JP5038352B2 - 心臓の僧帽弁輪の形状に影響を与える組立体 - Google Patents
心臓の僧帽弁輪の形状に影響を与える組立体 Download PDFInfo
- Publication number
- JP5038352B2 JP5038352B2 JP2009109156A JP2009109156A JP5038352B2 JP 5038352 B2 JP5038352 B2 JP 5038352B2 JP 2009109156 A JP2009109156 A JP 2009109156A JP 2009109156 A JP2009109156 A JP 2009109156A JP 5038352 B2 JP5038352 B2 JP 5038352B2
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- Prior art keywords
- anchor
- instrument
- distal
- proximal
- support
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- Expired - Lifetime
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Classifications
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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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2451—Inserts in the coronary sinus for correcting the valve shape
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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
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/001—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a 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
- A61F2250/0059—Additional features; Implant or prostheses properties not otherwise provided for temporary
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic 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)
- Surgical Instruments (AREA)
Description
心臓切開手術をしないで僧帽弁閉鎖不全を治療するための改良された治療法が以下の特許文献1〜12で提案された(特許文献1〜12参照)。これは、心臓の冠状静脈洞が、僧帽弁輪の近傍にあるか、少なくとも部分的には僧帽弁輪を取り囲んでいて、大心静脈を含む静脈系に伸びていることの認識によって可能になった。ここで用いられる「冠状静脈洞」という用語は、前記冠状静脈洞そのものを指すだけではなく、これに加えて、前記大心静脈を含む冠状静脈洞と関連する静脈系をも指す。前記治療法は、僧帽弁輪の形状を再形成して有利な効果を与えるために冠状静脈の中に導入される治療器具を使用するものである。
本体から第2の形状に枢動する場合がある。
前記固定部材は、第1の形状のとき、前記器具の本体と密接な間隔を置いて前記器具の本体に沿って伸びる場合があり、第2の形状のとき、冠状静脈洞と係合し前記器具を冠状静脈洞に繋止するために、前記器具の本体から枢動する場合がある。前記器具は、第2の形状のとき、実質的に前記固定部材を剛性にする支持体を含む場合がある。前記支持体は前記固定部材の延長の場合があり、該固定部材は、第1の端の反対側に第2の端を含み、前記ロックが前記固定部材の第2の端を前記器具の本体に錠止する。前記固定部材の第2の端は前記器具の本体に沿って滑動可能な場合があり、前記器具は、複数の固定部材を含む場合がある。
22、24、26 皮弁
28 空隙
50、100、250、300 静脈内支持体
52、140、256、306、550、636、836、876 近位のアンカー
54、120、254、266、304、634、834、874 遠位のアンカー
56、102 支持ワイヤーまたは再形成用具
60 冠状静脈洞および血管
80 切り口
82 案内カテーテル
84 前進機構
104 近位端
106 遠位端
108、260、310 遠位の圧着管
110、264 遠位のロック
110a 遠位のロックの第1の半分
110b 遠位のロックの第2の半分
112、270、320 近位の圧着管
114 矢尻状の近位のロック
121 ストップループ
122、272 2重のアイレット
123、124、143、144 近位の腕
142、262、312、322 アイレット
145、146 近位の腕の近位の部分
147、148 近位の腕の遠位の部分
150、160、170 管
152、154、156、158、162、164、166、168、172、174
、176、178 穴
200、652、852、862、892 カテーテル
201、656、899 テザー
202、404、452、454、502、504、646、857 ループ
204 ヒッチピン
252、302、412、462、512 支持ワイヤー
314 遠位の止め具
400、450、500、684、704 アンカー
406、456、506 窓
408、458、508 圧着管
410 支柱
411、457、507 圧着管の一方の端
505 交差支柱
552 近位のアンカーのワイヤー
558 ねじりばね
610、810 ヒトの心臓
614、814 冠状静脈洞
615 環状動脈
616、816 前弁尖
617 回旋枝動脈
618、818 後弁尖
620、820 僧帽弁輪
622、822 肺動脈弁
624、824 大動脈弁
626、826 三弁尖弁
630、830、870 僧帽弁治療器具
632、832 本体
638、688 固定部材
640 ヒンジ
642 支持体
644 ヒンジポイント
648 膨れた部分
650、850、890 配設システム
654、854 プッシャ
658 プッシャの内腔
660 カテーテルの内腔
670 圧着材
672 矢印
692、712 支持部材
694 枢動連結
708 1対の固定部材
720 破線の円
838 連結ループ
855 中心内腔
856 連結構造部材
858 錠止ピン
859 ループ857の脚
860 リトラクタ組立体
863 ケーブル
864 リトラクタ
865 細長いコイル
866 連結部材
869 ケーブル863の自由端
878 連結構造
894 プッシャ部材
896 連結構造
898 錠止部材1
Claims (6)
- 心臓の僧帽弁輪の病状に影響を与える組立体であって、
心臓の僧帽弁輪に隣接する心臓の冠状静脈洞内に配置されるときに僧帽弁輪を整形し、連結構造(838)を含む近位端を有する僧帽弁治療器具(830)と、
該僧帽弁治療器具を心臓の冠状静脈洞内に導く、内腔を有するカテーテル(852)と、
前記僧帽弁治療器具の連結構造に錠止可能な第2の連結構造(856)と、
前記僧帽弁器具の連結構造を第2の連結構造に錠止したり前記僧帽弁治療器具の連結構造を第2の連結構造から解除したりする錠止部材(858)とを含み、
前記僧帽弁治療器具の連結構造がループ構造(838)を含んでいる、心臓の僧帽弁輪の病状に影響を与える組立体。 - 前記第2の連結構造がループ構造を含んでいる、請求項1に記載の組立体。
- 前記錠止部材が、前記僧帽弁治療器具の連結構造を一緒に錠止するために前記ループ構造を通って伸び且つ前記ループ構造を解除するために後退することができるピンを含んでいる、請求項2に記載の組立体。
- 前記カテーテルが遠位端を有し、前記ピンは、細長く且つ前記カテーテルの遠位端を通って伸びている、請求項3に記載の組立体。
- 前記カテーテルの内腔を通って前記僧帽弁治療器具を押すプッシャ部材を更に含んでおり、当該プッシャ部材は、前記僧帽弁治療器具の近位端に係合する遠位端と、近位端と、内腔とを有し、前記ピンは、細長く且つ前記プッシャ部材の内腔を通って前記プッシャ部材の近位端から出ていくようになされている、請求項3に記載の組立体。
- 前記プッシャ部材が細長いコイルである、請求項5に記載の組立体。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/142,637 | 2002-05-08 | ||
US10/142,637 US6824562B2 (en) | 2002-05-08 | 2002-05-08 | Body lumen device anchor, device and assembly |
US10/331,143 US6793673B2 (en) | 2002-12-26 | 2002-12-26 | System and method to effect mitral valve annulus of a heart |
US10/331,143 | 2002-12-26 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2004502891A Division JP4351151B2 (ja) | 2002-05-08 | 2003-05-02 | 体内臓器の形状を改変する器具および方法 |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2009219883A JP2009219883A (ja) | 2009-10-01 |
JP5038352B2 true JP5038352B2 (ja) | 2012-10-03 |
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ID=29423050
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2004502891A Expired - Fee Related JP4351151B2 (ja) | 2002-05-08 | 2003-05-02 | 体内臓器の形状を改変する器具および方法 |
JP2009109156A Expired - Lifetime JP5038352B2 (ja) | 2002-05-08 | 2009-04-28 | 心臓の僧帽弁輪の形状に影響を与える組立体 |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
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JP2004502891A Expired - Fee Related JP4351151B2 (ja) | 2002-05-08 | 2003-05-02 | 体内臓器の形状を改変する器具および方法 |
Country Status (9)
Country | Link |
---|---|
US (3) | US7857846B2 (ja) |
EP (3) | EP1513474B1 (ja) |
JP (2) | JP4351151B2 (ja) |
AT (1) | ATE417573T1 (ja) |
AU (2) | AU2003228865B2 (ja) |
CA (4) | CA2877641C (ja) |
DE (1) | DE60325356D1 (ja) |
ES (1) | ES2318130T3 (ja) |
WO (1) | WO2003094801A1 (ja) |
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-
2003
- 2003-05-02 EP EP03726639A patent/EP1513474B1/en not_active Expired - Lifetime
- 2003-05-02 JP JP2004502891A patent/JP4351151B2/ja not_active Expired - Fee Related
- 2003-05-02 CA CA2877641A patent/CA2877641C/en not_active Expired - Lifetime
- 2003-05-02 CA CA2483024A patent/CA2483024C/en not_active Expired - Lifetime
- 2003-05-02 AU AU2003228865A patent/AU2003228865B2/en not_active Expired
- 2003-05-02 AT AT03726639T patent/ATE417573T1/de not_active IP Right Cessation
- 2003-05-02 EP EP10180626A patent/EP2289467A1/en not_active Withdrawn
- 2003-05-02 US US10/429,225 patent/US7857846B2/en not_active Expired - Fee Related
- 2003-05-02 CA CA2950492A patent/CA2950492C/en not_active Expired - Lifetime
- 2003-05-02 WO PCT/US2003/014007 patent/WO2003094801A1/en active Application Filing
- 2003-05-02 DE DE60325356T patent/DE60325356D1/de not_active Expired - Lifetime
- 2003-05-02 EP EP08021269A patent/EP2039325A1/en not_active Withdrawn
- 2003-05-02 CA CA2744868A patent/CA2744868C/en not_active Expired - Lifetime
- 2003-05-02 ES ES03726639T patent/ES2318130T3/es not_active Expired - Lifetime
-
2005
- 2005-08-04 US US11/198,044 patent/US20050272969A1/en not_active Abandoned
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2007
- 2007-12-21 US US11/963,417 patent/US7828841B2/en not_active Expired - Fee Related
-
2009
- 2009-04-06 AU AU2009201343A patent/AU2009201343B2/en not_active Expired
- 2009-04-28 JP JP2009109156A patent/JP5038352B2/ja not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
EP2039325A1 (en) | 2009-03-25 |
JP2009219883A (ja) | 2009-10-01 |
US7857846B2 (en) | 2010-12-28 |
CA2744868C (en) | 2015-12-29 |
WO2003094801A1 (en) | 2003-11-20 |
EP1513474A1 (en) | 2005-03-16 |
ES2318130T3 (es) | 2009-05-01 |
JP4351151B2 (ja) | 2009-10-28 |
US20080097594A1 (en) | 2008-04-24 |
DE60325356D1 (de) | 2009-01-29 |
AU2009201343B2 (en) | 2011-01-27 |
ATE417573T1 (de) | 2009-01-15 |
AU2009201343A1 (en) | 2009-04-30 |
CA2483024C (en) | 2011-09-13 |
US7828841B2 (en) | 2010-11-09 |
EP1513474B1 (en) | 2008-12-17 |
CA2877641A1 (en) | 2003-11-20 |
AU2003228865A1 (en) | 2003-11-11 |
CA2950492A1 (en) | 2003-11-20 |
EP2289467A1 (en) | 2011-03-02 |
CA2877641C (en) | 2017-01-17 |
US20050272969A1 (en) | 2005-12-08 |
AU2003228865B2 (en) | 2009-01-15 |
CA2950492C (en) | 2018-12-04 |
US20060142854A1 (en) | 2006-06-29 |
CA2483024A1 (en) | 2003-11-20 |
JP2006502749A (ja) | 2006-01-26 |
CA2744868A1 (en) | 2003-11-20 |
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