laboratories, Inc. | Stent for heart valve |
US3671979A (en) | 1969-09-23 | 1972-06-27 | Univ Utah | Catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve |
US3657744A (en) | 1970-05-08 | 1972-04-25 | Univ Minnesota | Method for fixing prosthetic implants in a living body |
US3714671A (en) | 1970-11-30 | 1973-02-06 | Cutter Lab | Tissue-type heart valve with a graft support ring or stent |
US3755823A (en) | 1971-04-23 | 1973-09-04 | Hancock Laboratories Inc | Flexible stent for heart valve |
GB1402255A (en) | 1971-09-24 | 1975-08-06 | Smiths Industries Ltd | Medical or surgical devices of the kind having an inflatable balloon |
US4035849A (en) | 1975-11-17 | 1977-07-19 | William W. Angell | Heart valve stent and process for preparing a stented heart valve prosthesis |
CA1069652A (en) | 1976-01-09 | 1980-01-15 | Alain F. Carpentier | Supported bioprosthetic heart valve with compliant orifice ring |
US4056854A (en) | 1976-09-28 | 1977-11-08 | The United States Of America As Represented By The Department Of Health, Education And Welfare | Aortic heart valve catheter |
US4297749A (en) | 1977-04-25 | 1981-11-03 | Albany International Corp. | Heart valve prosthesis |
US4222126A (en) | 1978-12-14 | 1980-09-16 | The United States Of America As Represented By The Secretary Of The Department Of Health, Education & Welfare | Unitized three leaflet heart valve |
US4265694A (en) | 1978-12-14 | 1981-05-05 | The United States Of America As Represented By The Department Of Health, Education And Welfare | Method of making unitized three leaflet heart valve |
US4574803A (en) | 1979-01-19 | 1986-03-11 | Karl Storz | Tissue cutter |
GB2056023B (en) | 1979-08-06 | 1983-08-10 | Ross D N Bodnar E | Stent for a cardiac valve |
US4373216A (en) | 1980-10-27 | 1983-02-15 | Hemex, Inc. | Heart valves having edge-guided occluders |
US4388735A (en) | 1980-11-03 | 1983-06-21 | Shiley Inc. | Low profile prosthetic xenograft heart valve |
US4339831A (en) | 1981-03-27 | 1982-07-20 | Medtronic, Inc. | Dynamic annulus heart valve and reconstruction ring |
US4470157A (en) | 1981-04-27 | 1984-09-11 | Love Jack W | Tricuspid prosthetic tissue heart valve |
US4345340A (en) | 1981-05-07 | 1982-08-24 | Vascor, Inc. | Stent for mitral/tricuspid heart valve |
US4406022A (en) | 1981-11-16 | 1983-09-27 | Kathryn Roy | Prosthetic valve means for cardiovascular surgery |
SE445884B (sv) | 1982-04-30 | 1986-07-28 | Medinvent Sa | Anordning for implantation av en rorformig protes |
IT1212547B (it) | 1982-08-09 | 1989-11-30 | Iorio Domenico | Strumento di impiego chirurgico destinato a rendere piu' facili e piu' sicuri gli interventi per l'impianto di bioprotesi in organi umani |
GB8300636D0 (en) | 1983-01-11 | 1983-02-09 | Black M M | Heart valve replacements |
US4535483A (en) | 1983-01-17 | 1985-08-20 | Hemex, Inc. | Suture rings for heart valves |
US4612011A (en) | 1983-07-22 | 1986-09-16 | Hans Kautzky | Central occluder semi-biological heart valve |
US4787899A (en) | 1983-12-09 | 1988-11-29 | Lazarus Harrison M | Intraluminal graft device, system and method |
US4627436A (en) | 1984-03-01 | 1986-12-09 | Innoventions Biomedical Inc. | Angioplasty catheter and method for use thereof |
US4592340A (en) | 1984-05-02 | 1986-06-03 | Boyles Paul W | Artificial catheter means |
US4979939A (en) | 1984-05-14 | 1990-12-25 | Surgical Systems & Instruments, Inc. | Atherectomy system with a guide wire |
US4883458A (en) | 1987-02-24 | 1989-11-28 | Surgical Systems & Instruments, Inc. | Atherectomy system and method of using the same |
US5007896A (en) | 1988-12-19 | 1991-04-16 | Surgical Systems & Instruments, Inc. | Rotary-catheter for atherectomy |
DE3426300A1 (de) | 1984-07-17 | 1986-01-30 | Doguhan Dr.med. 6000 Frankfurt Baykut | Zweiwegeventil und seine verwendung als herzklappenprothese |
DE3442088A1 (de) | 1984-11-17 | 1986-05-28 | Beiersdorf Ag, 2000 Hamburg | Herzklappenprothese |
SU1271508A1 (ru) | 1984-11-29 | 1986-11-23 | Горьковский государственный медицинский институт им.С.М.Кирова | Искусственный клапан сердца |
US4759758A (en) | 1984-12-07 | 1988-07-26 | Shlomo Gabbay | Prosthetic heart valve |
FR2587614B1 (fr) | 1985-09-23 | 1988-01-15 | Biomasys Sa | Valve cardiaque prothetique |
US4733665C2 (en) | 1985-11-07 | 2002-01-29 | Expandable Grafts Partnership | Expandable intraluminal graft and method and apparatus for implanting an expandable intraluminal graft |
DE3640745A1 (de) | 1985-11-30 | 1987-06-04 | Ernst Peter Prof Dr M Strecker | Katheter zum herstellen oder erweitern von verbindungen zu oder zwischen koerperhohlraeumen |
CH672247A5 (zh) | 1986-03-06 | 1989-11-15 | Mo Vysshee Tekhnicheskoe Uchil | |
US4878906A (en) | 1986-03-25 | 1989-11-07 | Servetus Partnership | Endoprosthesis for repairing a damaged vessel |
US4777951A (en) | 1986-09-19 | 1988-10-18 | Mansfield Scientific, Inc. | Procedure and catheter instrument for treating patients for aortic stenosis |
US4762128A (en) | 1986-12-09 | 1988-08-09 | Advanced Surgical Intervention, Inc. | Method and apparatus for treating hypertrophy of the prostate gland |
US4878495A (en) | 1987-05-15 | 1989-11-07 | Joseph Grayzel | Valvuloplasty device with satellite expansion means |
US4796629A (en) | 1987-06-03 | 1989-01-10 | Joseph Grayzel | Stiffened dilation balloon catheter device |
US4829990A (en) | 1987-06-25 | 1989-05-16 | Thueroff Joachim | Implantable hydraulic penile erector |
US4851001A (en) | 1987-09-17 | 1989-07-25 | Taheri Syde A | Prosthetic valve for a blood vein and an associated method of implantation of the valve |
US5266073A (en) | 1987-12-08 | 1993-11-30 | Wall W Henry | Angioplasty stent |
US5032128A (en) | 1988-07-07 | 1991-07-16 | Medtronic, Inc. | Heart valve prosthesis |
DE8815082U1 (de) | 1988-11-29 | 1989-05-18 | Biotronik Meß- und Therapiegeräte GmbH & Co Ingenieurbüro Berlin, 1000 Berlin | Herzklappenprothese |
US4856516A (en) | 1989-01-09 | 1989-08-15 | Cordis Corporation | Endovascular stent apparatus and method |
US4966604A (en) | 1989-01-23 | 1990-10-30 | Interventional Technologies Inc. | Expandable atherectomy cutter with flexibly bowed blades |
US4994077A (en) | 1989-04-21 | 1991-02-19 | Dobben Richard L | Artificial heart valve for implantation in a blood vessel |
JP3127378B2 (ja) | 1989-05-31 | 2001-01-22 | バクスター インターナショナル インコーポレーテッド | 生物学的弁補綴 |
US5609626A (en) | 1989-05-31 | 1997-03-11 | Baxter International Inc. | Stent devices and support/restrictor assemblies for use in conjunction with prosthetic vascular grafts |
US5047041A (en) | 1989-08-22 | 1991-09-10 | Samuels Peter B | Surgical apparatus for the excision of vein valves in situ |
US4986830A (en) | 1989-09-22 | 1991-01-22 | Schneider (U.S.A.) Inc. | Valvuloplasty catheter with balloon which remains stable during inflation |
US5089015A (en) | 1989-11-28 | 1992-02-18 | Promedica International | Method for implanting unstented xenografts and allografts |
US5591185A (en) | 1989-12-14 | 1997-01-07 | Corneal Contouring Development L.L.C. | Method and apparatus for reprofiling or smoothing the anterior or stromal cornea by scraping |
US5037434A (en) | 1990-04-11 | 1991-08-06 | Carbomedics, Inc. | Bioprosthetic heart valve with elastic commissures |
US5059177A (en) | 1990-04-19 | 1991-10-22 | Cordis Corporation | Triple lumen balloon catheter |
US5411552A (en) | 1990-05-18 | 1995-05-02 | Andersen; Henning R. | Valve prothesis for implantation in the body and a catheter for implanting such valve prothesis |
US5085635A (en) | 1990-05-18 | 1992-02-04 | Cragg Andrew H | Valved-tip angiographic catheter |
DK124690D0 (da) | 1990-05-18 | 1990-05-18 | Henning Rud Andersen | Klapprotes til implantering i kroppen for erstatning af naturlig klap samt kateter til brug ved implantering af en saadan klapprotese |
US5152771A (en) | 1990-12-31 | 1992-10-06 | The Board Of Supervisors Of Louisiana State University | Valve cutter for arterial by-pass surgery |
US5282847A (en) | 1991-02-28 | 1994-02-01 | Medtronic, Inc. | Prosthetic vascular grafts with a pleated structure |
JPH05184611A (ja) | 1991-03-19 | 1993-07-27 | Kenji Kusuhara | 弁輪支持器具及びその取り付け方法 |
US5295958A (en) | 1991-04-04 | 1994-03-22 | Shturman Cardiology Systems, Inc. | Method and apparatus for in vivo heart valve decalcification |
US5167628A (en) | 1991-05-02 | 1992-12-01 | Boyles Paul W | Aortic balloon catheter assembly for indirect infusion of the coronary arteries |
US5397351A (en) | 1991-05-13 | 1995-03-14 | Pavcnik; Dusan | Prosthetic valve for percutaneous insertion |
US5769812A (en) | 1991-07-16 | 1998-06-23 | Heartport, Inc. | System for cardiac procedures |
US5558644A (en) | 1991-07-16 | 1996-09-24 | Heartport, Inc. | Retrograde delivery catheter and method for inducing cardioplegic arrest |
US5370685A (en) | 1991-07-16 | 1994-12-06 | Stanford Surgical Technologies, Inc. | Endovascular aortic valve replacement |
US5584803A (en) | 1991-07-16 | 1996-12-17 | Heartport, Inc. | System for cardiac procedures |
US5192297A (en) | 1991-12-31 | 1993-03-09 | Medtronic, Inc. | Apparatus and method for placement and implantation of a stent |
US5756476A (en) | 1992-01-14 | 1998-05-26 | The United States Of America As Represented By The Department Of Health And Human Services | Inhibition of cell proliferation using antisense oligonucleotides |
US5163953A (en) | 1992-02-10 | 1992-11-17 | Vince Dennis J | Toroidal artificial heart valve stent |
US5683448A (en) | 1992-02-21 | 1997-11-04 | Boston Scientific Technology, Inc. | Intraluminal stent and graft |
US5628792A (en) | 1992-03-13 | 1997-05-13 | Jcl Technic Ab | Cardiac valve with recessed valve flap hinges |
US5332402A (en) | 1992-05-12 | 1994-07-26 | Teitelbaum George P | Percutaneously-inserted cardiac valve |
DE4327825C2 (de) | 1992-11-24 | 1996-10-02 | Mannesmann Ag | Drosselrückschlagelement |
US6346074B1 (en) | 1993-02-22 | 2002-02-12 | Heartport, Inc. | Devices for less invasive intracardiac interventions |
GB9312666D0 (en) | 1993-06-18 | 1993-08-04 | Vesely Ivan | Bioprostetic heart valve |
CA2125258C (en) | 1993-08-05 | 1998-12-22 | Dinah B Quiachon | Multicapsule intraluminal grafting system and method |
US5545209A (en) | 1993-09-30 | 1996-08-13 | Texas Petrodet, Inc. | Controlled deployment of a medical device |
US5480424A (en) | 1993-11-01 | 1996-01-02 | Cox; James L. | Heart valve replacement using flexible tubes |
US5609627A (en) | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US5728068A (en) | 1994-06-14 | 1998-03-17 | Cordis Corporation | Multi-purpose balloon catheter |
US5554185A (en) | 1994-07-18 | 1996-09-10 | Block; Peter C. | Inflatable prosthetic cardiovascular valve for percutaneous transluminal implantation of same |
US5639274A (en) | 1995-06-02 | 1997-06-17 | Fischell; Robert E. | Integrated catheter system for balloon angioplasty and stent delivery |
US5571175A (en) | 1995-06-07 | 1996-11-05 | St. Jude Medical, Inc. | Suture guard for prosthetic heart valve |
US5716417A (en) | 1995-06-07 | 1998-02-10 | St. Jude Medical, Inc. | Integral supporting structure for bioprosthetic heart valve |
DE19532846A1 (de) | 1995-09-06 | 1997-03-13 | Georg Dr Berg | Ventileinrichtung |
US5591195A (en) | 1995-10-30 | 1997-01-07 | Taheri; Syde | Apparatus and method for engrafting a blood vessel |
DE19546692C2 (de) | 1995-12-14 | 2002-11-07 | Hans-Reiner Figulla | Selbstexpandierende Herzklappenprothese zur Implantation im menschlichen Körper über ein Kathetersystem |
FR2742994B1 (fr) | 1995-12-28 | 1998-04-03 | Sgro Jean-Claude | Ensemble de traitement chirurgical d'une lumiere intracorporelle |
US5855602A (en) | 1996-09-09 | 1999-01-05 | Shelhigh, Inc. | Heart valve prosthesis |
EP0808614B1 (en) | 1996-05-23 | 2003-02-26 | Samsung Electronics Co., Ltd. | Flexible self-expandable stent and method for making the same |
US5855601A (en) | 1996-06-21 | 1999-01-05 | The Trustees Of Columbia University In The City Of New York | Artificial heart valve and method and device for implanting the same |
US6217585B1 (en) | 1996-08-16 | 2001-04-17 | Converge Medical, Inc. | Mechanical stent and graft delivery system |
US5749890A (en) | 1996-12-03 | 1998-05-12 | Shaknovich; Alexander | Method and system for stent placement in ostial lesions |
NL1004827C2 (nl) | 1996-12-18 | 1998-06-19 | Surgical Innovations Vof | Inrichting voor het reguleren van de bloedsomloop. |
EP0850607A1 (en) | 1996-12-31 | 1998-07-01 | Cordis Corporation | Valve prosthesis for implantation in body channels |
GB9701479D0 (en) | 1997-01-24 | 1997-03-12 | Aortech Europ Ltd | Heart valve |
US5957949A (en) | 1997-05-01 | 1999-09-28 | World Medical Manufacturing Corp. | Percutaneous placement valve stent |
US6206917B1 (en) | 1997-05-02 | 2001-03-27 | St. Jude Medical, Inc. | Differential treatment of prosthetic devices |
US6245102B1 (en) | 1997-05-07 | 2001-06-12 | Iowa-India Investments Company Ltd. | Stent, stent graft and stent valve |
US5855597A (en) | 1997-05-07 | 1999-01-05 | Iowa-India Investments Co. Limited | Stent valve and stent graft for percutaneous surgery |
US5925063A (en) | 1997-09-26 | 1999-07-20 | Khosravi; Farhad | Coiled sheet valve, filter or occlusive device and methods of use |
US6769161B2 (en) | 1997-10-16 | 2004-08-03 | Scimed Life Systems, Inc. | Radial stent crimper |
US5910170A (en) | 1997-12-17 | 1999-06-08 | St. Jude Medical, Inc. | Prosthetic heart valve stent utilizing mounting clips |
US6530952B2 (en) | 1997-12-29 | 2003-03-11 | The Cleveland Clinic Foundation | Bioprosthetic cardiovascular valve system |
ATE449581T1 (de) | 1997-12-29 | 2009-12-15 | The Cleveland Clinic Foundation | System zur minimalinvasiven einführung einer herzklappen- bioprothese |
EP0935978A1 (en) | 1998-02-16 | 1999-08-18 | Medicorp S.A. | Angioplasty and stent delivery catheter |
US6174327B1 (en) | 1998-02-27 | 2001-01-16 | Scimed Life Systems, Inc. | Stent deployment apparatus and method |
EP0943300A1 (en) | 1998-03-17 | 1999-09-22 | Medicorp S.A. | Reversible action endoprosthesis delivery device. |
US6527979B2 (en) | 1999-08-27 | 2003-03-04 | Corazon Technologies, Inc. | Catheter systems and methods for their use in the treatment of calcified vascular occlusions |
US6334873B1 (en) | 1998-09-28 | 2002-01-01 | Autogenics | Heart valve having tissue retention with anchors and an outer sheath |
DE19857887B4 (de) | 1998-12-15 | 2005-05-04 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Verankerungsstütze für eine Herzklappenprothese |
SG76636A1 (en) | 1998-12-22 | 2000-11-21 | Medinol Ltd | Apparatus and method for securing a stent on a balloon |
FR2788217A1 (fr) | 1999-01-12 | 2000-07-13 | Brice Letac | Valvule prothetique implantable par catheterisme, ou chirurgicalement |
US6350277B1 (en) | 1999-01-15 | 2002-02-26 | Scimed Life Systems, Inc. | Stents with temporary retaining bands |
CA2358521C (en) | 1999-01-26 | 2009-12-29 | Edwards Lifesciences Corporation | Flexible heart valve |
US6896690B1 (en) | 2000-01-27 | 2005-05-24 | Viacor, Inc. | Cardiac valve procedure methods and devices |
US6425916B1 (en) | 1999-02-10 | 2002-07-30 | Michi E. Garrison | Methods and devices for implanting cardiac valves |
DE19907646A1 (de) | 1999-02-23 | 2000-08-24 | Georg Berg | Ventileinrichtung zum Einsetzen in ein Hohlorgan |
US6210408B1 (en) | 1999-02-24 | 2001-04-03 | Scimed Life Systems, Inc. | Guide wire system for RF recanalization of vascular blockages |
US6231602B1 (en) | 1999-04-16 | 2001-05-15 | Edwards Lifesciences Corporation | Aortic annuloplasty ring |
JP2002541974A (ja) | 1999-04-28 | 2002-12-10 | セント・ジュード・メディカル・インコーポレーテッド | 心臓代用弁 |
EP1057460A1 (en) | 1999-06-01 | 2000-12-06 | Numed, Inc. | Replacement valve assembly and method of implanting same |
US7628803B2 (en) | 2001-02-05 | 2009-12-08 | Cook Incorporated | Implantable vascular device |
US6299637B1 (en) | 1999-08-20 | 2001-10-09 | Samuel M. Shaolian | Transluminally implantable venous valve |
US6352547B1 (en) | 1999-09-22 | 2002-03-05 | Scimed Life Systems, Inc. | Stent crimping system |
IT1307268B1 (it) | 1999-09-30 | 2001-10-30 | Sorin Biomedica Cardio Spa | Dispositivo per interventi di riparazione o sostituzione valvolarecardiaca. |
FR2800984B1 (fr) | 1999-11-17 | 2001-12-14 | Jacques Seguin | Dispositif de remplacement d'une valve cardiaque par voie percutanee |
FR2815844B1 (fr) | 2000-10-31 | 2003-01-17 | Jacques Seguin | Support tubulaire de mise en place, par voie percutanee, d'une valve cardiaque de remplacement |
US7018406B2 (en) | 1999-11-17 | 2006-03-28 | Corevalve Sa | Prosthetic valve for transluminal delivery |
DE19955490A1 (de) | 1999-11-18 | 2001-06-13 | Thermamed Gmbh | Medizintechnische Wärmevorrichtung |
US6458153B1 (en) | 1999-12-31 | 2002-10-01 | Abps Venture One, Ltd. | Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof |
SK11022002A3 (sk) | 2000-01-27 | 2003-03-04 | 3F Therapeutics, Inc | Umelá srdcová chlopňa |
EP1255510B3 (en) | 2000-01-31 | 2009-03-04 | Cook Biotech, Inc. | Stent valves |
DE10010074B4 (de) | 2000-02-28 | 2005-04-14 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Vorrichtung zur Befestigung und Verankerung von Herzklappenprothesen |
US6454799B1 (en) | 2000-04-06 | 2002-09-24 | Edwards Lifesciences Corporation | Minimally-invasive heart valves and methods of use |
US7510572B2 (en) | 2000-09-12 | 2009-03-31 | Shlomo Gabbay | Implantation system for delivery of a heart valve prosthesis |
WO2002022054A1 (en) | 2000-09-12 | 2002-03-21 | Gabbay S | Valvular prosthesis and method of using same |
US6461382B1 (en) | 2000-09-22 | 2002-10-08 | Edwards Lifesciences Corporation | Flexible heart valve having moveable commissures |
DE10047614C2 (de) | 2000-09-26 | 2003-03-27 | Generis Gmbh | Vorrichtung zum schichtweisen Aufbau von Modellen |
DE10049815B4 (de) | 2000-10-09 | 2005-10-13 | Universitätsklinikum Freiburg | Vorrichtung zum lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz |
DE10049812B4 (de) | 2000-10-09 | 2004-06-03 | Universitätsklinikum Freiburg | Vorrichtung zum Ausfiltern makroskopischer Teilchen aus der Blutbahn beim lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz |
DE10049813C1 (de) | 2000-10-09 | 2002-04-18 | Universitaetsklinikum Freiburg | Vorrichtung zum lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz |
DE10049814B4 (de) | 2000-10-09 | 2006-10-19 | Universitätsklinikum Freiburg | Vorrichtung zur Unterstützung chirurgischer Maßnahmen innerhalb eines Gefäßes, insbesondere zur minimalinvasiven Explantation und Implantation von Herzklappen |
US6482228B1 (en) | 2000-11-14 | 2002-11-19 | Troy R. Norred | Percutaneous aortic valve replacement |
ES2247198T3 (es) | 2000-11-21 | 2006-03-01 | Rex Medical, Lp | Valvula aortica percutanea. |
US6440764B1 (en) | 2000-11-22 | 2002-08-27 | Agere Systems Guardian Corp. | Enhancement of carrier concentration in As-containing contact layers |
US6494909B2 (en) | 2000-12-01 | 2002-12-17 | Prodesco, Inc. | Endovascular valve |
ES2253325T3 (es) | 2000-12-15 | 2006-06-01 | ANGIOMED GMBH & CO. MEDIZINTECHNIK KG | Protesis endovascular con valvula. |
US6716244B2 (en) | 2000-12-20 | 2004-04-06 | Carbomedics, Inc. | Sewing cuff assembly for heart valves |
US6468660B2 (en) | 2000-12-29 | 2002-10-22 | St. Jude Medical, Inc. | Biocompatible adhesives |
US6783542B2 (en) | 2001-02-22 | 2004-08-31 | Scimed Life Systems, Inc | Crimpable balloon/stent protector |
US6488704B1 (en) | 2001-05-07 | 2002-12-03 | Biomed Solutions, Llc | Implantable particle measuring apparatus |
US6503272B2 (en) | 2001-03-21 | 2003-01-07 | Cordis Corporation | Stent-based venous valves |
US6733525B2 (en) | 2001-03-23 | 2004-05-11 | Edwards Lifesciences Corporation | Rolled minimally-invasive heart valves and methods of use |
US7556646B2 (en) | 2001-09-13 | 2009-07-07 | Edwards Lifesciences Corporation | Methods and apparatuses for deploying minimally-invasive heart valves |
US7374571B2 (en) | 2001-03-23 | 2008-05-20 | Edwards Lifesciences Corporation | Rolled minimally-invasive heart valves and methods of manufacture |
ATE319388T1 (de) | 2001-03-30 | 2006-03-15 | Terumo Corp | Stent |
WO2002087474A1 (en) | 2001-05-01 | 2002-11-07 | Imperial Medical Devices Limited | Valve prosthesis |
US6936067B2 (en) | 2001-05-17 | 2005-08-30 | St. Jude Medical Inc. | Prosthetic heart valve with slit stent |
US6893460B2 (en) | 2001-10-11 | 2005-05-17 | Percutaneous Valve Technologies Inc. | Implantable prosthetic valve |
WO2003043676A2 (en) | 2001-11-23 | 2003-05-30 | Mindguard Ltd. | Expandable delivery appliance particularly for delivering intravascular devices |
US7182779B2 (en) | 2001-12-03 | 2007-02-27 | Xtent, Inc. | Apparatus and methods for positioning prostheses for deployment from a catheter |
US7141064B2 (en) | 2002-05-08 | 2006-11-28 | Edwards Lifesciences Corporation | Compressed tissue for heart valve leaflets |
US20040024452A1 (en) | 2002-08-02 | 2004-02-05 | Kruse Steven D. | Valved prostheses with preformed tissue leaflets |
US6878162B2 (en) | 2002-08-30 | 2005-04-12 | Edwards Lifesciences Ag | Helical stent having improved flexibility and expandability |
US7137184B2 (en) | 2002-09-20 | 2006-11-21 | Edwards Lifesciences Corporation | Continuous heart valve support frame and method of manufacture |
US7316710B1 (en) | 2002-12-30 | 2008-01-08 | Advanced Cardiovascular Systems, Inc. | Flexible stent |
US7399315B2 (en) | 2003-03-18 | 2008-07-15 | Edwards Lifescience Corporation | Minimally-invasive heart valve with cusp positioners |
US7096554B2 (en) | 2003-04-04 | 2006-08-29 | Boston Scientific Scimed, Inc. | Protective loading of stents |
ATE446061T1 (de) | 2003-04-24 | 2009-11-15 | Cook Inc | Künstliche klappe für blutgefäss mit verbessertem fliessverhalten |
JP2006526464A (ja) | 2003-06-05 | 2006-11-24 | フローメディカ,インコーポレイテッド | 分枝した身体管腔において両側介入または診断を行うためのシステムおよび方法 |
US7959665B2 (en) | 2003-07-31 | 2011-06-14 | Abbott Cardiovascular Systems Inc. | Intravascular stent with inverted end rings |
US8021421B2 (en) | 2003-08-22 | 2011-09-20 | Medtronic, Inc. | Prosthesis heart valve fixturing device |
US20050075725A1 (en) | 2003-10-02 | 2005-04-07 | Rowe Stanton J. | Implantable prosthetic valve with non-laminar flow |
US20050096738A1 (en) | 2003-10-06 | 2005-05-05 | Cali Douglas S. | Minimally invasive valve replacement system |
AU2004296816A1 (en) | 2003-12-04 | 2005-06-23 | The Brigham And Women's Hospital, Inc. | Aortic valve annuloplasty rings |
US8052749B2 (en) | 2003-12-23 | 2011-11-08 | Sadra Medical, Inc. | Methods and apparatus for endovascular heart valve replacement comprising tissue grasping elements |
US20050137686A1 (en) | 2003-12-23 | 2005-06-23 | Sadra Medical, A Delaware Corporation | Externally expandable heart valve anchor and method |
US8182528B2 (en) | 2003-12-23 | 2012-05-22 | Sadra Medical, Inc. | Locking heart valve anchor |
US7959666B2 (en) | 2003-12-23 | 2011-06-14 | Sadra Medical, Inc. | Methods and apparatus for endovascularly replacing a heart valve |
EP1718246A4 (en) | 2004-02-05 | 2009-11-18 | Childrens Medical Center | TRANSCATHETER DELIVERY OF A HEARTLAPPROTHESIS |
US7225518B2 (en) | 2004-02-23 | 2007-06-05 | Boston Scientific Scimed, Inc. | Apparatus for crimping a stent assembly |
US7207204B2 (en) | 2004-02-26 | 2007-04-24 | Boston Scientific Scimed, Inc. | Crimper |
CA2557657C (en) | 2004-02-27 | 2013-06-18 | Aortx, Inc. | Prosthetic heart valve delivery systems and methods |
ITTO20040135A1 (it) | 2004-03-03 | 2004-06-03 | Sorin Biomedica Cardio Spa | Protesi valvolare cardiaca |
EP2308425B2 (en) | 2004-03-11 | 2023-10-18 | Percutaneous Cardiovascular Solutions Pty Limited | Percutaneous Heart Valve Prosthesis |
US20060004323A1 (en) | 2004-04-21 | 2006-01-05 | Exploramed Nc1, Inc. | Apparatus and methods for dilating and modifying ostia of paranasal sinuses and other intranasal or paranasal structures |
BRPI0510107A (pt) | 2004-04-23 | 2007-09-25 | 3F Therapeutics Inc | válvula protéica implantável |
PL1768630T3 (pl) | 2004-06-16 | 2015-07-31 | Machine Solutions Inc | Urządzenie obciskające stenty |
US7276078B2 (en) | 2004-06-30 | 2007-10-02 | Edwards Lifesciences Pvt | Paravalvular leak detection, sealing, and prevention |
US7462191B2 (en) | 2004-06-30 | 2008-12-09 | Edwards Lifesciences Pvt, Inc. | Device and method for assisting in the implantation of a prosthetic valve |
CA2580053C (en) | 2004-09-14 | 2014-07-08 | Edwards Lifesciences Ag. | Device and method for treatment of heart valve regurgitation |
EP2491891A3 (en) | 2004-10-02 | 2013-03-20 | Endoheart AG | Devices for embolic protection and mitral valve repair |
US7316148B2 (en) | 2005-02-15 | 2008-01-08 | Boston Scientific Scimed, Inc. | Protective sheet loader |
US8062359B2 (en) | 2005-04-06 | 2011-11-22 | Edwards Lifesciences Corporation | Highly flexible heart valve connecting band |
SE531468C2 (sv) | 2005-04-21 | 2009-04-14 | Edwards Lifesciences Ag | En anordning för styrning av blodflöde |
US7914569B2 (en) | 2005-05-13 | 2011-03-29 | Medtronics Corevalve Llc | Heart valve prosthesis and methods of manufacture and use |
EP1883375B1 (en) | 2005-05-24 | 2016-12-07 | Edwards Lifesciences Corporation | Rapid deployment prosthetic heart valve |
US7681430B2 (en) | 2005-05-25 | 2010-03-23 | Boston Scientific Scimed, Inc. | Method and apparatus for reducing a stent |
US7238200B2 (en) | 2005-06-03 | 2007-07-03 | Arbor Surgical Technologies, Inc. | Apparatus and methods for making leaflets and valve prostheses including such leaflets |
US7780723B2 (en) | 2005-06-13 | 2010-08-24 | Edwards Lifesciences Corporation | Heart valve delivery system |
US20080058856A1 (en) | 2005-06-28 | 2008-03-06 | Venkatesh Ramaiah | Non-occluding dilation device |
US8167932B2 (en) | 2005-10-18 | 2012-05-01 | Edwards Lifesciences Corporation | Heart valve delivery system with valve catheter |
US7785366B2 (en) | 2005-10-26 | 2010-08-31 | Maurer Christopher W | Mitral spacer |
US8449606B2 (en) | 2005-10-26 | 2013-05-28 | Cardiosolutions, Inc. | Balloon mitral spacer |
US8778017B2 (en) | 2005-10-26 | 2014-07-15 | Cardiosolutions, Inc. | Safety for mitral valve implant |
US8764820B2 (en) | 2005-11-16 | 2014-07-01 | Edwards Lifesciences Corporation | Transapical heart valve delivery system and method |
WO2007067942A1 (en) | 2005-12-07 | 2007-06-14 | Arbor Surgical Technologies, Inc. | Connection systems for two piece prosthetic heart valve assemblies |
US20070213813A1 (en) | 2005-12-22 | 2007-09-13 | Symetis Sa | Stent-valves for valve replacement and associated methods and systems for surgery |
US9078781B2 (en) | 2006-01-11 | 2015-07-14 | Medtronic, Inc. | Sterile cover for compressible stents used in percutaneous device delivery systems |
WO2007097983A2 (en) | 2006-02-14 | 2007-08-30 | Sadra Medical, Inc. | Systems and methods for delivering a medical implant |
EP2583640B1 (en) * | 2006-02-16 | 2022-06-22 | Venus MedTech (HangZhou), Inc. | Minimally invasive replacement heart valve |
US8147541B2 (en) | 2006-02-27 | 2012-04-03 | Aortx, Inc. | Methods and devices for delivery of prosthetic heart valves and other prosthetics |
US8219229B2 (en) | 2006-03-02 | 2012-07-10 | Edwards Lifesciences Corporation | Virtual heart valve |
EP2004095B1 (en) | 2006-03-28 | 2019-06-12 | Medtronic, Inc. | Prosthetic cardiac valve formed from pericardium material and methods of making same |
EP2012712B1 (en) | 2006-04-29 | 2016-02-10 | Medtronic, Inc. | Guide shields for multiple component prosthetic heart valve assemblies |
US20080021546A1 (en) | 2006-07-18 | 2008-01-24 | Tim Patz | System for deploying balloon-expandable heart valves |
WO2008015257A2 (en) | 2006-08-02 | 2008-02-07 | Syntach Ag | Luminal implant with large expansion ratio |
US8414643B2 (en) | 2006-09-19 | 2013-04-09 | Medtronic Ventor Technologies Ltd. | Sinus-engaging valve fixation member |
US8029556B2 (en) | 2006-10-04 | 2011-10-04 | Edwards Lifesciences Corporation | Method and apparatus for reshaping a ventricle |
US7655034B2 (en) | 2006-11-14 | 2010-02-02 | Medtronic Vascular, Inc. | Stent-graft with anchoring pins |
US7832251B2 (en) | 2006-11-15 | 2010-11-16 | Abbott Laboratories | Patterned mold for medical device |
US8236045B2 (en) | 2006-12-22 | 2012-08-07 | Edwards Lifesciences Corporation | Implantable prosthetic valve assembly and method of making the same |
EP2111190B1 (en) | 2007-01-19 | 2013-10-09 | Medtronic, Inc. | Stented heart valve devices for atrioventricular valve replacement |
US20100168844A1 (en) | 2007-01-26 | 2010-07-01 | 3F Therapeutics, Inc. | Methods and systems for reducing paravalvular leakage in heart valves |
US20080183271A1 (en) | 2007-01-31 | 2008-07-31 | Abbott Laboratories | Compliant crimping sheath |
US20080208327A1 (en) | 2007-02-27 | 2008-08-28 | Rowe Stanton J | Method and apparatus for replacing a prosthetic valve |
US7896915B2 (en) | 2007-04-13 | 2011-03-01 | Jenavalve Technology, Inc. | Medical device for treating a heart valve insufficiency |
US8388673B2 (en) | 2008-05-02 | 2013-03-05 | Abbott Cardiovascular Systems Inc. | Polymeric stent |
US8002817B2 (en) | 2007-05-04 | 2011-08-23 | Abbott Cardiovascular Systems Inc. | Stents with high radial strength and methods of manufacturing same |
US20080294248A1 (en) | 2007-05-25 | 2008-11-27 | Medical Entrepreneurs Ii, Inc. | Prosthetic Heart Valve |
US9572660B2 (en) | 2007-06-04 | 2017-02-21 | St. Jude Medical, Inc. | Prosthetic heart valves |
US9814611B2 (en) | 2007-07-31 | 2017-11-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US9566178B2 (en) | 2010-06-24 | 2017-02-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
US8728154B2 (en) | 2007-08-24 | 2014-05-20 | St. Jude Medical, Inc. | Prosthetic aortic heart valves |
DE102007043830A1 (de) | 2007-09-13 | 2009-04-02 | Lozonschi, Lucian, Madison | Herzklappenstent |
EP3028670B1 (en) | 2007-09-26 | 2023-12-20 | St. Jude Medical, LLC | Collapsible prosthetic heart valves |
US8647381B2 (en) | 2007-10-25 | 2014-02-11 | Symetis Sa | Stents, valved-stents, and methods and systems for delivery thereof |
WO2009061389A2 (en) | 2007-11-05 | 2009-05-14 | St. Jude Medical, Inc. | Collapsible/expandable prosthetic heart valves with non-expanding stent posts and retrieval features |
WO2009067519A2 (en) * | 2007-11-19 | 2009-05-28 | The Cleveland Clinic Foundation | Apparatus and method for treating a regurgitant heart valve |
HUE048270T4 (hu) | 2007-12-14 | 2022-02-28 | Edwards Lifesciences Corp | Billentyûprotézis |
DK2254514T3 (en) | 2008-01-24 | 2018-12-17 | Medtronic Inc | STENTS FOR HEART VALVE PROSTHESIS |
US8313525B2 (en) | 2008-03-18 | 2012-11-20 | Medtronic Ventor Technologies, Ltd. | Valve suturing and implantation procedures |
AU2009236062A1 (en) | 2008-04-18 | 2009-10-22 | Cook Medical Technologies Llc | Branched vessel prosthesis |
US20090276040A1 (en) | 2008-05-01 | 2009-11-05 | Edwards Lifesciences Corporation | Device and method for replacing mitral valve |
US9061119B2 (en) | 2008-05-09 | 2015-06-23 | Edwards Lifesciences Corporation | Low profile delivery system for transcatheter heart valve |
ES2386239T3 (es) | 2008-05-16 | 2012-08-14 | Sorin Biomedica Cardio S.R.L. | Prótesis cardiovalvular atraumática |
US8291570B2 (en) | 2008-05-30 | 2012-10-23 | Boston Scientific Scimed, Inc. | Methods for abluminally coating medical devices |
DK3501455T3 (da) | 2008-06-06 | 2020-03-02 | Edwards Lifesciences Corp | Transkateterhjerteklap med lav profil |
US8323335B2 (en) | 2008-06-20 | 2012-12-04 | Edwards Lifesciences Corporation | Retaining mechanisms for prosthetic valves and methods for using |
EP2815724B2 (en) | 2008-07-15 | 2024-03-13 | St. Jude Medical, Inc. | Collapsible and re-expandable prosthetic heart valve cuff designs and complementary technological applications |
CN102245129B (zh) | 2008-07-21 | 2015-03-18 | 詹妮弗·K·怀特 | 可重新定位的腔内支撑结构及其应用 |
US8652202B2 (en) | 2008-08-22 | 2014-02-18 | Edwards Lifesciences Corporation | Prosthetic heart valve and delivery apparatus |
AU2009295960A1 (en) | 2008-09-29 | 2010-04-01 | Cardiaq Valve Technologies, Inc. | Heart valve |
EP4321134A3 (en) | 2008-11-21 | 2024-05-01 | Percutaneous Cardiovascular Solutions Pty Limited | Heart valve prosthesis and method |
EP2810620B1 (en) | 2009-04-15 | 2022-09-14 | Edwards Lifesciences CardiAQ LLC | Vascular implant and delivery system |
US8075611B2 (en) | 2009-06-02 | 2011-12-13 | Medtronic, Inc. | Stented prosthetic heart valves |
US8348998B2 (en) | 2009-06-26 | 2013-01-08 | Edwards Lifesciences Corporation | Unitary quick connect prosthetic heart valve and deployment system and methods |
US8475522B2 (en) | 2009-07-14 | 2013-07-02 | Edwards Lifesciences Corporation | Transapical delivery system for heart valves |
US8652203B2 (en) | 2010-09-23 | 2014-02-18 | Cardiaq Valve Technologies, Inc. | Replacement heart valves, delivery devices and methods |
US8449599B2 (en) | 2009-12-04 | 2013-05-28 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
US8641757B2 (en) | 2010-09-10 | 2014-02-04 | Edwards Lifesciences Corporation | Systems for rapidly deploying surgical heart valves |
CA3063561C (en) | 2010-10-05 | 2023-02-07 | Edwards Lifesciences Corporation | Prosthetic heart valve |
US8568475B2 (en) | 2010-10-05 | 2013-10-29 | Edwards Lifesciences Corporation | Spiraled commissure attachment for prosthetic valve |
US8888843B2 (en) | 2011-01-28 | 2014-11-18 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valve regurgitation |
WO2012142189A1 (en) * | 2011-04-11 | 2012-10-18 | Skardia, Llc | Prostheses, systems and methods for percutaneous heart valve replacement |
US8945209B2 (en) | 2011-05-20 | 2015-02-03 | Edwards Lifesciences Corporation | Encapsulated heart valve |
US8795357B2 (en) | 2011-07-15 | 2014-08-05 | Edwards Lifesciences Corporation | Perivalvular sealing for transcatheter heart valve |
US20130190857A1 (en) | 2011-09-09 | 2013-07-25 | Endoluminal Sciences Pty Ltd. | Means for controlled sealing of endovascular devices |
US20130331929A1 (en) | 2011-09-09 | 2013-12-12 | Endoluminal Sciences Pty Ltd. | Means for Controlled Sealing of Endovascular Devices |
US9827093B2 (en) | 2011-10-21 | 2017-11-28 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
PT2787926T (pt) | 2011-12-09 | 2022-09-20 | Edwards Lifesciences Corp | Apois de comissuras melhorados de válvula cardíaca protésica |
WO2013106585A1 (en) | 2012-01-10 | 2013-07-18 | White Jennifer K | Articulated support structure with secondary strut features |
US20130274873A1 (en) | 2012-03-22 | 2013-10-17 | Symetis Sa | Transcatheter Stent-Valves and Methods, Systems and Devices for Addressing Para-Valve Leakage |
US9132007B2 (en) | 2013-01-10 | 2015-09-15 | Medtronic CV Luxembourg S.a.r.l. | Anti-paravalvular leakage components for a transcatheter valve prosthesis |
US9439763B2 (en) | 2013-02-04 | 2016-09-13 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
US9636222B2 (en) | 2013-03-12 | 2017-05-02 | St. Jude Medical, Cardiology Division, Inc. | Paravalvular leak protection |
US8986375B2 (en) | 2013-03-12 | 2015-03-24 | Medtronic, Inc. | Anti-paravalvular leakage component for a transcatheter valve prosthesis |
CN111685915B (zh) | 2013-03-13 | 2024-01-09 | 爱德华兹生命科学卡迪尔克有限责任公司 | 铰接式连合瓣膜支架和方法 |
US9326856B2 (en) | 2013-03-14 | 2016-05-03 | St. Jude Medical, Cardiology Division, Inc. | Cuff configurations for prosthetic heart valve |
EP2991585B1 (en) | 2013-05-03 | 2023-08-16 | Medtronic Inc. | Medical devices for implanting in a valve |
ES2699785T3 (es) | 2013-05-20 | 2019-02-12 | Edwards Lifesciences Corp | Dispositivo para la administración de válvula protésica cardiaca |
WO2015038458A1 (en) | 2013-09-12 | 2015-03-19 | St. Jude Medical, Cardiology Division, Inc. | Stent designs for prosthetic heart valves |
WO2015070249A1 (en) | 2013-11-11 | 2015-05-14 | Jenesis Surgical, Llc | Systems and methods for manufacturing a stent frame |
US10098734B2 (en) | 2013-12-05 | 2018-10-16 | Edwards Lifesciences Corporation | Prosthetic heart valve and delivery apparatus |
CN110141399B (zh) * | 2015-02-05 | 2021-07-27 | 卡迪尔维尔福股份有限公司 | 带有轴向滑动框架的人工瓣膜 |
US9974650B2 (en) | 2015-07-14 | 2018-05-22 | Edwards Lifesciences Corporation | Prosthetic heart valve |
US11096781B2 (en) | 2016-08-01 | 2021-08-24 | Edwards Lifesciences Corporation | Prosthetic heart valve |
US10357361B2 (en) * | 2016-09-15 | 2019-07-23 | Edwards Lifesciences Corporation | Heart valve pinch devices and delivery systems |
US10603165B2 (en) | 2016-12-06 | 2020-03-31 | Edwards Lifesciences Corporation | Mechanically expanding heart valve and delivery apparatus therefor |
US11135056B2 (en) | 2017-05-15 | 2021-10-05 | Edwards Lifesciences Corporation | Devices and methods of commissure formation for prosthetic heart valve |
US10869759B2 (en) | 2017-06-05 | 2020-12-22 | Edwards Lifesciences Corporation | Mechanically expandable heart valve |
-
2018
- 2018-05-17 CN CN202210246717.9A patent/CN114631913A/zh active Pending
- 2018-05-17 CN CN201880033559.0A patent/CN110650711B/zh active Active
- 2018-05-17 CA CA3061793A patent/CA3061793A1/en active Pending
- 2018-05-17 WO PCT/US2018/033086 patent/WO2018217525A1/en active Application Filing
- 2018-05-17 EP EP18806243.4A patent/EP3630013B1/en active Active
-
2019
- 2019-11-21 US US16/691,244 patent/US11026781B2/en active Active
-
2021
- 2021-05-28 US US17/334,464 patent/US20210282923A1/en active Pending
Patent Citations (11)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008010817A1 (en) * | 2006-07-17 | 2008-01-24 | 3F Therapeutics, Inc. | Minimally invasive valve replacement system |
US20160143733A1 (en) * | 2009-09-29 | 2016-05-26 | Edwards Lifesciences Cardiaq Llc | Replacement heart valve and method |
CN102791223A (zh) * | 2010-03-05 | 2012-11-21 | 爱德华兹生命科学公司 | 小外形心脏瓣膜及递送*** |
US20150216661A1 (en) * | 2010-07-21 | 2015-08-06 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
CN103153232A (zh) * | 2010-10-21 | 2013-06-12 | 美敦力公司 | 具有低心室型面的二尖瓣假体 |
CN103974674A (zh) * | 2011-10-19 | 2014-08-06 | 托尔福公司 | 人工心脏瓣膜装置、人工二尖瓣和相关***及方法 |
CN105283149A (zh) * | 2013-03-11 | 2016-01-27 | 内奥瓦斯克迪亚拉公司 | 具有防枢转机构的假体瓣膜 |
CN105101911A (zh) * | 2013-03-15 | 2015-11-25 | 托尔福公司 | 人造心瓣装置、人造二尖瓣以及相关***和方法 |
US20150328000A1 (en) * | 2014-05-19 | 2015-11-19 | Cardiaq Valve Technologies, Inc. | Replacement mitral valve with annular flap |
US20160051362A1 (en) * | 2014-08-21 | 2016-02-25 | Edwards Lifesciences Corporation | Dual-flange prosthetic valve frame |
WO2016093877A1 (en) * | 2014-12-09 | 2016-06-16 | Cephea Valve Technologies, Inc. | Replacement cardiac valves and methods of use and manufacture |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN115957047A (zh) * | 2021-11-17 | 2023-04-14 | 北京佰仁医疗科技股份有限公司 | 一种分体式可精准锚定的介入环中瓣*** |
CN115957047B (zh) * | 2021-11-17 | 2023-11-14 | 北京佰仁医疗科技股份有限公司 | 一种分体式可精准锚定的介入环中瓣*** |
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EP3630013A1 (en) | 2020-04-08 |
EP3630013A4 (en) | 2020-06-17 |
CN114631913A (zh) | 2022-06-17 |
US11026781B2 (en) | 2021-06-08 |
US20200085573A1 (en) | 2020-03-19 |
US20210282923A1 (en) | 2021-09-16 |
CA3061793A1 (en) | 2018-11-29 |
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CN110650711B (zh) | 2022-04-01 |
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