JP5313902B2 - 心臓の拡張機能を改善する方法およびシステム - Google Patents
心臓の拡張機能を改善する方法およびシステム Download PDFInfo
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- A—HUMAN NECESSITIES
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- 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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0649—Coils or spirals
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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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
- A61F2002/2484—Delivery devices therefor
-
- 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
- A61F2250/0067—Means for introducing or releasing pharmaceutical products into the body
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- Transplantation (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Prostheses (AREA)
- External Artificial Organs (AREA)
- Surgical Instruments (AREA)
Description
好ましくは、交互で、かつ一連の弾性要素および取付け要素の1つまたは複数の鎖はほぼ平行である。
Claims (21)
- a)弾性要素であって、該弾性要素は1つまたは複数のねじりばねからなり、それぞれのねじりばねはさらに頂点に1つまたは複数のばねループを備え、「V」または「U」字形を形成する2つのアームを備えている、弾性要素と、
b)取付け要素を備え、
前記弾性要素の末端が曲げられて、前記取付け要素に設けられた固着手段に係合することができる曲線状の締結具を形成しており、
前記弾性要素および前記取付け要素が相互接続され、交互に、かつ一連の前記弾性要素および前記取付け要素にて鎖を形成することができるように構成され、
前記取付け要素が、心臓壁に固着され、前記心臓壁に薬剤を送達する選択肢を備えるように適合された、心臓の拡張機能を改善するシステム。 - 前記弾性要素が、単一のねじりばねと、「V」字形を形成する2つのアームと、を備え、前記アームがそれぞれ、らせん形または「G」字形の形態に形作られた曲線状の締結具を備える、請求項1に記載のシステム。
- 各アームの端部が「S」字形に屈曲され、前記「S」字形の底部がさらに屈曲されて、らせん形または「G」字形の曲線状の締結具を提供する、請求項2に記載のシステム。
- 各弾性要素が、比較的直線のアームと、前記ねじりばねおよび前記弾性要素の前記比較的直線のアームの面に対して曲線状部分を有するアームと、から成る、請求項1に記載のシステム。
- 前記弾性要素の前記曲線状の締結具の少なくとも1つが、固着要素の一部分の上に置かれ、かつそこに締め付けることができる1つまたは複数の締結ループを備える、請求項1に記載のシステム。
- 前記弾性要素の他方の曲線状の締結具が固着ループの形態で提供される、請求項5に記載のシステム。
- 前記締結ループを前記固着要素の一部分の上に置く前に、それらを拡大するのを支援するための、前記締結ループ上またはその付近に設けられた拡大ループをさらに備える、請求項5に記載のシステム。
- 前記締結ループを拡大するのを支援するための、前記曲線状の締結具付近の前記弾性要素のアーム部分上に形成されたサドルをさらに備える、請求項5に記載のシステム。
- 前記弾性要素が、ジグザグ形の要素を形成する、共通のアームを有する2つの「V」字形のねじりばねから成り、共通ではないアームが曲線状の締結具を備える、請求項1に記載のシステム。
- 前記取付け要素が、取付け部分およびヘッド部分を有するヘリックスの形状で形成され、前記取付け部分が組織にねじ込まれるように適合され、前記ヘッド部分が前記固着手段を備える、請求項1に記載のシステム。
- 前記取付け要素が、前記取付け部分と前記ヘッド部分との間に設けられた首部分をさらに備え、前記首部分が、前記取付け要素の前記組織への過度のねじ込みを防ぐように適合された、請求項10に記載のシステム。
- 前記首部分が、前記取付け要素の前記取付け部分の上方で前記ヘリックスループ間の距離を急激に低減することによって形成される、請求項11に記載のシステム。
- 前記取付け要素の前記固着手段は、ヘリックスループがわずかに低減された半径を有する前記首部分の連続部分である、請求項11に記載のシステム。
- 前記固着手段が、前記取付け要素に設けられた固着ループとして実現される、請求項1に記載のシステム。
- 前記取付け要素が、爪部分に取り付けられた1つまたは複数のかえしを有する壁内アンカーである、請求項1に記載のシステム。
- 取付け要素を用いて心臓の外壁の上に装着される弾性ワイヤまたは伸縮性コードをさらに備える、請求項1に記載のシステム。
- 交互に、かつ一連の前記弾性要素および前記取付け要素の前記鎖の末端において、前記取付け要素に接続することができる弾性ワイヤまたは伸縮性コードをさらに備え、前記弾性ワイヤまたは伸縮性コードと、弾性要素および取付け要素の前記鎖とが心臓の周囲を取り囲む、請求項1に記載のシステム。
- 心臓の心室に導入し、その内部で膨張させることができる膨張式バルーンをさらに備える、請求項1に記載のシステム。
- 前記心臓壁にねじ込まれるように適合された1つまたは複数の圧縮性要素をさらに備える、請求項1に記載のシステム。
- 心臓壁に取り付けることができる請求項1に記載のシステムを構成する1つまたは複数の前記取付け要素と、取付け要素に設けられた固着手段に接続することができる請求項1に記載のシステムを構成する少なくとも2つの前記弾性要素と、前記固着手段を把持し保持するように適合された把持具と、隣接した取付け要素間の距離および/または前記取付け要素および弾性要素の相互接続された鎖の間の距離を示すのに使用することができる1つまたは複数の距離指示器具とを含む、心室機能支援システムを心臓壁上に装着するための要素および器具のキット。
- 前記心臓壁にねじ込むことができる1つもしくは複数の圧縮性要素と、心臓の心室に導入し、その内部で膨張させることができる展開式バルーンと、かつ/または前記取付け要素の前記固着手段に接続することができる弾性ワイヤもしくは伸縮性コードと、をさらに含む、請求項20に記載のキット。
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US84674806P | 2006-09-25 | 2006-09-25 | |
US60/846,748 | 2006-09-25 | ||
PCT/IL2007/001180 WO2008038276A2 (en) | 2006-09-25 | 2007-09-25 | Method and system for improving diastolic function of the heart |
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JP2010504137A JP2010504137A (ja) | 2010-02-12 |
JP2010504137A5 JP2010504137A5 (ja) | 2010-11-04 |
JP5313902B2 true JP5313902B2 (ja) | 2013-10-09 |
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EP (1) | EP2068768A4 (ja) |
JP (1) | JP5313902B2 (ja) |
AU (1) | AU2007301475B2 (ja) |
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WO2008038276A3 (en) | 2010-09-16 |
JP2010504137A (ja) | 2010-02-12 |
US8382653B2 (en) | 2013-02-26 |
CA2663833C (en) | 2014-10-07 |
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