JP6460563B2 - 人工弁 - Google Patents
人工弁 Download PDFInfo
- Publication number
- JP6460563B2 JP6460563B2 JP2016196818A JP2016196818A JP6460563B2 JP 6460563 B2 JP6460563 B2 JP 6460563B2 JP 2016196818 A JP2016196818 A JP 2016196818A JP 2016196818 A JP2016196818 A JP 2016196818A JP 6460563 B2 JP6460563 B2 JP 6460563B2
- Authority
- JP
- Japan
- Prior art keywords
- stent
- mitral valve
- flange portion
- valve
- intermediate region
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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Links
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Classifications
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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
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- 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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- A61F2/02—Prostheses implantable into 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
- 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
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in adsorbability or resorbability, i.e. in adsorption or resorption time
-
- 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
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
-
- 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
- A61F2250/0069—Sealing means
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- 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)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
Description
以下の開示は、本開示の第1の一般的実施形態に関するもので、この第1の一般的実施形態は、進歩性のある人工弁と、損傷し若しくは病変のある弁を置換する方法とに関する。
以下の説明は、本開示の第2の一般的実施形態に関するもので、この第1の一般的実施形態は、進歩性のある人工弁と、損傷し若しくは病変のある弁を置換する方法と、人工弁を送達するシステムと、キットと、人工弁を送達する方法とに関する。
例示的な送達および移植処置は、人工弁を送達する本開示のシステムと、本開示に係る人工弁とを使って次のように行われる。
本発明に係る人工弁は、in situで、いくつかの異なる力を弁輪とその周囲の組織に及ぼす。そのような力は、移植部位で係止されて適切に配置された状態で保たれる当該人工弁独自の能力に寄与する。例えば、前記上方および下方フランジは、それぞれへ向かって反り曲がり、フランジと前記中間領域との間に介在する組織は、そのフランジと中間領域との間に把持される。また、前記ステントも弁輪壁に対して径方向外向きの力を及ぼす。そのような力を個別に測定することは難しいが、移植された人工弁を抜去する上で必要な力は、前記ステントが及ぼす各力の総計の一部を表す。
Claims (17)
- 人工僧帽弁であって、
拡張状態と未拡張状態とを有するステントであって、
長軸と、
第1の端部と第2の端部とを備えるとともに、外面および内面を画定するワイヤーフレームワークを有する中間領域と、
前記中間領域の前記第1の端部に形成され、複数のフランジ要素を有する下方フランジ部であって、前記フランジ要素の各々は、前記中間領域に取着された第1の端部と、当該第1の端部から離間され且つ当該第1の端部と対向する位置にある第2の端部とを有するものである、前記下方フランジ部と、
前記中間領域の前記第2の端部に形成され、複数のフランジ要素を有する上方フランジ部であって、前記フランジ要素の各々は、前記中間領域に取着された第1の端部と、当該第1の端部から離間され且つ当該第1の端部と対向する位置にある第2の端部とを有するものである、前記上方フランジ部と
を有するものである、前記ステントと、
前記ステントの前記中間領域の内面に取り付けられた弁と
を有し、
前記下方フランジ部は、前記上方フランジ部の対応する寸法より大きい、少なくとも1つの幾何学的寸法を有するものであり、
前記上方フランジ部および前記下方フランジ部は、前記ステントが前記未拡張状態にあるとき、前記ステントの長軸に実質的に沿った位置に配置されており、
前記下方フランジ部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、空間内で形状が変化して前記ステントの長軸に実質的に沿った位置ではない位置に配置されるものであり、
前記ステントが拡張状態にあるとき、
前記下方フランジ部は、前記ステントの前記中間領域の外面に近接して配置され、僧帽弁輪の心室側において組織を当該下方フランジ部と前記中間領域の外面によって包み込むようにして挟持することで前記ステントを前記僧帽弁輪の心室側に係止するものであり、
前記上方フランジ部は、前記ステントの前記中間領域の外面に近接して配置され、僧帽弁輪の心房側において組織を当該上方フランジ部と前記中間領域の外面によって包み込むようにして挟持することで前記ステントを前記僧帽弁輪の心房側に係止するものである、
人工僧帽弁。 - 請求項1記載の人工僧帽弁において、前記下方フランジ部は、当該下方フランジ部と前記中間領域の外面によって前記僧帽弁輪の心室側の弁下組織を挟持することにより、前記ステントを前記僧帽弁輪内に係止するように構成されているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部は、天然僧帽弁の弁尖を当該下方フランジ部と前記中間領域の外面によって包み込むようにして挟持することにより、前記ステントを前記僧帽弁輪内に係止するように構成されているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部は、当該下方フランジ部と前記中間領域の外面によって前記僧帽弁輪の心室側の腱索を挟持することにより、前記ステントを前記僧帽弁輪内に係止するように構成されているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部は、左心室壁を当該下方フランジ部と前記中間領域の外面によって挟持することにより、前記ステントを前記僧帽弁輪内に係止するように構成されているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部は、左心房の組織を当該上方フランジ部と前記中間領域の外面によって挟持することにより、前記ステントを前記僧帽弁輪内に係止するように構成されているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部は、前記ステントが前記拡張状態にあるとき、前記ステントの長軸に対して所定の傾斜した角度を成しているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部は、前記ステントが前記未拡張状態にあるとき、前記ステントの長軸に対して実質的に平行である人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記ステントは自己拡張するものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記ステントはワイヤー織りから成るものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部は、前記ステントが前記拡張状態にあるとき、前記ステントの長軸に対して所定の傾斜した角度を成しているものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部は、前記ステントが前記未拡張状態にあるとき、前記ステントの長軸に対して実質的に平行である人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、空間内で形状が変化して前記ステントの長軸に実質的に沿った位置ではない位置に配置されるものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部における前記フランジ要素の前記第2の端部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、前記ステントの中間領域に向かって移動するものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部における前記フランジ要素の前記第2の端部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、前記ステントの中間領域に向かって移動するものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記下方フランジ部における前記フランジ要素の前記第2の端部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、前記ステントの長軸から離れる方向に移動するものである人工僧帽弁。
- 請求項1記載の人工僧帽弁において、前記上方フランジ部における前記フランジ要素の前記第2の端部は、前記ステントが前記未拡張状態から前記拡張状態に移行するとき、前記ステントの長軸から離れる方向に移動するものである人工僧帽弁。
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