JP2020520297A - 三尖弁又は僧帽弁のための関節式プロテーゼ及び関連する捕捉装置 - Google Patents
三尖弁又は僧帽弁のための関節式プロテーゼ及び関連する捕捉装置 Download PDFInfo
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- 210000000591 tricuspid valve Anatomy 0.000 title claims abstract description 34
- 210000004115 mitral valve Anatomy 0.000 title claims abstract description 25
- 210000005166 vasculature Anatomy 0.000 claims 1
- 238000001356 surgical procedure Methods 0.000 abstract description 2
- 210000003709 heart valve Anatomy 0.000 description 15
- 201000001943 Tricuspid Valve Insufficiency Diseases 0.000 description 9
- 238000000034 method Methods 0.000 description 9
- 241000219793 Trifolium Species 0.000 description 8
- 206010044640 Tricuspid valve incompetence Diseases 0.000 description 5
- 208000031481 Pathologic Constriction Diseases 0.000 description 3
- 238000013459 approach Methods 0.000 description 3
- 230000010339 dilation Effects 0.000 description 3
- 230000036262 stenosis Effects 0.000 description 3
- 208000037804 stenosis Diseases 0.000 description 3
- 206010067171 Regurgitation Diseases 0.000 description 2
- 238000004873 anchoring Methods 0.000 description 2
- 210000000038 chest Anatomy 0.000 description 2
- 230000003902 lesion Effects 0.000 description 2
- 239000000463 material Substances 0.000 description 2
- 210000005241 right ventricle Anatomy 0.000 description 2
- 208000012287 Prolapse Diseases 0.000 description 1
- 206010044642 Tricuspid valve stenosis Diseases 0.000 description 1
- 239000000560 biocompatible material Substances 0.000 description 1
- 230000000747 cardiac effect Effects 0.000 description 1
- 238000013132 cardiothoracic surgery Methods 0.000 description 1
- 238000013130 cardiovascular surgery Methods 0.000 description 1
- 201000010099 disease Diseases 0.000 description 1
- 208000037265 diseases, disorders, signs and symptoms Diseases 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 229940079593 drug Drugs 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 238000005516 engineering process Methods 0.000 description 1
- 238000002682 general surgery Methods 0.000 description 1
- 230000007774 longterm Effects 0.000 description 1
- 210000003540 papillary muscle Anatomy 0.000 description 1
- 238000011477 surgical intervention Methods 0.000 description 1
- 210000000115 thoracic cavity Anatomy 0.000 description 1
- 210000001519 tissue Anatomy 0.000 description 1
- 230000007704 transition Effects 0.000 description 1
- 230000000472 traumatic effect Effects 0.000 description 1
- 208000028073 tricuspid valve disease Diseases 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
- 210000003462 vein Anatomy 0.000 description 1
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- A61B17/122—Clamps or clips, e.g. for the umbilical cord
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/246—Devices for obstructing a leak through a native valve in a closed condition
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
- A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
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- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
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- A61B2017/00778—Operations on blood vessels
- A61B2017/00783—Valvuloplasty
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0091—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/0008—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a position by translation along an axis or two perpendicular axes
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- Health & Medical Sciences (AREA)
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- Life Sciences & Earth Sciences (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Engineering & Computer Science (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgery (AREA)
- Reproductive Health (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
− 遠位環状円筒部分6と、
− 中央環状円筒部分7と、
− 円筒状のカラー8、及びカラー8に係合し、長手方向軸線に沿って自由に回転するようにそれによって支持されたねじ9を有する近位環状円筒形部分と、
− 遠位環状円筒部分6の外側表面にヒンジ結合された第1の複数の剛性アーム10と、
− カラー8の外側表面にヒンジ結合された第2の複数の剛性アーム11と、
− 各々が、一方の端部から中央環状円筒部分7の外側表面に、及び反対の端部から剛性アーム10の対応する端部にヒンジ結合されている、第3の複数の剛性アーム12と、
− 各々が、一方の端部から中央環状円筒部分7の外側表面に、及び反対の端部から剛性アーム11の対応する端部にヒンジ結合されている、第4の複数の剛性アーム13と
を備える。
− 収縮されたバルーン3を、近位部分を通って遠位部分6から出るまで挿入する操作と、
− バルーン3を膨張させ、それを遠位部分6に当接させる操作と、
− ねじ込み手段17を使用して遠位部分6からねじ9を緩め、関節式プロテーゼ5が膨張構成を呈することを可能にする操作と、
− 最後に、膨張チューブ4を引っ張ることによって、膨張された関節式プロテーゼをカテーテルの中に挿入する操作と
を介して患者の心臓から取り外されてもよい。
Claims (7)
- 三尖弁又は僧帽弁のための関節式プロテーゼであって、
遠位環状部分、中央環状部分、及び近位環状部分と、
前記遠位環状部分の外側表面にヒンジ結合された複数の第1の剛性アームと、
前記近位環状部分の外側表面にヒンジ結合された複数の第2の剛性アームと、
複数の第3の剛性アームであって、各第3の剛性アームは、一方の端部から前記中央環状部分の外側表面に、及び反対の端部から前記複数の第1の剛性アームのうちの対応する第1の剛性アームの端部にヒンジ結合されている、複数の第3の剛性アームと、
複数の第4の剛性アームであって、各第4の剛性アームは、一方の端部から前記中央環状部分の外側表面に、及び反対の端部から前記複数の第2の剛性アームのうちの対応する第2の剛性アームの端部にヒンジ結合されている、複数の第4の剛性アームと
を備え、
前記複数の第3の剛性アーム及び/又は前記複数の第4の剛性アームは、対向する捕捉表面において画定されたローレットをそれぞれ有し、前記複数の第3の剛性アームの前記捕捉表面はまた、三尖弁又は僧帽弁の弁尖にスパイクを打つように構成された尖った突起を画定し、
前記遠位環状部分は雌ねじを有し、前記近位環状部分は、
前記複数の第2の剛性アームがヒンジ結合されている側面において円筒状のカラーと、
前記カラーに係合されたねじであって、前記ねじは、それによって前記ねじの長手方向軸線に沿って自由に回転するように支持され、前記雌ねじと係合するように構成されたねじと
を有し、前記中央環状部分は、前記近位環状部分を通過させるための貫通孔を画定し、
前記関節式プロテーゼは、端部に対応してヒンジ接続された全ての剛性アームが膨張されている膨張構成から、前記近位環状部分が前記中央環状部分を通ってねじ込まれ、前記遠位環状部分と係合されている拡張構成に移動可能であって、前記複数の第3の剛性アーム及び前記複数の第4の剛性アームは、それらの間に三尖弁又は僧帽弁の弁尖を保持するように構成され、前記関節式プロテーゼが前記拡張構成にある場合に、前記尖った突起は前記弁尖にスパイクを打つ、関節式プロテーゼ。 - 前記複数の第3の剛性アーム及び前記複数の第4の剛性アームは、前記関節式プロテーゼが拡張構成にある場合に前記近位環状部分に向かって配向された凹面を画定するために長手方向に凹状である、請求項1に記載の関節式プロテーゼ。
- 前記複数の第2の剛性アーム及び前記複数の第3の剛性アームの数は、前記複数の第1の剛性アーム及び前記複数の第4の剛性アームの数の2倍であり、
前記複数の第4の剛性アームの各々は、前記反対の端部において前記複数の第2の剛性アームの2つと共にヒンジ結合され、
前記複数の第3の剛性アームの各々は、前記反対の端部において前記複数の第1の剛性アームの2つと共にヒンジ結合されている、請求項2に記載の関節式プロテーゼ。 - 前記複数の剛性アームの各々は、3つの剛性アーム又は3つの剛性アームの整数倍を備える、三尖弁のための請求項1〜3の何れか一項に記載の関節式プロテーゼ。
- 前記複数の剛性アームの各々は、偶数の数の剛性アームを備える、僧帽弁のための請求項1〜3の何れか一項に記載の関節式プロテーゼ。
- 三尖弁又は僧帽弁の弁尖のための捕捉装置であって、
請求項1〜5の何れか一項に記載の三尖弁又は僧帽弁のための関節式プロテーゼと、
前記関節式プロテーゼの前記遠位環状部分、前記中央環状部分、及び前記近位環状部分を通ってねじ込まれた膨張チューブに機能的に接続された膨張可能なバルーンと、
前記膨張チューブの周りに同軸に配置され、前記関節式プロテーゼの前記近位環状部分の前記ねじを押圧して回転させるように構成されたねじ込み手段と
を備える捕捉装置。 - 三尖弁又は僧帽弁を修復するための装置であって、
血管系から又は患者の胸部の切開から三尖弁又は僧帽弁内の位置まで通過するように構成された介入カテーテルと、
請求項6に記載の三尖弁又は僧帽弁の弁尖のための捕捉装置と
を備える装置。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IT102017000052909A IT201700052909A1 (it) | 2017-05-16 | 2017-05-16 | Protesi articolata per valvola tricuspide o mitrale e relativo dispositivo di afferraggio |
IT102017000052909 | 2017-05-16 | ||
PCT/IB2018/053074 WO2018211346A1 (en) | 2017-05-16 | 2018-05-03 | Articulated prosthesis for a tricuspid or mitral valve and related catching device |
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JP2020520297A true JP2020520297A (ja) | 2020-07-09 |
JP7012148B2 JP7012148B2 (ja) | 2022-01-27 |
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US (1) | US11576780B2 (ja) |
EP (1) | EP3624705B1 (ja) |
JP (1) | JP7012148B2 (ja) |
CN (1) | CN110636804B (ja) |
AU (1) | AU2018268369A1 (ja) |
BR (1) | BR112019024024A2 (ja) |
IT (1) | IT201700052909A1 (ja) |
WO (1) | WO2018211346A1 (ja) |
Families Citing this family (19)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8579964B2 (en) | 2010-05-05 | 2013-11-12 | Neovasc Inc. | Transcatheter mitral valve prosthesis |
US9308087B2 (en) | 2011-04-28 | 2016-04-12 | Neovasc Tiara Inc. | Sequentially deployed transcatheter mitral valve prosthesis |
US9554897B2 (en) | 2011-04-28 | 2017-01-31 | Neovasc Tiara Inc. | Methods and apparatus for engaging a valve prosthesis with tissue |
US9345573B2 (en) | 2012-05-30 | 2016-05-24 | Neovasc Tiara Inc. | Methods and apparatus for loading a prosthesis onto a delivery system |
US9572665B2 (en) | 2013-04-04 | 2017-02-21 | Neovasc Tiara Inc. | Methods and apparatus for delivering a prosthetic valve to a beating heart |
CN113893064A (zh) | 2016-11-21 | 2022-01-07 | 内奥瓦斯克迪亚拉公司 | 用于快速收回经导管心脏瓣膜递送***的方法和*** |
IT201700052909A1 (it) | 2017-05-16 | 2018-11-16 | Star Tric S R L | Protesi articolata per valvola tricuspide o mitrale e relativo dispositivo di afferraggio |
WO2019036810A1 (en) | 2017-08-25 | 2019-02-28 | Neovasc Tiara Inc. | TRANSCATHETER MITRAL VALVULE PROSTHESIS WITH SEQUENTIAL DEPLOYMENT |
JP7260930B2 (ja) | 2018-11-08 | 2023-04-19 | ニオバスク ティアラ インコーポレイテッド | 経カテーテル僧帽弁人工補綴物の心室展開 |
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- 2018-05-03 JP JP2020514783A patent/JP7012148B2/ja active Active
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- 2018-05-03 CN CN201880032422.3A patent/CN110636804B/zh active Active
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- 2018-05-03 EP EP18725307.5A patent/EP3624705B1/en active Active
- 2018-05-03 BR BR112019024024-1A patent/BR112019024024A2/pt not_active Application Discontinuation
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EP3624705B1 (en) | 2021-12-29 |
AU2018268369A1 (en) | 2019-12-12 |
US11576780B2 (en) | 2023-02-14 |
CN110636804A (zh) | 2019-12-31 |
BR112019024024A2 (pt) | 2020-06-02 |
IT201700052909A1 (it) | 2018-11-16 |
WO2018211346A1 (en) | 2018-11-22 |
JP7012148B2 (ja) | 2022-01-27 |
US20200163757A1 (en) | 2020-05-28 |
EP3624705A1 (en) | 2020-03-25 |
CN110636804B (zh) | 2023-03-28 |
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