JP7168607B2 - 生来の弁機能の保存、補充、および/または置換のための、単腔固定部を備えたベース、メッシュ、およびドーム部分を備えた心腔人工弁移植 - Google Patents
生来の弁機能の保存、補充、および/または置換のための、単腔固定部を備えたベース、メッシュ、およびドーム部分を備えた心腔人工弁移植 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
- A61F2/2412—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
- 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
-
- 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
- A61F2/2409—Support rings therefor, e.g. for connecting valves to tissue
-
- 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
-
- 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
-
- 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
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- 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
- A61F2/2487—Devices within the heart chamber, e.g. splints
-
- 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
-
- 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
- A61F2/2463—Implants forming part of the valve leaflets
-
- 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
- A61F2/2469—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 resilient valve members, e.g. conical spiral
-
- 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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
-
- 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
- A61F2230/0069—Three-dimensional shapes cylindrical
-
- 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
- A61F2250/0048—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 mechanical expandability, e.g. in mechanical, self- or balloon expandability
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- 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)
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Description
アメリカ合衆国、ミネソタ州、メープルグローブのJeffrey W.Chambers
関連出願の相互参照
本出願は、2016年8月11日に出願された、HEART CHAMBER PROSTHETIC VALVE IMPLANT WITH STENT,SPRING AND DOME SECTIONSと題する米国仮特許出願第62/373541号、2016年8月11日に出願された、HEART CHAMBER PROSTHETIC VALVE IMPLANT WITH STENT,MESH AND DOME SECTIONSと題する米国仮特許出願第62/373560号、および2016年8月11日に出願された、HEART CHAMBER PROSTHETIC VALVE IMPLANT WITH ELEVATED VALVE SECTIONと題する米国特許仮出願第62/373551号の利益を主張し、その全体が参照により本明細書に組み込まれる。
連邦政府資金による研究開発の記載
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Claims (21)
- 環状平面、内輪、および前記環状平面と生来の弁尖の屈曲点との間に位置する上部環状面を含む弁輪と流体連通している心腔内での拡張移植のための装置であって、前記心腔の下部境界は前記上部環状面まで延在し、
前記装置は、
上面、および前記環状平面上に少なくとも部分的に配置された下面を有する基部と、
ワイヤ境界を含むドーム部分と、
前記基部の前記上面と、前記ドーム部分との間に動作可能に配置された中間のステント構造又はメッシュ構造と、
それを通る血流のために開き、前記基部に接続され、少なくとも部分的にその中に位置し、かつ前記弁輪と整列された中央弁支持体と
を含む拡張可能な固定構造を備え、
前記中間のステント構造又はメッシュ構造は、前記基部の前記上面の周りに動作可能に接続され、かつ、前記ドーム部分の前記ワイヤ境界の周りに動作可能に接続されており、
前記中央弁支持体は、前記中央弁支持体内に取り付けられた少なくとも1つの人工弁尖、および下面を含み、
前記中央弁支持体は、少なくとも1つの人工弁尖を通る順行性の血流を可能にし、少なくとも1つの人工弁尖を通る逆行性の血流を防止し、
前記中央弁支持体の前記下面は、前記上部環状面にまたはそれより上に位置する、装置。 - 前記上部環状面は、前記環状平面上に存在する、請求項1に記載の装置。
- 前記上部環状面は、前記環状平面の下、かつ前記生来の弁尖の屈曲点の上方に存在する、請求項1に記載の装置。
- 前記固定構造が拡張したとき、前記中央弁支持体の前記下面は、前記基部の下面の下に延びる、請求項3に記載の装置。
- 前記中央弁支持体の前記下面は、前記基部の外側に位置する、請求項4に記載の装置。
- 前記中央弁支持体の前記下面は、前記環状平面の下に位置する、請求項3に記載の装置。
- 前記上部環状面は、前記内輪内かつ前記生来の弁尖の屈曲点より上に位置し、
前記中央弁支持体の前記下面は、前記上部環状面上に位置する、
請求項3に記載の装置。 - 前記中央弁支持体はシリンダを含む、請求項1に記載の装置。
- 前記ドーム部分が、前記ワイヤ境界によって画定される開放構造を含む、請求項1に記載の装置。
- 前記ドーム部分が、前記ワイヤ境界によって画定される被覆構造を含む、請求項1に記載の装置。
- 前記少なくとも1つの人工弁尖が、前記中央弁支持体の前記下面で該中央弁支持体内に取り付けられた、請求項1又は4に記載の装置。
- 前記少なくとも1つの人工弁尖が、前記中央弁支持体の前記下面の上方で該中央弁支持体内に取り付けられた、請求項1又は4に記載の装置。
- 前記少なくとも1つの人工弁尖を含む前記中央弁支持体が、生来の弁尖の逸脱を緩和するために適用される、請求項11に記載の装置。
- 前記心腔が左心房を含み、前記生来の弁尖が僧帽弁尖を含む、請求項1に記載の装置。
- 環状平面、内輪、および前記環状平面と生来の弁尖の屈曲点との間に位置する上部環状面を含む弁輪と流体連通している心腔内での拡張移植のための装置であって、
患者の少なくとも部分的に機能しなくなった生来の弁尖を含む生来の心臓弁の機能を保存および/または補充するための方法の使用に適しており、
前記装置は、
上面、および前記環状平面上に少なくとも部分的に配置された下面を有する基部と、
ワイヤ境界を含むドーム部分と、
前記基部の前記上面と、前記ドーム部分との間に動作可能に配置された中間のステント構造又はメッシュ構造と、
それを通る血流のために開き、前記基部に接続され、少なくとも部分的にその中に位置し、かつ前記弁輪と整列された中央弁支持体と
を含む拡張可能な固定構造を備え、
前記方法は、
前記心腔内での拡張移植のための装置を設けるステップと、
前記患者の少なくとも部分的に機能しなくなった生来の心臓弁の前記機能を保存および/または補充するステップと、
を含む、装置。 - 前記装置と前記患者の生来の弁尖との間に、物理的な相互作用がないことをさらに含む、請求項15に記載の装置。
- 前記機能しなくなった生来の心臓弁が、逸脱した生来の弁尖を含み、前記生来の弁尖の逸脱距離を最小限にするステップをさらに含む、請求項16に記載の装置。
- 環状平面、内輪、および前記環状平面と生来の弁尖の屈曲点との間に位置する上部環状面を含む弁輪と流体連通している心腔内での拡張移植のための装置であって、
患者の少なくとも部分的に機能しなくなった生来の心臓弁の機能を補充および/または完全に置換するための方法の使用に適しており、
前記装置は、
上面、および前記環状平面上に少なくとも部分的に配置された下面を有する基部と、
ワイヤ境界を含むドーム部分と、
前記基部の前記上面と、前記ドーム部分との間に動作可能に配置された中間のステント構造又はメッシュ構造と、
それを通る血流のために開き、前記基部に接続され、少なくとも部分的にその中に位置し、かつ前記弁輪と整列された中央弁支持体と
を含む拡張可能な固定構造を備え、
前記方法は、
前記心腔内での拡張移植のための装置を設けるステップと、
前記患者の少なくとも部分的に機能しなくなった生来の心臓弁の前記機能を補充および/または完全に置換するステップと、
を含む、装置。 - 前記装置と前記患者の生来の弁尖との間に、物理的な相互作用がないことをさらに含む、請求項18に記載の装置。
- 前記機能しなくなった生来の心臓弁が、逸脱した生来の弁尖を含み、前記生来の弁尖の逸脱距離を最小限にするステップをさらに含む、請求項18に記載の装置。
- 環状平面、内輪、および前記環状平面と生来の弁尖の屈曲点との間に位置する上部環状面を含む弁輪と流体連通している心腔内での拡張移植のための装置であって、
患者の少なくとも部分的に機能しなくなった生来の心臓弁における生来の弁尖の逸脱距離を最小限にするための方法の使用に適しており、
前記装置は、
上面、および前記環状平面上に少なくとも部分的に配置された下面を有する基部と、
ワイヤ境界を含むドーム部分と、
前記基部の前記上面と、前記ドーム部分との間に動作可能に配置された中間のステント構造又はメッシュ構造と、
それを通る血流のために開き、前記基部に接続され、少なくとも部分的にその中に位置し、かつ前記弁輪と整列された中央弁支持体と
を含む拡張可能な固定構造を備え、
前記方法は、
前記心腔内での拡張移植のための装置を設けるステップと、
前記生来の弁尖の逸脱距離を最小限にするステップと、
を含む、装置。
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