CN106535820A - System and method for heart valve anchoring - Google Patents
System and method for heart valve anchoring Download PDFInfo
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- CN106535820A CN106535820A CN201580037981.XA CN201580037981A CN106535820A CN 106535820 A CN106535820 A CN 106535820A CN 201580037981 A CN201580037981 A CN 201580037981A CN 106535820 A CN106535820 A CN 106535820A
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- driver
- ring
- applicator
- arm
- anchoring piece
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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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
-
- 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
- A61F2/243—Deployment by mechanical expansion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0409—Instruments for applying suture anchors
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0427—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body
- A61B2017/0437—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having anchoring barbs or pins extending outwardly from the anchor body the barbs being resilient or spring-like
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0464—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors for soft tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
-
- 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
- A61F2/2448—D-shaped rings
-
- 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)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Surgery (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Mechanical Engineering (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Prostheses (AREA)
Abstract
A system and method for percutaneous heart valve replacement includes implanting a heart valve replacement prosthetic into tissue and driving anchors into the heart valve replacement to affix the prosthetic to the tissue.
Description
Cross-Reference to Related Applications
This application claims the U.S. Provisional Patent Application Serial No. 62/010,680 submitted on June 11st, 2014 is preferential
Weigh, and this application is incorporated herein by reference in their entirety.
Additionally, each in following is incorporated herein by reference in their entirety：The United States Patent (USP) submitted on July 1st, 2014
Patent application serial numbers 14/321,476, the U.S. Patent Application Serial Number 14/301,106 submitted on June 10th, 2014, in 2013
The U.S. Patent Application Serial Number 13/843,930 of on March 15, in submission, the PCT application submitted on March 17th, 2014
No.PCT/US14/30868, on January 20th, 2011 submit to U.S. Patent Application Serial Number 13/010,769, in 2010 1
The U.S. Provisional Patent Application Serial No. 61/296,868 of the submission of the moon 20, the United States Patent (USP) Shen submitted on January 20th, 2011
Please serial number 13/010,766, the U.S. Patent Application Serial Number 13/010,777, Yi Jiyu submitted on January 20th, 2011
The U.S. Patent Application Serial Number 13/010,774 that on January 20th, 2011 submits to.
Technical field
The present invention relates to the system and method for percutaneous heart valve displacement, which includes anchoring cardiac valve replacement thing
(anchoring) in tissue.
Background technology
Have been developed for cardiac valve replacement thing to resist due to heart valve regurgitation (regurgitation) (that is, heart
The failure that valve is correctly closed) or due to the heart of valvular stenosiss (that is, the failure that cardiac valve is correctly opened)
Valve failure.Although the early efforts made in heart valve repair and displacement include open surgery, recently
Development include percutaneous surgery application.
However, percutaneous heart valve reparation has shown that some shortcomings.For example, percutaneous reparation is related to the surgical operation improved
Technology, this can limit the benefit of the process.Annular ring can lack effectiveness, and including erosion, perforation and coronary artery thrombosises
The risk of formation.It can be technically harsh that edge-to-edge repairs (edge-to-edge repair), and can lack
Long durability.According to specific valve failure, the combination of different recovery techniques can be required, and this makes the process further
Complicate and limit its effectiveness.
By contrast, cardiac valve replacement has been provided for some advantages, limits the risk related to heart valve repair,
And it is applied to the wider patient of scope.However, the open surgery solution for cardiac valve replacement gives trouble
Person brings significant risk.Accordingly, it would be desirable to less invasive percutaneous heart valve displacement.
Existing percutaneous solution includes United States Patent (USP) No.7,621,948, that patent describes the heart being percutaneously inserted
Valve prosthesis, which is may be folded in conduit to be delivered to implantation position.Can be from U.S. Patent Application Publication No.2013/0144378
Described in CardiAQ Valve Technologies, Inc obtains another kind of percutaneous solution.Other percutaneous artificial valve
Including Neovasc Tiara, Valtech Cardiovalve, ValveXchange, Lutter Valve and from
The valve of Medtronic, Inc. and Edwards Lifesciences Corporation.
In percutaneous heart valve displacement is provided, challenge includes providing following implants：The implant is collapsible into conduit
In for delivering, and can be from conduit out being suitably fitted in implant site and serve as valve.Therefore, plant
Enter valve and must be small enough that to fold in conduit, but in implantation must the sufficiently large function to provide valve, and not
Obstruction ventricle stream is arrived greatly can.
Additionally, cardiac valve implant is fixed to into implant site can be challenging to, because implant site can shape
Into irregularly shaped, calcium can be lacked and carry out secure valve, or can cause to be difficult to correctly be orientated fixation implant valve.
Need percutaneous heart valve solution fully and to efficiently solve these challenges.
The content of the invention
Some exemplaries of the invention, there is provided for by cardiac valve replacement prosthesis delivery, implantation
With the device for being fixed to tissue.Described device can include ring, and the ring can be sufficiently flexible to fold into little space (for example
The chamber of conduit) in.The ring can be elastic, to be expanded after its folding position release from conduit automatically.Planting
In the case of entering the irregular shaping in position, the elasticity of the ring allows ring to form the shape of implant site.Described device can be with
Comprising the one or more foliation structures (leaflet) for being connected to the ring, the foliation structure effectively stops fluid edge
Flow and fluid is allowed along second fluid flowing direction flowing in first fluid flowing direction.
The system of the present invention can include applicator (applicator), and the applicator includes applicator axle (shaft), institute
Applicator axle is stated through ring and is terminated in one or more elastic arms (spring arm) in its distal end.The elastic arm
The distal end of applicator axle can be connected so that elastic arm applies spring force to the ring, so as to ring is radially outward promoted.Each bullet
Property arm is individually connected to the ring so that in the case of multiple elastic arms, each elastic arm can be each to irregularly shaped
Implant site make individually response, it is allowed to the ring forms the shape of the implant site, and is prosthetic heart valve
More preferable bearing (seat) is provided.
Prosthese can be for example by conduit dermal delivery to implant site, and wherein, prosthese is collapsible in conduit.When being delivered to
During implant site, prosthese can be pushed through the distal end of conduit so that allow ring extension.Then, prosthese can be implanted to
In implant site, wherein, the elasticity of ring and independent elastic arm allows prosthese to form any irregularly shaped of implant site.
Once implantation, in an exemplary of the present invention, driver (driver) can be used to drive anchoring
Part (anchor) passes through ring, and in the tissue of implant site, so as to prosthese to be fixed to the tissue of implant site.Driver
May be configured to for one or more anchoring pieces to be driven into the one or more positions around ring, and can be according to each elasticity
The driving indexing that arm makes.Once prosthese has been secured to implant site, then applicator can be recalled, makes prosthese in position.Prosthese
Can be with the less width of the width or diameter than implant site or diameter so that once anchoring piece has been driven to implantation
In the surrounding tissue at position, then the tissue of implant site can be pulled to less prosthese, to meet the external shape of prosthese.
By this way, artificial valve can be firmly-fixed to implant site, more efficiently and effectively to improve valve
Function.Prosthese can adopt various shapes.Shape for the prosthese of application-specific can be needed based on the particular geometric of application-specific
To select.
Some exemplaries of the invention, surgery device include applicator, and the applicator has
Applicator axle, the applicator axle pass through ring and terminate at one or more elastic arms (elastic arm will apply
The distal end of device axle is connected to ring) distal end so that the proximal force for being applied to applicator axle is passed to one or more elasticity
Arm is simultaneously transferred to flexible ring (pliable ring)；And driver, the driver has guide member (guide) and at least one
Individual percussion arm (firing arm), the guide member are circlewise located at around the applicator axle, and the percussion arm is comprising at least
One anchoring piece outlet, driver constructions are into sliding between proximal location and remote location along applicator axle, wherein described
At least one percussion arm is articulated and connected (hinged communication) with driver Jing so that in the near-end position of driver
Put, at least one anchoring piece outlet in parallel with applicator axle, and in the remote location of driver, described at least one
Anchoring piece outlet is pointed at flexible ring, and driver constructions are into applying driving force with by anchoring piece at least one anchoring piece
It is driven in flexible ring.
Artificial valve can by catheter delivery to implant site, once during flexible ring is folded to insert conduit and from leading
The distal end of pipe is pushed out just expansible.Artificial valve can be implanted at implant site, and driver may be configured to drive anchor
Firmware is at least partially through ring and in the tissue around implant site.
Anchoring piece can include distal end and rods, and the distal end tapers are to the distal tip for being configured to puncture tissue
(distal tip)；At least one barb (barb), the barb is from distal end is with proximad and radially outer mode is extended to
Free end, the barb include radially-outer surface and inner radial surface；And rods, the rods prolong from distal end proximad
Stretch, the rods are flexible relative at least one barb and distal tip.Rods are may be configured to by coordinating
The power that is applied on anchoring piece and flexing (flex).At least one anchoring piece may be configured to tissue engage (engage) and
Prevent near-end motion (proximal movement).
Driver may be configured to rotate around applicator axle, and be also configured to the driving indexing made according to each elastic arm
(index)。
Applicator by applying distal force to applicator axle releasing the engagement of the elastic arm and the flexible ring, and
Apply proximal force to applicator axle to remove from artificial valve so that applicator is pulled through artificial valve proximally.
Percussion arm can be hinged to driver in the proximal end of percussion arm, or can be hinged in the far-end of percussion arm
Driver.
Some exemplaries of the invention, surgery device include the driver with distal end；With drive
At least one percussion arm that the distal end Jing of dynamic device is articulated and connected, each percussion arm are exported comprising at least one anchoring piece, and each swashs
Send out utensil have retracted position and firing position, the retracted position parallel to driver, and fire arm firing position by
Near-end and radially outward guide；Guide member in the driver；And firing lock (firing mechanism), institute
State firing lock to be connected to guide member and be configured to come along the near-end and radially outward direction transmission for firing arm in firing position
The power of self-aiming part.
Some exemplaries of the invention, surgery device are included：Flexible ring, the flexible ring is can
It is during (collapsible) for turning up is used for inserting conduit and expansible after stretching out from conduit；Applicator, the applying utensil
There are one or more elastic arms, the elastic arm is configured to exert a force on ring so that ring is encompassed and tissue attachment
(apposition)；And driver, with least one percussion arm, the percussion arm is configured at least one the driver
Individual anchoring piece be driven into ring and tissue in so that ring is fixed to tissue.Elastic arm is also configured to make the profile of ring and surrounding tissue
It is consistent.When at least one anchoring piece being driven into driver ring and tissue so that ring is fixed to tissue, elastic arm can
Exert a force on ring.
Surgery device can include applicator axle, and the applicator axle passes through ring and terminates at the distal end of applicator axle
It is connected in one or more elastic arms of ring so that apply to the proximal force of applicator axle to be passed to one or more
Elastic arm is simultaneously transferred to flexible ring, and fires arm and can be articulated and connected with driver Jing, and the percussion arm has percussion arm and applies
Plus the parallel retracted position of device axle and percussion arm are pointed at the firing position of ring.
Driver can include multiple percussion arms, and the plurality of percussion arm can fire multiple anchoring pieces simultaneously.
Firing position can be perpendicular to applicator axle.Firing position also can be with retracted position into less than 90 degree.
Percussion arm can be hinged to driver in the proximal end of percussion arm, or can be hinged to drive in the far-end of percussion arm
Dynamic device.
With reference to the accompanying drawings other features and aspect of some exemplaries of the present invention are carried out in more detail
Description.
Brief description
Fig. 1 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 2 is cardiac valve replacement prosthese, applicator axle and the elasticity of an exemplary of the invention
The diagram of arm.
Fig. 3 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 4 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 5 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 6 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 7 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 8 is the cardiac valve replacement prosthese of an exemplary of the invention, applicator axle, elastic arm
With the diagram of driver.
Fig. 9 is the diagram of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 10 is the diagram of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 11 is the diagram of the anchoring piece of an exemplary of the invention.
Figure 12 is the diagram of the anchoring piece of an exemplary of the invention.
Figure 13 is the diagram of the driver of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 14 is the section of the driver of the cardiac valve replacement prosthese of an exemplary of the invention
The diagram of figure.
Figure 15 is the diagram of the driver of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 16 is the section of the driver of the cardiac valve replacement prosthese of an exemplary of the invention
The diagram of figure.
Figure 17 is the diagram of the driver of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 18 is the section of the driver of the cardiac valve replacement prosthese of an exemplary of the invention
The diagram of figure.
Figure 19 is the diagram of the driver of the cardiac valve replacement prosthese of an exemplary of the invention.
Figure 20 is the section of the driver of the cardiac valve replacement prosthese of an exemplary of the invention
The diagram of figure.
Detailed description of the invention
Illustrate in greater detail below, some exemplaries of the present invention are allowed reliably and effectively to deliver, planted
Enter and fix cardiac valve replacement prosthese so that prosthese can efficiently solve cardiac valve failure.
Fig. 1 presents an exemplary of the present invention.Fig. 1 shows that the cardiac valve replacement with ring 10 is false
Body 1, the ring 10 can be elastic in an exemplary embodiment.Fig. 1 also show applicator 20, the applicator
20 have applicator axle 21 and elastic arm 22.Elastic arm 22 can be fixed to the distal end of applicator axle 21 and can be by applicator
The distal end of axle 21 is connected to the ring 10 of replacement prosthesises 1.Fig. 1 further illustrates driver as will be described in more detail below
40。
As being generally understood that, for example, such as United States Patent (USP) No.7, described by 621,948 and entire contents are by drawing
With being expressly incorporated herein (such as full disclosure herein), the replacement prosthesises 1 of the present invention can be delivered to implanting portion by following manner
Position：First replacement prosthesises 1 are turned up or folding position so that prosthese is assemblied in the intracavity of conduit.Including turning up or roll over
The conduit of folded prosthese is percutaneously advanced to implant site.Once the distal end of conduit, then can be by conduit adjacent to implant site
The prosthese that distal end promotes or compressing has been turned up.
Cardiac valve replacement prosthese 1 can be by flexible, elastomeric material (such as deformable plastics or Nitinol (nitinol))
Formed so that once the prosthese turned up occurs from the distal end of conduit, ring 10 can be returned resiliently to not turn up or expand shape
Into as illustrated in Fig. 1 to Figure 10.Prosthese 1 comprising ring 10 can be manipulated in implant site, wherein it is possible to prosthese 1 is being planted
Press in place in entering position.
As further illustrated in Fig. 1 to Figure 10, the ring 10 in an exemplary of the present invention can be in implantation
The shape at position, which can be irregular shape (for example, non-circular).Some the exemplary realities illustrated in Fig. 1 to Figure 10
Apply in scheme, ring 10 is formed as non-circular irregular shape.By this way, cardiac valve replacement prosthese of the invention can be fitted
For various implant sites, to solve a variety of cardiac valve failures.
As shown in Fig. 2 cardiac valve replacement prosthese 1 is also comprising the foliation structure 30 for performing valvular function.Foliation structure 30
Ring 10 is connected to, and is further held in place by by valve pillar 31.Foliation structure 30 is configured to prevent fluid edge
Flow and fluid is allowed along second fluid flowing direction flowing in first fluid flowing direction.
Fig. 2 to Fig. 8 shows an exemplary of the tissue that replacement prosthesises 1 are fixed to implant site.
As shown in Figure 2, from ductal ectasia, wherein, ring 10 is in almost fully expanded formation to replacement prosthesises 1.Applicator
Proximally direction extends through ring 10 and extends to the distal side of ring 10 axle 21.Elastic arm 22 is connected to the remote of applicator axle 21
End so that the distal end of applicator axle 21 forms the summit that the axis for surrounding applicator axle 21 by elastic arm 22 forms cone shape.
Once being delivered to implant site, applicator axle 21 can be used to press ring 10 by proximally pulling applicator axle 21
To in the tissue of implant site so that power is proximally passed to elastic arm 22, this is further in proximal direction and radial direction side
Upwards to 10 applying power of ring.Because elastic arm includes spring element 23, such as spring or spring band, each elastic arm are flexible
With independently of other elastic arm absorbing powers.By this way, ring 10 can also be realized irregularly shaped to meet any implantation group
The shape knitted.Fig. 2 to Fig. 8 shows the various elastic arms 22 to extend in various degree or compress.
As shown in Figure 3, once prosthese 1 is in place at implant site, driver 40 can activated to fasten ring 10
To the tissue of implant site.Driver 40 includes percussion arm 41 and guide member 43, and the percussion arm 41 has anchoring piece outlet 42.
Driver 40 can be operable to along applicator axle 21 slide or otherwise move.Guide member 43 and percussion arm 41 can be located at
The opposite side of applicator axle 21, as shown in Figure 3.
As shown in Figure 4, driver 40 is moved to the distal end of applicator axle 21, wherein applicator axle 21 and 22 phase of elastic arm
Meet.
As shown in Figure 5, fire arm 41 be configured to from the position being aligned with the axis limited by applicator axle 21 rotate to
Radially away from the position of applicator axle 21 so that ring 10 is pointed in the anchoring piece outlet 42 of percussion arm.
As shown in Figure 6, fire arm 41 to may be configured to drive anchoring piece 50 by anchoring piece outlet 42.Anchoring piece 50 can be with
It is driven through ring 10 and in the surrounding tissue of implant site, so that ring 10 is fixed or is fastened to the group of implant site
Knit.
As shown in Figure 7, once anchoring piece 50 is driven in ring 10 and surrounding tissue, then firing arm 41 can rotate back to
To being aligned with the axis limited by applicator axle 21 so that driver 40 can be retracted from the distal end of applicator axle 20, in such as Fig. 8
It is shown.
In an exemplary of the present invention, the driving of anchoring piece 50 can be by driver 40 and percussion arm 41
Repeat, anchoring piece 50 is driven to surround ring 10.Multiple anchoring pieces 50 can be loaded in the box or disk of anchoring piece so that attached
Plus anchoring piece can be loaded in place to be driven in ring 10 and surrounding tissue.Driver 40 may indicate that and drive each anchoring piece
The position of 50 to the periphery around ring 10 each elastic arm 22.In replacement scheme, applicator axle 21 can have groove or other
Labelling, driver 40 may indicate that and drive each anchoring piece 50.
As shown in Figure 9, cardiac valve replacement prosthese 1 is illustrated separately, lacks applicator 20, driver 40 or anchoring piece
50。
Figure 10 show driver 40 completed around the periphery of ring 10 drive multiple anchoring pieces 50 after and enter one
Walk the cardiac valve replacement prosthese 1 after the applicator 20 comprising applicator axle 21 and elastic arm 22 has been pumped out.In order to take out
Go out applicator 20, applicator axle 21 distally can be moved, and elastic arm 22 is further extended over the distal end of ring 10
Side, and allow the pyramidal structure formed by elastic arm 22 to turn up.Once turning up, elastic arm 22 can be allowed in applicator axle 21
Extraction in the case of pass through ring 10 so that whole applicator 20 can be extracted out from implant site.
Anchoring piece 50 can be on January 20th, 2010 submit to U.S. Provisional Patent Application No.61/296,868, in
The U.S. Patent Application Serial Number 13/010,766 of the submission of on January 20th, 2011, the United States Patent (USP) submitted on March 14th, 2013
Patent application serial numbers 13/828,256, on March 15th, 2013 submit to U.S. Patent Application Serial Number 13/843,930 and in
The U.S. Patent Application Serial Number 14/301 that on June 10th, 2014 submits to, any one anchoring piece described in 106, which each leads to
Cross reference to be integrally incorporated herein such as full disclosure herein.
For example, Figure 11 shows the anchoring piece or implant 200 for being configured to be driven in tissue.Anchoring piece 200 is included
Corrugated bodies (corrugated body) 201.The groove that body 201 axially extends comprising the length along body 201
203.Therefore, extend circumferentially over upon around body 201, multiple grooves 203 are replaced with multiple spines 205.Additionally, anchoring piece body 201
Comprising paired alar part or division portion (split portion) 207 and 208.Division portion 207 and 208 by the portion of division accordingly or
Otch 209 is formed in body 201.Thus, division portion 209 by making the otch of radial direction in body 201 and can make
Otch extends in the axial direction and is formed.Therefore, two division portions 207 and 208 be connected to body 201 positioned at remote location
The remainder at place, and proximally extend to free end.Free end includes the multiple sharp projections along curved surface.These
Point is formed due to corrugated part.Especially, spine 205 defines sharp projection, such as being partially inserted into shown in side view for Figure 11,
This is conducive to grasp tissue and prevents the distal end of anchoring piece 200 from sliding.Although each division portion 207 and 208 wraps as shown
Containing three such projections it should be appreciated that anchoring piece 200 may be designed such that one or more division portion tools
There is the projection of any other quantity, including single sharp projection.For example, if it is desired to greater amount of sharp projection, then body
201 can be more dense corrugated part shapes (i.e., it is possible to providing greater number of alternate groove 203 and spine 205) and/or cut
The angle of mouth or section can be adjusted.Additionally, can be by changing depth of the groove 203 relative to spine 205 adjusting projection
Proximal portion length.
Division portion 207 and 208 essentially without prevent distal end insertion tissue, but can by with tissue engage and prevent from
The near-end motion of on position.It has been found that the near-end of the tip and/or sharp edges in division portion 207 and 208 with point
The combination for splitting the alternating spine on the near-end in portion generates the performance of improvement.
Additionally, division portion or alar part 207 and 208 are axially offset each other.For example, division portion 207 be axially located at along
At the position of axis xx, and division portion 208 is axially located at along at the position b of axis xx.Compared with un-offset configuration, this
Allow the other parts of body 201 that there is bigger structural strength.Especially, due to otch when which is distally advanced continuously
It is advanced radially inward, so un-offset portion has substantially lesser amount of material in the cross section of the far-end of otch.This
By the mechanical weakness of the axis caused along body or region, and mechanical breakdown can be caused, especially in undersized anchoring
In part.Although anchoring piece 200 is anchored to resist from the near of tissue using paired alar part 207 and 208 to anchoring piece 200
Retract at end it should be appreciated that any amount of alar part can be provided, it is also possible to which any other suitable anchoring knot is provided
Replacement or supplement of the structure (for example anchoring silk) as alar part 207 and 208.
The distal tip of anchoring piece 200 is taper, with sharp point, and by the edge point assembled in the sharp point
The multiple surfaces opened.Although providing four flat surfaces it should be appreciated that any appropriate number of table can be provided
Face, and one or more or all surface can be nonplanar.
Anchoring piece 200 can include one or more shoulders, connection of the shoulder by alar part 207,208 and body 201
And formed, or otherwise from the wherein alar part 207,208 of anchoring piece 200 from distal end or its distal end proximally and radially to
The region of outer extension limits.As shown in figure 11, alar part 207,208 has lax uncompressed position, but may be compressed to
With 201 closer second compression position of body.Additionally, body 201 can be flexible so that the power undergone in near-end can shadow
Body or bar 201 is rung relative to alar part 207,208 and the position of distal end.
Anchoring piece 200 by for example passing through injection moulding first or can be extruded into the body 201 with corrugated part, then
For example form division portion 207 and 208 to produce by the side of radial direction incision body 201.As illustrated, otch is bending
, the angle with longitudinal axis x x relative to body 201 (at near-end inlet point), its proximally initial cut location court
Distal end to anchoring piece 200 is gradually reduced, and eventually becomes linear.Although the division portion of shown example or otch relative to
Longitudinal axis x x of body 201 has bending or the angle for changing it should be appreciated that can carry out any appropriate cutting
Cut, including linear incision.
Although anchoring piece 200 includes evenly-spaced two alar parts of radial perimeter around body 201 or division portion,
It is it should be appreciated that any amount of division portion comprising single division portion can be provided, and around the radial direction of anchoring piece 200
Periphery is spaced apart any appropriately.
Modern manufacturing technique allows nearly nanotechnology application.This allows anchoring piece to be manufactured in possible in the past few years
Impossible size and sophistication.Anchoring piece 200 can by can absorb or nonabsorable injection molding of polymers molding, then process
(such as by cutting) is adding the feature of alar part 207 and 208.Although anchoring piece 200 is formed by polymer it should be appreciated that
Be, it is possible to use any appropriate material, such as metal or composite.Anchoring piece 200 can have such as one millimeter or big
About one millimeter of diameter, and the length in the range of such as 5 millimeters to 10 millimeters.According to some exemplaries, directly
Footpath is less than 1 millimeter.According to some exemplaries, diameter is in the range of from 0.8 millimeter to 1.2 millimeters.However, should
It is understood by, other sizes can be provided.
In an exemplary of the present invention, the anchoring piece 4200 illustrated in describing Figure 12.Anchoring piece
4200 bars 4201 proximally extended comprising distal tip 4230 and the base portion from distal tip 4230.Bar 4201 is in shoulder 4240
The base portion of place's engagement distal tip 4230.Alar part or barb 4207,4208 proximally extend, and to a certain extent radially
Proximally extend and connect at shoulder 4240 base portion of distal tip 4230 from the base portion of distal tip 4230.Barb 4207,
4208 proximally and extend radially to free end from distal tip 4230.Free end can open further outward radially, such as
Shown in Figure 12.Different from the alar part or division portion 207,208 being outlined above, alar part or barb 4207,4208 are not by anchor
What the otch on the body of firmware or division portion were formed so that the thickness of bar 4201 can not be received comprising barb 4207,4208
Affect.Alar part or barb 4207,4208 can have lax uncompressed position, as shown in Figure 12.In uncompressed position,
Hook 4207,4208 is non-bias, with barb opening W.Barb 4207,4208 can be compressed into closer with bar 4201.Can
Different amounts of compression is applied to into barb so that compression is bigger, and barb is closer to bar.Freedom of the barb 4207,4208 in barb
Projection can be included at end, to engage with tissue when anchoring piece has launched.Although showing two barbs 4207,4208,
It is it should be appreciated that any number of barb can be provided.It is likewise possible to the free end in barb provides any amount
Projection, including a sharp projection.
Bar 4201 can be flexible and can bend or bend relative to barb 4207,4208 and distal tip 4230
It is bent.Once being deployed in tissue, compared with the anchoring piece of the bar with rigidity or hardness, rods are provided and act on anchoring piece
The different distributions of the power on 4200.Can relative to the flexible shaft of barb and distal tip flexing anchoring piece these elements it
Between form hinges.The power for acting on anchoring piece near-end can be absorbed by rods at least in part so that act on anchoring
These power on the alar part or barb of part can be reduced.In some organizational environments, flexible shaft is more likely prevented by anchoring piece
Leverage, and thus can prevent anchoring piece partially or even fully from tissue pull out.
Additionally, anchoring piece 50,200,4200 can be included in the U.S. Provisional Patent Application sequence submitted on January 20th, 2010
Row number 61/296,868, the U.S. Patent Application Serial Number 13/010,766 submitted on January 20th, 2011, and in 2014
Any one securing member disclosed in U.S. Patent Application Serial Number 14/301,106 or other similar implantation that June 10 submitted to
Thing feature, which is integrally incorporated herein such as full disclosure herein each via reference, and can be used disclosed herein
Any mechanism is driving.
In order to fire anchoring piece, power delivery system can be located at the close end of driver.Power delivery system can be using almost
Any mechanism of transient force transmission, such as spring, gas, compression fluid etc..According to application, power is transmitted by the axle of driver,
The axle of driver can be stiff shaft or flexible shaft., for shifting firing lock in the far-end of axle, this is further in anchoring for power
Apply driving force anchoring piece is driven and is driven in artificial valve and surrounding tissue from percussion arm on part.Driving force can root
According to application by the thrust delivery system of the far end party superior directed force in driver or by the sensing on the proximal direction of driver
The pulling force delivery system of power is produced.
In an exemplary of the present invention, multiple percussion arms can be set around applicator, such as Figure 13 is extremely
Shown in Figure 20.Figure 13 and Figure 14 show driver 60, and driver 60 has in its distal end and be circlewise located at tubular guide
Multiple percussion arms 61 around 63.Guide member 63 can surround applicator axle, and this is very similar with guide member 43.Percussion arm 61 exists
Diameter parallel of the retracted position against driver and with driver.Figure 14 also show the anchoring piece being arranged in percussion arm 61
4200.Window 64 allows the quilt before being driven and being entered in ring 10 and surrounding tissue from anchoring piece outlet of barb 4207,4208
It is stored in the percussion arm 61 of slack position.
Figure 15 and Figure 16 show driver 60, wherein fire arm and are moved to firing position from retracted position.Percussion
Arm can be for example, by by means of screw or cunning to the movement of the firing position of Figure 15 and Figure 16 from the retracted position of Figure 13 and Figure 14
The manual or electric actuation translational force of motivation structure or by any other mechanically actuated realizing.Percussion arm 61 is in the remote of driver
Driver 60 is hinged at end so that percussion arm 61 is radially outward opened wide from the position of the distal end for being close to hinge and driver 60.
The firing position of percussion arm can be with the axis of driver 60 into the angle less than 90 degree.The acute angle of percussion arm 61 allows angled
Anchoring piece is delivered in ring 10 and surrounding tissue, and therefore better controls over the placement during anchoring piece is organized around.
As shown in Figure 16, fire arm 61 and include firing lock 65 and finger (finge) 66, to be exported by anchoring piece
62 drive anchor 4200.Guide member 63 is connected to firing lock 65 and finger 66 so that near-end or pulling force apply to guiding
Power is proximally moved to part firing lock 65 and finger 66, and finger 66 abuts the shoulder 4240 of anchoring piece 4200 simultaneously
And pulling force can be delivered to anchoring piece 4200 from guide member 63 and firing lock 65.
Figure 17, Figure 18, Figure 19 and Figure 20 show the percussion of anchoring piece 4200.Anchoring piece 4200 is by applying near-end or drawing
Power firing, to pull guide member 63 along the proximal direction relative to driver 60.As shown in Figure 17 and Figure 18, guide member 63
It pulled into almost concordant with the hinged end of percussion arm 61, and as illustrated in figures 19 and 20, guide member 63 is pulled to phase
For the concave position of the hinged end of percussion arm 61.The proximal force of drawing guide member 63 is passed to firing lock 65 further
Finger 66 is delivered to, then driving force is delivered to finger 66 shoulder 4240 of anchoring piece 4200, by anchoring piece 4200
Drive and be driven in ring 10 and surrounding tissue by anchoring piece outlet 62.By this way, all of percussion arm 61 can be same
When fire anchoring piece 4200.
Additionally, any implantable element (such as anchoring piece 50,200,4200 and ring 10, foliation structure described herein
30th, any other element closure member of valve pillar 31 or cardiac valve replacement prosthese 1) can be according to such as concrete application whole
Or partly formed by the material or nonabsorable material that can absorb in patient's body.For example, these elements can be by polyglycolic acid
Or PGA copolymers are formed (PGA).These elements can also or as an alternative by polyester and/or nylon and/or other polymerizations
The copolymer of thing is formed.Additionally, these elements can include one or more of marmems (such as Nitinol), spring
Loading steel or other alloys with appropriate characteristics or material.
Absorbable material can be have in the case where there is a possibility that various implant mistake percussions or inappropriate positioning
Profit.For example, in the case where driver drives anchoring piece 50,200,4200 at unexpected position, or do not have in tissue
In the case of suitably receiving anchoring piece 50,200,4200, even if anchoring piece 50,200,4200 is also in the case of unwanted
Relative harmless, reason is that the anchoring piece is eventually absorbed in patient's body.
Although the particular instance of cardiac valve replacement prosthesis system has been described, system described here and
Equipment is in no way limited to these examples.
Although describing the present invention with reference to some particular instances and exemplary it should be appreciated that
It is that above description is limited never in any form.Additionally, feature described herein can be used in any combination way.
Claims (according to the 19th article of modification of treaty)
1. surgery device, which includes：
Prosthetic valve apparatus, the prosthetic valve apparatus have flexible ring；
Applicator, the applicator have applicator axle, and the applicator axle passes through the ring and terminates at distal end, the distal end
With one or more elastic arms that the distal end of the applicator axle is connected to the ring so that apply to the applicator
The proximal force of axle is passed to one or more elastic arms and is transferred to the flexible ring；And
Driver, the driver have guide member and at least one percussion arm, and the guide member is circlewise located at the applying
Around device axle, the percussion arm includes the outlet of at least one anchoring piece, and the driver constructions are into existing along the applicator axle
Slide between proximal location and remote location,
Wherein described at least one percussion arm is articulated and connected with driver Jing so that in the proximal location of the driver,
At least one anchoring piece outlet in parallel with the applicator axle, and in the remote location of the driver, it is described extremely
The flexible ring is pointed in few anchoring piece outlet；And
It is described soft so that the anchoring piece to be driven into that paired at least one anchoring piece of wherein described driver constructions applies driving force
In tough ring.
2. the surgery device described in claim 1, wherein described artificial valve by catheter delivery to implant site, it is described
Once it is pushed out during flexible ring is folded to insert the conduit and from the distal end of the conduit expansible.
3. the surgery device described in claim 1, wherein described artificial valve are implanted to implant site, and the drive
Dynamic device is configured to drive the anchoring piece at least partially through the ring and in the tissue around the implant site.
4. the surgery device described in claim 1, at least one anchoring piece are included：
Distal end, the distal end tapers are to the distal tip for being configured to puncture tissue；
At least one barb, the barb proximally and extend radially outwardly to free end from the distal end, and the barb is included
Radially-outer surface and inner radial surface；And
Rods, the rods proximally extend from the distal end, the rods relative at least one barb and
It is flexible for distal tip.
5. the surgery device described in claim 4, wherein described rods are configured to cooperation and are applied on the anchoring piece
Power and flexing.
6. the surgery device described in claim 1, wherein described at least one anchoring piece are configured to engage with the tissue
And opposing motion proximally.
7. the surgery device described in claim 1, wherein described driver constructions are into rotating around the applicator axle.
8. the surgery device described in claim 7, wherein described driver constructions are into the driving made according to each elastic arm
Indexing.
9. the surgery device described in claim 1, the applicator can be by following and remove from the artificial valve：It is logical
Cross and apply distal force to the applicator axle to release the engagement of the elastic arm and the flexible ring, and to the applicator
Axle applies proximal force the applicator is proximally pulled through the artificial valve.
10. the surgery device described in claim 1, wherein described percussion arm are hinged to institute in the proximal end of the percussion arm
State driver.
Surgery device described in 11. claim 1, wherein described percussion arm are hinged to institute in the far-end of the percussion arm
State driver.
12. surgery devices, which includes：
Driver, the driver have distal end；
At least one percussion arm, the percussion arm are articulated and connected with the distal end Jing of the driver, and each percussion arm is comprising at least
The outlet of one anchoring piece, with retracted position and firing position, the retracted position parallel to the driver, in the percussion
Position, the percussion arm proximally and are radially outward directed；
Guide member, the guide member are located in the driver；And
Firing lock, the firing lock are connected to the guide member and are configured in the firing position along the percussion arm
Near-end and radially outward direction transmission from the guide member power.
13. surgery devices, which includes：
Flexible ring, the flexible ring can turn up for insert in conduit and after stretching out from conduit it is expansible；
Applicator, the applicator have one or more elastic arms, and the elastic arm is configured to make the ring applying power
The ring is obtained with tissue attachment；And
Driver, with least one percussion arm, the percussion arm is configured to drive at least one anchoring piece the driver
To in the ring and the tissue so that the ring is fixed to the tissue.
Surgery device described in 14. claim 13, wherein described elastic arm are also configured to make the ring and surrounding tissue
Profile be consistent.
At least one anchoring piece is wherein driven by the surgery device described in 15. claim 13 in the driver
During in the ring and the tissue, the elastic arm is applied to the power on the ring, and the ring is fixed to described group
Knit.
16. the surgery device described in claim 13, which also includes：
Applicator axle, the applicator axle pass through the ring and terminate at and the distal end of the applicator axle is connected to institute
State the one of ring or more elastic arms so that apply to the proximal force of the applicator axle be passed to it is one or
More elastic arms are simultaneously transferred to the flexible ring；
Wherein described percussion arm is articulated and connected with driver Jing, and the percussion arm has retracted position and firing position,
The retracted position, the percussion arm are parallel with the applicator axle, and in the firing position, the percussion arm points to described
Ring.
Surgery device described in 17. claim 15, wherein described driver include multiple percussion arms, and the plurality of
Percussion arm fires multiple anchoring pieces simultaneously.
Surgery device described in 18. claim 15, wherein described firing position is perpendicular to the applicator axle.
Surgery device described in 19. claim 15, wherein described firing position is relative to the retracted position into being less than
90 degree.
Surgery device described in 20. claim 15, wherein described percussion arm are hinged in the proximal end of the percussion arm
The driver.
Surgery device described in 21. claim 15, wherein described percussion arm are hinged in the far-end of the percussion arm
The driver.
Claims (21)
1. surgery device, which includes：
Prosthetic valve apparatus, the prosthetic valve apparatus have flexible ring；
Applicator, the applicator have applicator axle, and the applicator axle passes through the ring and terminates at distal end, the distal end
With one or more elastic arms that the distal end of the applicator axle is connected to the ring so that apply to the applicator
The proximal force of axle is passed to one or more elastic arms and is transferred to the flexible ring；And
Driver, the driver have guide member and at least one percussion arm, and the guide member is circlewise located at the applying
Around device axle, the percussion arm includes the outlet of at least one anchoring piece, and the driver constructions are into existing along the applicator axle
Slide between proximal location and remote location,
Wherein described at least one percussion arm is articulated and connected with driver Jing so that in the proximal location of the driver,
At least one anchoring piece outlet in parallel with the applicator axle, and in the remote location of the driver, it is described extremely
The flexible ring is pointed in few anchoring piece outlet；And
It is described soft so that the anchoring piece to be driven into that paired at least one anchoring piece of wherein described driver constructions applies driving force
In tough ring.
2. the surgery device described in claim 1, wherein described artificial valve by catheter delivery to implant site, it is described
Once it is pushed out during flexible ring is folded to insert the conduit and from the distal end of the conduit expansible.
3. the surgery device described in claim 1, wherein described artificial valve are implanted to implant site, and the drive
Dynamic device is configured to drive the anchoring piece at least partially through the ring and in the tissue around the implant site.
4. the surgery device described in claim 1, at least one anchoring piece are included：
Distal end, the distal end tapers are to the distal tip for being configured to puncture tissue；
At least one barb, the barb proximally and extend radially outwardly to free end from the distal end, and the barb is included
Radially-outer surface and inner radial surface；And
Rods, the rods proximally extend from the distal end, the rods relative at least one barb and
It is flexible for distal tip.
5. the surgery device described in claim 5, wherein described rods are configured to cooperation and are applied on the anchoring piece
Power and flexing.
6. the surgery device described in claim 1, wherein described at least one anchoring piece are configured to engage with the tissue
And opposing motion proximally.
7. the surgery device described in claim 1, wherein described driver constructions are into rotating around the applicator axle.
8. the surgery device described in claim 7, wherein described driver constructions are into the driving made according to each elastic arm
Indexing.
9. the surgery device described in claim 1, the applicator can be by following and remove from the artificial valve：It is logical
Cross and apply distal force to the applicator axle to release the engagement of the elastic arm and the flexible ring, and to the applicator
Axle applies proximal force the applicator is proximally pulled through the artificial valve.
10. the surgery device described in claim 1, wherein described percussion arm are hinged to institute in the proximal end of the percussion arm
State driver.
Surgery device described in 11. claim 1, wherein described percussion arm are hinged to institute in the far-end of the percussion arm
State driver.
12. surgery devices, which includes：
Driver, the driver have distal end；
At least one percussion arm, the percussion arm are articulated and connected with the distal end Jing of the driver, and each percussion arm is comprising at least
The outlet of one anchoring piece, with retracted position and firing position, the retracted position parallel to the driver, in the percussion
Position, the percussion arm proximally and are radially outward directed；
Guide member, the guide member are located in the driver；And
Firing lock, the firing lock are connected to the guide member and are configured in the firing position along the percussion arm
Near-end and radially outward direction transmission from the guide member power.
13. surgery devices, which includes：
Flexible ring, the flexible ring can turn up for insert in conduit and after stretching out from conduit it is expansible；
Applicator, the applicator have one or more elastic arms, and the elastic arm is configured to make the ring applying power
The ring is obtained with tissue attachment；And
Driver, with least one percussion arm, the percussion arm is configured to drive at least one anchoring piece the driver
To in the ring and the tissue so that the ring is fixed to the tissue.
Surgery device described in 14. claim 13, wherein described elastic arm are also configured to make the ring and surrounding tissue
Profile be consistent.
At least one anchoring piece is wherein driven by the surgery device described in 15. claim 13 in the driver
During in the ring and the tissue, the elastic arm is applied to the power on the ring, and the ring is fixed to described group
Knit.
Surgery device described in 16. claim 13, which also includes：
Applicator axle, the applicator axle pass through the ring and terminate at and the distal end of the applicator axle is connected to institute
State the one of ring or more elastic arms so that apply to the proximal force of the applicator axle be passed to it is one or
More elastic arms are simultaneously transferred to the flexible ring；
Wherein described percussion arm is articulated and connected with driver Jing, and the percussion arm has retracted position and firing position,
The retracted position, the percussion arm are parallel with the applicator axle, and in the firing position, the percussion arm points to described
Ring.
Surgery device described in 17. claim 15, wherein described driver include multiple percussion arms, and the plurality of
Percussion arm fires multiple anchoring pieces simultaneously.
Surgery device described in 18. claim 15, wherein described firing position is perpendicular to the applicator axle.
Surgery device described in 19. claim 15, wherein described firing position is relative to the retracted position into being less than
90 degree.
Surgery device described in 20. claim 15, wherein described percussion arm are hinged in the proximal end of the percussion arm
The driver.
Surgery device described in 21. claim 15, wherein described percussion arm are hinged in the far-end of the percussion arm
The driver.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201462010680P | 2014-06-11 | 2014-06-11 | |
| US62/010,680 | 2014-06-11 | ||
| PCT/US2015/035427 WO2015191923A1 (en) | 2014-06-11 | 2015-06-11 | System and method for heart valve anchoring |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN106535820A true CN106535820A (en) | 2017-03-22 |
| CN106535820B CN106535820B (en) | 2019-12-17 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201580037981.XA Expired - Fee Related CN106535820B (en) | 2014-06-11 | 2015-06-11 | Systems and methods for heart valve anchoring |
Country Status (8)
| Country | Link |
|---|---|
| EP (1) | EP3154473A4 (en) |
| JP (1) | JP6633550B2 (en) |
| CN (1) | CN106535820B (en) |
| BR (1) | BR112016028910A2 (en) |
| CA (1) | CA2951906A1 (en) |
| MX (1) | MX2016016353A (en) |
| SG (1) | SG11201610363SA (en) |
| WO (1) | WO2015191923A1 (en) |
Families Citing this family (12)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8870950B2 (en) | 2009-12-08 | 2014-10-28 | Mitral Tech Ltd. | Rotation-based anchoring of an implant |
| US11653910B2 (en) | 2010-07-21 | 2023-05-23 | Cardiovalve Ltd. | Helical anchor implantation |
| WO2013021374A2 (en) | 2011-08-05 | 2013-02-14 | Mitraltech Ltd. | Techniques for percutaneous mitral valve replacement and sealing |
| WO2013021375A2 (en) | 2011-08-05 | 2013-02-14 | Mitraltech Ltd. | Percutaneous mitral valve replacement and sealing |
| EP4166111A1 (en) | 2013-01-24 | 2023-04-19 | Cardiovalve Ltd. | Ventricularly-anchored prosthetic valves |
| EP4066786A1 (en) | 2014-07-30 | 2022-10-05 | Cardiovalve Ltd. | Articulatable prosthetic valve |
| US10531866B2 (en) | 2016-02-16 | 2020-01-14 | Cardiovalve Ltd. | Techniques for providing a replacement valve and transseptal communication |
| US20190231525A1 (en) | 2016-08-01 | 2019-08-01 | Mitraltech Ltd. | Minimally-invasive delivery systems |
| US12064347B2 (en) | 2017-08-03 | 2024-08-20 | Cardiovalve Ltd. | Prosthetic heart valve |
| US11793633B2 (en) | 2017-08-03 | 2023-10-24 | Cardiovalve Ltd. | Prosthetic heart valve |
| US10888421B2 (en) | 2017-09-19 | 2021-01-12 | Cardiovalve Ltd. | Prosthetic heart valve with pouch |
| WO2024147747A1 (en) * | 2023-01-08 | 2024-07-11 | Общество с ограниченной ответственностью "КАРДИОТЕК" | Prosthetic heart valve |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6203553B1 (en) * | 1999-09-08 | 2001-03-20 | United States Surgical | Stapling apparatus and method for heart valve replacement |
| US20050222665A1 (en) * | 1999-04-23 | 2005-10-06 | Ernest Aranyi | Endovascular fastener applicator |
| US20080221672A1 (en) * | 2007-02-23 | 2008-09-11 | Endovalve, Inc. | Mitral Valve System |
| US7569062B1 (en) * | 1998-07-15 | 2009-08-04 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
| CN103118630A (en) * | 2010-09-24 | 2013-05-22 | 西美蒂斯股份公司 | Stent valve, delivery apparatus and method therefor |
Family Cites Families (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US8454628B2 (en) * | 2002-09-20 | 2013-06-04 | Syntheon, Llc | Surgical fastener aligning instrument particularly for transoral treatment of gastroesophageal reflux disease |
| ATE442107T1 (en) * | 2003-07-21 | 2009-09-15 | Univ Pennsylvania | PERCUTANE HEART VALVE |
| NL1025830C2 (en) * | 2004-03-26 | 2005-02-22 | Eric Berreklouw | Prosthesis e.g. heart valve secured in place by ring with shape memory material anchor, includes anchor temperature control system |
| US9192471B2 (en) * | 2007-01-08 | 2015-11-24 | Millipede, Inc. | Device for translumenal reshaping of a mitral valve annulus |
| US9566178B2 (en) * | 2010-06-24 | 2017-02-14 | Edwards Lifesciences Cardiaq Llc | Actively controllable stent, stent graft, heart valve and method of controlling same |
| CN104203157B (en) * | 2011-12-12 | 2016-02-03 | 戴维·阿隆 | Heart valve repair apparatus |
-
2015
- 2015-06-11 SG SG11201610363SA patent/SG11201610363SA/en unknown
- 2015-06-11 EP EP15806896.5A patent/EP3154473A4/en not_active Withdrawn
- 2015-06-11 WO PCT/US2015/035427 patent/WO2015191923A1/en active Application Filing
- 2015-06-11 BR BR112016028910A patent/BR112016028910A2/en not_active Application Discontinuation
- 2015-06-11 MX MX2016016353A patent/MX2016016353A/en unknown
- 2015-06-11 JP JP2016572487A patent/JP6633550B2/en active Active
- 2015-06-11 CA CA2951906A patent/CA2951906A1/en not_active Abandoned
- 2015-06-11 CN CN201580037981.XA patent/CN106535820B/en not_active Expired - Fee Related
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7569062B1 (en) * | 1998-07-15 | 2009-08-04 | St. Jude Medical, Inc. | Mitral and tricuspid valve repair |
| US20050222665A1 (en) * | 1999-04-23 | 2005-10-06 | Ernest Aranyi | Endovascular fastener applicator |
| US6203553B1 (en) * | 1999-09-08 | 2001-03-20 | United States Surgical | Stapling apparatus and method for heart valve replacement |
| US20080221672A1 (en) * | 2007-02-23 | 2008-09-11 | Endovalve, Inc. | Mitral Valve System |
| CN103118630A (en) * | 2010-09-24 | 2013-05-22 | 西美蒂斯股份公司 | Stent valve, delivery apparatus and method therefor |
Also Published As
| Publication number | Publication date |
|---|---|
| BR112016028910A2 (en) | 2017-08-22 |
| MX2016016353A (en) | 2017-06-12 |
| CA2951906A1 (en) | 2015-12-17 |
| JP2017517343A (en) | 2017-06-29 |
| WO2015191923A1 (en) | 2015-12-17 |
| CN106535820B (en) | 2019-12-17 |
| SG11201610363SA (en) | 2017-01-27 |
| EP3154473A1 (en) | 2017-04-19 |
| JP6633550B2 (en) | 2020-01-22 |
| EP3154473A4 (en) | 2017-11-22 |
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