JP2010508093A - 心不全を治療するための装置及び方法 - Google Patents
心不全を治療するための装置及び方法 Download PDFInfo
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Abstract
Description
本体;
該本体を通る少なくとも1つの通路;
該通路における少なくとも1つの逆止め弁;及び、
患者の心房中隔において与えられる孔に本体を取り付けるよう適合される取付け手段(mounting means)、
を有する。当該装置は使用時、患者の左心房圧が患者の右心房圧を所定の量分(by predetermined amount)上回る際に、血液が左心房から右心房まで通路を通って流れるよう逆止め弁が開放し、それによって左心房圧が低減するよう、方向付けられる。
本体;
該本体を通る少なくとも1つの通路;
該通路における少なくとも1つ逆止め弁;及び、
患者の静脈系において本体を取り付けるよう適合される取付け手段、
を有する。当該装置は使用時、血液が自然な流れ(natural flow)の方向とは反対方向において通路を通って流れることを逆止め弁が防ぐよう、方向付けられる。
本体;
該本体を通る少なくとも1つの通路;
該通路における少なくとも1つ逆止め弁;及び、
患者の下肢静脈系において本体を取り付けるよう適合される取付け手段、
を有する。当該装置は使用時、血液が自然な流れの方向とは反対方向において通路を通って流れることを逆止め弁が防ぐよう、方向付けられる。
本体;
該本体を通る少なくとも1つの通路;
そこを通る血液の流れを可能にすると同時に血栓を実質的に排除する寸法の開口を有する、通路内におけるメッシュ又はグリル配置(mesh or grill arrangement);及び、
患者の心房中隔において与えられる孔において本体を取り付けるよう適合される取付け手段、
を有する。当該装置は使用時、患者の左心房圧が患者の右心房圧を上回る際に血液が左心房から右心房まで通路を通って流れ得るようにし、それによって患者の左心房圧を低減する。
患者の心房中隔において孔を形成する段階;
孔において少なくとも1つの逆止め弁を挿入し、該逆止め弁は、患者の左心房圧が患者の右心房圧を上回る際に、血液を左心房から右心房まで通路を通って流すよう方向付けられる段階と、
患者の心房中隔に対して逆止め弁を固定する段階と、
を有する。患者の左心房圧が患者の右心房圧を所定の量分上回る際に、弁は、血液を左心房から右心房まで通路を通って流すよう開放し、それによって患者の左心房圧を低減する。
患者の心房中隔において孔を形成する段階;
そこを介する血液の通過を可能にすると同時に血栓の通過を実質的に排除する寸法の開口を有する孔内においてメッシュ又はグリル配置を挿入する段階;及び、
患者の心房中隔に対してメッシュ又はグリル配置を固定する段階、
を有する。
患者の静脈系において少なくとも1つの逆止め弁を挿入し、該逆止め弁は、血液が自然な流れの方向とは反対方向において静脈系を通って流れることを防ぐよう方向付けられる段階;及び、
患者の静脈系に対して逆止め弁を固定する段階、
を有する。
心臓の左心房及び右心房と夫々流体連通する第1及び第2の端部を有するチューブ;及び、
流体がチューブを通って流れることを選択的に防ぐかあるいは可能にするよう適合される、第1の端部と第2の端部との間における弁、
を有する。使用時に、患者の左心房圧が患者の右心房圧を所定の量分上回る際、弁は、血液が左心房から右心房までチューブを通って流れ得るよう開放し、それによって左心房圧を低減する。
心臓の左心房及び右心房に夫々流体連通する第1及び第2の端部を有するチューブ;及び、
該チューブにおける逆止め弁、
を有する。使用時に、逆止め弁は、血液が右心房から左心房までチューブを通って流れることを防ぐ。
患者の左心房と右心房との間において外側でチューブを接続させる段階;及び、
チューブにおいて少なくとも1つの逆止め弁を挿入し、該逆止め弁は、患者の左心房圧が患者の右心房圧を上回る際に、血液を左心房から右心房まで通路を通って流すよう方向付けられる段階、
を有する。患者の左心房圧が患者の右心房圧を所定の量分上回る際に、弁は、血液が左心房から右心房まで通路を通って流れ得るよう開放し、それによって左心房圧を低減する。
Claims (60)
- 患者における心不全を治療する装置であって、
本体と、
該本体を通る少なくとも1つの通路と、
該通路における少なくとも1つの逆止め弁と、
前記患者の心房中隔において与えられる孔に前記本体を取り付けるよう適合される取付け手段と、
を有し、
当該装置は使用時に、前記患者の左心房圧が前記患者の右心房圧を所定の量分上回る際に、前記左心房から前記右心房まで前記通路を通って血液が流れ得るよう前記逆止め弁が開放し、それによって前記左心房圧が低減するよう、方向付けられる、
装置。 - 患者における心不全又は肺静脈高血圧症を治療する装置であって、
本体と、
該本体を通る少なくとも1つの通路と、
該通路における少なくとも1つ逆止め弁と、
前記患者の静脈系において前記本体を取り付けるよう適合される取付け手段と、
を有し、
当該装置は使用時に、血液が自然な流れの方向とは反対方向において前記通路を通って流れることを前記逆止め弁が防ぐよう、方向付けられる、
装置。 - 下大動脈、上大動脈、肝静脈、腸骨静脈、あるいは1つ又はそれより多くの肺静脈等である患者の静脈系における血管へと装着されるよう適合される、
請求項2記載の装置。 - 患者における下肢静脈高血圧症を治療する装置であって、
本体と、
該本体を通る少なくとも1つの通路と、
該通路における少なくとも1つ逆止め弁と、
前記患者の下肢静脈系において前記本体を取り付けるよう適合される取付け手段と、
を有し、
当該装置は、使用時に、血液が自然な流れの方向とは反対方向において前記通路を通って流れることを前記逆止め弁が防ぐよう、方向付けられる、
装置。 - 前記本体は、ステントの形状における、
請求項4記載の装置。 - 前記本体は、拡張ステントの形状における、
請求項5記載の装置。 - 前記弁は、ダックビル弁、小葉弁、フラップ弁、ディスク・イン・ケージ型弁、又はボール・イン・ケージ型弁である、
請求項1乃至6のうちいずれか一項記載の装置。 - 前記弁は、閉位置に対して付勢される、
請求項7記載の装置。 - 前記弁は、前記弁の材料の固有の弾性によって前記閉位置に対して付勢される、
請求項8記載の装置。 - 前記弁は、圧力差の前記所定の量が少なくとも約2mm Hgである際に、開放する、
請求項8又は9記載の装置。 - 前記弁は、圧力差の前記所定の量が約5乃至25mm Hgである際に、開放する、
請求項10記載の装置。 - 前記弁は、圧力差の前記所定の量が約5乃至15mm Hgである際に、開放する、
請求項11記載の装置。 - 前記本体を通る単一の通路を有する、
請求項1乃至12のうちいずれか一項記載の装置。 - 前記単一の通路は、前記本体に対して中心に位置決めされる、
請求項13記載の装置。 - 前記単一の通路は、前記本体に対して偏心的に位置決めされる、
請求項13記載の装置。 - 前記本体を通る複数の通路を有し、
該複数の通路の各々は、その中に逆止め弁を備える、
請求項1乃至12のうちいずれか一項記載の装置。 - 前記通路は各々、前記本体の中心に対して偏心的に位置決めされる、
請求項16記載の装置。 - 患者における心不全を治療する装置であって、
本体と、
該本体を通る少なくとも1つの通路と、
そこを通る血液の流れを可能にすると同時に血栓を実質的に排除する寸法の開口を有する、前記通路にわたるメッシュ又はグリル配置と、
前記患者の心房中隔において与えられる孔において前記本体を取り付けるよう適合される取付け手段と、
を有し、
当該装置は使用時に、前記患者の左心房圧が前記患者の右心房圧を上回る際に血液が左心房から右心房まで前記通路を通って流れ得るようにし、それによって前記患者の左心房圧を低減する、
装置。 - 前記通路の一端にわたってメッシュ又はグリル配置を有する、
請求項18記載の装置。 - 前記通路の両端にわたってメッシュ又はグリル配置を有する、
請求項18記載の装置。 - 前記開口は、4mmより小さい最大寸法を有する、
請求項18乃至20のうちいずれか一項記載の装置。 - 前記開口は、2mmより小さい最大寸法を有する、
請求項21記載の装置。 - 前記メッシュ又はグリルは、前記患者の心房中隔における前記孔の内皮化又は血栓症を防ぐよう適合される、1つ又はそれより多くの薬物を有してコーティング又は含浸される、
請求項18乃至22のうちいずれか一項記載の装置。 - 前記1つ又はそれより多くの薬物は、ヘパリン、シロリムス及びパクリタキセルを有する、
請求項23記載の装置。 - 前記本体を通る単一の通路を有する、
請求項18乃至24のうちいずれか一項記載の装置。 - 前記単一の通路は、前記本体に対して中心に位置決めされる、
請求項25記載の装置。 - 前記単一の通路は、前記本体に対して偏心的に位置決めされる、
請求項25記載の装置。 - 前記本体を通る複数の通路を有し、
該複数の通路の各々は、その中にメッシュ又はグリル配置を備える、
請求項28記載の装置。 - 前記複数の通路は各々、前記本体の中心に対して偏心的に位置決めされる、
請求項28記載の装置。 - 可撓性である、
請求項1乃至29のうちいずれか一項記載の装置。 - 変形可能であり得るが、のちにその本来の形状に戻る材料から形成される、
請求項30記載の装置。 - ニチノールから形成される、
請求項31記載の装置。 - 折畳み可能であり、カテーテルを介して埋め込まれるよう適合される、
請求項1乃至29のうちいずれか一項記載の装置。 - 当該装置は、前記患者の心房中隔において作られる孔を通過することができる寸法まで折畳み可能であり、また、当該装置の少なくとも複数の部分が前記患者の心房中隔における前記孔を通過することができない形状に戻るよう適合される、
請求項33記載の装置。 - ニチノールメッシュから形成される、
請求項34記載の装置。 - 前記取付け手段は、前記患者の中隔における前記孔より大きな寸法を有する少なくとも1つのフランジを有する、
請求項1又は7乃至35のうちいずれか一項記載の装置。 - 前記取付け手段は、前記患者の中隔における前記孔より大きな寸法を有する一組の離間されたフランジを有する、
請求項36記載の装置。 - 前記フランジから離れた前記本体の外部寸法は、前記患者の心房中隔における前記孔の内部寸法と実質的に同等である、
請求項36又は37記載の装置。 - 前記フランジは、前記患者の中隔に対する接着、縫合、ステープル留め、又はピン留めに対して適合される、
請求項36乃至38のうちいずれか一項記載の装置。 - 前記フランジは、前記患者の心房中隔の略厚さ分を離間され、その間において前記患者の心房中隔を位置決めするよう適合される、
請求項36乃至38のうちいずれか一項記載の装置。 - 前記フランジは、前記患者の心房中隔の略厚さ分を離間され、その間において前記患者の心房中隔をグリップするよう適合される、
請求項36乃至38のうちいずれか一項記載の装置。 - 患者における心不全を治療する方法であって、
前記患者の心房中隔において孔を形成する段階と、
前記孔において少なくとも1つの逆止め弁を挿入し、該逆止め弁は、前記患者の左心房圧が前記患者の右心房圧を上回る際に該逆止め弁が血液を前記左心房から前記右心房まで前記通路を通って流すよう、方向付けられる段階と、
前記患者の心房中隔に対して前記逆止め弁を固定する段階と、
を有し、
前記患者の左心房圧が前記患者の右心房圧を所定の量分上回る際に、前記弁は、血液を前記左心房から前記右心房まで前記通路を通って流すよう開放し、それによって患者の左心房圧を低減する、
方法。 - 圧力差の前記所定の量は、少なくとも約2mm Hgである、
請求項42記載の方法。 - 圧力差の前記所定の量は、約5乃至25mm Hgである、
請求項43記載の方法。 - 圧力差の前記所定の量は、約5乃至15mm Hgである、
請求項44記載の方法。 - 患者における心不全を治療する方法であって、
前記患者の心房中隔において孔を形成する段階と、
そこを介する血液の通過を可能にすると同時に血栓の通過を実質的に排除する寸法の開口を有する前記孔内においてメッシュ又はグリル配置を挿入する段階と、
前記患者の心房中隔に対して前記メッシュ又はグリル配置を固定する段階と、
を有する方法。 - 前記メッシュ又はグリル配置は、本体の通路内において与えられ、
前記患者の心房中隔に対して前記本体を固定する段階を有する、
請求項46記載の方法。 - 患者における心不全を治療する方法であって、
前記患者の静脈系において少なくとも1つの逆止め弁を挿入し、該逆止め弁は、血液が自然な流れの方向とは反対方向において前記静脈系を通って流れることを防ぐよう方向付けられる段階と、
前記患者の静脈系に対して前記逆止め弁を固定する段階と、
を有する方法。 - 下大動脈、上大動脈、肝静脈、腸骨静脈、あるいは1つ又はそれより多くの肺静脈等である患者の血管において前記逆止め弁を挿入する段階及び固定する段階、
を有する請求項48記載の方法。 - 前記逆止め弁を有するステントを挿入及び固定する段階、
を有する請求項48又は49記載の方法。 - 前記ステントを拡張することによって固定する段階、
を有する請求項50記載の方法。 - 患者における心不全を治療する装置であって、
心臓の左心房及び右心房と夫々流体連通する第1及び第2の端部を有するチューブと、
流体が前記チューブを通って流れることを選択的に防ぐかあるいは可能にするよう適合される、第1の端部と第2の端部との間における弁と、
を有し、
使用時に、前記患者の左心房圧が前記患者の右心房圧を所定の量分上回る際に、前記弁は、左心房から右心房まで血液が前記チューブを通って流れ得るよう開放し、それによって前記左心房圧を低減する、
装置。 - 前記弁は、圧力差の前記所定の量が少なくとも約2mm Hgである際に、開放する、
請求項52記載の装置。 - 前記弁は、圧力差の前記所定の量が約5乃至25mm Hgである際に、開放する、
請求項53記載の装置。 - 前記弁は、圧力差の前記所定の量が約5乃至15mm Hgである際に、開放する、
請求項54記載の装置。 - 患者における心不全又は肺静脈高血圧症を治療する装置であって、
心臓の左心房及び右心房に夫々流体連通する第1及び第2の端部を有するチューブと、
該チューブにおける逆止め弁と、
を有し、
使用時に、前記逆止め弁は、血液が前記右心房から前記左心房まで前記チューブを通って流れることを防ぐ、
装置。 - 患者における心不全を治療する方法であって、
前記患者の左心房と右心房との間において外側にチューブを接続させる段階と、
前記チューブにおいて少なくとも1つの逆止め弁を挿入し、該逆止め弁は、前記患者の左心房圧が前記患者の右心房圧を上回る際に、血液を前記左心房から前記右心房まで前記通路を通って流すよう方向付けられる段階と、
を有し、
前記患者の左心房圧が前記患者の右心房圧を所定の量分上回る際に、前記弁は、血液が前記左心房から前記右心房まで通路を通って流れ得るよう開放し、それによって前記左心房圧を低減する、
方法。 - 圧力差の前記所定の量は、少なくとも約2mm Hgである、
請求項57記載の方法。 - 圧力差の前記所定の量は、約5乃至25mm Hgである、
請求項58記載の方法。 - 圧力差の前記所定の量は、約5乃至15mm Hgである、
請求項59記載の方法。
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JPWO2019188916A1 (ja) * | 2018-03-29 | 2021-04-01 | テルモ株式会社 | 医療デバイス及び処置方法 |
JP7357604B2 (ja) | 2018-03-29 | 2023-10-06 | テルモ株式会社 | 医療デバイス及び処置方法 |
US11950836B2 (en) | 2018-03-29 | 2024-04-09 | Terumo Kabushiki Kaisha | Medical device and treatment method |
US11160961B2 (en) | 2019-09-09 | 2021-11-02 | Shifamed Holdings, Llc | Adjustable shunts and associated systems and methods |
US11253685B2 (en) | 2019-12-05 | 2022-02-22 | Shifamed Holdings, Llc | Implantable shunt systems and methods |
US11622695B1 (en) | 2020-04-23 | 2023-04-11 | Shifamed Holdings, Llc | Intracardiac sensors with switchable configurations and associated systems and methods |
US11801369B2 (en) | 2020-08-25 | 2023-10-31 | Shifamed Holdings, Llc | Adjustable interatrial shunts and associated systems and methods |
US11633194B2 (en) | 2020-11-12 | 2023-04-25 | Shifamed Holdings, Llc | Adjustable implantable devices and associated methods |
US11857197B2 (en) | 2020-11-12 | 2024-01-02 | Shifamed Holdings, Llc | Adjustable implantable devices and associated methods |
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