CN102283721B - 用于改善心瓣膜功能的人工插入物 - Google Patents
用于改善心瓣膜功能的人工插入物 Download PDFInfo
- Publication number
- CN102283721B CN102283721B CN201110206268.7A CN201110206268A CN102283721B CN 102283721 B CN102283721 B CN 102283721B CN 201110206268 A CN201110206268 A CN 201110206268A CN 102283721 B CN102283721 B CN 102283721B
- Authority
- CN
- China
- Prior art keywords
- insertion parts
- valve
- anchoring members
- prosthesis
- heart
- 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.)
- Active
Links
Classifications
-
- 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
- A61F2/246—Devices for obstructing a leak through a native valve in a closed condition
-
- 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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/2436—Deployment by retracting a sheath
-
- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—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
- 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
-
- 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
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0823—Modular anchors comprising a plurality of separate parts
- A61F2002/0835—Modular anchors comprising a plurality of separate parts with deformation of anchor parts, e.g. expansion of dowel by set screw
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
公开了用于改善心瓣膜如主动脉瓣功能的装置和方法。在一个实施方式中,所述装置包括插入部件,其配置用于插入主动脉瓣的小叶之间。插入部件优选地包括三个从中心部分向外延伸的径向臂状物。该装置还包括锚定部件,其与插入部件连接并被配置用于将插入部件保持在心瓣膜内。在工作时,每个臂状物可填补心瓣膜小叶之间的间隙,从而最大限度地减少或防止通过心瓣膜的反流。
Description
本申请是分案申请,原申请的申请日为2007年5月31日、申请号为200780020260.3(PCT/US2007/070141)、发明名称为“用于改善心瓣膜功能的人工插入物”。
相关申请的交叉参考
本申请要求2006年6月1日提交的美国临时专利申请号60/810,085的权益,在此以其整体并入作为参考。
技术领域
本公开涉及可植入心脏修复学(implantable cardiac prosthetics)领域,具体而言,涉及心脏人工插入物,用于减少通过心瓣膜如主动脉瓣的反流,以及涉及植入心脏人工插入物的方法。
背景技术
心瓣膜反流,或从心瓣膜流出侧到流入侧的泄漏,是当心瓣膜无法正常关闭时发生的状况。心瓣膜反流降低心脏的效率,减少血液循环,并增加对心脏的压力。在早期,心瓣膜反流使人感到疲劳和呼吸急促。如果任其发展,这一问题可导致充血性心力衰竭、心律失常或死亡。
通过主动脉瓣的反流,有时也被称为主动脉瓣关闭不全(aorticinsufficiency),是影响到数百万成年人健康的严重问题。主动脉瓣位于心脏左侧,在左心室与主动脉之间。心室收缩期间,健康的主动脉瓣打开,以允许血液从左心室流进主动脉;然后在心室舒张期间关闭,以防止血液从主动脉回流进入左心室。但是,随着时间推移,主动脉环的几何构造发生变化,或其它原因,如钙化、感染和损伤,可能会影响到主动脉瓣的功能性。结果是,主动脉瓣可能无法在心室舒张时完全关闭,从而导致反流。
主动脉瓣关闭不全典型地通过在心内直视手术过程中用人工瓣膜替换有缺陷的天然瓣膜来治疗。但是,心内直视手术具有高度创伤性,因此对于许多高危患者来说并非一种选择。因此,近年来,微创方法(lessinvasive method),如经皮瓣膜置换术(percutaneous valve replacement),已经发展用于替换主动脉瓣。在一个实例中,包括支架和瓣膜的人工修复物(prosthesis)被卷曲成较小外形,然后通过经皮途径被递送到心脏中。一旦定位于治疗部位,人工修复物被扩张用以代替天然主动脉瓣的功能。虽然经皮瓣膜置换术已显示出大有前景,但是在递送技术、瓣周漏(perivalvular leakage)和瓣膜耐用性方面仍然存在挑战。此外,如果可能,修复而不是替换天然瓣膜是期望的。
发明概述
因此,在此处公开的是用于治疗心瓣膜疾病的装置和方法,其包括示例性实施方式,一种不需要体外循环的微创方法。这种装置和方法的某些实施方式期望能够减少或消除通过心瓣膜的反流。还期望的是,这种装置和方法的实施方式非常适合用于在经皮或微创方法中递送。还期望的是,这种装置和方法的实施方式非常适合用于修复主动脉瓣。还期望的是,这种装置的递送是安全、可靠和容易的。还期望的是,这种装置和方法的实施方式适用于针对广泛多样化的心瓣膜缺损而改善心瓣膜功能。还期望的是,这种装置和方法的实施方式能够不用替换天然瓣膜就可改善瓣膜功能。
本公开的各种实施方式提供了用于改善有缺陷的心瓣膜功能的改进的装置和方法。具体实施方式可被配置为采用经皮或微创的方法植入心脏,其中体外循环不是必需的。
在本公开一个代表性实施方式中,人工装置包括锚定部件和插入部件,所述插入部件被配置用于在天然瓣膜如主动脉瓣的小叶之间展开。插入部件期望被成形为填补小叶之间的间隙(一个或多个),以在心室舒张期间产生紧密密封,从而最大限度地减少或防止通过主动脉瓣的反流。插入部件期望被制造成使得天然小叶与插入部件表面啮合的尺寸。当被配置用于典型的主动脉瓣时,插入部件期望包括三个臂状物,它们从中心区域径向向外延伸。每个臂状物被成形为放置在主动脉瓣的邻近小叶之间。锚定部件被提供用于将插入部件稳固在其展开的位置。在示例性实施方式中,锚定部件采用支架的形式,所述支架被配置用于在升主动脉(ascending aorta)内的展开。在一种变体中,插入部件可以被配置(例如,具有两个臂状物)用于只有两个小叶的主动脉瓣。在另一种变体中,插入部件可以被配置在肺动脉瓣中使用,用于治疗肺动脉瓣闭锁不全。
在本公开另一代表性实施方式中,人工装置包括由支架形成的锚定部件,和插入部件——其被配置用于在天然主动脉瓣的小叶之间展开。锚定部件期望包括用于提供单向流动的瓣膜部件。锚定部件期望被配置用于递送至升主动脉。支架通过自扩张或球囊扩张进行扩张,使得支架被锚定在主动脉中。展开之后,在支架里的瓣膜部件防止或最大程度地减少通过主动脉的血液回流。插入部件被递送到天然主动脉瓣中,以改善天然瓣膜的功能。因此,两个单独的瓣膜(例如支架瓣膜和天然瓣膜)协同工作,以防止通过主动脉环的反流。通过在天然瓣膜内展开插入部件,使天然瓣膜发挥它应有的功能,并且血液以基本自然方式进入冠状动脉。该支架瓣膜补充了天然瓣膜的功能。如果期望,该支架瓣膜可建造成在天然瓣膜之前或之后(期望的是之后)关闭,以进一步影响和改善天然瓣膜的功能,并改善血液动力学。
在一个代表性实施方式中,提供了用于治疗有缺陷的心瓣膜的系统和方法。所述系统包括人工装置,其包括锚定部件和插入部件。所述系统进一步包括递送导管,用于通过经皮途径将人工装置递送至心脏中。递送导管期望包括具有腔的伸长护套(外壳,sheath),该腔的大小适于容纳人工装置。在示例性实施方式中,在通过对象脉管系统推进的过程中,人工装置以收缩的构造被容纳在护套内。在一种变体中,外壳被配置用于逆行推进,并可以配置有可偏转的末端部分,用于促进在主动脉弓周围的导向(navigation)。达到治疗部位后,护套被移动至相对人工装置近端,以便从外壳弹出该装置。该装置随后被允许扩张,使得插入与主动脉瓣中的间隙相符,锚定部件与主动脉内壁啮合。
在本公开另一个代表性实施方式中,人工装置包括锚定部件和具有三个可扩张臂状物的插入部件,所述插入部件被配置用于在闭锁不全的主动脉瓣中的间隙之间展开。每个臂状物期望包括可扩张区域,其以有些类似降落伞的方式打开,以防止反流。在心室收缩期间,每个可扩张区域会收缩以使通过主动脉瓣的血液流动不受阻碍。
在本公开某个代表性实施方式中,人工装置包括:插入部件,其被配置用于在主动脉瓣内展开:和锚定部件,其被配置用于固定在左心室内。伸长的主体部分被提供用于连接插入部件与锚定部件。在一种变体中,人工装置可以以多个阶段被递送。在第一阶段,锚定部件被递送,然后使其生长至心脏壁中。在第二阶段,在充分的向内生长发生后,插入部件被附着至锚定部件。
在本公开另一代表性实施方式中,人工装置包括锚定部件和插入部件,所述插入部件被配置用于在二尖瓣的前叶和后叶之间展开。插入部件期望被成形为填补天然小叶之间的间隙,以防止通过二尖瓣的反流。插入部件的大小使得在心室收缩期间二尖瓣小叶与插入部件表面啮合以产生紧密密封。作为本实施方式的变体,提供一个或多个通过插入部件的通道以允许血液在一个方向通过装置流动,而进一步改善瓣膜功能。
上述和其它特征根据以下对几个实施方式的详细描述将变得更加明显,所述描述参考附图来进行。
附图说明
图1显示了心脏的横截面图。
图2是人工装置的透视图,其包括锚定部件和插入部件,所述插入部件被配置用于在天然主动脉瓣的小叶之间展开。
图3是插入部件的横截面图,其带有生物相容性材料的外涂层。
图4是放置在主动脉瓣内的图2插入部件的横截面图。
图5是主动脉的部分剖视图,图解在治疗主动脉瓣关闭不全的对象内展开的图2的人工装置。
图6是透视图,其图解人工装置的一种实施方式,其中插入部件被直接附着到锚定部件。
图7是收缩状态下包含在外壳内的图6插入部件的横截面图,用于递送至治疗部位。
图8图解从护套弹出并扩张成扩张状态后的图6的插入部件。
图9A是人工装置的透视图,该人工装置包括用于在主动脉瓣里展开的插入部件和带有用于稳固到左心室的啮合部件的锚定部件。
图9B是以扩张状态显示的多个啮合部件的示例性实施方式的分解图。
图9C是以压缩状态显示的图9B的多个啮合部件的透视图,用于递送到心脏。
图10是图9A所示的实施方式的变体,其中提供可选的锚定部件。
图11是类似于图2所示的实施方式的人工装置的透视图,其中所述锚定部件包括支架和用于在升主动脉里展开的瓣膜部件。
图12是类似于图2所示的实施方式的人工装置的透视图,其中插入部件以两个臂状物形成。
图13是人工装置的透视图,该人工装置包括锚定部件和在心脏中展开的插入部件,用于治疗闭合不全的二尖瓣。
图14是图13插入部件的横截面图。
图15是横截面图,图解说明带有通道和瓣膜部件的插入部件,以允许血液在一个方向通过插入部件流动。
具体实施方式详述
I.术语解释
除非另有说明,此处使用的所有技术和科学术语,具有与本公开所属领域普通技术人员通常理解的相同含义。为了便于查阅本公开各种实施方式,提供下列术语解释:
单数术语“一(a)”、“一(an)”和“所述(the)”包括复数指称,除非上下文另有明确表示。术语“或(or)”指所陈述的可选要素的单个要素或两个或更多要素的组合,除非上下文另有明确表示。
术语“包括”(“include”)是指“包含”(“comprises”)。举例来说,包括或包含A和B的装置含有A和B,但可以任选地含有C或除A和B之外的其它组分。另外,包含或包括A或B的装置可以含有A或B或者A和B,并任选地含有一个或多个其它组分,如C。
术语“近端(proximal)”是指更靠近操作者的设备部分,而“远端”(distal)是指远离操作者的设备部分。
术语“对象”是指人和其它动物对象。在某些实施方式中,对象是人或其它哺乳动物,如灵长类动物、猫、狗、牛、马、啮齿类动物、绵羊、山羊或猪。在具体实例中,所述的对象是人类患者。
虽然与此处所述类似或等同的方法和材料可用于本公开的实践或测试中,但是合适的方法和材料描述如下。在冲突的情况下,遵循包括术语在内的本说明书。此外,材料、方法和实施例仅仅是说明性的,而不意图是限定性的。
II.人类心脏的解剖学概述
参考图1,提供了心脏1的横截面图。血液流经上腔静脉2和下腔静脉4进入心脏1的右心房6。三尖瓣8控制右心房6和右心室15之间的血液流动。当血液从右心室15泵出至肺部时,三尖瓣8关闭。此后,三尖瓣8开放,将来自右心房6的血液再填充右心室15。三尖瓣8小叶的游离缘通过腱索10连接至右心室15内的乳头肌12,用于控制三尖瓣8的运动。血液从右心室15被泵送通过肺动脉瓣20到达肺动脉22,其分支进入伸向肺部的动脉。
离开肺后,充氧的血液流经肺静脉28,进入心脏1的左心房26。二尖瓣30控制血液在左心房26和左心室17之间的流动。二尖瓣30在心室收缩期关闭,此时血液从左心室17流出进入主动脉34。此后,二尖瓣30开放,将来自左心房26的血液再填充左心室17。二尖瓣30小叶的游离缘通过腱索11连接至左心室的乳头肌13,用于控制二尖瓣30的运动。来自左心室17的血液经主动脉瓣32被泵送至主动脉34,其分支进入通向身体各个部位的动脉。主动脉瓣32包括三个小叶(也称为皮瓣或尖),其被统称为36。当心脏跳动时,小叶36开启和关闭来控制血液从心脏的左心室17流至主动脉34中。
III.用于减少通过心瓣膜的反流的人工装置
如果心瓣膜的任何部分不能正常发挥功能,心脏的效率可能会受到严重损害。例如,心瓣膜可能会失去正常关闭的能力,原因在于瓣膜周围的环面或松弛下垂的小叶的扩张。小叶还可由于疾病如风湿性疾病而收缩,从而在瓣膜内小叶之间留下间隙。心瓣膜关闭能力的丧失导致血液回漏(与正常血液流动相反),通常被称为反流,其通过主动脉瓣进入左心室。反流可严重损害心脏功能,因为更多的血液不得不通过反流瓣膜被泵出,以保持足够的循环。
本公开的实施方式提供用于改善有缺陷的心瓣膜如主动脉瓣的功能的装置和方法。此处公开的装置和方法期望采用经皮或微创手术方法被递送到对象的心脏中。因此,此处所述的期望递送方法不需要体外循环(例如,来自对象的循环血液被发送至机体以外的路线,以对其进行处理,然后返回至对象的循环)。例如,在一个实施方式中,递送导管(或类似的递送装置)通过胸壁切口插入,然后通过心脏组织(例如,通过心尖)进入患者跳动心脏的腔体。递送导管可允许人工装置以收缩的结构被递送到心脏中,然后在心脏内扩张用于治疗有缺陷的心瓣膜。因为期望传送方式不需要体外循环,所以与传统的心内直视手术相比,并发症大大减少。
图2图解了人工装置100的实施例,其可被用于减少或消除通过心瓣膜如主动脉瓣的反流。人工装置100包括插入部件102和锚定部件110。插入部件102期望包括用于接触天然瓣膜小叶如天然主动脉瓣小叶的实体外表面。在此处使用,“实体(实心,无孔,solid)”表面是指非穿孔表面,其不包含血液可以通过的任何开口。如图2所示,插入部件102包含第一延伸部分或臂状物104,第二延伸部分或臂状物106,和第三延伸部分或臂状物108。延伸部分104、106、108期望在插入部件102的中心部分112周围,以相同角度间隔,并从此处向外径向延伸。人工装置100可包括多个间隔物(spacer)或连接部件120,用于在与锚定部件110隔开的位置安装插入部件102。如图2所示,三个这样的间隔物或连接部件在图解的实施方式中被提供,用于将插入部件102连接至锚定部件110。
在图解的实施方式中,锚定部件110采取自扩张或球囊扩张支架的形式,其具有开放式框架结构,如图2所描绘。所述锚定部件可用各种合适的扩张材料和/或弹性材料制造,如不锈钢、钛、形状记忆合金或其它生物相容性金属。在一个实施例中,锚定部件110是自扩张式的,并用形状记忆合金制造,如镍钛(nickel titanium,NiTi)形状记忆合金,例如如以商品名称Nitinol销售。在另一个实施例中,锚定部件110是球囊扩张式的,并用不锈钢或其它合适的材料制造。
在具体实施方式中,所述的锚定部件110包括支架,该支架具有多个成角度间隔的轴向支柱,或支撑部件,其沿部件轴向(纵向)延伸。锚定部件110也可包括多个轴向间隔的圆周带或支柱,其附着至轴向支柱。圆周形支柱形成有多个弯曲,这些弯曲允许锚定部件110被压缩到较小的直径以便递送到植入部位,并扩张至其发挥功能的大小,以便将插入部件102锚定至心脏。圆周形支柱可包括多个以Z字形(zig-zag)或锯齿(saw-tooth)构造排列的线型支柱部件,其形成确定相邻支柱部件之间的弯曲。在其它实施例中,一个或一个以上的圆周带可具有弯曲或蜿蜒的形状,而不是Z字形形状。在变体中,锚定部件110可进一步包括固定或附着部件,如倒钩、钉、凸缘、吊钩等等,其沿锚定部件110的外部分布,用于提高锚定部件110在主动脉内锚定插入部件的能力。对可以在此处公开的实施方式中使用的示例性支架的进一步详述,在美国专利号6730118、美国专利号6767362和美国专利号6908481中公开,在此处每篇专利都以其全部并入作为参考。
虽然锚定部件主要以支架的形式进行描述,应该可以理解广泛多样的锚定机构都可以使用,同时保留在本公开范围之内。例如,锚定部件可以由一个或一个以上固定器形成。在一个具体实施例中,锚定部件可以是多个间隔分开的固定器,其向外延伸以接触心瓣膜环附近或心瓣膜环内的组织。固定器的尺寸和配置适于将主体稳固至心瓣膜环。例如,所述一个或多个固定器可以是环形带,其由聚乙烯、聚丙烯、聚碳酸酯、尼龙、聚四氟乙烯、聚氨基甲酸酯、不锈钢、Nitinol、钛、聚酰亚胺、聚酯、形状记忆材料或它们的混合物制成。所述一个或多个固定器可包括突起、倒钩、针和吊钩等等啮合部件,用于辅助将人工装置锚定在心瓣膜内。
插入部件102被配置用于插入闭锁不全的主动脉瓣的小叶之间,以填补小叶之间的间隙。在一个具体实施例中,插入部件102显示出足够的刚性,以基本保持其展开的形状,并具有足够的弹性和/或柔性,以便被压缩到减小的直径,用于在递送护套中递送。插入部件可由塑料、金属(如形状记忆金属)或适于植入到对象内的其它生物相容性材料制造。在具体实施例中,如图3所图解,插入部件102可包括内支撑层127和外层或护套128。外层128可由生物相容性材料制造,如布类或织物材料(天然或合成)或生物材料,如胶原或生物组织材料,以保护天然小叶免受损害(例如,阻止响应小叶接合和解除接合可能发生的磨损)。例如,与天然小叶相容的平滑的动物心包(smooth animal pericardium),如马、牛、猪或其它动物的心包组织,可以包括在外层128内。这些组织可以通过适当的鞣革环境来鞣制或固定,或心包可以与通过解毒方法结合的戊二醛和肝素交联。在某个实施例中,生物组织材料可以是NO-REACT天然组织产品之一,其显示出改进的生物相容性,并减轻钙化及血栓形成。外层128可覆盖内层127的整个外表面或经选择的一部分的外表面,如那些接触天然瓣膜的部分。
在某些实施例中,插入部件102的直径与天然主动脉瓣的直径相似,这样,每个延伸部分就延伸进入主动脉瓣小叶之间的尖端中。因此,装置100的插入部件102在展开后保持在主动脉瓣内居中。在某些实施例中,插入部件的直径约18mm至约26mm,其中约22毫米为具体实施例。与锚定部件110的直径相比,插入部件102的直径可以略小。此构造允许插入部件收缩或折叠成较小直径,用于在递送护套中递送。此外,插入部件的长度可以有所变化。例如,在一个实施方式中,插入部件的长度与锚定部件长度大致相同。在其它实施例中,插入部件的长度大于或小于锚定部件的长度。在某些实施例中,插入部件的长度为约20mm到约30mm,其中约25mm为具体实施例。
如图4所示,插入部件102的横截面轮廓可以成形为使得天然小叶36a、36b、36c能够接触插入部件102的侧面,以在心室舒张期建立紧密密封。例如,三个间隔开的延伸或臂状物104、106和108从插入部件102的中心区域112径向向外延伸。在某些实施例中,臂状物在宽度上从中心部分向延伸部分外端逐渐变细。例如,每个臂状物包括第一末端114和第二末端116。所述的第一末端114比第二末端116宽。每个臂状物都包括第一侧面122和第二侧面124,每一个侧面被配置为与天然小叶接触。末端114、116和侧面122、124可被配置为具有平滑边缘,以尽量减少或消除溶血效应。此外,每个臂状物被配置为填补主动脉瓣的相邻小叶之间的间隙,从而防止通过主动脉瓣的反流。臂状物的接触表面可以显示出足够的顺应性和/或柔韧性,以允许天然小叶与插入部件102啮合,产生紧密密封而不损坏小叶。例如,如上所述,每个臂状物可包括生物相容性材料,如胶原或心包组织,以阻止响应臂状物与天然小叶啮合或接合而可能发生的磨损。
当用于治疗主动脉瓣时,插入部件的横截面轮廓可以被最小化,以便当主动脉瓣完全开放时限制从左心室到主动脉的血流阻力。此外,插入部件的一个端部或两个端部可以是锥形或圆形的,这样就不存在垂直面对血液流动的平面。关于图解的实施方式,应当理解人工装置能够最大限度地减少或防止反流,而不利用任何移动部件。因此,与需要利用移动部件的可选心瓣膜修复和更换技术相比,该装置可以获得更大的耐用性。
插入部件102可被配置以可扩张的结构,如可移动的薄片(flap),以进一步阻止通过主动脉瓣的反流。每个可扩张的结构可被配置用于填补相邻天然瓣膜小叶之间的空隙。在一个实施例中,可移动的薄片可以被配置为以类似于降落伞的方式打开,以阻止天然主动脉瓣小叶之间的血液反流。在心室收缩期,可移动薄片收缩,以使血液以基本无阻碍的方式,从左心室经天然主动脉瓣流进主动脉。关于可扩张插入部件(例如瓣膜部分)的另外详细说明,可以在申请人于2006年4月19日提交的共同未决的美国申请号11/407,582(美国专利公布号2006/0241745)中找到,其在此以全文并入作为参考。在′528申请中所述的、被配置用于二尖瓣的可扩张人工装置的原理和特点,也适用于此处所述的在主动脉瓣里使用的装置。
如上所述,并如图2所示,人工装置100包括多个间隔物或连接部件120。每个连接部件通常可以为圆柱形状,尽管可使用任何其它合适的形状。在某些实施例中,每个连接部件的长度为约6mm到约14mm,其中约10mm为具体实施例。每个连接部件优选地将插入部件102的臂状物结合至锚定部件110。连接部件120可协助稳定插入部件102。每个连接部件期望显示出足够的刚性,以基本将插入部件保持在相对于锚定部件的固定位置。连接部件可由塑料、金属或其它生物相容性材料制成,其适于植入到对象中。连接部件120也最大限度地减少人工装置对流向冠状动脉血流的干扰,这是通过使锚定部件110定位于冠状动脉口之上以及插入部件102定位在天然主动脉瓣内来实施。
正如图4中最佳图解,主动脉瓣32的天然小叶36a、36b、36c在心室舒张期与插入部件102接触而产生紧密密封。通过使主动脉瓣32产生紧密密封,可以最大限度地减少或避免从主动脉进入左心室的反流。在心室收缩期,天然小叶开放——正如它们自然而为,使血液从左心室被泵至主动脉。从图4可以看出,插入部件102的横截面面积与通过主动脉瓣环的流通面积相比,相对较小。因此,在图解的实施方式中,插入部件102基本不会在心室收缩期阻碍血液经主动脉瓣的流动。
参考图5,其图解了在对象中展开后的人工装置100。如图5所示,锚定部件110在主动脉瓣上方如冠状动脉口38上方的主动脉中展开,以便不干扰通过冠状动脉的血液流动。插入部件102在天然主动脉瓣中展开,以改善主动脉瓣的功能。例如,插入部件102位于天然主动脉瓣内,其每个臂状物104、106和108在两个小叶的相邻边缘之间延伸,这样,主动脉瓣32的小叶与臂状物104、106和108接合。连接部件120从锚定部件110延伸至插入部件102,以保持插入部件102处于充分固定的位置。在心室舒张期,主动脉瓣32的小叶关闭并挤压插入部件的壁而产生一个紧密密封。虽然闭锁不全或有缺陷的主动脉瓣中的天然小叶可能无法完全关闭,但是插入部件102的臂状物填充间隙,使得很少或没有血液能够从主动脉回流至左心室。
正如所示,天然主动脉瓣不被切除,并继续以基本正常的方式发挥作用。因此,随着时间推移,如果天然瓣膜能够自身治愈或如果发现可替代治疗,有可能去除人工装置。
参考图6,显示了根据另一实施方式的人工装置200。人工装置200包括插入部件102和锚定部件110。在图解的实施方式中,插入部件102直接与锚定部件110连接,而不通过连接部件120。例如,插入部件可以通过插入部件102的近端118连接到锚定部件110,例如插入部件102的近端被部分容纳在锚定部件110的末端部分内并被其环绕。在图解的实施方式中,插入部件102的直径小于锚定部件110的直径。此结构允许插入部件102在植入过程中收缩或折叠,并随后在瓣膜里展开。
所公开的人工装置可被配置用于以经皮或微创方法递送,其中只需要小的进入切口。在一个实施例中,人工装置可被配置以便其能够被卷曲或以其它方式收缩成较小外形,然后放置在递送护套中,用于推进至治疗部位。例如,图7图解了在收缩状况下护套(sheath)142内的人工装置200。如所示,插入部件102可被配置具有足够的柔韧性,以使臂状物可以折叠,或者使其呈现弯曲外形,以便在递送过程中暂时减小插入外形。从护套142中弹出后,锚定部件110和插入部件102扩张到完全扩张的状态,如图8所示。当以经皮方法被递送到主动脉瓣后,期望利用可偏转护套,以便于通过病人的血管和在主动脉弓周围的导向。关于被配置用于将治疗装置递送到主动脉瓣的可偏转护套的各种实施方式的详细说明,可以在申请人于2005年6月13日提交的共同未决的美国申请号11/152,288中找到,其名称为“心瓣膜递送系统”,其此处以全文引用的方式并入。
图9A显示人工装置300,其可用于减少或消除心瓣膜反流,如主动脉瓣反流。在此实施方式中,人工装置包括插入部件102——其被配置用于插入主动脉瓣中,和锚定部件302——其被配置用于固定至左心室内的肌肉壁。锚定部件302可以包括多个啮合部件304,如钩或指状物,其沿肌肉壁穿透组织,以将插入部件102固定至心脏。啮合部件304可用任何生物相容性材料制成,如生物相容性的金属或塑料,其能穿透左心室肌肉壁,以将插入部件102固定至心脏,而不会基本损伤该壁。锚定部件302可包括伸长的主体部分或轴306,其连接啮合部件304与插入部件102。在一个实施例中,伸长主体部分306和啮合部件304可由单块材料制成。另一个实施例中,伸长主体部分306和啮合部件304可以各自单独制造,随后通过任何合适的方法如焊接而彼此结合。伸长主体部分306和啮合部件304可以由相同或不同的材料制成,这取决于装置300的每一部分所期望的材料特性(弹性、刚性、收缩性等)。
通过将多个啮合部件304放置在左心室心尖附近的左心室内,人工装置300可放置在心脏内,以最大限度减少主动脉瓣反流。在图解的实施方式中,多个指状物或钩沿左心室心尖附近的左心室肌肉壁穿透组织。插入部件102定位在主动脉瓣环内,以使其上部和下部可在天然主动脉瓣的上面和下面延伸,并且插入部件102的臂状物被调整为与主动脉瓣的三个尖端接合,因此,每个小叶可在插入臂状物之间上下移动。
图9B和9C显示了锚定部件302的下端部分,其具有用伸长尖头物制成的多个啮合部件304。伸长尖头物304期望被配置为,当其被推离递送护套时,从图9C压缩构造自扩张成图9B的“开花的”或扩张的构造。此开花式构造借助自弯曲区域304a期望实现,其使尖头物304从主体502的中心径向向外并向后朝向主体的第二末端偏转。尖头物304期望有尖角或有刺,以促进与心脏肌肉壁渗透和啮合。
锚定部件302可由单管形状记忆材料制成,例如,举例来说,Nitinol。在制造过程中,形状记忆材料可以用机械或激光切割工具来切割。切割管后,扩张或开花式形状可以采用本领域已知的技术(如热定形形状)被赋予形状记忆材料的记忆。制造锚定部件的方法在申请人共同未决的美国申请号11/750,272(以下简称“′272申请”)中详细描述,其在此以引用方式并入。在一个优选的实施方式中,锚定部件被制成具有延伸的构造,其符合在锚定部件将被展开的位置处心脏特定表面区域的轮廓,如′272申请所述。
包括尖头物304在内的锚定部件302的表面,期望被配置用于促进组织在其表面甚至进入其中生长。在一个实施例中,通过给锚定部件提供相对粗糙和/或多孔表面来实现这种生长。此外,本领域已知的生物涂层类型可被包括在锚定部件302的表面上,以促进愈合和组织生长。
图10显示了锚定部件402的另一种变体,其中一个或多个锚如图示的板404,位于心脏肌肉壁的相对侧上,用于将人工装置400锚定至心脏。板404可由任何生物相容性材料制成,如生物相容性金属或塑料。锚定部件402包括轴406,其具有被连接到插入部件102的上端部分和延伸通过心脏壁的下端部分。一块板404被安置于左心室内的轴上,另一块板404被安置于左心室外的轴上,以将轴稳固在适当的位置。
如果期望,人工装置可以以多个阶段展开,其中,在第一阶段,插入部件被递送之前,锚定部件附着到主动脉(或心室壁)。在第二阶段,该装置的插入部件后来(如几个小时、几天或几周后)被连接到锚定部件。第一阶段和第二阶段之间的时间间隔有利于组织愈合,甚至在锚定部件上生长,从而进一步在心脏内嵌入锚定部件。在不存在装置的插入部件可赋予组织额外压力的情况下,愈合和过度生长可以更迅速地进行,其具有较小的副作用(例如不必要的疤痕)。关于示例性锚定部件、可扩张插入部件和两阶段展开的附加详细说明可在‘272申请中找到。
图11显示了人工装置的另一种可选实施方式,以500表示。锚定部件110可以是支架,并且可以包括安装在支架内的瓣膜部件130。在图解的实施方式中,瓣膜部件130是有三小叶式生物人工瓣膜。在具体实施例中,锚定部件和瓣膜部件可采取Cribier-Edwards瓣膜的形式,由加利福尼亚的Edwards Lifesciencea of Irvine制造。关于有支架瓣膜示例性实施方式的附加详细说明可以在美国专利号6,893,460中找到,其在此以全文引用的方式并入。
支架中的瓣膜部件130确保通过支架的单向流动。支架期望被配置用于递送到升主动脉中。支架以自扩胀或球囊扩张的方式扩张,以使支架被锚定在主动脉内。展开后,支架内的瓣膜部件防止血液经主动脉回流。插入部件被递送到天然主动脉瓣中,以改善天然瓣膜的功能。因此,两个单独的瓣膜(即支架瓣膜和天然瓣膜)协同运作,以阻止经主动脉环的反流。通过插入部件在天然瓣膜内的展开,天然瓣膜被允许发挥它应有的功能,血液被允许以基本自然的方式流入冠状动脉。该支架瓣膜补充了天然瓣膜的功能。如果期望,支架瓣膜可被建造成在天然瓣膜之前或之后闭合,以进一步影响和改善天然瓣膜功能,并改善进入冠状动脉的血流动力学和/或灌注。
参考图12,提供了根据又一种实施方式的人工装置600。人工装置600被配置用于在只有两个小叶的异常主动脉瓣中使用。为了治疗这部分人群,插入部件602具有两个臂状物604、606,用于填补小叶之间的间隙。此外,在某些具有三个小叶的主动脉瓣中,可能没有必要填补三个小叶各个之间的间隙。因此,使用图12所示类型的插入部件可以是期望的,用于防止或减少在三个小叶瓣膜中的反流。
为了说明起见,人工装置的期望实施方式已在上文描述,用于用在通常具有三个小叶的瓣膜如主动脉瓣中。但是,本领域普通技术人员应该认识到,装置的变体也可以一种类似的方式用于治疗另一种具有三个小叶的瓣膜,如肺动脉瓣。用于治疗肺动脉瓣时,锚定部件(例如支架)可被配置用于在肺动脉干或肺动脉内展开。可选地,锚定部件可被固定在右心室内。
参考图13到15,人工装置700被配置用于治疗二尖瓣,如缺陷型二尖瓣。如图13所示,人工装置700包括插入部件702和锚定部件704。插入部件702包括一个主体,其尺寸和形状适于填补闭锁不全的二尖瓣前小叶与后小叶之间的间隙。
在一种具体实施方式中,插入部件702显示出足够的刚性,以基本保持其展开的形状,并具有足够的弹性和/或柔性,以便被压缩到减小的直径,用于在递送护套中递送。插入部件可由塑料、金属或适于植入到对象内的其它生物相容性材料制造。在具体实施例中,如上所述,插入部件可包括基本由生物相容性材料制成的外层或护套,所述生物相容性材料如布类或织物材料(天然或合成)或生物材料,如胶原或生物组织材料,以保护天然小叶免受损害(例如,阻止响应小叶接合和解除接合可能发生的磨损)。例如,与天然小叶相容的平滑的动物心包,如马、牛、猪或其它动物的心包组织,可以包括在外层内。这些组织可以通过适当的鞣革环境来鞣制或固定,或心包可以与通过解毒方法结合的戊二醛和肝素交联。在某个实施例中,生物组织材料可以是NO-REACT天然组织产品之一,其显示出改进的生物相容性,并减轻钙化及血栓形成。外层可覆盖插入部件102的整个外表面或外表面的选定部分,例如那些接触到天然小叶的部分。插入部件702的形状可为锥形和/或平滑边缘,以最大程度地减少或消除溶血作用。
插入部件702的横截面轮廓被成形为使得天然小叶能够接触插入部件702的侧面703a和703b,以产生紧密密封。如图13-15所示,插入部件702优选地具有月牙形横截面轮廓,以更好地符合天然小叶的弯曲。插入部件702的表面具有顺应性,其允使得天然小叶能够与插入部件702啮合,以产生紧密密封,而不损坏小叶。例如,如上所述,表面可包括生物相容性材料,如胶原或心包组织,以阻止响应插入部件表面与天然小叶啮合或接合时可能发生的磨损。在工作中,二尖瓣的天然小叶在心室收缩期挤压插入部件的壁,以产生紧密密封,并防止血液从左心室到左心房的反流。
在图解的实施方式中,人工装置700的锚定部件704包括轴或伸长的主体部分706,其下端部分形成穿透部分708。板709可以在心脏壁的相对侧上安置在穿透部分708之上,以将轴固定在适当的位置。锚定部件704的主体部分706和穿透部件708可以是任何合适的形状和材料,其赋予装置700每个部分所期望的材料特性(弹性、刚性、收缩性等等)。例如,穿透部件708可以由任何生物相容性材料制造,如生物相容性的金属或塑料,其能穿透左心室肌壁以将插入部件702固定至心脏,而不会基本损害该壁。
在一个实施例中,锚定部件704可被配置为在左心室内展开。图14是图13所示插入部件702的横截面图。在此实施方式中,插入部件702具有基本实心的横截面。在一种变体中,如图15所示,插入部件702可以包括沿纵轴延伸的通道。该通道可适合于使血液在一个方向经插入部件流动。瓣膜部件可被包括在插入内,以确保血液仅在一个方向流动。在一个具体实施例中,瓣膜部件可以包括一个或多个薄片部件712,其界定出狭缝或开口710。通过使血液仅在一个方向流动,瓣膜部件模仿目标瓣膜的功能。因此,从一个方向流动进入通道的血液打开薄片,从而流经插入部件,而从相反方向流动进入通道的血液被瓣膜阻止。
IV.用于减少通过心瓣膜反流的系统和方法
此处公开的是用于治疗有缺陷的心瓣膜的系统和方法。在一种实施方式中,所述的系统包括人工装置,其包括锚定部件如自扩张式锚定部件和插入部件。该系统可进一步包括递送导管,用于通过经皮方法将人工装置递送至心脏。例如,该导管可被经皮引入患者的脉管系统中(例如引入外周动脉如股动脉中)并推进至植入部位。在某些实施方式中,例如,导管的尺寸适于通过在腹股沟内的小切口插入,并具有至少约80cm通常为90-100cm的长度,以使轴以逆向途径实现从股动脉和髂动脉到升主动脉的经腔定位。可选地,导管以具有较短的长度,例如约20-60cm,用于通过其它插入点导入,如,例如髂动脉、肱动脉、颈动脉或锁骨下动脉。在股骨途径中,导管期望具有足够长度和柔韧性,以穿过经股动脉、髂动脉、降主动脉和主动脉弓的路径。与此同时,导管期望具有足够的可推性,以通过在近端的推动使其推进至升主动脉;并具有足够的轴向、弯曲和扭转硬度,以便于即使导管位于曲折的血管结构内,医生也可控制远端的位置。可选地,导管可经肋骨之间的通道穿过。在一种技术中,导管以所谓微创的方法通过患者心脏以上的胸腔并穿过主动脉弓内的切口推进。在另一项技术中,导管通过心脏壁中的切口推进,优选地是沿心尖。人工装置被推进至将被治疗的心瓣膜,并且其被定位为跨过瓣膜延伸,其中该装置的臂状物被插入小叶之间,使得瓣膜小叶关闭并挤压插入部件的壁而产生紧密密封。
在某些实施方式中,递送导管包括伸长的护套,其具有大小适于容纳人工装置的腔。在推进通过对象的脉管系统的过程中,人工装置以收缩的构造被容纳在护套中。例如,在推进至左心室的过程中,该装置最初被包含在递送护套中,其中锚定部件保持处于径向压缩状态。在一种变体中,递送护套的远端部分被配置用于逆向推进,并可以被配置有可偏转的末端部分,用于促进主动脉弓周围的导向。到达治疗部位后,护套被移至相对人工装置近端,以便从护套中弹出该装置。随后,该装置被允许扩张,使得其插入与主动脉瓣内的间隙相符,并且锚定部件与主动脉内壁啮合。
尽管本发明实施方式优选地被配置用于经皮或微创递送方法,但是,在某些情况下,插入部件可通过心脏直视外科手术而展开。在这些实施方式中,递送导管可能不是必需的,因为有缺陷的天然瓣膜可被直接进入。
尽管本公开已在具体实施方式和应用方面进行描述,但是本领域普通技术人员根据该教导可以创造出另外的实施方式和修改,而不偏离所要求包含的发明的精神或超出其范围。因此,应当理解,此处附图和描述以实施例的方式提供,以便于对本公开的理解,其不应被理解为限制其范围。
Claims (7)
1.用于改善二尖心瓣膜功能的装置,其包括:
插入部件,其被配置用于插入所述二尖心瓣膜的小叶之间,所述插入部件具有第一和第二小叶接触表面,用于密封所述二尖心瓣膜的小叶之间的间隙,并防止从左心室到左心房的反流;和
锚定部件,其与所述插入部件连接,所述锚定部件包括伸长的主体部分,所述锚定部件的下端部分形成穿透部件,所述穿透部件适于啮合沿着所述左心室壁的组织,
其特征在于所述插入部件足够刚性以在展开后维持基本上恒定的横截面轮廓。
2.根据权利要求1所述的装置,其中所述插入部件具有基本实心的横截面。
3.根据权利要求1所述的装置,其中所述插入部件进一步包括通道和安置于所述通道内的瓣膜部件,用于使血液仅在一个方向流动,所述通道沿纵轴延伸。
4.根据权利要求1所述的装置,其中所述插入部件包括内部支撑和界定所述第一和第二小叶接触表面的外层,所述外层包括生物材料,用以当所述二尖心瓣膜小叶接触所述第一和第二小叶接触表面时,抑制所述二尖心瓣膜小叶的磨损。
5.根据权利要求4所述的装置,其中所述外层由心包组织形成。
6.根据权利要求1所述的装置,其中所述穿透部件进一步包括被配置为安置在心脏壁的相对侧上的两个板。
7.根据权利要求1所述的装置,其中所述插入部件可压缩到减小的直径适合用于在递送护套中递送。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US81008506P | 2006-06-01 | 2006-06-01 | |
US60/810,085 | 2006-06-01 | ||
CN2007800202603A CN101484093B (zh) | 2006-06-01 | 2007-05-31 | 用于改善心瓣膜功能的人工插入物 |
Related Parent Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN2007800202603A Division CN101484093B (zh) | 2006-06-01 | 2007-05-31 | 用于改善心瓣膜功能的人工插入物 |
Publications (2)
Publication Number | Publication Date |
---|---|
CN102283721A CN102283721A (zh) | 2011-12-21 |
CN102283721B true CN102283721B (zh) | 2015-08-26 |
Family
ID=38779486
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN2007800202603A Active CN101484093B (zh) | 2006-06-01 | 2007-05-31 | 用于改善心瓣膜功能的人工插入物 |
CN201110206268.7A Active CN102283721B (zh) | 2006-06-01 | 2007-05-31 | 用于改善心瓣膜功能的人工插入物 |
Family Applications Before (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CN2007800202603A Active CN101484093B (zh) | 2006-06-01 | 2007-05-31 | 用于改善心瓣膜功能的人工插入物 |
Country Status (6)
Country | Link |
---|---|
US (9) | US20070282429A1 (zh) |
EP (2) | EP2032080B1 (zh) |
CN (2) | CN101484093B (zh) |
AU (1) | AU2007266448B2 (zh) |
CA (1) | CA2652471C (zh) |
WO (1) | WO2007140470A2 (zh) |
Families Citing this family (231)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7691144B2 (en) | 2003-10-01 | 2010-04-06 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
EP3308744B2 (en) | 2004-03-11 | 2023-08-02 | Percutaneous Cardiovascular Solutions Pty Limited | Percutaneous heart valve prosthesis |
US7803168B2 (en) | 2004-12-09 | 2010-09-28 | The Foundry, Llc | Aortic valve repair |
US8608797B2 (en) | 2005-03-17 | 2013-12-17 | Valtech Cardio Ltd. | Mitral valve treatment techniques |
US8333777B2 (en) | 2005-04-22 | 2012-12-18 | Benvenue Medical, Inc. | Catheter-based tissue remodeling devices and methods |
US8951285B2 (en) | 2005-07-05 | 2015-02-10 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
US8778017B2 (en) | 2005-10-26 | 2014-07-15 | Cardiosolutions, Inc. | Safety for mitral valve implant |
US8449606B2 (en) | 2005-10-26 | 2013-05-28 | Cardiosolutions, Inc. | Balloon mitral spacer |
US8216302B2 (en) | 2005-10-26 | 2012-07-10 | Cardiosolutions, Inc. | Implant delivery and deployment system and method |
US7785366B2 (en) * | 2005-10-26 | 2010-08-31 | Maurer Christopher W | Mitral spacer |
US8852270B2 (en) | 2007-11-15 | 2014-10-07 | Cardiosolutions, Inc. | Implant delivery system and method |
US9259317B2 (en) | 2008-06-13 | 2016-02-16 | Cardiosolutions, Inc. | System and method for implanting a heart implant |
US8092525B2 (en) | 2005-10-26 | 2012-01-10 | Cardiosolutions, Inc. | Heart valve implant |
US8062321B2 (en) * | 2006-01-25 | 2011-11-22 | Pq Bypass, Inc. | Catheter system for connecting adjacent blood vessels |
US8932348B2 (en) | 2006-05-18 | 2015-01-13 | Edwards Lifesciences Corporation | Device and method for improving heart valve function |
US20070282429A1 (en) | 2006-06-01 | 2007-12-06 | Hauser David L | Prosthetic insert for improving heart valve function |
FR2906454B1 (fr) * | 2006-09-28 | 2009-04-10 | Perouse Soc Par Actions Simpli | Implant destine a etre place dans un conduit de circulation du sang. |
US8029556B2 (en) | 2006-10-04 | 2011-10-04 | Edwards Lifesciences Corporation | Method and apparatus for reshaping a ventricle |
US9883943B2 (en) | 2006-12-05 | 2018-02-06 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
US11259924B2 (en) | 2006-12-05 | 2022-03-01 | Valtech Cardio Ltd. | Implantation of repair devices in the heart |
US20080195126A1 (en) * | 2007-02-14 | 2008-08-14 | Jan Otto Solem | Suture and method for repairing a heart |
US11660190B2 (en) | 2007-03-13 | 2023-05-30 | Edwards Lifesciences Corporation | Tissue anchors, systems and methods, and devices |
US8480730B2 (en) | 2007-05-14 | 2013-07-09 | Cardiosolutions, Inc. | Solid construct mitral spacer |
EP2211779B1 (en) | 2007-10-15 | 2014-08-20 | Edwards Lifesciences Corporation | Transcatheter heart valve with micro-anchors |
US8597347B2 (en) * | 2007-11-15 | 2013-12-03 | Cardiosolutions, Inc. | Heart regurgitation method and apparatus |
US8382829B1 (en) | 2008-03-10 | 2013-02-26 | Mitralign, Inc. | Method to reduce mitral regurgitation by cinching the commissure of the mitral valve |
US20090276040A1 (en) | 2008-05-01 | 2009-11-05 | Edwards Lifesciences Corporation | Device and method for replacing mitral valve |
US8668668B2 (en) | 2008-05-14 | 2014-03-11 | Onset Medical Corporation | Expandable iliac sheath and method of use |
US8728153B2 (en) | 2008-05-14 | 2014-05-20 | Onset Medical Corporation | Expandable transapical sheath and method of use |
US8591460B2 (en) | 2008-06-13 | 2013-11-26 | Cardiosolutions, Inc. | Steerable catheter and dilator and system and method for implanting a heart implant |
EP2296744B1 (en) | 2008-06-16 | 2019-07-31 | Valtech Cardio, Ltd. | Annuloplasty devices |
WO2010037141A1 (en) | 2008-09-29 | 2010-04-01 | Cardiaq Valve Technologies, Inc. | Heart valve |
WO2010040009A1 (en) | 2008-10-01 | 2010-04-08 | Cardiaq Valve Technologies, Inc. | Delivery system for vascular implant |
EP3613383B1 (en) | 2008-11-21 | 2023-08-30 | Percutaneous Cardiovascular Solutions Pty Limited | Heart valve prosthesis |
US8715342B2 (en) | 2009-05-07 | 2014-05-06 | Valtech Cardio, Ltd. | Annuloplasty ring with intra-ring anchoring |
US10517719B2 (en) | 2008-12-22 | 2019-12-31 | Valtech Cardio, Ltd. | Implantation of repair devices in the heart |
US8147542B2 (en) | 2008-12-22 | 2012-04-03 | Valtech Cardio, Ltd. | Adjustable repair chords and spool mechanism therefor |
US9011530B2 (en) | 2008-12-22 | 2015-04-21 | Valtech Cardio, Ltd. | Partially-adjustable annuloplasty structure |
ES2873182T3 (es) | 2008-12-22 | 2021-11-03 | Valtech Cardio Ltd | Dispositivos de anuloplastia ajustables |
US8911494B2 (en) | 2009-05-04 | 2014-12-16 | Valtech Cardio, Ltd. | Deployment techniques for annuloplasty ring |
US8241351B2 (en) | 2008-12-22 | 2012-08-14 | Valtech Cardio, Ltd. | Adjustable partial annuloplasty ring and mechanism therefor |
US8353956B2 (en) | 2009-02-17 | 2013-01-15 | Valtech Cardio, Ltd. | Actively-engageable movement-restriction mechanism for use with an annuloplasty structure |
US9078751B2 (en) * | 2009-03-17 | 2015-07-14 | Mitrassist Medical Ltd. | Heart valve prosthesis with collapsible valve and method of delivery thereof |
CA2757273C (en) | 2009-03-30 | 2017-05-02 | Cardiovantage Medical, Inc. | Sutureless valve prostheses and devices and methods for delivery |
EP2419050B2 (en) | 2009-04-15 | 2023-10-18 | Edwards Lifesciences CardiAQ LLC | Vascular implant and delivery system |
US9968452B2 (en) | 2009-05-04 | 2018-05-15 | Valtech Cardio, Ltd. | Annuloplasty ring delivery cathethers |
US9180007B2 (en) | 2009-10-29 | 2015-11-10 | Valtech Cardio, Ltd. | Apparatus and method for guide-wire based advancement of an adjustable implant |
US10098737B2 (en) | 2009-10-29 | 2018-10-16 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
US9011520B2 (en) | 2009-10-29 | 2015-04-21 | Valtech Cardio, Ltd. | Tissue anchor for annuloplasty device |
US8734467B2 (en) | 2009-12-02 | 2014-05-27 | Valtech Cardio, Ltd. | Delivery tool for implantation of spool assembly coupled to a helical anchor |
US8449599B2 (en) * | 2009-12-04 | 2013-05-28 | Edwards Lifesciences Corporation | Prosthetic valve for replacing mitral valve |
US8870950B2 (en) | 2009-12-08 | 2014-10-28 | Mitral Tech Ltd. | Rotation-based anchoring of an implant |
US9307980B2 (en) | 2010-01-22 | 2016-04-12 | 4Tech Inc. | Tricuspid valve repair using tension |
US10058323B2 (en) | 2010-01-22 | 2018-08-28 | 4 Tech Inc. | Tricuspid valve repair using tension |
US8475525B2 (en) * | 2010-01-22 | 2013-07-02 | 4Tech Inc. | Tricuspid valve repair using tension |
US8579964B2 (en) | 2010-05-05 | 2013-11-12 | Neovasc Inc. | Transcatheter mitral valve prosthesis |
EP2590595B1 (en) | 2010-07-09 | 2015-08-26 | Highlife SAS | Transcatheter atrio-ventricular valve prosthesis |
US11653910B2 (en) | 2010-07-21 | 2023-05-23 | Cardiovalve Ltd. | Helical anchor implantation |
US9005279B2 (en) * | 2010-11-12 | 2015-04-14 | Shlomo Gabbay | Beating heart buttress and implantation method to prevent prolapse of a heart valve |
CA3035048C (en) | 2010-12-23 | 2021-05-04 | Mark Deem | System for mitral valve repair and replacement |
US8888843B2 (en) | 2011-01-28 | 2014-11-18 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valve regurgitation |
US8845717B2 (en) * | 2011-01-28 | 2014-09-30 | Middle Park Medical, Inc. | Coaptation enhancement implant, system, and method |
US9554897B2 (en) | 2011-04-28 | 2017-01-31 | Neovasc Tiara Inc. | Methods and apparatus for engaging a valve prosthesis with tissue |
US9308087B2 (en) | 2011-04-28 | 2016-04-12 | Neovasc Tiara Inc. | Sequentially deployed transcatheter mitral valve prosthesis |
US9289282B2 (en) | 2011-05-31 | 2016-03-22 | Edwards Lifesciences Corporation | System and method for treating valve insufficiency or vessel dilatation |
EP3964176A1 (en) | 2011-06-21 | 2022-03-09 | Twelve, Inc. | Prosthetic heart valve devices |
US10792152B2 (en) | 2011-06-23 | 2020-10-06 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
US9918840B2 (en) | 2011-06-23 | 2018-03-20 | Valtech Cardio, Ltd. | Closed band for percutaneous annuloplasty |
CA2842288A1 (en) * | 2011-07-21 | 2013-01-24 | 4Tech Inc. | Method and apparatus for tricuspid valve repair using tension |
US9655722B2 (en) | 2011-10-19 | 2017-05-23 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US11202704B2 (en) | 2011-10-19 | 2021-12-21 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9039757B2 (en) | 2011-10-19 | 2015-05-26 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US10016271B2 (en) | 2011-10-19 | 2018-07-10 | Twelve, Inc. | Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods |
US9763780B2 (en) | 2011-10-19 | 2017-09-19 | Twelve, Inc. | Devices, systems and methods for heart valve replacement |
AU2012325809B2 (en) | 2011-10-19 | 2016-01-21 | Twelve, Inc. | Devices, systems and methods for heart valve replacement |
US8858623B2 (en) | 2011-11-04 | 2014-10-14 | Valtech Cardio, Ltd. | Implant having multiple rotational assemblies |
US9724192B2 (en) | 2011-11-08 | 2017-08-08 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
CA2858149C (en) | 2011-12-12 | 2017-04-18 | David Alon | Heart valve repair device |
US9579198B2 (en) | 2012-03-01 | 2017-02-28 | Twelve, Inc. | Hydraulic delivery systems for prosthetic heart valve devices and associated methods |
US9427315B2 (en) | 2012-04-19 | 2016-08-30 | Caisson Interventional, LLC | Valve replacement systems and methods |
US9011515B2 (en) | 2012-04-19 | 2015-04-21 | Caisson Interventional, LLC | Heart valve assembly systems and methods |
GB201207100D0 (en) * | 2012-04-23 | 2012-06-06 | Aortech Internat Plc | Valve |
EP3508173A1 (en) | 2012-05-16 | 2019-07-10 | Edwards Lifesciences Corporation | Systems for placing a coaptation member between valvular leaflets |
US9474605B2 (en) | 2012-05-16 | 2016-10-25 | Edwards Lifesciences Corporation | Devices and methods for reducing cardiac valve regurgitation |
US9345573B2 (en) | 2012-05-30 | 2016-05-24 | Neovasc Tiara Inc. | Methods and apparatus for loading a prosthesis onto a delivery system |
US8961594B2 (en) | 2012-05-31 | 2015-02-24 | 4Tech Inc. | Heart valve repair system |
US9216018B2 (en) | 2012-09-29 | 2015-12-22 | Mitralign, Inc. | Plication lock delivery system and method of use thereof |
US9949828B2 (en) | 2012-10-23 | 2018-04-24 | Valtech Cardio, Ltd. | Controlled steering functionality for implant-delivery tool |
WO2014064695A2 (en) | 2012-10-23 | 2014-05-01 | Valtech Cardio, Ltd. | Percutaneous tissue anchor techniques |
WO2014087402A1 (en) | 2012-12-06 | 2014-06-12 | Valtech Cardio, Ltd. | Techniques for guide-wire based advancement of a tool |
EP2943132B1 (en) | 2013-01-09 | 2018-03-28 | 4Tech Inc. | Soft tissue anchors |
US9681952B2 (en) | 2013-01-24 | 2017-06-20 | Mitraltech Ltd. | Anchoring of prosthetic valve supports |
WO2014134183A1 (en) | 2013-02-26 | 2014-09-04 | Mitralign, Inc. | Devices and methods for percutaneous tricuspid valve repair |
US10583002B2 (en) | 2013-03-11 | 2020-03-10 | Neovasc Tiara Inc. | Prosthetic valve with anti-pivoting mechanism |
US10449333B2 (en) | 2013-03-14 | 2019-10-22 | Valtech Cardio, Ltd. | Guidewire feeder |
JP6329570B2 (ja) | 2013-03-14 | 2018-05-23 | 4テック インコーポレイテッド | テザーインターフェースを有するステント |
US11259923B2 (en) | 2013-03-14 | 2022-03-01 | Jc Medical, Inc. | Methods and devices for delivery of a prosthetic valve |
JP2016512077A (ja) | 2013-03-14 | 2016-04-25 | カーディオヴァンテージ・メディカル・インク | 塞栓保護デバイスおよび使用方法 |
US11406497B2 (en) | 2013-03-14 | 2022-08-09 | Jc Medical, Inc. | Heart valve prosthesis |
US9681951B2 (en) | 2013-03-14 | 2017-06-20 | Edwards Lifesciences Cardiaq Llc | Prosthesis with outer skirt and anchors |
US9289297B2 (en) | 2013-03-15 | 2016-03-22 | Cardiosolutions, Inc. | Mitral valve spacer and system and method for implanting the same |
EP2968847B1 (en) | 2013-03-15 | 2023-03-08 | Edwards Lifesciences Corporation | Translation catheter systems |
US9232998B2 (en) | 2013-03-15 | 2016-01-12 | Cardiosolutions Inc. | Trans-apical implant systems, implants and methods |
US9572665B2 (en) | 2013-04-04 | 2017-02-21 | Neovasc Tiara Inc. | Methods and apparatus for delivering a prosthetic valve to a beating heart |
CA2910751C (en) * | 2013-05-09 | 2021-02-23 | Mitrassist Medical Ltd. | Heart valve assistive prosthesis |
US10111747B2 (en) | 2013-05-20 | 2018-10-30 | Twelve, Inc. | Implantable heart valve devices, mitral valve repair devices and associated systems and methods |
KR20160041040A (ko) | 2013-06-14 | 2016-04-15 | 카디오솔루션즈, 인코포레이티드 | 승모판 스페이서 및 이를 이식하기 위한 시스템 및 방법 |
CA2919221C (en) * | 2013-06-17 | 2021-09-21 | Alan HELDMAN | Prosthetic heart valve with linking element and methods for implanting same |
CN105592808B (zh) * | 2013-06-26 | 2018-11-09 | Sat集团(控股)有限公司 | 用于二尖瓣膜修复的定向装置 |
US10070857B2 (en) | 2013-08-31 | 2018-09-11 | Mitralign, Inc. | Devices and methods for locating and implanting tissue anchors at mitral valve commissure |
US9839511B2 (en) | 2013-10-05 | 2017-12-12 | Sino Medical Sciences Technology Inc. | Device and method for mitral valve regurgitation treatment |
US9393111B2 (en) | 2014-01-15 | 2016-07-19 | Sino Medical Sciences Technology Inc. | Device and method for mitral valve regurgitation treatment |
US9421094B2 (en) | 2013-10-23 | 2016-08-23 | Caisson Interventional, LLC | Methods and systems for heart valve therapy |
US10299793B2 (en) | 2013-10-23 | 2019-05-28 | Valtech Cardio, Ltd. | Anchor magazine |
US10166098B2 (en) | 2013-10-25 | 2019-01-01 | Middle Peak Medical, Inc. | Systems and methods for transcatheter treatment of valve regurgitation |
DE102013017750A1 (de) | 2013-10-28 | 2015-04-30 | Universität Duisburg-Essen | Implantierbare Vorrichtung zur Verbesserung oder Behebung einer Herzklappeninsuffizienz |
EP3062709A2 (en) | 2013-10-30 | 2016-09-07 | 4Tech Inc. | Multiple anchoring-point tension system |
US10022114B2 (en) | 2013-10-30 | 2018-07-17 | 4Tech Inc. | Percutaneous tether locking |
US10052095B2 (en) | 2013-10-30 | 2018-08-21 | 4Tech Inc. | Multiple anchoring-point tension system |
US9848880B2 (en) * | 2013-11-20 | 2017-12-26 | James E. Coleman | Adjustable heart valve implant |
US9901444B2 (en) * | 2013-12-17 | 2018-02-27 | Edwards Lifesciences Corporation | Inverted valve structure |
US9610162B2 (en) | 2013-12-26 | 2017-04-04 | Valtech Cardio, Ltd. | Implantation of flexible implant |
US20150182335A1 (en) * | 2014-01-01 | 2015-07-02 | Physicians Creek Inc. | LEFT VENTRICULAR OUTFLOW DEVICE (LVODe) |
US9974647B2 (en) | 2014-06-12 | 2018-05-22 | Caisson Interventional, LLC | Two stage anchor and mitral valve assembly |
WO2015195823A1 (en) | 2014-06-18 | 2015-12-23 | Middle Peak Medical, Inc. | Mitral valve implants for the treatment of valvular regurgitation |
US9801720B2 (en) | 2014-06-19 | 2017-10-31 | 4Tech Inc. | Cardiac tissue cinching |
CN107072784B (zh) | 2014-06-24 | 2019-07-05 | 中峰医疗公司 | 用于锚固植入物的系统和方法 |
CN104055604B (zh) * | 2014-07-07 | 2016-06-01 | 宁波健世生物科技有限公司 | 一种带锚定装置的心脏瓣膜植入器械 |
CN104055605B (zh) * | 2014-07-07 | 2016-06-01 | 宁波健世生物科技有限公司 | 一种用于阻止瓣膜反流的假体 |
WO2016016899A1 (en) | 2014-07-30 | 2016-02-04 | Mitraltech Ltd. | Articulatable prosthetic valve |
ES2676060T3 (es) * | 2014-09-26 | 2018-07-16 | Nvt Ag | Dispositivo implantable para el tratamiento de la regurgitación de la válvula mitral |
EP3200726B1 (en) * | 2014-09-29 | 2023-07-05 | The Provost, Fellows, Foundation Scholars, & the other members of Board, of the College of the Holy & Undiv. Trinity of Queen Elizabeth near Dublin | A heart valve treatment device |
WO2016059639A1 (en) | 2014-10-14 | 2016-04-21 | Valtech Cardio Ltd. | Leaflet-restraining techniques |
US9750607B2 (en) | 2014-10-23 | 2017-09-05 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
US9750605B2 (en) | 2014-10-23 | 2017-09-05 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
WO2016087934A1 (en) | 2014-12-02 | 2016-06-09 | 4Tech Inc. | Off-center tissue anchors |
CN110141399B (zh) | 2015-02-05 | 2021-07-27 | 卡迪尔维尔福股份有限公司 | 带有轴向滑动框架的人工瓣膜 |
ES2877699T3 (es) | 2015-02-05 | 2021-11-17 | Tendyne Holdings Inc | Válvula cardiaca protésica con ligación y almohadilla epicárdica expandible |
US10105226B2 (en) | 2015-02-10 | 2018-10-23 | Edwards Lifesciences Corporation | Offset cardiac leaflet coaptation element |
US20160256269A1 (en) | 2015-03-05 | 2016-09-08 | Mitralign, Inc. | Devices for treating paravalvular leakage and methods use thereof |
AU2016233216B2 (en) | 2015-03-19 | 2020-08-20 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
CN114515173A (zh) | 2015-04-30 | 2022-05-20 | 瓦尔泰克卡迪欧有限公司 | 瓣膜成形术技术 |
CN107920895B (zh) | 2015-08-21 | 2020-06-26 | 托尔福公司 | 可植入心脏瓣膜装置、二尖瓣修复装置以及相关系统和方法 |
US9872765B2 (en) * | 2015-10-12 | 2018-01-23 | Venus Medtech (Hangzhou) Inc | Mitral valve assembly |
US9592121B1 (en) | 2015-11-06 | 2017-03-14 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
CN108992209B (zh) | 2015-11-06 | 2022-03-04 | 麦克尔有限公司 | 二尖瓣假体 |
WO2017100785A1 (en) | 2015-12-10 | 2017-06-15 | Mvrx, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
EP3184081B1 (en) * | 2015-12-22 | 2021-03-24 | Medira Ag | Prosthetic mitral valve coaptation enhancement device |
US10265166B2 (en) | 2015-12-30 | 2019-04-23 | Caisson Interventional, LLC | Systems and methods for heart valve therapy |
US10751182B2 (en) | 2015-12-30 | 2020-08-25 | Edwards Lifesciences Corporation | System and method for reshaping right heart |
US10828160B2 (en) | 2015-12-30 | 2020-11-10 | Edwards Lifesciences Corporation | System and method for reducing tricuspid regurgitation |
US10433952B2 (en) | 2016-01-29 | 2019-10-08 | Neovasc Tiara Inc. | Prosthetic valve for avoiding obstruction of outflow |
CN107019581B (zh) * | 2016-02-02 | 2021-07-16 | 中国人民解放军第二军医大学 | 一种升主动脉主动脉瓣一体化血管内支架 |
US10531866B2 (en) | 2016-02-16 | 2020-01-14 | Cardiovalve Ltd. | Techniques for providing a replacement valve and transseptal communication |
EP3448316B1 (en) * | 2016-04-29 | 2023-03-29 | Medtronic Vascular Inc. | Prosthetic heart valve devices with tethered anchors |
US10702274B2 (en) | 2016-05-26 | 2020-07-07 | Edwards Lifesciences Corporation | Method and system for closing left atrial appendage |
GB201611910D0 (en) | 2016-07-08 | 2016-08-24 | Valtech Cardio Ltd | Adjustable annuloplasty device with alternating peaks and troughs |
US20190231525A1 (en) | 2016-08-01 | 2019-08-01 | Mitraltech Ltd. | Minimally-invasive delivery systems |
CN109789018B (zh) | 2016-08-10 | 2022-04-26 | 卡迪尔维尔福股份有限公司 | 具有同轴框架的人工瓣膜 |
WO2018050203A1 (en) * | 2016-09-16 | 2018-03-22 | Coramaze Technologies Gmbh | Heart implant |
EP3541462A4 (en) | 2016-11-21 | 2020-06-17 | Neovasc Tiara Inc. | METHODS AND SYSTEMS FOR RAPID RETRACTION OF A TRANSCATHETER HEART VALVE DELIVERY SYSTEM |
EP3558164A1 (en) | 2016-12-21 | 2019-10-30 | Triflo Cardiovascular Inc. | Heart valve support device and methods for making and using the same |
KR20190137769A (ko) * | 2017-01-05 | 2019-12-11 | 하모니 디벨럽먼트 그룹 인코포레이티드 | 심실 기능 및 모델링을 실시하기 위한 역류성 분사, 체적, 및 힘을 포획하기 위한 팽창가능한 디바이스 |
US10675017B2 (en) | 2017-02-07 | 2020-06-09 | Edwards Lifesciences Corporation | Transcatheter heart valve leaflet plication |
US10682229B2 (en) | 2017-02-08 | 2020-06-16 | 4Tech Inc. | Post-implantation tensioning in cardiac implants |
WO2018160456A1 (en) | 2017-03-01 | 2018-09-07 | 4Tech Inc. | Post-implantation tension adjustment in cardiac implants |
US10478303B2 (en) | 2017-03-13 | 2019-11-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
JP7159230B2 (ja) | 2017-03-13 | 2022-10-24 | ポラレス・メディカル・インコーポレイテッド | 弁逆流の経カテーテル治療のためのデバイス、システム、および方法 |
US10653524B2 (en) | 2017-03-13 | 2020-05-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
CN106821548B (zh) * | 2017-04-01 | 2020-11-03 | 上海纽脉医疗科技有限公司 | 经导管人工二尖瓣成形环装置及系统 |
US10575950B2 (en) | 2017-04-18 | 2020-03-03 | Twelve, Inc. | Hydraulic systems for delivering prosthetic heart valve devices and associated methods |
US10433961B2 (en) | 2017-04-18 | 2019-10-08 | Twelve, Inc. | Delivery systems with tethers for prosthetic heart valve devices and associated methods |
US10702378B2 (en) | 2017-04-18 | 2020-07-07 | Twelve, Inc. | Prosthetic heart valve device and associated systems and methods |
US11045627B2 (en) | 2017-04-18 | 2021-06-29 | Edwards Lifesciences Corporation | Catheter system with linear actuation control mechanism |
US20180318082A1 (en) * | 2017-05-05 | 2018-11-08 | Edwards Lifesciences Corporation | Papillary muscle binding |
US10792151B2 (en) | 2017-05-11 | 2020-10-06 | Twelve, Inc. | Delivery systems for delivering prosthetic heart valve devices and associated methods |
US10646338B2 (en) | 2017-06-02 | 2020-05-12 | Twelve, Inc. | Delivery systems with telescoping capsules for deploying prosthetic heart valve devices and associated methods |
US10709591B2 (en) | 2017-06-06 | 2020-07-14 | Twelve, Inc. | Crimping device and method for loading stents and prosthetic heart valves |
CA3066361A1 (en) | 2017-06-07 | 2018-12-13 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
US10463482B2 (en) * | 2017-06-14 | 2019-11-05 | William Joseph Drasler | Free edge supported mitral valve |
US10940002B2 (en) | 2017-06-28 | 2021-03-09 | Harmony Development Group, Inc. | Force transducting inflatable implant system including a dual force annular transduction implant |
CN107320219A (zh) * | 2017-07-03 | 2017-11-07 | 中国人民解放军第二军医大学第二附属医院 | 主动脉根部用带瓣管道装置 |
US10729541B2 (en) | 2017-07-06 | 2020-08-04 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US10786352B2 (en) | 2017-07-06 | 2020-09-29 | Twelve, Inc. | Prosthetic heart valve devices and associated systems and methods |
US10765503B2 (en) * | 2017-07-31 | 2020-09-08 | Edwards Lifesciences Corporation | Bicuspid valve dissection device |
US11793633B2 (en) | 2017-08-03 | 2023-10-24 | Cardiovalve Ltd. | Prosthetic heart valve |
US12064347B2 (en) | 2017-08-03 | 2024-08-20 | Cardiovalve Ltd. | Prosthetic heart valve |
WO2019028264A1 (en) | 2017-08-03 | 2019-02-07 | The Regents Of The University Of California | AURICULAR CAGE FOR THE PLACEMENT, FASTENING AND ANCHORING OF ATRIOVENTRICULAR VALVES |
US11141145B2 (en) | 2017-08-25 | 2021-10-12 | Edwards Lifesciences Corporation | Devices and methods for securing a tissue anchor |
US10856984B2 (en) | 2017-08-25 | 2020-12-08 | Neovasc Tiara Inc. | Sequentially deployed transcatheter mitral valve prosthesis |
US11173032B2 (en) * | 2017-08-28 | 2021-11-16 | Edwards Lifesciences Corporation | Transcatheter device for treating mitral regurgitation |
US11065117B2 (en) * | 2017-09-08 | 2021-07-20 | Edwards Lifesciences Corporation | Axisymmetric adjustable device for treating mitral regurgitation |
US10835221B2 (en) | 2017-11-02 | 2020-11-17 | Valtech Cardio, Ltd. | Implant-cinching devices and systems |
US11511103B2 (en) | 2017-11-13 | 2022-11-29 | Shifamed Holdings, Llc | Intravascular fluid movement devices, systems, and methods of use |
US11135062B2 (en) | 2017-11-20 | 2021-10-05 | Valtech Cardio Ltd. | Cinching of dilated heart muscle |
US10799350B2 (en) | 2018-01-05 | 2020-10-13 | Edwards Lifesciences Corporation | Percutaneous implant retrieval connector and method |
CN210582753U (zh) | 2018-01-07 | 2020-05-22 | 苏州杰成医疗科技有限公司 | 用于输送瓣膜假体的输送系统 |
CN110013356B (zh) | 2018-01-07 | 2023-08-01 | 苏州杰成医疗科技有限公司 | 心脏瓣膜假体递送系统 |
WO2019144121A1 (en) | 2018-01-22 | 2019-07-25 | Edwards Lifesciences Corporation | Heart shape preserving anchor |
EP3743015A1 (en) | 2018-01-24 | 2020-12-02 | Valtech Cardio, Ltd. | Contraction of an annuloplasty structure |
WO2019145941A1 (en) | 2018-01-26 | 2019-08-01 | Valtech Cardio, Ltd. | Techniques for facilitating heart valve tethering and chord replacement |
CN112004563B (zh) | 2018-02-01 | 2024-08-06 | 施菲姆德控股有限责任公司 | 血管内血泵以及使用和制造方法 |
WO2019154927A1 (en) * | 2018-02-09 | 2019-08-15 | The Provost, Fellows, Foundation Scholars, And The Other Members Of Board, Of The College Of The Holy And Undivided Trinity Of Queen Elizabeth Near Dublin | A heart valve therapeutic device |
WO2019173385A1 (en) | 2018-03-05 | 2019-09-12 | Harmony Development Group, Inc. | A force transducting implant system for the mitigation of atrioventricular pressure gradient loss and the restoration of healthy ventricular geometry |
US11285003B2 (en) | 2018-03-20 | 2022-03-29 | Medtronic Vascular, Inc. | Prolapse prevention device and methods of use thereof |
US11026791B2 (en) | 2018-03-20 | 2021-06-08 | Medtronic Vascular, Inc. | Flexible canopy valve repair systems and methods of use |
US11389297B2 (en) | 2018-04-12 | 2022-07-19 | Edwards Lifesciences Corporation | Mitral valve spacer device |
US11007061B2 (en) | 2018-05-24 | 2021-05-18 | Edwards Lifesciences Corporation | Adjustable percutaneous heart valve repair system |
CR20210020A (es) | 2018-07-12 | 2021-07-21 | Valtech Cardio Ltd | Sistema de anuloplastía y herramientas de bloqueo para ello |
CN109106485B (zh) * | 2018-08-31 | 2020-02-07 | 高峰 | 保留主动脉瓣的跨瓣膜锚定装置 |
AU2019374743B2 (en) | 2018-11-08 | 2022-03-03 | Neovasc Tiara Inc. | Ventricular deployment of a transcatheter mitral valve prosthesis |
EP3886766A1 (en) | 2018-11-27 | 2021-10-06 | Boston Scientific Scimed Inc. | Systems and methods for treating regurgitating cardiac valves |
CN111248952A (zh) * | 2018-11-30 | 2020-06-09 | 杭州唯强医疗科技有限公司 | 一种用于主动脉瓣膜关闭不全的辅助封堵装置 |
CN109350310B (zh) * | 2018-12-14 | 2021-07-02 | 宁波健世科技股份有限公司 | 一种避免冠脉堵塞的瓣膜支架 |
EP3934591A4 (en) | 2019-03-08 | 2022-11-23 | Neovasc Tiara Inc. | RETRIEVABLE PROSTHETIC RELEASE SYSTEM |
JP7438236B2 (ja) | 2019-04-01 | 2024-02-26 | ニオバスク ティアラ インコーポレイテッド | 制御可能に展開可能な補綴弁 |
CA3136334A1 (en) | 2019-04-10 | 2020-10-15 | Neovasc Tiara Inc. | Prosthetic valve with natural blood flow |
CN109966024B (zh) * | 2019-04-26 | 2024-02-06 | 中国人民解放军第四军医大学 | 一种心脏动脉瓣返流测试器 |
EP3962397A1 (en) * | 2019-05-01 | 2022-03-09 | Materialise NV | System and method of fluid passageway cross-sectional area determination in an anatomy |
CN114025813B (zh) | 2019-05-20 | 2024-05-14 | 内奥瓦斯克迪亚拉公司 | 具有止血机构的引入器 |
US10842628B1 (en) | 2019-05-22 | 2020-11-24 | TriFlo Cardiovascular Inc. | Heart valve support device |
CN114144144A (zh) | 2019-06-20 | 2022-03-04 | 内奥瓦斯克迪亚拉公司 | 低轮廓假体二尖瓣 |
WO2021011473A1 (en) | 2019-07-12 | 2021-01-21 | Shifamed Holdings, Llc | Intravascular blood pumps and methods of manufacture and use |
WO2021016372A1 (en) | 2019-07-22 | 2021-01-28 | Shifamed Holdings, Llc | Intravascular blood pumps with struts and methods of use and manufacture |
WO2021024183A1 (en) | 2019-08-05 | 2021-02-11 | Croivalve Ltd. | Apparatus and methods for treating a defective cardiac valve |
US11724089B2 (en) | 2019-09-25 | 2023-08-15 | Shifamed Holdings, Llc | Intravascular blood pump systems and methods of use and control thereof |
AU2020375903A1 (en) | 2019-10-29 | 2021-12-23 | Edwards Lifesciences Innovation (Israel) Ltd. | Annuloplasty and tissue anchor technologies |
CN115916114A (zh) | 2020-05-20 | 2023-04-04 | 心脏植入物有限公司 | 通过独立控制发射到心脏瓣膜瓣环中的每个锚定件来减小瓣环的直径 |
US11464634B2 (en) | 2020-12-16 | 2022-10-11 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation with secondary anchors |
US11759321B2 (en) | 2021-06-25 | 2023-09-19 | Polares Medical Inc. | Device, system, and method for transcatheter treatment of valvular regurgitation |
CN115153678A (zh) * | 2022-06-23 | 2022-10-11 | 上海傲流医疗科技有限公司 | 一种瓣膜间隙封堵填充器及填充机构 |
Family Cites Families (135)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JPS4211278Y1 (zh) | 1964-11-11 | 1967-06-22 | ||
US3671979A (en) * | 1969-09-23 | 1972-06-27 | Univ Utah | Catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve |
US3689942A (en) † | 1969-11-28 | 1972-09-12 | Richard K Rapp | Prosthetic heart valve |
US3898701A (en) * | 1974-01-17 | 1975-08-12 | Russa Joseph | Implantable heart valve |
US4306319A (en) * | 1980-06-16 | 1981-12-22 | Robert L. Kaster | Heart valve with non-circular body |
US4407271A (en) | 1980-07-28 | 1983-10-04 | Peter Schiff | Apparatus for left heart assist |
US5397351A (en) | 1991-05-13 | 1995-03-14 | Pavcnik; Dusan | Prosthetic valve for percutaneous insertion |
US5167239A (en) | 1991-05-30 | 1992-12-01 | Endomedix Corporation | Anchorable guidewire |
US5332402A (en) | 1992-05-12 | 1994-07-26 | Teitelbaum George P | Percutaneously-inserted cardiac valve |
US6346074B1 (en) | 1993-02-22 | 2002-02-12 | Heartport, Inc. | Devices for less invasive intracardiac interventions |
ES2157918T3 (es) * | 1993-12-14 | 2001-09-01 | Sante Camilli | Una valvula percutanea implantable para su uso en vasos sanguineos. |
US5554184A (en) * | 1994-07-27 | 1996-09-10 | Machiraju; Venkat R. | Heart valve |
FR2728457B1 (fr) | 1994-12-21 | 1997-03-21 | Franceschi Claude | Valve artificielle pour vaisseau sanguin |
US5735842A (en) | 1995-09-11 | 1998-04-07 | St. Jude Medical, Inc. | Low profile manipulators for heart valve prostheses |
US6068623A (en) | 1997-03-06 | 2000-05-30 | Percusurge, Inc. | Hollow medical wires and methods of constructing same |
US6050972A (en) | 1996-05-20 | 2000-04-18 | Percusurge, Inc. | Guidewire inflation system |
NL1004827C2 (nl) * | 1996-12-18 | 1998-06-19 | Surgical Innovations Vof | Inrichting voor het reguleren van de bloedsomloop. |
EP0850607A1 (en) | 1996-12-31 | 1998-07-01 | Cordis Corporation | Valve prosthesis for implantation in body channels |
US5957949A (en) † | 1997-05-01 | 1999-09-28 | World Medical Manufacturing Corp. | Percutaneous placement valve stent |
EP2133030A1 (en) * | 1997-06-27 | 2009-12-16 | The Trustees of Columbia University of the City of New York | Method and apparatus for circulatory valve repair |
US6332893B1 (en) * | 1997-12-17 | 2001-12-25 | Myocor, Inc. | Valve to myocardium tension members device and method |
CN1210021A (zh) * | 1998-07-02 | 1999-03-10 | 天津大学形状记忆材料工程研究中心 | 拉网式自扩张支架 |
US6165183A (en) * | 1998-07-15 | 2000-12-26 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
US6425916B1 (en) | 1999-02-10 | 2002-07-30 | Michi E. Garrison | Methods and devices for implanting cardiac valves |
US7666204B2 (en) * | 1999-04-09 | 2010-02-23 | Evalve, Inc. | Multi-catheter steerable guiding system and methods of use |
US6752813B2 (en) * | 1999-04-09 | 2004-06-22 | Evalve, Inc. | Methods and devices for capturing and fixing leaflets in valve repair |
EP2078498B1 (en) | 1999-04-09 | 2010-12-22 | Evalve, Inc. | Apparatus for cardiac valve repair |
US6312464B1 (en) * | 1999-04-28 | 2001-11-06 | NAVIA JOSé L. | Method of implanting a stentless cardiac valve prosthesis |
SE514718C2 (sv) | 1999-06-29 | 2001-04-09 | Jan Otto Solem | Anordning för behandling av bristande tillslutningsförmåga hos mitralisklaffapparaten |
US7279007B2 (en) * | 1999-08-09 | 2007-10-09 | Cardioklnetix, Inc. | Method for improving cardiac function |
US6312447B1 (en) * | 1999-10-13 | 2001-11-06 | The General Hospital Corporation | Devices and methods for percutaneous mitral valve repair |
US6994092B2 (en) | 1999-11-08 | 2006-02-07 | Ev3 Sunnyvale, Inc. | Device for containing embolic material in the LAA having a plurality of tissue retention structures |
US7018406B2 (en) * | 1999-11-17 | 2006-03-28 | Corevalve Sa | Prosthetic valve for transluminal delivery |
US6458153B1 (en) † | 1999-12-31 | 2002-10-01 | Abps Venture One, Ltd. | Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof |
US20020128708A1 (en) * | 1999-12-09 | 2002-09-12 | Northrup William F. | Annuloplasty system |
US6402781B1 (en) * | 2000-01-31 | 2002-06-11 | Mitralife | Percutaneous mitral annuloplasty and cardiac reinforcement |
US7011682B2 (en) † | 2000-01-31 | 2006-03-14 | Edwards Lifesciences Ag | Methods and apparatus for remodeling an extravascular tissue structure |
US7322957B2 (en) | 2000-02-01 | 2008-01-29 | Harold D. Kletschka | Angioplasty device and method of making same |
US6797002B2 (en) * | 2000-02-02 | 2004-09-28 | Paul A. Spence | Heart valve repair apparatus and methods |
AU2001233227A1 (en) * | 2000-02-02 | 2001-08-14 | Robert V. Snyders | Artificial heart valve |
US20050070999A1 (en) * | 2000-02-02 | 2005-03-31 | Spence Paul A. | Heart valve repair apparatus and methods |
TR200202014T2 (tr) | 2000-02-18 | 2003-02-21 | E. V. R. Endovascular Researches S. A. | Genişleyebilen lümen içi protez konması, yerleştirilmesinin lümen içi cihazı |
US6454799B1 (en) * | 2000-04-06 | 2002-09-24 | Edwards Lifesciences Corporation | Minimally-invasive heart valves and methods of use |
US7083628B2 (en) | 2002-09-03 | 2006-08-01 | Edwards Lifesciences Corporation | Single catheter mitral valve repair device and method for use |
US6419695B1 (en) * | 2000-05-22 | 2002-07-16 | Shlomo Gabbay | Cardiac prosthesis for helping improve operation of a heart valve |
US6869444B2 (en) | 2000-05-22 | 2005-03-22 | Shlomo Gabbay | Low invasive implantable cardiac prosthesis and method for helping improve operation of a heart valve |
US6840246B2 (en) | 2000-06-20 | 2005-01-11 | University Of Maryland, Baltimore | Apparatuses and methods for performing minimally invasive diagnostic and surgical procedures inside of a beating heart |
US6358277B1 (en) * | 2000-06-21 | 2002-03-19 | The International Heart Institute Of Montana Foundation | Atrio-ventricular valvular device |
US6419696B1 (en) | 2000-07-06 | 2002-07-16 | Paul A. Spence | Annuloplasty devices and related heart valve repair methods |
SE0002878D0 (sv) * | 2000-08-11 | 2000-08-11 | Kimblad Ola | Device and method for treatment of atrioventricular regurgitation |
US8956407B2 (en) * | 2000-09-20 | 2015-02-17 | Mvrx, Inc. | Methods for reshaping a heart valve annulus using a tensioning implant |
US8784482B2 (en) * | 2000-09-20 | 2014-07-22 | Mvrx, Inc. | Method of reshaping a heart valve annulus using an intravascular device |
US6808483B1 (en) † | 2000-10-03 | 2004-10-26 | Paul A. Spence | Implantable heart assist devices and methods |
US6602288B1 (en) * | 2000-10-05 | 2003-08-05 | Edwards Lifesciences Corporation | Minimally-invasive annuloplasty repair segment delivery template, system and method of use |
US6482228B1 (en) * | 2000-11-14 | 2002-11-19 | Troy R. Norred | Percutaneous aortic valve replacement |
EP1363559A4 (en) * | 2001-02-05 | 2008-10-01 | Viacor Inc | APPARATUS AND METHOD FOR REDUCING MITRAL REGURGITATION |
US20020107531A1 (en) | 2001-02-06 | 2002-08-08 | Schreck Stefan G. | Method and system for tissue repair using dual catheters |
US7556646B2 (en) | 2001-09-13 | 2009-07-07 | Edwards Lifesciences Corporation | Methods and apparatuses for deploying minimally-invasive heart valves |
US6619291B2 (en) * | 2001-04-24 | 2003-09-16 | Edwin J. Hlavka | Method and apparatus for catheter-based annuloplasty |
KR100393548B1 (ko) * | 2001-06-05 | 2003-08-02 | 주식회사 엠아이텍 | 의료용 스텐트 |
FR2826863B1 (fr) * | 2001-07-04 | 2003-09-26 | Jacques Seguin | Ensemble permettant la mise en place d'une valve prothetique dans un conduit corporel |
US20030078654A1 (en) * | 2001-08-14 | 2003-04-24 | Taylor Daniel C. | Method and apparatus for improving mitral valve function |
KR100606183B1 (ko) | 2001-09-28 | 2006-08-01 | 가부시키가이샤 가네카 | 스텐트 딜리버리 카테터 |
JP4458845B2 (ja) | 2001-10-01 | 2010-04-28 | アンプル メディカル,インコーポレイテッド | 医療用デバイス |
US6893460B2 (en) * | 2001-10-11 | 2005-05-17 | Percutaneous Valve Technologies Inc. | Implantable prosthetic valve |
AU2002347900B8 (en) * | 2001-10-11 | 2006-01-12 | Emphasys Medical, Inc. | Bronchial flow control devices and methods of use |
GB0125925D0 (en) * | 2001-10-29 | 2001-12-19 | Univ Glasgow | Mitral valve prosthesis |
US7309350B2 (en) | 2001-12-03 | 2007-12-18 | Xtent, Inc. | Apparatus and methods for deployment of vascular prostheses |
US6978176B2 (en) † | 2001-12-08 | 2005-12-20 | Lattouf Omar M | Treatment for patient with congestive heart failure |
US20030120341A1 (en) | 2001-12-21 | 2003-06-26 | Hani Shennib | Devices and methods of repairing cardiac valves |
US6764510B2 (en) | 2002-01-09 | 2004-07-20 | Myocor, Inc. | Devices and methods for heart valve treatment |
US7004958B2 (en) * | 2002-03-06 | 2006-02-28 | Cardiac Dimensions, Inc. | Transvenous staples, assembly and method for mitral valve repair |
US8348963B2 (en) * | 2002-07-03 | 2013-01-08 | Hlt, Inc. | Leaflet reinforcement for regurgitant valves |
JP4808964B2 (ja) | 2002-08-01 | 2011-11-02 | ザ ジェネラル ホスピタル コーポレイション | 低侵襲的に虚血性僧帽弁閉鎖不全症を修復するための心臓デバイスおよび方法 |
US8172856B2 (en) * | 2002-08-02 | 2012-05-08 | Cedars-Sinai Medical Center | Methods and apparatus for atrioventricular valve repair |
EP1534146B1 (en) * | 2002-08-13 | 2008-01-23 | The General Hospital Corporation | Cardiac devices for percutaneous repair of atrioventricular valves |
US20040092858A1 (en) * | 2002-08-28 | 2004-05-13 | Heart Leaflet Technologies, Inc. | Leaflet valve |
CA2498030A1 (en) * | 2002-10-01 | 2004-04-15 | Ample Medical, Inc. | Devices, systems, and methods for reshaping a heart valve annulus |
AU2003277115A1 (en) | 2002-10-01 | 2004-04-23 | Ample Medical, Inc. | Device and method for repairing a native heart valve leaflet |
US7404824B1 (en) | 2002-11-15 | 2008-07-29 | Advanced Cardiovascular Systems, Inc. | Valve aptation assist device |
AU2003290979A1 (en) | 2002-11-15 | 2004-06-15 | The Government Of The United States Of America As Represented By The Secretary Of Health And Human Services | Method and device for catheter-based repair of cardiac valves |
US20040193259A1 (en) * | 2003-03-25 | 2004-09-30 | Shlomo Gabbay | Sizing apparatus for cardiac prostheses and method of using same |
US7175656B2 (en) * | 2003-04-18 | 2007-02-13 | Alexander Khairkhahan | Percutaneous transcatheter heart valve replacement |
DE602004023350D1 (de) | 2003-04-30 | 2009-11-12 | Medtronic Vascular Inc | Perkutaneingesetzte provisorische Klappe |
US20040225233A1 (en) | 2003-05-09 | 2004-11-11 | Frankowski Brian J. | Magnetic guidewires |
US8052751B2 (en) * | 2003-07-02 | 2011-11-08 | Flexcor, Inc. | Annuloplasty rings for repairing cardiac valves |
US7201772B2 (en) * | 2003-07-08 | 2007-04-10 | Ventor Technologies, Ltd. | Fluid flow prosthetic device |
BRPI0412362A (pt) * | 2003-07-08 | 2006-09-05 | Ventor Technologies Ltd | dispositivos para implante protéticos particularmente para transporte transarterial no tratamento das estenoses aórticas e métodos para implantação para tais dispositivos |
WO2005007036A1 (en) | 2003-07-18 | 2005-01-27 | Brivant Research & Development Limited | A device for correcting inversion of the leaflets of a leaflet valve in the heart |
US7040733B2 (en) * | 2003-07-28 | 2006-05-09 | Colin Chee Chong Hin | Determining a position of an optical sensor associated with a printhead relative to a print media |
US7160322B2 (en) * | 2003-08-13 | 2007-01-09 | Shlomo Gabbay | Implantable cardiac prosthesis for mitigating prolapse of a heart valve |
US20050038509A1 (en) * | 2003-08-14 | 2005-02-17 | Ashe Kassem Ali | Valve prosthesis including a prosthetic leaflet |
WO2005027797A1 (en) | 2003-09-23 | 2005-03-31 | Ersin Erek | A mitral web apparatus for mitral valve insufficiencies |
US20050075729A1 (en) * | 2003-10-06 | 2005-04-07 | Nguyen Tuoc Tan | Minimally invasive valve replacement system |
US7070616B2 (en) | 2003-10-31 | 2006-07-04 | Cordis Corporation | Implantable valvular prosthesis |
US7166127B2 (en) * | 2003-12-23 | 2007-01-23 | Mitralign, Inc. | Tissue fastening systems and methods utilizing magnetic guidance |
US20050228495A1 (en) * | 2004-01-15 | 2005-10-13 | Macoviak John A | Suspended heart valve devices, systems, and methods for supplementing, repairing, or replacing a native heart valve |
EP3308744B2 (en) † | 2004-03-11 | 2023-08-02 | Percutaneous Cardiovascular Solutions Pty Limited | Percutaneous heart valve prosthesis |
US7678129B1 (en) | 2004-03-19 | 2010-03-16 | Advanced Cardiovascular Systems, Inc. | Locking component for an embolic filter assembly |
US20090069885A1 (en) | 2004-05-14 | 2009-03-12 | Rahdert David A | Devices, systems, and methods for reshaping a heart valve annulus |
US7815580B2 (en) | 2004-09-07 | 2010-10-19 | Stereotaxis, Inc. | Magnetic guidewire for lesion crossing |
CA2580053C (en) * | 2004-09-14 | 2014-07-08 | Edwards Lifesciences Ag. | Device and method for treatment of heart valve regurgitation |
US20070219630A1 (en) | 2004-11-24 | 2007-09-20 | Xi Chu | Devices and Methods for Beating Heart Cardiac Surgeries |
US20060178700A1 (en) | 2004-12-15 | 2006-08-10 | Martin Quinn | Medical device suitable for use in treatment of a valve |
US20070032850A1 (en) * | 2004-12-16 | 2007-02-08 | Carlos Ruiz | Separable sheath and method for insertion of a medical device into a bodily vessel using a separable sheath |
US20100298929A1 (en) | 2005-02-07 | 2010-11-25 | Thornton Troy L | Methods, systems and devices for cardiac valve repair |
DE602006013946D1 (de) | 2005-02-08 | 2010-06-10 | Koninkl Philips Electronics Nv | System zur perkutanen glossoplastik |
US7320665B2 (en) | 2005-03-02 | 2008-01-22 | Venkataramana Vijay | Cardiac Ventricular Geometry Restoration Device and Treatment for Heart Failure |
SE531468C2 (sv) | 2005-04-21 | 2009-04-14 | Edwards Lifesciences Ag | En anordning för styrning av blodflöde |
US7854762B2 (en) | 2005-05-20 | 2010-12-21 | Mayo Foundation For Medical Education And Research | Devices and methods for reducing cardiac valve regurgitation |
US7780723B2 (en) | 2005-06-13 | 2010-08-24 | Edwards Lifesciences Corporation | Heart valve delivery system |
US8778017B2 (en) | 2005-10-26 | 2014-07-15 | Cardiosolutions, Inc. | Safety for mitral valve implant |
US8216302B2 (en) | 2005-10-26 | 2012-07-10 | Cardiosolutions, Inc. | Implant delivery and deployment system and method |
US7785366B2 (en) | 2005-10-26 | 2010-08-31 | Maurer Christopher W | Mitral spacer |
US8449606B2 (en) | 2005-10-26 | 2013-05-28 | Cardiosolutions, Inc. | Balloon mitral spacer |
US8092525B2 (en) | 2005-10-26 | 2012-01-10 | Cardiosolutions, Inc. | Heart valve implant |
US9259317B2 (en) | 2008-06-13 | 2016-02-16 | Cardiosolutions, Inc. | System and method for implanting a heart implant |
US7632308B2 (en) * | 2005-11-23 | 2009-12-15 | Didier Loulmet | Methods, devices, and kits for treating mitral valve prolapse |
WO2007078772A1 (en) | 2005-12-15 | 2007-07-12 | The Cleveland Clinic Foundation | Apparatus and method for treating a regurgitant valve |
EP1959866B1 (en) * | 2005-12-15 | 2019-03-06 | Georgia Tech Research Corporation | Papillary muscle position control devices and systems |
US7955380B2 (en) | 2006-03-17 | 2011-06-07 | Medtronic Vascular, Inc. | Prosthesis fixation apparatus and methods |
ATE441356T1 (de) | 2006-04-19 | 2009-09-15 | Transpid Ltd | Gerät zur kontrollierten blutregurgitation durch die trikuspidalklappe |
US8932348B2 (en) * | 2006-05-18 | 2015-01-13 | Edwards Lifesciences Corporation | Device and method for improving heart valve function |
US20070282429A1 (en) * | 2006-06-01 | 2007-12-06 | Hauser David L | Prosthetic insert for improving heart valve function |
US8133213B2 (en) | 2006-10-19 | 2012-03-13 | Direct Flow Medical, Inc. | Catheter guidance through a calcified aortic valve |
WO2009092782A1 (en) | 2008-01-25 | 2009-07-30 | Jenavalve Technology Inc. | Medical apparatus for the therapeutic treatment of an insufficient cardiac valve |
US8591460B2 (en) | 2008-06-13 | 2013-11-26 | Cardiosolutions, Inc. | Steerable catheter and dilator and system and method for implanting a heart implant |
US20110077733A1 (en) | 2009-09-25 | 2011-03-31 | Edwards Lifesciences Corporation | Leaflet contacting apparatus and method |
US8845717B2 (en) | 2011-01-28 | 2014-09-30 | Middle Park Medical, Inc. | Coaptation enhancement implant, system, and method |
US8888843B2 (en) | 2011-01-28 | 2014-11-18 | Middle Peak Medical, Inc. | Device, system, and method for transcatheter treatment of valve regurgitation |
WO2013016618A2 (en) | 2011-07-27 | 2013-01-31 | The Cleveland Clinic Foundation | Apparatus, system, and method for treating a regurgitant heart valve |
EP3508173A1 (en) | 2012-05-16 | 2019-07-10 | Edwards Lifesciences Corporation | Systems for placing a coaptation member between valvular leaflets |
US9474605B2 (en) | 2012-05-16 | 2016-10-25 | Edwards Lifesciences Corporation | Devices and methods for reducing cardiac valve regurgitation |
US9289297B2 (en) | 2013-03-15 | 2016-03-22 | Cardiosolutions, Inc. | Mitral valve spacer and system and method for implanting the same |
US9232998B2 (en) | 2013-03-15 | 2016-01-12 | Cardiosolutions Inc. | Trans-apical implant systems, implants and methods |
-
2007
- 2007-05-31 US US11/756,530 patent/US20070282429A1/en not_active Abandoned
- 2007-05-31 AU AU2007266448A patent/AU2007266448B2/en active Active
- 2007-05-31 CN CN2007800202603A patent/CN101484093B/zh active Active
- 2007-05-31 WO PCT/US2007/070141 patent/WO2007140470A2/en active Application Filing
- 2007-05-31 EP EP07811990.6A patent/EP2032080B1/en active Active
- 2007-05-31 CN CN201110206268.7A patent/CN102283721B/zh active Active
- 2007-05-31 EP EP17000717.3A patent/EP3241525B2/en active Active
- 2007-05-31 CA CA2652471A patent/CA2652471C/en active Active
-
2012
- 2012-04-04 US US13/439,336 patent/US8968395B2/en active Active
-
2015
- 2015-03-02 US US14/636,011 patent/US20150173900A1/en not_active Abandoned
- 2015-12-08 US US14/963,149 patent/US9579199B2/en active Active
-
2017
- 2017-02-27 US US15/443,289 patent/US10441423B2/en active Active
-
2019
- 2019-10-04 US US16/593,360 patent/US10583009B2/en active Active
-
2020
- 2020-02-27 US US16/803,455 patent/US10799361B2/en active Active
- 2020-09-22 US US17/028,719 patent/US11141274B2/en active Active
-
2021
- 2021-10-07 US US17/496,649 patent/US11839545B2/en active Active
Also Published As
Publication number | Publication date |
---|---|
EP3241525A1 (en) | 2017-11-08 |
AU2007266448A1 (en) | 2007-12-06 |
US20160089239A1 (en) | 2016-03-31 |
US10583009B2 (en) | 2020-03-10 |
US20120191182A1 (en) | 2012-07-26 |
CN101484093A (zh) | 2009-07-15 |
CA2652471A1 (en) | 2007-12-06 |
US20150173900A1 (en) | 2015-06-25 |
US8968395B2 (en) | 2015-03-03 |
US20200030084A1 (en) | 2020-01-30 |
US20210015608A1 (en) | 2021-01-21 |
US9579199B2 (en) | 2017-02-28 |
EP3241525B1 (en) | 2019-04-24 |
EP3241525B2 (en) | 2022-06-08 |
WO2007140470A2 (en) | 2007-12-06 |
US11839545B2 (en) | 2023-12-12 |
CN101484093B (zh) | 2011-09-07 |
EP2032080A2 (en) | 2009-03-11 |
EP2032080B1 (en) | 2017-05-03 |
US20170165055A1 (en) | 2017-06-15 |
AU2007266448B2 (en) | 2013-07-18 |
CN102283721A (zh) | 2011-12-21 |
US11141274B2 (en) | 2021-10-12 |
US20200197173A1 (en) | 2020-06-25 |
WO2007140470A3 (en) | 2008-03-13 |
US10441423B2 (en) | 2019-10-15 |
US10799361B2 (en) | 2020-10-13 |
US20220023033A1 (en) | 2022-01-27 |
CA2652471C (en) | 2014-09-09 |
US20070282429A1 (en) | 2007-12-06 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
CN102283721B (zh) | 用于改善心瓣膜功能的人工插入物 | |
JP2021178225A (ja) | 患者の心臓の移植部位で弁プロテーゼを位置決めし固定するためのステント | |
AU2005234793B2 (en) | Implantable prosthetic valve | |
CN102438546B (zh) | 人工心脏瓣膜 | |
JP4403183B2 (ja) | 置換心臓弁の経カテーテル送達 | |
JP2020531189A (ja) | 僧帽弁逆流を治療するための径カテーテルデバイス | |
JP2018528810A (ja) | 埋込可能な心臓弁デバイス、僧帽弁修復デバイス、ならびに関連するシステム及び方法 | |
JP2016519973A (ja) | 埋込可能な心臓弁デバイス、僧帽弁修復デバイス、および関連するシステムおよび方法 | |
AU2017204546B2 (en) | Prosthetic insert for improving heart valve function |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
C06 | Publication | ||
PB01 | Publication | ||
C10 | Entry into substantive examination | ||
SE01 | Entry into force of request for substantive examination | ||
C14 | Grant of patent or utility model | ||
GR01 | Patent grant |