JP4364633B2 - 体内の管腔の中に人工弁を配置するためのアッセンブリー - Google Patents
体内の管腔の中に人工弁を配置するためのアッセンブリー Download PDFInfo
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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
- A61F2/2403—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 with pivoting rigid closure members
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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
- A61F2/2412—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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
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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
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
-
- 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
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
-
- 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
- A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0067—Three-dimensional shapes conical
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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
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
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- Health & Medical Sciences (AREA)
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- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Description
−インプラントされるべき人工弁と;
−ステントと称されるような径方向に拡張可能なフレームワークであって、拡径状態においては、人工弁の取付対象をなす体内の管腔の壁に対して係合することができ、この係合によって、その壁に対してステントを不動化し得るような、フレームワークと;
−ステントに対して人工弁を固定するための手段と;
を具備したアッセンブリーが、開示されている。
−インプラントされるべき人工弁と;
−ステントと称されるような径方向に拡張可能なフレームワークであって、このステントを拡径させることを意図した少なくとも1つの拡径領域を備え、拡径状態においては、人工弁の取付対象をなす体内の管腔の壁に対して係合することができ、この係合によって、その壁に対してステントを不動化し得るような、フレームワークと;
−このステントに対して人工弁を取り付けるための取付手段であって、ステントを配置することによって人工弁を体内の管腔内に取り付け得るようにして、ステントに対して人工弁を連結することができるような、取付手段と;
−インプラント位置においてステントの拡径を起動し得るような、例えばバルーンカテーテルといったような、拡径手段と;
を具備している。
−例えばスパイクやフックや爪といったような固定手段が、人工弁上に設けられていて、このような固定手段は、体内の管腔をなす壁内に挿入可能とされ、さらに、そのような固定手段は、人工弁の拡径時に壁内へと挿入され得るよう人工弁に対して径方向に配向されている、あるいは、そのような固定手段は、軸回りにおける人工弁の回転時にまたはステントに対しての長手方向移動時に壁内へと挿入され得るよう人工弁に対して接線方向に配向されている、という構成。
−生物学的接着剤または他の適切な接着剤製品が充填された複数の破裂可能な小胞が、人工弁の外面上に配置され、人工弁がインプラント箇所に配置されたときに小胞が破裂可能とされ、特に、人工弁とステントとの間において破裂し得るようになっている、という構成。
−少なくとも1つの、円形をなすようなまたは螺旋状をなすような、ワイヤまたはバンドが、人工弁の周縁壁に一体形成され、さらに、形状記憶材料から形成され、これにより、人工弁のインプラント状態においては、人工弁がステントに対して押し付けられ、その押付けが維持されるようになっている、という構成。
−複数の導管が、人工弁の周縁壁内に形成されまたは人工弁の周縁壁上に固定され、かつ、複数のロッドが、ステント上に形成され、あるいは逆に、複数の導管がステント上に設けられかつ複数のロッドが人工弁上に設けられ、この場合、人工弁がインプラントされていない状態からインプラントされた状態へと移動する際には、ロッドは、導管内をスライド可能とされて導管に対して係合可能とされ、さらにこの場合、例えばフックといったような、インプラントされた状態においてロッドに対して導管を不動化し得る手段を設けることができ、さらに、ワイヤを、ロッドの端部に連結することができ、これらワイヤを、導管を挿通させることができ、これにより、導管内へとロッドを容易に案内し得るものとした、という構成。
−人工弁は、周縁壁を備え;
−ステントは、ステントのうちの、人工弁を取り付けるための取付領域の先端側に、折曲可能部分を備え、この折曲可能部分は、取付領域の先端側に位置した延出状態と、人工弁の周縁壁の内面に当接するようにして配置されこれにより折曲可能部分と取付領域との間に周縁壁を拘束するような折曲状態と、の間にわたって移動可能とされ;
−折曲状態においては、折曲可能部分を維持するための保持手段が設けられている。
−ステント(2)を拡径させるために使用される1つまたは複数のバルーンによって人工弁(4)が損傷を受けるというリスクが除去される。
−ステント(2)に対してかなり大きな膨張力を付与することができる。これにより、アッセンブリー(1)のアンカー止めを確実に行うことができる。このような大きな膨張力は、付加的に、張出フック(15)によるアンカー止めを可能とする。
−最適の機能発揮を行い得ないような直径にまで特に小弁の接骨特性の損失に基づいて最適の機能発揮を行い得ないような直径にまで人工弁(4)を拡径してしまうというリスクを除去することができる。
−心臓弁膜リング(103)と人工弁(4)との間の領域において、アッセンブリー(1)の完璧な密封性を得ることができる。
−冠状動脈入口部分(101)を塞いでしまうというリスクを除去することができる。
−アッセンブリー(1)のインプラント後において、アッセンブリー(1)の全周にわたっての生体流体の流通を維持することができる。
2 ステント
3 シース
4 人工弁
10 基端側円錐台形状部分(拡径領域)
11 基端側円筒形状部分(拡径領域)
12 先端側円錐台形状部分(取付領域)
13 連結ロッド(糸状ロッド)
14 端側円筒形状部分(拡径領域、相補的当接部分)
15 フック
25 アーム(取付手段)
30 周縁壁
31 トンネル(導管、取付手段)
41 拡径可能周縁チャンバ
43 拡径可能周縁チャンバ
45 スリーブ(折曲可能部分)
46 ワイヤ(保持手段)
50 チューブ(導管、取付手段)
51 クリップ(取付手段)
53 外部アーム(ロッド)
55 ワイヤ
60 リング(取付手段)
61 側部開口
100 大動脈(体内の管腔)
101 冠状動脈入口部分
103 心臓弁膜リング
Claims (99)
- インプラント可能な人工弁アッセンブリーであって、
人工弁(4)と、
前記人工弁(4)を支持し、且つ、少なくとも1つの拡張可能な領域(10,11,14)を有するフレイムワーク(2)であり、フレイムワーク(2)の拡張状態において、前記拡張可能な領域(10,11,14)が天然の体内の管腔の壁にフレイムワーク(2)の移動が防止されるような態様で当接するように形成されている径方向に拡張可能なフレイムワーク(2)と、
フレイムワーク(2)の拡張状態において、前記人工弁(4)が前記領域(10,11,14)以外の所(12)に位置するように前記人工弁(4)をフレイムワーク(2)に取付けるための取付手段とを備え、
前記取付手段は、拡張される前記領域(10,11,14)以外の位置におけるインプラントされていない状態と、インプラントされた状態、即ちフレイムワーク(2)の拡張の後に達する状態であり、その状態においては前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動しないようになるインプラントされた状態との間において、前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動可能となるように形成され、
前記取付手段が、前記人工弁(4)の周面壁の一部となっており且つ形状記憶特性を有する少なくとも1つのバンドを有し、この人工弁(4)が前記のようにインプラントされた状態において、前記バンドが前記人工弁(4)をフレイムワーク(2)に押付け続けるように構成されている。 - 請求項1に記載の人工弁アッセンブリーであって、
所望のインプラントする位置においてフレイムワーク(2)の少なくとも前記領域(10,11,14)を拡径させる拡径手段をさらに備えている。 - 請求項1に記載の人工弁アッセンブリーであって、
前記バンドはワイヤを有する。 - 請求項1に記載の人工弁アッセンブリーであって、
前記バンドは円環状である。 - 請求項1に記載の人工弁アッセンブリーであって、
前記バンドは螺旋状である。 - 請求項1に記載の人工弁アッセンブリーであって、
前記取付手段は前記人工弁(4)とフレイムワーク(2)の拡径量の違いを許容するように形成され、これにより、フレイムワーク(2)の拡径度合いの変更が前記人工弁(4)の拡径度合いに実質的には大きな影響を与えない。 - 請求項1に記載の人工弁アッセンブリーであって、
前記人工弁(4)の拡径を制限する手段をさらに備えている。 - 請求項1に記載の人工弁アッセンブリーであって、
前記人工弁(4)はテーパー状に変化する直径の周縁壁(30)を有し、フレイムワーク(2)における前記人工弁(4)を支持している領域が前記周縁壁(30)に対応した形状を有する。 - 請求項1に記載の人工弁アッセンブリーであって、
フレイムワーク(2)はその両端の直径よりも小さい直径を有する中央部分を有し、前記人工弁(4)は、人工弁(4)が取付けられるフレイムワーク(2)の領域に対応した形状を有する。 - 請求項1に記載の人工弁アッセンブリーであって、
不浸透性且つ生体適合性の材料から成り、少なくともフレイムワーク(2)を部分的に覆うシース(3)をさらに備えている。 - 請求項10に記載の人工弁アッセンブリーであって、
シース(3)は、インプラントされた時に環状動脈入口部分に対向して配置されるように形成された複数の側部開口を有する。 - 請求項1に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は天然の心臓弁膜リングに当接する円筒状部分(11)と、その円筒状部分(11)に連結された先端部分(12)とを有する。 - 請求項1に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は先端に向かうにつれて直径が減少するようなテーパー状の基端部分(10)を有し、基端部分(10)はインプラントされた時に心臓の心室の壁や心臓の対応心耳に対して当接するように形成されている。 - 請求項12に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の先端部分(12)または円筒状部分(11)に複数のロッド(13)によって連結された補助的に当接する部分(14)を有し、インプラントされた時に前記補助的に当接する部分(14)が環状動脈入口部分を超えたところに位置するように、前記複数のロッド(13)は十分な長さを有するように形成されている。 - 請求項1に記載の人工弁アッセンブリーであって、
フレイムワーク(2)に設けられてフレイムワークの移動を最小限化する退避可能な複数のフック(15)をさらに備えている。 - 請求項1に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は高い径方向力の部分を有する。 - インプラント可能な人工弁アッセンブリーであって、
人工弁(4)と、
少なくとも1つの拡張可能な領域(10,11,14)を有するフレイムワーク(2)であり、フレイムワーク(2)の拡張状態において、前記拡張可能な領域(10,11,14)が天然の体内の管腔の壁にフレイムワーク(2)の移動が防止されるような態様で当接するように形成されている径方向に拡張可能なフレイムワーク(2)と、
フレイムワーク(2)の拡張状態において、前記人工弁(4)が前記領域以外の所(12)に位置するように前記人工弁(4)をフレイムワーク(2)に取付けるための取付手段とを備え、
フレイムワーク(2)はその両端の直径よりも小さい直径を有する中央部分を有し、前記人工弁(4)は、人工弁(4)が取付けられるフレイムワーク(2)の領域に対応した形状を有し、
前記中央部分は2つの円錐台形状を互いに反対向きに接合した形状を有する。 - 請求項17に記載の人工弁アッセンブリーであって、
所望のインプラントする位置においてフレイムワーク(2)の少なくとも前記領域(10,11,14)を拡径させる拡径手段をさらに備えている。 - 請求項17に記載の人工弁アッセンブリーであって、
前記取付手段は、拡張される前記領域(10,11,14)以外の位置におけるインプラントされていない状態と、インプラントされた状態、即ちフレイムワーク(2)の拡張の後に達する状態であり、その状態においては前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動しないようになるインプラントされた状態との間において、前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動可能となるように形成されている。 - 請求項19に記載の人工弁アッセンブリーであって、
取付手段は、前記人工弁(4)上に設けられ、体内の壁に差し込まれるように形成されるとともに径方向に配向された固定手段を有する。 - 請求項20に記載の人工弁アッセンブリーであって、
固定手段は、軸回りにおける前記人工弁の回転時に体内に差し込まれるように形成されている。 - 請求項20に記載の人工弁アッセンブリーであって、
固定手段は、フレイムワーク(2)に対する前記人工弁(4)の長手方向移動時に体内に差し込まれるように形成されている。 - 請求項20に記載の人工弁アッセンブリーであって、
固定手段は、スパイク、フック、爪等を有する。 - 請求項19に記載の人工弁アッセンブリーであって、
取付手段が、前記人工弁(4)の周面壁の一部となっており且つ形状記憶特性を有する少なくとも1つのバンドを有し、この人工弁(4)が前記のようにインプラントされた状態において、前記バンドが前記人工弁(4)をフレイムワーク(2)に押付け続けるように構成されている。 - 請求項24に記載の人工弁アッセンブリーであって、
前記バンドはワイヤを有する。 - 請求項24に記載の人工弁アッセンブリーであって、
前記バンドは円環状である。 - 請求項24に記載の人工弁アッセンブリーであって、
前記バンドは螺旋状である。 - 請求項19に記載の人工弁アッセンブリーであって、
前記取付手段は複数の導管(50)を有する。 - 請求項28に記載の人工弁アッセンブリーであって、
前記人工弁(4)がインプラントされていない状態からインプラントされた状態まで移動する時に前記複数の導管(50)に係合するとともに挿通する複数のロッド(51)をさらに備えている。 - 請求項29に記載の人工弁アッセンブリーであって、
前記複数の導管(50)を前記複数のロッド(51)に対してインプラントされた状態で不動化する手段をさらに備えている。 - 請求項30に記載の人工弁アッセンブリーであって、
前記複数のロッド(51)に連結され、前記複数のロッド(51)を前記複数の導管(50)に案内するために前記複数の導管(50)を挿通するように形成された複数のワイヤ(55)をさらに備えている。 - 請求項17に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の拡径が開始された後、前記取付手段は前記人工弁(4)とフレイムワーク(2)の拡径量の違いを許容するように形成され、これにより、フレイムワーク(2)の拡径度合いの変更が前記人工弁(4)の拡径度合いに実質的には大きな影響を与えない。 - 請求項17に記載の人工弁アッセンブリーであって、
前記人工弁(4)の拡径を制限する手段をさらに備えている。 - 請求項17に記載の人工弁アッセンブリーであって、
前記人工弁(4)はテーパー状に変化する直径の周縁壁(30)を有し、フレイムワーク(2)における前記人工弁(4)を支持している領域が前記周縁壁(30)に対応した形状を有する。 - 請求項17に記載の人工弁アッセンブリーであって、
前記人工弁(4)が周縁壁(30)を有し、フレイムワーク(2)が、前記人工弁(4)を受容するためのフレイムワーク(2)の領域に対して先端側に続く位置において、前記領域の先端側に位置する延出状態と前記人工弁(4)の周縁壁(30)の内周面に当接するように位置する折曲状態との間で移動可能な折曲可能部分を有し、折曲可能部分とフレイムワーク(2)の間で前記周縁壁を拘束されるようになっている。 - 請求項35に記載の人工弁アッセンブリーであって、
この折曲可能部分を折り曲げられた状態で維持するための保持手段をさらに備えている。 - 請求項17に記載の人工弁アッセンブリーであって、
不浸透性且つ生体適合性の材料から成り、少なくともフレイムワーク(2)を部分的に覆うシース(3)をさらに備えている。 - 請求項37に記載の人工弁アッセンブリーであって、
シース(3)は、インプラントされた時に環状動脈入口部分に対向して配置されるように形成された複数の側部開口を有する。 - 請求項17に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は天然の心臓弁膜リングに当接する円筒状部分(11)と、その円筒状部分(11)に連結された先端部分(12)とを有する。 - 請求項17に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は先端に向かうにつれて直径が減少するようなテーパー状の基端部分(10)を有し、基端部分(10)はインプラントされた時に心臓の心室の壁や心臓の対応心耳に対して当接するように形成されている。 - 請求項39に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の先端部分(12)または円筒状部分(11)に複数のロッド(13)によって連結された補助的に当接する部分(14)を有し、インプラントされた時に前記補助的に当接する部分(14)が環状動脈入口部分を超えたところに位置するように、前記複数のロッド(13)は十分な長さを有するように形成されている。 - 請求項17に記載の人工弁アッセンブリーであって、
フレイムワーク(2)に設けられてフレイムワーク(2)の移動を最小限化する退避可能な複数のフック(15)をさらに備えている。 - 請求項17に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は高い径方向力の部分を有する。 - インプラント可能な人工弁アッセンブリーであって、
人工弁(4)と、
少なくとも1つの拡張可能な領域(10,11,14)を有するフレイムワーク(2)であり、フレイムワーク(2)の拡張状態において、前記拡張可能な領域(10,11,14)が天然の体内の管腔の壁にフレイムワーク(2)の移動が防止されるような態様で当接するように形成されている径方向に拡張可能なフレイムワーク(2)と、
フレイムワーク(2)の拡張状態において、前記人工弁(4)が前記領域以外の所(12)に位置するように前記人工弁(4)をフレイムワーク(2)に取付けるための取付手段とを備え、
フレイムワーク(2)はその両端の直径よりも小さい直径を有する中央部分を有し、前記人工弁(4)は、人工弁(4)が取付けられるフレイムワーク(2)の領域に対応した形状を有し、
前記中央部分は砂時計形状を有する。 - 請求項44に記載の人工弁アッセンブリーであって、
所望のインプラントする位置においてフレイムワーク(2)の少なくとも前記領域(10,11,14)を拡径させる拡径手段をさらに備えている。 - 請求項44に記載の人工弁アッセンブリーであって、
前記取付手段は、拡張される前記領域(10,11,14)以外の位置におけるインプラントされていない状態と、インプラントされた状態、即ちフレイムワーク(2)の拡張の後に達する状態であり、その状態においては前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動しないようになるインプラントされた状態との間において、前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動可能となるように形成されている。 - 請求項46に記載の人工弁アッセンブリーであって、
取付手段は、前記人工弁(4)上に設けられ、体内の壁に差し込まれるように形成されるとともに径方向に配向された固定手段を有する。 - 請求項47に記載の人工弁アッセンブリーであって、
固定手段は、軸回りにおける前記人工弁の回転時に体内に差し込まれるように形成されている。 - 請求項47に記載の人工弁アッセンブリーであって、
固定手段は、フレイムワーク(2)に対する前記人工弁(4)の長手方向移動時に体内に差し込まれるように形成されている。 - 請求項47に記載の人工弁アッセンブリーであって、
固定手段は、スパイク、フック、爪等を有する。 - 請求項46に記載の人工弁アッセンブリーであって、
取付手段が、前記人工弁(4)の周面壁の一部となっており且つ形状記憶特性を有する少なくとも1つのバンドを有し、この人工弁(4)が前記のようにインプラントされた状態において、前記バンドが前記人工弁(4)をフレイムワーク(2)に押付け続けるように構成されている。 - 請求項51に記載の人工弁アッセンブリーであって、
前記バンドはワイヤを有する。 - 請求項51に記載の人工弁アッセンブリーであって、
前記バンドは円環状である。 - 請求項51に記載の人工弁アッセンブリーであって、
前記バンドは螺旋状である。 - 請求項46に記載の人工弁アッセンブリーであって、
前記取付手段は複数の導管(50)を有する。 - 請求項55に記載の人工弁アッセンブリーであって、
前記人工弁(4)がインプラントされていない状態からインプラントされた状態まで移動する時に前記複数の導管(50)に係合するとともに挿通する複数のロッド(51)をさらに備えている。 - 請求項56に記載の人工弁アッセンブリーであって、
前記複数の導管(50)を前記複数のロッド(51)に対してインプラントされた状態で不動化する手段をさらに備えている。 - 請求項57に記載の人工弁アッセンブリーであって、
前記複数のロッド(51)に連結され、前記複数のロッド(51)を前記複数の導管(50)に案内するために前記複数の導管(50)を挿通するように形成された複数のワイヤ(55)をさらに備えている。 - 請求項44に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の拡径が開始された後、前記取付手段は前記人工弁(4)とフレイムワーク(2)の拡径量の違いを許容するように形成され、これにより、フレイムワーク(2)の拡径度合いの変更が前記人工弁(4)の拡径度合いに実質的には大きな影響を与えない。 - 請求項44に記載の人工弁アッセンブリーであって、
前記人工弁(4)の拡径を制限する手段をさらに備えている。 - 請求項44に記載の人工弁アッセンブリーであって、
前記人工弁(4)はテーパー状に変化する直径の周縁壁(30)を有し、フレイムワーク(2)における前記人工弁(4)を支持している領域が前記周縁壁(30)に対応した形状を有する。 - 請求項44に記載の人工弁アッセンブリーであって、
前記人工弁(4)が周縁壁(30)を有し、フレイムワーク(2)が、前記人工弁(4)を受容するためのフレイムワーク(2)の領域に対して先端側に続く位置において、前記領域の先端側に位置する延出状態と前記人工弁(4)の周縁壁(30)の内周面に当接するように位置する折曲状態との間で移動可能な折曲可能部分を有し、折曲可能部分とフレイムワーク(2)の間で前記周縁壁が拘束されるようになっている。 - 請求項62に記載の人工弁アッセンブリーであって、
この折曲可能部分を折り曲げられた状態で維持するための保持手段をさらに備えている。 - 請求項44に記載の人工弁アッセンブリーであって、
不浸透性且つ生体適合性の材料から成り、少なくともフレイムワーク(2)を部分的に覆うシース(3)をさらに備えている。 - 請求項64に記載の人工弁アッセンブリーであって、
シース(3)は、インプラントされた時に環状動脈入口部分に対向して配置されるように形成された複数の側部開口を有する。 - 請求項44に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は天然の心臓弁膜リングに当接する円筒状部分(11)と、その円筒状部分(11)に連結された先端部分(12)とを有する。 - 請求項44に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は先端に向かうにつれて直径が減少するようなテーパー状の基端部分(10)を有し、基端部分(10)はインプラントされた時に心臓の心室の壁や心臓の対応心耳に対して当接するように形成されている。 - 請求項66に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の先端部分(12)または円筒状部分(11)に複数のロッド(13)によって連結された補助的に当接する部分(14)を有し、インプラントされた時に前記補助的に当接する部分(14)が環状動脈入口部分を超えたところに位置するように、前記複数のロッド(13)は十分な長さを有するように形成されている。 - 請求項44に記載の人工弁アッセンブリーであって、
フレイムワーク(2)に設けられてフレイムワーク(2)の移動を最小限化する退避可能な複数のフック(15)をさらに備えている。 - 請求項44に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は高い径方向力の部分を有する。 - インプラント可能な人工弁アッセンブリーであって、
人工弁(4)と、
少なくとも1つの拡張可能な領域(10,11,14)を有するフレイムワーク(2)であり、フレイムワーク(2)の拡張状態において、前記拡張可能な領域(10,11,14)が天然の体内の管腔の壁にフレイムワーク(2)の移動が防止されるような態様で当接するように形成されている径方向に拡張可能なフレイムワーク(2)と、
不浸透性且つ生体適合性の材料から成り、少なくともフレイムワーク(2)を部分的に覆うシース(3)と、
フレイムワーク(2)の拡張状態において、前記人工弁(4)が前記領域以外の所(12)に位置するように前記人工弁(4)をフレイムワーク(2)に取付けるための取付手段とを備えている。 - 請求項71に記載の人工弁アッセンブリーであって、
所望のインプラントする位置においてフレイムワーク(2)の少なくとも前記領域(10,11,14)を拡径させる拡径手段をさらに備えている。 - 請求項71に記載の人工弁アッセンブリーであって、
前記取付手段は、拡張される前記領域(10,11,14)以外の位置におけるインプラントされていない状態と、インプラントされた状態、即ちフレイムワーク(2)の拡張の後に達する状態であり、その状態においては前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動しないようになるインプラントされた状態との間において、前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動可能となるように形成されている。 - 請求項73記載の人工弁アッセンブリーであって、
取付手段が、前記人工弁(4)の周面壁の一部となっており且つ形状記憶特性を有する少なくとも1つのバンドを有し、この人工弁(4)が前記のようにインプラントされた状態において、前記バンドが前記人工弁(4)をフレイムワーク(2)に押付け続けるように構成されている。 - 請求項74に記載の人工弁アッセンブリーであって、
前記バンドはワイヤを有する。 - 請求項74に記載の人工弁アッセンブリーであって、
前記バンドは円環状である。 - 請求項74に記載の人工弁アッセンブリーであって、
前記バンドは螺旋状である。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の拡径が開始された後、前記取付手段は前記人工弁(4)とフレイムワーク(2)の拡径量の違いを許容するように形成され、これにより、フレイムワーク(2)の拡径度合いの変更が前記人工弁(4)の拡径度合いに実質的には大きな影響を与えない。 - 請求項71に記載の人工弁アッセンブリーであって、
前記人工弁(4)の拡径を制限する手段をさらに備えている。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)はその両端の直径よりも小さい直径を有する中央部分を有し、前記人工弁(4)は、人工弁(4)が取付けられるフレイムワーク(2)の領域に対応した形状を有する。 - 請求項71に記載の人工弁アッセンブリーであって、
シース(3)は、インプラントされた時に環状動脈入口部分に対向して配置されるように形成された複数の側部開口を有する。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は天然の心臓弁膜リングに当接する円筒状部分(11)と、その円筒状部分(11)に連結された先端部分(12)とを有する。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は先端に向かうにつれて直径が減少するようなテーパー状の基端部分(10)を有し、基端部分(10)はインプラントされた時に心臓の心室の壁や心臓の対応心耳に対して当接するように形成されている。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)に設けられてフレイムワーク(2)の移動を最小限化する退避可能な複数のフック(15)をさらに備えている。 - 請求項71に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は高い径方向力の部分を有する。 - インプラント可能な人工弁アッセンブリーであって、
人工弁(4)と、
少なくとも1つの拡張可能な領域(10,11,14)を有するフレイムワーク(2)であり、フレイムワーク(2)の拡張状態において、前記拡張可能な領域(10,11,14)が天然の体内の管腔の壁にフレイムワーク(2)の移動が防止されるような態様で当接するように形成されている径方向に拡張可能なフレイムワーク(2)と、
フレイムワーク(2)の拡張状態において、前記人工弁(4)が前記領域以外の所(12)に位置するように前記人工弁(4)をフレイムワーク(2)に取付けるための取付手段とを備え、
フレイムワーク(2)に設けられてフレイムワーク(2)の移動を最小限化する退避可能な複数のフック(15)をさらに備えている。 - 請求項86に記載の人工弁アッセンブリーであって、
所望のインプラントする位置においてフレイムワーク(2)の少なくとも前記領域(10,11,14)を拡径させる拡径手段をさらに備えている。 - 請求項86に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は前記第1の領域とは異なる第2の領域に取付けられている。 - 請求項86に記載の人工弁アッセンブリーであって、
前記取付手段は、拡張される前記領域(10,11,14)以外の位置におけるインプラントされていない状態と、インプラントされた状態、即ちフレイムワーク(2)の拡張の後に達する状態であり、その状態においては前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動しないようになるインプラントされた状態との間において、前記人工弁(4)がフレイムワーク(2)に対して軸方向に移動可能となるように形成されている。 - 請求項86に記載の人工弁アッセンブリーであって、
フレイムワーク(2)の拡径が開始された後、前記取付手段は前記人工弁(4)とフレイムワーク(2)の拡径量の違いを許容するように形成され、これにより、フレイムワーク(2)の拡径度合いの変更が前記人工弁(4)の拡径度合いに実質的には大きな影響を与えない。 - 請求項86に記載の人工弁アッセンブリーであって、
前記人工弁(4)の拡径を制限する手段をさらに備えている。 - 請求項86に記載の人工弁アッセンブリーであって、
前記人工弁(4)はテーパー状に変化する直径の周縁壁(30)を有し、フレイムワーク(2)における前記人工弁(4)を支持している領域が前記周縁壁(30)に対応した形状を有する。 - 請求項86に記載の人工弁アッセンブリーであって、
フレイムワーク(2)はその両端の直径よりも小さい直径を有する中央部分を有し、前記人工弁(4)は、人工弁(4)が取付けられるフレイムワーク(2)の領域に対応した形状を有する。 - 請求項86に記載の人工弁アッセンブリーであって、
前記人工弁(4)が周縁壁(30)を有し、フレイムワーク(2)が、前記人工弁(4)を受容するためのフレイムワーク(2)の領域に対して先端側に続く位置において、前記領域の先端側に位置する延出状態と前記人工弁(4)の周縁壁(30)の内周面に当接するように位置する折曲状態との間で移動可能な折曲可能部分を有し、折曲可能部分とフレイムワーク(2)の間で前記周縁壁を拘束されるようになっている。 - 請求項94に記載の人工弁アッセンブリーであって、
この折曲可能部分を折り曲げられた状態で維持するための保持手段をさらに備えている。 - 請求項94に記載の人工弁アッセンブリーであって、
不浸透性且つ生体適合性の材料から成り、少なくともフレイムワーク(2)を部分的に覆うシース(3)をさらに備えている。 - 請求項96に記載の人工弁アッセンブリーであって、
シース(3)は、インプラントされた時に環状動脈入口部分に対向して配置されるように形成された複数の側部開口を有する。 - 請求項86に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は天然の心臓弁膜リングに当接する円筒状部分(11)と、その円筒状部分(11)に連結された先端部分(12)とを有する。 - 請求項86に記載の人工弁アッセンブリーであって、
フレイムワーク(2)は先端に向かうにつれて直径が減少するようなテーパー状の基端部分(10)を有し、基端部分(10)はインプラントされた時に心臓の心室の壁や心臓の対応心耳に対して当接するように形成されている。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
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FR0108898A FR2826863B1 (fr) | 2001-07-04 | 2001-07-04 | Ensemble permettant la mise en place d'une valve prothetique dans un conduit corporel |
PCT/FR2002/002352 WO2003003949A2 (fr) | 2001-07-04 | 2002-07-04 | Ensemble permettant la mise en place d'une valve prothetique dans un conduit corporel |
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JP2005505320A JP2005505320A (ja) | 2005-02-24 |
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EP (1) | EP1401359B1 (ja) |
JP (1) | JP4364633B2 (ja) |
AT (1) | ATE440567T1 (ja) |
AU (1) | AU2002329324B2 (ja) |
CA (1) | CA2450935C (ja) |
DE (1) | DE60233493D1 (ja) |
ES (1) | ES2335651T3 (ja) |
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Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2015027557A (ja) * | 2007-10-25 | 2015-02-12 | サイメティス エスアー | ステント、弁付きステントおよび方法ならびにその送達システム |
JP2012512718A (ja) * | 2008-12-19 | 2012-06-07 | エドワーズ ライフサイエンシーズ コーポレイション | 迅速接続人工心臓弁および方法 |
Also Published As
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US20110301692A1 (en) | 2011-12-08 |
US9149357B2 (en) | 2015-10-06 |
CA2450935A1 (fr) | 2003-01-16 |
ATE440567T1 (de) | 2009-09-15 |
US20080215143A1 (en) | 2008-09-04 |
US8002826B2 (en) | 2011-08-23 |
EP1401359A2 (fr) | 2004-03-31 |
CA2450935C (fr) | 2010-09-21 |
EP1401359B1 (fr) | 2009-08-26 |
DE60233493D1 (de) | 2009-10-08 |
US20100036485A1 (en) | 2010-02-11 |
ES2335651T3 (es) | 2010-03-31 |
WO2003003949A3 (fr) | 2004-01-22 |
US20140188220A1 (en) | 2014-07-03 |
AU2002329324B2 (en) | 2007-07-12 |
FR2826863B1 (fr) | 2003-09-26 |
US7252682B2 (en) | 2007-08-07 |
FR2826863A1 (fr) | 2003-01-10 |
WO2003003949A2 (fr) | 2003-01-16 |
US20050043790A1 (en) | 2005-02-24 |
JP2005505320A (ja) | 2005-02-24 |
US7780726B2 (en) | 2010-08-24 |
US8628570B2 (en) | 2014-01-14 |
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