JP5685560B2 - ツーピース心臓弁を移植するために適合化されたプロテーゼ - Google Patents
ツーピース心臓弁を移植するために適合化されたプロテーゼ Download PDFInfo
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- JP5685560B2 JP5685560B2 JP2012144585A JP2012144585A JP5685560B2 JP 5685560 B2 JP5685560 B2 JP 5685560B2 JP 2012144585 A JP2012144585 A JP 2012144585A JP 2012144585 A JP2012144585 A JP 2012144585A JP 5685560 B2 JP5685560 B2 JP 5685560B2
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Images
Classifications
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- 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
- A61F2/2409—Support rings therefor, e.g. for connecting valves to tissue
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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
- A61F2/2412—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
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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
- A61F2/2412—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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
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Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Vascular Medicine (AREA)
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- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本発明は、患者に移植することができる心臓弁に関し、より具体的には、一体に組み立てることができる複数部材の心臓弁アセンブリと、そのような移植を行うための装置と、移植するための方法とに関する。
別法として、パイロット縫合糸94を除くことができ、ツール(図示せず)を用いてガスケット部材12を弁輪90の中に運ぶことができ、その際に、ガスケット部材12を通して、弁輪90を包囲している組織の中に複数のファスナー99を供給することができる。場合により、ツールは、ガスケット部材12によって組織の中へのファスナー12の係合を向上させるために、組織を出現させるためのエレメント(図示せず)を有することもできるし、または独立したツール(図示せず)を弁輪90の中へ導入して、組織を出現させるか、またはその他の方法によってファスナー99の供給を向上させることもできる。
12 ガスケット部材
14 弁部材(クラウン)
18 アンカリング・リング
20 縫合リング(縫合カフ)
32 フレーム
218 環状リング
330 バレーンエレメント
Claims (9)
- 複数部品の心臓弁アセンブリであって、
プロテーゼと、
前記プロテーゼから分離して切り離された人工生体弁であって、自然弁の弁輪の上方に移植するために、前記長軸に対して半径方向に複数の小葉状の形状を有する人工生体弁と、
前記プロテーゼを前記自然弁の弁輪内に導入した後に、前記プロテーゼに前記人工生体弁を固定するための1つ以上のコネクタと、
を含み、
前記プロテーゼが、
(1)洞腔に隣接する生体の弁輪内で、既に存在している自然のまたは人工の心臓弁を交換するための人工弁を収容するプロテーゼであって、
中央の長軸の周りに配置されたファブリック被覆の中に実質的に包み込まれた環状バンドを含み、前記生体の弁輪を包囲する組織を拡張するために前記生体の弁輪内に移植可能な環状部材であって、前記生体の弁輪内への挿入を容易に行うことができるように半径方向内側に圧縮することができ、前記生体の弁輪を包囲する組織を拡張するために、半径方向外側に拡がるように付勢されている環状部材と、
可撓性のコアが緩和状態において前記長軸に対して角度を規定するテーパー形状を含むように、前記環状部材の上側部分から半径方向外側上向きに拡がるファブリックによって少なくとも一部を被覆された前記可撓性のコアを含む縫合カフであって、前記生体の弁輪の上方の前記洞腔を包囲する組織の形状に適合可能な縫合カフと、
前記環状部材に人工弁を固定するための1つ以上のコネクタと、
を含むことを特徴とするプロテーゼ、又は
(2)洞腔に隣接する生体の弁輪内で、既に存在している自然のまたは人工の心臓弁を交換するための人工弁を収容するプロテーゼであって、
中央の長軸の周りに配置されたファブリック被覆の中に実質的に包み込まれた環状バンドを含み、前記生体の弁輪を包囲する組織を拡張するために前記生体の弁輪内に移植可能な環状部材であって、前記生体の弁輪内への挿入を容易に行うことができるように前記長軸に向かって半径方向内側に圧縮することができ、前記生体の弁輪を包囲する組織を拡張するために、半径方向外側に拡がるように付勢されている環状部材と、
前記環状部材の上側部分から半径方向外側に拡がる縫合カフであって、
前記縫合カフは、前記生体の弁輪の上方の前記洞腔を包囲する組織の形状に適合可能であり、
前記縫合カフは、可撓性のコアと、該コアの少なくとも一部を被覆するファブリックとを含み、前記コアは、該コアが緩和状態において前記長軸に対して角度を規定するテーパー形状を含むように、前記環状部材の上側部分から半径方向外側上向きに拡がっており、
前記環状部材に人工弁を固定するための1つ以上のコネクタと、
を含むことを特徴とするプロテーゼ、
のいずれかであることを特徴とする心臓弁アセンブリ。 - 前記1つ以上のコネクタが、前記人工生体弁を前記プロテーゼに対して前記長軸の周りで所定の半径方向に固定することを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記1つ以上のコネクタが、前記人工生体弁の一部に係合するために前記プロテーゼ上にクリップを含むことを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記人工生体弁を前記プロテーゼに固定するとき、前記縫合カフは前記人工生体弁の前記複数の小葉状の形状に適合するように弾性的に変形することができ、前記縫合カフが適合して前記人工生体弁と前記プロテーゼとの間のシールを向上させることを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記環状部材は、前記生体の弁輪内への挿入を容易に行うことができるように、半径方向内側に圧縮することができ、前記環状部材は、前記生体の弁輪を包囲する組織を拡張するために、半径方向外側に拡がるように付勢されていることを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記プロテーゼは、前記環状部材の周りに半径方向に配置され且つ前記ファブリックの少なくとも一部を前記環状部材から離れて半径方向外側に付勢するために前記ファブリックと前記環状部材との間に配置されたバレーンエレメントをさらに含むことを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記環状部材は、前記長軸の周りに実質的に円形の形状を有していることを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記縫合カフは前記環状部材の上側縁部から半径方向外側に拡がっていることを特徴とする請求項1に記載の心臓弁アセンブリ。
- 前記縫合カフは前記生体の弁輪の上方の前記洞腔を包囲する組織の形状に適合可能であることを特徴とする請求項1に記載の心臓弁アセンブリ。
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US11/069,617 US20060195186A1 (en) | 2005-02-28 | 2005-02-28 | Connectors for two piece heart valves and methods for implanting such heart valves |
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US7717955B2 (en) | 2010-05-18 |
JP2008531201A (ja) | 2008-08-14 |
AU2006218877B2 (en) | 2012-03-29 |
EP1858451A1 (en) | 2007-11-28 |
CA2603198A1 (en) | 2006-09-08 |
WO2006093795A1 (en) | 2006-09-08 |
US20100191327A1 (en) | 2010-07-29 |
EP1858451B1 (en) | 2019-06-12 |
US20160324631A1 (en) | 2016-11-10 |
JP2015061655A (ja) | 2015-04-02 |
US20060195186A1 (en) | 2006-08-31 |
US10226331B2 (en) | 2019-03-12 |
US9402719B2 (en) | 2016-08-02 |
JP2012205909A (ja) | 2012-10-25 |
US20120226348A1 (en) | 2012-09-06 |
CA2603198C (en) | 2014-09-02 |
AU2006218877A1 (en) | 2006-09-08 |
JP6007232B2 (ja) | 2016-10-12 |
US8163014B2 (en) | 2012-04-24 |
US20060195184A1 (en) | 2006-08-31 |
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