CN107106176B - 用于组织修复的改进的抓持器 - Google Patents

用于组织修复的改进的抓持器 Download PDF

Info

Publication number
CN107106176B
CN107106176B CN201580069505.6A CN201580069505A CN107106176B CN 107106176 B CN107106176 B CN 107106176B CN 201580069505 A CN201580069505 A CN 201580069505A CN 107106176 B CN107106176 B CN 107106176B
Authority
CN
China
Prior art keywords
distal
proximal
tissue
elements
fixation device
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
Application number
CN201580069505.6A
Other languages
English (en)
Other versions
CN107106176A (zh
Inventor
迈克尔·F·韦
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Abbott Cardiovascular Systems Inc
Original Assignee
Abbott Cardiovascular Systems Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Abbott Cardiovascular Systems Inc filed Critical Abbott Cardiovascular Systems Inc
Priority to CN202010099177.7A priority Critical patent/CN111297517B/zh
Publication of CN107106176A publication Critical patent/CN107106176A/zh
Application granted granted Critical
Publication of CN107106176B publication Critical patent/CN107106176B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/122—Clamps or clips, e.g. for the umbilical cord
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • 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
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00778—Operations on blood vessels
    • A61B2017/00783—Valvuloplasty
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
    • A61B2017/081—Tissue approximator
    • 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
    • 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
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0091—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • General Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Veterinary Medicine (AREA)
  • Public Health (AREA)
  • Animal Behavior & Ethology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Molecular Biology (AREA)
  • Vascular Medicine (AREA)
  • Reproductive Health (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Prostheses (AREA)
  • Surgical Instruments (AREA)

Abstract

本发明提供用于在治疗部位处接近及修复组织的改进的装置、系统和方法。本发明提供通过改进组织到装置中的捕获而可以更顺利地接近及修复组织的装置、系统和方法。本发明可以是允许组织进入机构但不允许其容易地离开的单向机构，比如片簧、突出部、枢转臂以及一个或更多个摩擦元件。

Description

用于组织修复的改进的抓持器
相关申请的交叉引用
本申请要求于2014年12月19日提交的美国申请No.14/577,852的优先权和权益，该申请通过参引全部并入本文中。
背景技术
本发明总体上涉及的医疗方法、医疗设备和医疗系统。具体地，本发明涉及用于身体组织腔内的、经皮的或微创治疗——比如组织接近或瓣修复——的方法、设备和系统。更具体地，本发明涉及修复心脏瓣膜或静脉瓣膜以及将通过微创手术将二尖瓣瓣膜修复部件移除或禁用的设备和方法。
身体组织的外科修复通常涉及组织接近以及这些组织在接近的装置中的紧固。在修复瓣膜时，组织接近包括将瓣膜的瓣叶对合在治疗装置中，该治疗装置随后可以通过紧固或固定瓣叶而被保持。这种对合可以用于治疗最常发生在二尖瓣中的返流。
二尖瓣反流的特征在于逆向血流从心脏的左心室通过关闭不全的二尖瓣流动到左心房。在心肌收缩(心脏收缩)的正常循环期间，二尖瓣用作用以防止含氧血液向回流动到左心房的止逆阀。以这种方式，含氧血液通过主动脉瓣被泵送到主动脉中。二尖瓣的反流会显著地降低心脏的泵送效率，从而使病人处于严重且渐进的心力衰竭的风险。
二尖瓣反流可能会因二尖瓣或左心室壁的多种不同的机械缺陷引起。瓣叶、将瓣叶连接至乳头肌的瓣索或者乳头肌自身或者左心室壁可能会被损坏或以其他方式机能失调。通常，瓣环可能会被损坏、膨胀或变弱，从而限制二尖瓣抵抗左心室的较大压力充分关闭的能力。
对二尖瓣反流的最常规的治疗依赖于瓣的置换或者瓣的修复包括瓣叶和瓣环重构，瓣叶和瓣环重构通常被称为瓣膜成形术。依赖于将相对两个瓣叶的相邻部段缝合在一起的一种二尖瓣修复的技术被称为“蝴蝶结”或“缘对缘”技术。尽管所有这些技术可能都非常有效，但其通常依赖于开心手术，在开心手术中，通常经由胸骨切开术将患者的胸腔剖开并且对患者进行心肺转流术。需要剖开胸腔并对患者进行心肺转流术是创伤性的并且具有相关联的发病率。
在一些患者中，固定装置可以利用微创技术安装到心脏中。该固定装置将相对的瓣叶的相邻的部段保持在一起并且可以使二尖瓣反流减小。用于将二尖瓣的前后瓣叶夹持在一起的一种设备是由美国加州Santa Clara的Abbott Vascular(雅培血管公司)出售的
Figure GDA0002220581740000021
固定装置。
背景技术描述
存在用于接近组织或器官以及在治疗部位处修复组织或器官的许多技术。例如，在PCT公布的NOs.WO 98/35638；WO 99/00059；WO 99/01377；以及WO 00/03759；WO 2000/060995；WO 2004/103162中描述了用于对合及修改二尖瓣瓣叶以治疗二尖瓣反流的微创技术和经皮穿刺技术。Maisano等人在(1998)Eur.J.Cardiothorac.Surg.(欧洲胸心外科杂志)13:240-246；Fucci等人在(1995)Eur.J.Cardiothorac.Surg.(欧洲胸心外科杂志)9:621-627；以及Umana等人在(1998)Ann.Thorac.Surg.(胸外科年鉴)66:1640-1646中描述了用于进行“缘对缘”或“蝴蝶结”二尖瓣修复的开放式外科手术，在该开放式外科手术中，相对的瓣叶的边缘被缝合在一起以使反流减小。Dec和Fuster在(1994)N.Engl.J.Med.(新英格兰医学杂志)331:1564-1575以及Alvarez等人在(1996)J.Thorac.Cardiovasc.Surg.(胸心血管外科杂志)112:238-247中的评论文章中论述了扩张型心肌病的本质以及治疗。
在下述出版物中描述了二尖瓣瓣膜成形术Bach和Bollin(1996)Am.J.Cardiol.(美国心脏病学杂志)78:966-969；Kameda等(1996)Ann.Thorac.Surg.(胸外科年鉴)61:1829-1832；Bach和Bolling(1995)Am.Heart J.(美国心脏学杂志)129:1165-1170；以及Bolling等(1995)109:676-683。在Ricchi等人在(1997)Ann.Thorac.Surg.(胸外科年鉴)63:1805-1806中描述了用于二尖瓣修复的线性区段瓣膜成形术。在McCarthy和Cosgrove(1997)Ann.Thorac.Surg.(胸外科年鉴)64:267-268；Tager等(1998)Am.J.Cardiol.(美国心脏病学杂志)81:1013-1016；以及Abe等(1989)Ann.Thorac.Surg.(胸外科年鉴)48:670-676中描述了三尖瓣瓣膜成形术。
在Park等(1978)Circulation 58:600-608；Uchida等(1991)Am.Heart J.121:1221-1224；以及Ali Khan等(1991)Cathet.Cardiovasc.Diagn.23:257-262中描述了经皮腔内的心脏修复手术。在美国专利Nos.5,840,081；5,411,552；5,554,185；5,332,402；4,994,077；以及4,056,854中描述了腔内心脏瓣膜置换术。专利No.3,671,979描述了用于人造心脏瓣膜的临时放置的导管。
在美国专利Nos.4,917,089；4,484,579；以及3,874,338和PCT公布No.WO 91/01689中描述了经皮和腔内心脏修复手术。
在美国专利Nos.5,855,614；5,829,447；5,823,956；5,797,960；5,769,812；以及5,718,725中描述了胸腔镜和其他微创心脏瓣膜修复及置换手术。
发明内容
本公开描述了意图用于血管内的输送并且用于治疗病人的二尖瓣缺陷的装置。人体心脏的二尖瓣具有心房侧、心室侧、前瓣叶、后瓣叶以及瓣叶之间的开口。
在一个实施方式中，该装置可以包括本体、一对近端元件和一对远端元件。各近端元件在第一端部处、分别于所述本体的相反两侧联接至所述本体，并且每个近端元件均具有第二自由端部。每个近端元件均具有位于其第一端部与第二端部之间的近端接合表面。每个近端接合表面构造成接近并接合瓣叶的与心房侧上的二尖瓣相邻的部分。每个近端接合表面还具有近端保持元件，所述近端保持元件构造成允许组织朝向近端元件的第一端部移动并且阻碍组织远离近端元件的第一端部移动。
各远端元件在第一端部处、分别于所述本体的相反两侧枢转地联接至所述本体，每个远端元件均具有第二自由端部。每个远端元件均具有位于其第一端部与第二端部之间的远端接合表面。每个远端接合表面构造成接近并接合瓣叶的与心室侧上的二尖瓣相邻的部分。
近端元件中的第一近端元件与远端元件中的第一远端元件进行配合，以在第一近端元件与第一远端元件之间形成用于接纳前瓣叶的一部分的空间。近端元件中的第二近端元件与远端元件中的第二远端元件进行配合，以在第二近端元件与第二远端元件之间形成用于接纳后瓣叶的一部分的空间。每个这种空间具有敞开的端部和闭合的端部，并且闭合的端部形成顶。
该装置包括致动器，所述致动器用于使远端元件在第一位置、第二位置与第三位置之间选择性地移动，其中，在第一位置中，远端元件处于收缩的小体积构型以便于该装置的输送，在第二位置中，远端元件处于扩张构型以将该装置相对于二尖瓣定位，在第三位置中，远端元件抵靠瓣叶的与心室侧上的二尖瓣相邻的部分而固定就位。
该装置还包括致动器，该致动器用于使近端元件在第一位置与第二位置之间选择性地移动，其中，在第一位置中，近端元件处于收缩的小体积构型以便于该装置的输送，在第二位置中，近端元件处于扩张构型以接合瓣叶的与心房侧上的二尖瓣相邻的部分。
每个远端元件还可以包括沿着远端接合表面定位的远端保持元件。每个远端保持元件构造成与对应的近端保持元件进行配合，以在该装置被相对于二尖瓣定位时捕获二尖瓣的瓣叶的自由边缘。每个保持元件可以构造成与摩擦元件进行配合，以允许瓣叶的前部自由边缘在几乎没有阻力或限制的情况下沿第一方向朝向本体移动以及阻碍或阻止瓣叶的自由边缘沿相反方向远离本体移动。
通过以下描述和所附权利要求，本公开的这些及其他目的和特征将变得充分明显，或者可以通过实施下文中阐述的本发明的实施方式而获得。
附图说明
为了进一步阐明本公开的以上以其他优点和特征，参照附图中示出的具体实施方式对本发明进行更具体的描述。应当理解的是，这些附图仅描绘本发明的示出的实施方式并且因此不被视为限制其范围。将通过使用附图以附加的特征和细节对本发明进行描述和说明：
图1示出了在正常对合时的二尖瓣的瓣叶的自由边缘，并且图2示出了处于反流对合时的自由边缘。
图3A至图3C分别示出了瓣叶的具有固定装置、固定装置的远端元件倒置以及将固定装置去除时的瓣叶的抓持。
图4示出了相对于瓣叶处于期望取向的固定装置。
图5示出了联接至轴的示例性固定装置。
图6A至图6B、图7A至7B和图8示出了在将该装置导入并布置在体内以进行治疗操作期间的处于各种可能的位置中的固定装置。
图9A至图9B示出了具有片簧的固定装置的实施方式。
图10示出了另一实施方式的固定装置的一部分的放大图。
图11A示出了另一实施方式的固定装置的一部分的放大图。
图11B和图11C分别示出了另一实施方式的固定装置的一部分的放大截面侧视图。
图11D和11E分别示出了另一实施方式的固定装置的一部分的放大截面横向视图。
图12示出了另一实施方式的固定装置的一部分的放大图。
具体实施方式
I.概述
A.心脏生理学
如图1中所示，二尖瓣(MV)包括具有自由边缘(FE)的一对瓣叶(LF)，所述自由边缘在具有正常心脏结构和功能的患者中均匀地接合以沿着对合线(C)闭合。瓣叶(LF)沿着被称为环(AN)的环形区域附接至周围的心脏结构。瓣叶(LF)的自由边缘(FE)通过腱索(或者“腱”)固定至左心室(LV)的下部。
作为心脏收缩(被称为“心脏收缩”)的左心室，从左心室通过二尖瓣至左心房的血液流动(被称为“二尖瓣反流”)通常被二尖瓣阻止。
反流在瓣叶闭合不全并且允许从左心室泄露到左心房中时发生。许多心脏结构缺陷会导致二尖瓣反流。图2示出了具有缺陷从而造成通过间隙(G)的反流的二尖瓣。
II.二尖瓣固定技术的总体概述
存在用于修复或置换有缺陷的二尖瓣的若干种方法。二尖瓣的一些缺陷可以通过血管内手术来处理，在血管内手术中，介入工具和设备通过血管被导入心脏并从心脏移除。修复某些二尖瓣缺陷的一种方法包括在血管内输送固定装置以将二尖瓣组织的一部分保持处于特定位置中。可以使用一个或更多个介入导管将固定装置输送至二尖瓣并将其作为治疗二尖瓣反流的植入物安装在二尖瓣处。
图3A示出了具有输送轴12和固定装置14的介入工具10的示意图。工具10已经从心房侧接近二尖瓣MV并抓持瓣叶LF。
固定装置14在轴12的远端端部处以可释放的方式附接至介入工具10的轴12，在本申请中，当描述装置时，“近端”指的是朝向该装置的待被位于患者体外的使用者操纵的端部的方向，“远端”指的是朝向该装置的定位在治疗部位处且远离使用者的工作端部的方向。当描述二尖瓣时，近端指的是瓣叶的心房侧，而远端指的是瓣叶的心室侧。
固定装置14包括近端元件16和远端元件18，近端元件16和远端元件18沿径向向外突出并且能够定位在瓣叶LF的相反两侧以将瓣叶捕获或保持在近端元件16与远端元件18之间。固定装置14能够通过联接机构17联接至轴12。
图3B示出了远端元件18可以沿箭头40的方向移动至反转位置。近端元件16可以如图3C中示出的那样被升高。在反转位置中，装置14可以被重新定位并且随后反转至如图3A中的抵靠瓣叶的抓持位置。或者，固定装置14可以如图3C中示出的那样从瓣叶收回(由箭头42指示)。这种反转可以减小对瓣叶的损伤并且可以使装置与周围组织的任何缠结最小化。
图4示出了相对于瓣叶LF处于期望的取向的固定装置14。由于从心房侧观察二尖瓣MV，所以近端元件16以实线示出而远端元件18以虚线示出。近端元件16和远端的元件18被定位成大致垂直于对合线C。在心脏舒张(当血液从左心房流动至左心室)期间，固定装置14将瓣叶LF在被由舒张压力梯度造成的开口或孔口围绕的元件16、18之间保持就位，如图4中所示。
一旦将瓣叶以期望的布置对合，则固定装置14从轴12脱离并且作为植入物留下。
A.示例性固定装置
图5示出了示例性固定装置14。固定装置14被示出为联接至轴12以形成介入工具10。固定装置14包括联接构件19、一对相对的近端元件16以及一对相对的远端元件18。
远端元件18包括长形臂53，每个臂均具有自由端部54以及以可旋转的方式连接至连接联接构件19的近端端部52。优选地，每个自由端部54限定绕下述两个轴线的曲率：垂直于臂53的纵向轴线的轴线66以及垂直于轴线66或臂53的纵向轴线的轴线67。
臂53具有接合表面50。臂53和接合表面50被构造成接合约4-10mm的组织，并且优选地沿者臂53的纵向轴线接合约6-8mm的组织。臂53还包括多个开口。
近端元件16优选地被朝向远端元件18弹性地偏置。当固定装置14处于打开位置时，每个近端元件16在臂53的近端端部52附近与接合表面50分离并且在自由端部54附件朝向接合表面50倾斜，使得近端元件16的自由端部接触接合表面50，如图5中所示。
近端元件16包括多个开口63和扇形侧边缘61以增强其对组织的抓持。近端元件16可选地包括摩擦元件或多个摩擦元件，以辅助抓持瓣叶。该摩擦附件可包括倒钩60，倒钩60具有朝向接合表面50延伸的逐渐变细的尖端。可以使用任何适合的摩擦元件，比如叉状物、翼状物、带状物、倒钩、凹槽、通道、突起、表面粗糙化、烧结、高摩擦垫、覆盖物、涂层或这些的组合。
近端元件16可以覆盖有织物或其他柔性材料。优选地，当织物或覆盖物与倒钩或其他摩擦特征组合使用时，这些特征将伸出穿过这些织物或其他覆盖物以接触被近端元件16接合的任何组织。
固定装置14还包括致动器或致动机构58。致动机构58包括两个连结构件或支腿68，每个支腿68均具有第一端部70和第二端部72，其中，第一端部70在铆接接合部76处以可旋转的方式与远端元件18中的一个远端元件接合，并且第二端部72可以以可旋转的方式与双头螺栓74接合。致动机构58包括各自以可移动的方式联接至基部69的两个支腿68。或者，每个支腿68可以通过单独的铆钉或销分别附接至双头螺栓74。双头螺栓74可以与下述致动器杆接合：该致动器杆延伸穿过轴12并且能够轴向延伸及缩回以使双头螺栓74移动并且因此使支腿68移动从而使远端元件18在闭合位置、打开位置和/或反转位置之间旋转。双头螺栓74的制动可以将支腿68保持就位并且因此将远端元件18保持在期望位置中。双头螺栓74还可以通过锁定特征被锁定就位。该致动器杆和双头螺栓组件可以被视为用于使远端元件在第一位置、第二位置与第三位置之间选择性地移动的第一器件，其中，在第一位置中，远端元件处于收缩的小体积构型以便于该装置的输送，在第二位置中，远端元件处于扩张构型以将该装置相对于二尖瓣定位，在第三位置中，远端元件抵靠瓣叶的与心室侧上的二尖瓣相邻的部分而固定就位。
图6A至图6B、图7A至图7B和图8示出了图5的固定装置14的各种可能的位置。图6A示出了通过导管86输送的介入工具10。导管86可以采用引导导管或护套的形式。介入工具10包括联接至轴12的固定装置14并且固定装置14被示出处于闭合位置。
图6B以较大的示图示出了与图6A的装置的类似的装置。在闭合位置中，该对相对的远端元件18定位成使得接合表面50面向彼此。每个远端元件18均包括长形臂53，长形臂53具有杯状形状或凹形形状，使得臂53一起围绕轴12。这为固定装置14提供了小体积。
图7A至图7B示出了处于打开位置的固定装置14。在打开位置中，远端元件18被旋转成使得接合表面50面向第一方向。致动器杆相对于轴12的向远端的前进运动并且因此双头螺栓74相对于联接构件19的向远端的前进运动向远端元件18施加力，远端元件18开始绕接合部76旋转。远端元件18的这种沿径向向外的旋转和移动使支腿68绕接合部80旋转，使得支腿68被略微向外引导。双头螺栓74可以前进与远端元件18的期望分离相关联的任意期望的距离。在打开位置中，接合表面50设置成相对于轴12成锐角，并且设置成优选地相对于彼此成90度与180度之间的角度。在打开位置中，臂53的自由端部54在其之间具有大约10mm-20mm、通常为大约12mm-18mm并且优选地为大约14mm-16mm的跨距。
近端元件16典型地朝向臂53向外偏置。近端元件16可以借助于呈缝合线、金属丝、镍-钛合金线材、杆、线缆、聚合物线材或其他适合的结构形式的近端元件线90而朝向轴12向内移动并且被保持抵靠轴12。近端元件线90延伸穿过输送导管300的轴302并与近端元件16连接。近端元件16通过近端元件线90的操纵而被升高或降低。一旦该装置被正确定位且部署，近端元件线就可以通过将其通过导管收回并离开装置10的近端端部而被移除。近端元件线90可以被视为用于使近端元件在第一位置与第二位置之间选择性地移动的第二器件，其中，在第一位置中，近端元件处于收缩的小体积构型以便于该装置的输送，在第二位置中，近端元件处于扩张构型以接合瓣叶的与心房侧上的二尖瓣相邻的部分。
在打开位置中，固定装置14可以接合待被接近或治疗的组织。介入工具10从左心房穿过二尖瓣前进至左心室。远端元件18随后通过下述方式部署：使致动器杆相对轴12前进从而将远端元件18重新定向成垂直于对合线。整个组件随后在近端收回并且定位成使得接合表面50接触瓣叶的心室表面、从而接合瓣叶的左心室侧表面。近端元件16保持处于瓣叶的左心房侧，使得瓣叶位于近端元件与远端元件之间。介入工具10可以被反复操纵以对固定装置14进行再定位，使得瓣叶在期望的位置处被适当地接触或者抓持。再定位可以通过处于打开位置的固定装置实现。在一些情况下，还可以在装置14处于打开位置时检查反流。如果反流未被令人满意地减少，则该装置可以被再定位并且反流被再次检查直到获得期望的结果为止。
还可以期望使固定装置14的远端元件18反转以辅助固定装置14的再定位或移除。图8示出了处于反转位置中的可固定装置14。通过致动器杆相对于轴12进一步前进，并且因此双头螺栓74相对于联接构件19的进一步前进，远端元件18进一步旋转，使得接合表面50面向外并且使得自由端部54在远端对准，使得每个臂53均相对于轴12形成钝角。
在该装置反转时，臂53之间的角度优选地在大约270度到360度的范围内。双头螺栓74的进一步前进还使远端元件18绕接合部76旋转。远端元件18的径向向外的旋转和移动使支腿68绕接合部80旋转，使得支腿68朝向其大致平行于彼此的初始位置返回。双头螺栓74可以前进至与远端元件18的期望反转相关联的任一期望距离。优选地，在完全反转的位置中，自由端部54之间的跨距不超过大约20mm，通常小于大约16mm，并且优选地是大约12mm-14mm。倒钩60在远端方向上(远离近端元件16的自由端部)略微成角度，从而降低了倒钩在固定装置收回时钩住或者撕裂组织的风险。
一旦固定装置14的远端元件18已经被定位在抵靠瓣叶的左心室侧表面的期望位置中，瓣叶就可以被捕获在近端元件16与远端元件18之间。近端元件16通过从近端元件线90释放张力从而释放近端元件16而使其朝向接合表面50降低，使得近端元件16响应于形成在近端元件16中的内部的弹簧偏置力从被约束的收缩位置自由移动至扩张的部署位置，并且使得瓣叶可以被保持在近端元件16与远端元件18之间。如果反流未能被令人满意地减少，则可以升高近端元件16并且调整或者反转远端元件18以对固定装置14进行再定位。
在瓣叶已经以期望的设置被捕获在近端元件16与远端元件18之间之后，远端元件18可以被锁定成将瓣叶LF保持在该位置或者固定装置14可以返回至闭合位置或者朝向闭合位置返回。这可以通过下述方式实现：双头螺栓74相对于联接构件19向近端缩回使得致动机构58的支腿68向远端元件18施加向上的力，这又使得远端元件18旋转，从而使得接合表面50再次面向彼此。朝向远端元件18向外偏置的被释放的近端元件16通过远端元件18被同时向内推动。固定装置14随后可以被锁定以将瓣叶保持在闭合位置。固定装置14随后可以被从轴12释放。
固定装置14可选地包括用于将装置14锁定在特定位置比如打开位置、闭合位置或反转位置或在打开位置、关闭位置与反转位置之间的任何位置的锁定机构。
锁定机构可以包括释放带。对释放带施加的张力可以解锁锁定机构。
锁线92接合锁定机构106的释放带108以锁定及解锁锁定机构106。锁线92延伸穿过输送导管300的轴302。使用附接至该轴的近端端部的把手来操纵固定装置14以及使固定装置14断开联接。
关于这种固定装置14的另外的公开内容可以在PCT公布No.WO2004/103162和美国专利申请No.14/216,787中找到，这两个申请的公开内容通过参引全部并入本文中。
B.改进的抓持机构
有时，可能难以将组织捕获或保持在固定装置内14内从而难以使固定装置14根据需要接近或者修复组织。尽管可以贯穿安装固定装置14的整个过程来评估瓣叶插入，但是可能难以区分良好和不佳的瓣叶插入和保持。例如，当在血管内的手术或微创手术中使用固定装置14时，组织的捕获或保持的可视化可能是困难的。
有时，在安装固定装置14的过程期间，在期望被捕获或者保持在近端元件16与远端部件18之间的组织实际上仅被部分地捕获或未牢固地捕获时，其可能看上去被牢固地捕获或保留。因此，瓣叶组织LF的自由边缘FE可能随后就与固定装置14分离，并且固定装置14随后可能不能正确地接合、接近或修复组织。即使成像方法使得在组织被捕获在固定装置中时可以可视化，但是也可能不允许观察者辨别被牢固捕获的组织和未被牢固捕获的组织。例如，尽管彩色多普勒超声可以示出反流已减小，但是其不能提供下述精确细节：固定装置14沿着瓣叶LF的哪个位置捕获了组织以及该捕获是否是牢固的。
如果瓣叶被不佳地抓持在近端元件16与远端元件18之间，则最终瓣叶LF会与固定装置14分开。这可导致固定装置14仅附接至瓣叶LF中的一个瓣叶，或者导致与两个瓣叶LF都分开，并且不再像所期望的那样起作用。
除了装置14在其被安装时的成像或可视化引起的困难之外，将组织捕获或者保持在固定装置14内的困难也由期望被捕获或保持的组织的性质造成。例如，在使用固定装置14将二尖瓣瓣叶LF固定至彼此以阻止或减小二尖瓣反流的情况下，瓣叶LF在心脏跳动时不断地移动。
图9至图12示出了意在在固定装置14’的布置期间辅助固定装置14’的捕获以及保持瓣叶LF的自由边缘FE的各种实施方式。为此，这些实施方式包括添加定位在每个远端元件18’的近端侧上的保持元件400。保持元件400与摩擦元件——比如倒钩410——在近端元件16’的下端部处结合，以在固定装置14’最初插入时捕获瓣叶的自由边缘FE并辅助将其保持在自由边缘处，直到近端元件和远端元件被完全部署。近端元件16’的下端部是最靠近双头螺栓74’的端部。
保持元件400和倒钩410构造成进行配合以允许瓣叶LF的自由边缘FE沿第一方向朝向形成于每个近端元件16’与对应的远端元件18’之间的顶430容易地或自由地移动，但同时阻碍或阻止瓣叶组织LF的自由边缘FE沿相反的方向远离顶430移动。以此方式，保持元件400与倒钩410配合来帮助在装置14’相对于瓣叶LF定位并且在近端元件16’和远端元件18’被完全部署之前将瓣叶LF保持在装置14’中。
保持元件400可以用作在无需被致动的情况下保持瓣叶组织LF的被动捕获机构。例如，保持元件400可以在长约4-10mm、优选地为大约6-8mm的组织沿着远端元件18’的纵向轴线定位时将瓣叶组织LF保持在装置14’中。如示出的实施方式中所示，保持元件400可以定位在远端元件18’上，或者保持元件400可以定位在近端元件16’上，或者保持元件400定位在远端元件18’和近端元件16’两者上。保持元件400可以在不使固定元件18’和抓持元件16’闭合的情况下将瓣叶LF保持就位。
如9A至图9B中所示，在一个实施方式中，保持元件400可以是保持插入到固定装置14’中的瓣叶LF的弹簧元件402。弹簧元件402可以帮助捕获或保持沿着远端元件18’插入穿过被确定是足够的插入深度的给定点的任何瓣叶LF。
再次参照图9A至图9B，弹簧元件402位于远端元件18’上。每个远端元件18’具有结合到远端元件18’中或者附接至远端元件18’的弹簧元件402。弹簧元件402可以在远端元件18’的附接至双头螺栓74’的第一端部404与远端元件18’的自由端部406之间的中点414处结合到远端元件18’中或者附接至远端元件18’。弹簧元件402也可以靠近每个远端元件18’的自由端部406或者靠近每个远端元件18’的第一端部404结合到远端元件18’中或者附接至远端元件18’。如图9A至图9B中所示，弹簧元件402的固定端部412位于远端元件18’的中点414与自由端部406之间。另外，保持元件400的弹簧元件402是长形的并且可以沿着远端元件18’和相关联的远端接合表面的整个长度以长形方式延伸。替代性地，保持元件400可以从第一端部404附近或者与第一端部404相邻的位置以长形方式延伸至远端元件18’的远端接合表面的位于中点远侧的位置或者从第二端部406附近或者与第二端部406相邻的位置延伸至远端元件18’的远端接合表面的位于中点远侧的位置。
弹簧元件402可以包括较小力的片簧408，片簧408偏置成将弹簧元件402朝向瓣叶LF推动并迫使摩擦元件或倒钩410深入地插入到瓣叶LF中，因此瓣叶LF保持处于完全就座状态直到远端元件18’被进一步闭合为止。如示出的，倒钩410以一角度指向顶430定向。在倒钩410沿该方向定向的情况下，瓣叶组织LF的前部边缘LE可以在几乎没有限制或阻力的情况下沿第一方向朝向顶430移动。当瓣叶组织的前部边缘朝向顶430移动时，弹簧元件420将瓣叶组织LF朝向倒钩410引导或者推动并使其与倒钩410接触。一旦瓣叶组织LF与倒钩410接触并接合，倒钩410的成角度的定向就使倒钩410穿入到瓣叶组织LF中并且随后限制或阻止瓣叶组织LF沿相反的方向远离顶430移动。因此，保持元件400与倒钩的组合有效地起到下述方向捕获器的作用：该方向捕获器允许瓣叶组织LF在几乎没有阻力的情况下沿第一方向朝向顶430移动且同时限制或者阻止瓣叶组织LF沿第二方向或相反的方向远离顶430移动。
片簧408可具有一个或更多个凸角或部分凸角。片簧408可以偏置成在瓣叶插入时对瓣叶几乎没有阻力。片簧408可以具有形成阻力使得瓣叶LF难以收回的表面特征、尖锐的边缘或其他元件。这些表面特征可以包括例如凹坑、凸块、脊部或凹进部。
例如，如图9A至图9B中所示，弹簧元件402的自由端部416可以构造成在瓣叶组织LF被捕获时朝向远端元件18’弯曲(如图9A中所示)并且在组织LF被释放时远离远端元件18’弯曲(如图9B中所示)。当瓣叶陷入远端元件18’与近端元件16’之间时，弹簧元件402的自由端部416可以构造成平伏抵靠远端元件18’。
在近端元件16’升高并且远端元件18’仍部分打开的情况下，保持元件400有助于固定装置14捕获组织。保持元件400可以构造成推动瓣叶组织抵靠近端元件16上的倒钩410。保持元件400可以是允许组织进入但不允许组织离开的单向机构，比如棘轮或者与棘轮类似的东西。
由于有时需要对固定装置14’进行再定位和再抓持，所以单向机构应当具有允许瓣叶组织LF脱离方法。保持元件可以设计成允许组织在某些情况下——比如当远端元件18’如图9B中示出的那样打开约180°，或者如图8中示出的那样进一步打开到反转位置时——离开。或者，当近端元件16’升高时，瓣叶组织LF可以被释放以允许再抓持。
为了确保瓣叶LF被正确地抓持在固定装置14’中，使用具有靠近每个成组的远端元件18’和近端元件16’定位的保持元件400——比如弹簧元件402——的装置的一个方法是首先将一个或两个瓣叶LF捕获在弹簧元件402中。该弹簧元件推动瓣叶LF在近端元件16’的下端部处抵靠倒钩410以在其初始插入时就捕获瓣叶LF的自由边缘FE并帮助将自由边缘FE保持在该位置处，直到近端元件16和远端元件18被完全部署为止。
基于比如彩色多普勒超声之类的成像方法可以确定一个或更多个瓣叶LF被捕获。当瓣叶LF被捕获在弹簧元件402与倒钩410之间时，随后近端元件16’可以朝向远端元件18’的表面50’降低，使得瓣叶LF被保持在近端元件16’与远端元件18’之间并且远端元件18’可以被锁定成将瓣叶LF保持在该位置或者固定装置14’可以返回至闭合位置或者朝向闭合位置返回。
在另一实施方式中，如图10中所示，保持元件400包括臂部417。每个远端元件18’具有结合到远端元件18’中或者附接至远端元件18’的臂部417。臂部417可以以固定端部415在远端元件18’的附接至双头螺栓74’的第一端部404与远端元件18’的自由端部406之间的中点414处结合到远端元件18’中或者附接至远端元件18’。臂部417还可以靠近每个远端元件18’的自由端部406或者靠近每个远端元件18’的第一端部404结合到远端元件18’中或者附接至远端元件18’。如图10中所示，臂部417的固定端部415位于远端元件18’的自由端部406与中点414之间。
臂部417具有适合形状和尺寸的、用以辅助将瓣叶LF保持就位的突出部或多个突出部418。这些突出部418可以具有与臂部417相对地定位的尖端，或者在其梢端与臂部417之间具有锐边。这些突出部可以包括具有渐缩的尖端的倒钩、扇形边缘、叉状物、翼状物、带状物、凹槽、通道、突起、表面粗糙化、烧结、高摩擦垫、覆盖物、涂层或这些的组合。如图10中所示，这些突出部可以远离表面50’定向并且远离远端元件18’的自由边缘406成角度地定向。这些突出部也可以朝向自由边缘406定向或者垂直于表面50’。这些突出部可以在固定装置14’闭合时朝向远端元件18’挠曲或收缩并且在固定装置14’打开时向外挠曲成固定角度。例如，突出部418可以从接合表面50’向固定角度偏置，但在远端元件18’绕轴12闭合时被推动成平伏抵靠远端元件18’。
该固定装置应该在近端元件16’与远端元件18’之间构造有足够的空间以使瓣叶LF在远端元件18’上容易地插入经过突出部418。腱索束缚(chordal tethered)的瓣叶LF可以在固定装置14’使远端元件18’和近端元件16’即将闭合之前略微地张紧。瓣叶LF也可以在远端元件18’与近端元件16’闭合之前牢固地附连至装置14’。
在一个实施方式中，臂部417可以是在固定端部415处进行枢转并且定位在近端元件16’与远端元件18’之间的柔性片簧。臂部还可以包括成角度的以允许组织进入远端元件18’与近端元件16’之间、但是阻止组织LF收回的突出部418系统。如示出的，突出部418和片簧417可以以相同的结构组合。另外，保持元件400的臂部417是长形的并且可以大致沿着远端元件18’和相关联的远端接合表面的整个长度以长形方式延伸。替代性地，保持元件400可以从第一端部404附近或者与第一端部404相邻的位置以长形方式延伸至远端元件18’的远端接合表面的位于中点远侧的位置或者从第二端部406附近或者与第二端部406相邻的位置延伸至远端元件18’的远端接合表面的位于中点远侧的位置。
如图11中所示，在另一实施方式中，保持元件400可以包括一个或更多个突出部420。一个或更多个突出部420可以定位成靠近远端元件18’在接合表面50’上的铰接点。当瓣叶LF插入经过突出部420时，突出部420可以在部署固定装置14’时通过引导或者推动瓣叶LF与位于对面的近端元件16’上的抓持表面或倒钩410接触而减少瓣叶脱离。突出特征420可以定位在远端元件18’的附接至双头螺栓74’的第一端部404与远端元件18’的自由端部406之间的中点414附近。突出特征420还可以靠近每个远端元件18’的自由端部406或者靠近每个远端元件18’的第一端部404结合到远端元件18’中或者附接至远端元件18’。突出特征420可以是附连至远端元件18’的接合表面50’的刚性材料件，并且突出特征420可以是能防损伤的以辅助引导或推动瓣叶LF且同时使对瓣叶LF的损害最小化，比如不穿刺或不穿透瓣叶LF。突出特征可以由任何一种或多种材料——比如聚合物、镍钛诺或其它合金或生物可吸收材料——制成。
远端元件18’的突出特征420可以在瓣叶组织LF被充分插入到装置14’中时被动地接合瓣叶组织LF。或者，突出特征420可以构造成在近端元件16’降低并且还被固定至瓣叶组织LF时帮助接合瓣叶组织并将其固定就位。突出特征420可以帮助使组织陷入突出特征420与近端元件16’的抓持表面之间。特征420可以推动组织LF抵靠倒钩410。
尽管突出特征420被示出为包括大体弯曲或半球形的外表面，但是将理解的是，只要保持防损伤性以及辅助引导或推动瓣叶LF的能力，各种其他表面取向示也是适合的。例如，如图11B至图11E中所示，突出特征420可以具在下述方向上对称的或不对称的弯曲表面：(i)从第一端部404朝向第二端部406的第一方向，(ii)与从第一端部404朝向第二端部406的方向相交的、横向于该方向或者相对于该方向倾斜的方向，或者(iii)上述第一方向以及与第一方向相交的、横向于该第一方向或者相对于该第一方向倾斜的方向两者。因此突出特征420可以在至少一条轴线、至少两条轴线上或者在所有三条轴线上是对称的。替代性地，突出特征420可以在至少一条轴线、至少两条轴线或者在所有轴线上是不对称的。
在图12中示出的另一实施方式中，保持元件400可以包括附接至远端元件18’的表面50’的铰接件422。铰接件422连接至可以朝向远端元件18’摆动或者远离远端元件18’摆动的臂部424。如图12中所示，臂部424可以朝向每个远端元件18’的第一端部404偏置。臂部424能够在朝向远端元件18’的第一端部404定向时平行于表面50’或者平伏抵靠表面50’。臂部424还能够在朝向远端元件18’的自由端部406定向时平行于表面50’或者平伏抵靠表面50’，并且因此能够旋转180°。铰接件422可以限制臂部424的运动，使得臂部424在朝向远端元件18’的第一端部404定向时例如仅平行于表面50’，并能够被旋转大约90°，从而使得在臂部424与远端元件18’的位于铰接件422下面的部分之间形成的角度不大于90°。铰接件422还可以是枢转元件。
还可以在远端元件18’上设置多个臂部424。例如，可以设置两个臂部，每个臂部定位成与端部404和端部406之间的距离相同并且在接合表面50’上彼此相邻地定位。如果设置有多个保持元件400，比如多个臂部424或多个弹簧元件402，则其可以构造成定位在近端元件上的倒钩410的两侧。如果在近端元件16’上设置有多个倒钩410，则一个或多个保持元件400还可以定位成位于近端元件16’上的倒钩410之间。另外，保持元件400的臂部424是长形的并且可以大致沿着远端元件18’和相关联的远端接合表面的整个长度以长形方式延伸。替代性地，保持元件400和相关联的臂部424可以从第一端部404附近或者与第一端部404相邻的位置以长形方式延伸至远端元件18’的远端接合表面的位于中点远侧的位置或者从第二端部406附近或者与第二端部406相邻的位置延伸至远端元件18’的远端接合表面的位于中点远侧的位置。
远端元件18可以覆盖有织物或其他柔性材料。优选地，当织物或覆盖物与突出部418组合使用时，这些特征将伸出穿过所述织物或其他覆盖物以接触瓣叶组织LF。
类似于机械爪，保持元件400的偏置、角度和方向可以允许瓣叶在没有太多阻力但可以限制瓣叶LF往回移出的能力的情况下下落或滑动地更深。通过允许瓣叶LF容易地进入但不允许其容易地从固定装置14’移除，可以有助于使瓣叶LF陷入完全插入状态。
在上述实施方式中，保持元件400是被动元件。然而，保持元件400也可以包括主动元件，使得当瓣叶组织LF件行进超出保持元件400的一部分或者与保持元件400的一部分相邻时，保持元件400可以自动地弹开或部署成使得将组织LF保持就位。
在另一实施方式中，固定装置14或14’可以包括指示在远端元件18’闭合以及固定装置14或14’部署之前瓣叶何时正确地插入到该装置中的机械或物理传感器或一些视觉指示器。例如，触觉传感器可以嵌置在每个远端元件的第一端部404附近。每个触觉传感器可以提供瓣叶何时触及传感器的信号或指示，并且传感器可以定位成使得瓣叶LF将不能够或不太可能触及传感器，除非瓣叶被充分地捕获。
使瓣叶组织LF在固定装置14或14’中的布置和保持增强的又一机理是便于每个近端元件16或16’和每个远端元件18和18’独立于彼此的致动。当用于两个叶瓣LF的近端元件16或16’被同时启用并且用于每个瓣叶LF的远端元件18或18’也被同时启用时，可能难以捕获两个瓣叶，这是因为需要同时捕获两个瓣叶。换言之，当两个近端元件16或16’的启用是对称的并且两个远端元件18或18’的启用也是对称的时，固定装置14或14’不能够先抓持一个瓣叶并且随后抓持另一瓣叶。如果导管或固定装置14或14’没有正确地定位，或者如果任一瓣叶LF具有冗余长度或松弛长度，则固定装置14或14’不能使瓣叶完全坐置在每个远端固定元件18或18’与近端抓持元件16或16’之间。
在一个实施方式中，每个近端元件16或16’和/或每个远端元件18或18’可以独立于彼此被启用。例如，为每个近端元件16或16’设置有单独的近端元件线。类似地，可以设置延伸穿过轴12的两个致动器杆64，其中每个致动器杆可以构造成启用一个远端元件18或18’。
除了用于修复二尖瓣之外，这些装置还可以用在多种治疗手术中，包括腔内手术、微创手术和开放式外科手术，并且还可以用在多种解剖学区域中，包括腹部系统、胸部系统、心脏血管系统、肠系统、消化系统、呼吸系统、泌尿系统以及其他系统和组织。本发明提供了通过改进组织到装置中的捕获而可以更顺利地接近及修复组织的装置、系统和方法。
可以在不背离本发明的精神或基本特征的条件下以其他具体形式实施本发明。所描述的实施方式在所有方面都仅为说明性的而非限制性的考虑。因此，本发明的范围由所附权利要求而不是由前面的描述指定。落入权利要求的等效含义和范围内的所有变化都包括在权利要求的范围内。

Claims (6)

1.一种用于接合组织的固定装置，包括：
一对远端元件，每个所述远端元件均具有第一端部、与所述第一端部相反的自由端部以及位于所述第一端部与所述自由端部之间的接合表面，一对所述远端元件具有打开位置和闭合位置；
一对近端元件，每个所述近端元件均具有第一端部、与该第一端部相反的自由端部以及位于该第一端部与该自由端部之间的接合表面，一对所述近端元件构造成能够朝向所述远端元件被升高和降低；以及
轴，所述近端元件的第一端部和所述远端元件的第一端部以可操作的方式联接至所述轴；
其中，所述远端元件中的每个远端元件均包括接合至所述远端元件的自由端并且从临近所述远端元件的自由端的位置延伸的保持元件，所述保持元件构造成允许组织朝向所述远端元件的第一端部移动并且阻碍组织远离所述远端元件的第一端部移动，在所述闭合位置，所述保持元件大致沿着所述远端元件的整个长度从临近所述远端元件的自由端部朝向所述远端元件的第一端部延伸。
2.根据权利要求1所述的固定装置，其中，每个所述近端元件还包括位于所述接合表面上的一个或更多个摩擦元件。
3.根据权利要求2所述的固定装置，其中，定位在每个所述近端元件上的所述摩擦元件包括一个或更多个倒钩。
4.根据权利要求1所述的固定装置，其中，每个所述保持元件还包括一个或更多个摩擦元件。
5.根据权利要求4所述固定装置，其中，定位在所述保持元件中的每个保持元件上的摩擦元件包括至少一个片簧，所述至少一个片簧构造成朝向定位在所述近端元件中的一个近端元件上的一个或更多个倒钩引导或推动组织以使组织与定位在所述近端元件中的一个近端元件上的所述一个或更多个倒钩接合。
6.根据权利要求4所述的固定装置，其中，定位在所述保持元件中的每个保持元件上的摩擦元件包括至少一个突出部，所述至少一个突出部构造成朝向定位在所述近端元件中的一个近端元件上的一个或更多个倒钩引导或推动组织以使组织与定位在所述近端元件中的一个近端元件上的所述一个或更多个倒钩接合。
CN201580069505.6A 2014-12-19 2015-10-20 用于组织修复的改进的抓持器 Active CN107106176B (zh)

Priority Applications (1)

Application Number Priority Date Filing Date Title
CN202010099177.7A CN111297517B (zh) 2014-12-19 2015-10-20 用于组织修复的改进的抓持器

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US14/577,852 2014-12-19
US14/577,852 US10188392B2 (en) 2014-12-19 2014-12-19 Grasping for tissue repair
PCT/US2015/056415 WO2016099650A1 (en) 2014-12-19 2015-10-20 Improved grasping for tissue repair

Related Child Applications (1)

Application Number Title Priority Date Filing Date
CN202010099177.7A Division CN111297517B (zh) 2014-12-19 2015-10-20 用于组织修复的改进的抓持器

Publications (2)

Publication Number Publication Date
CN107106176A CN107106176A (zh) 2017-08-29
CN107106176B true CN107106176B (zh) 2020-03-17

Family

ID=54361215

Family Applications (2)

Application Number Title Priority Date Filing Date
CN202010099177.7A Active CN111297517B (zh) 2014-12-19 2015-10-20 用于组织修复的改进的抓持器
CN201580069505.6A Active CN107106176B (zh) 2014-12-19 2015-10-20 用于组织修复的改进的抓持器

Family Applications Before (1)

Application Number Title Priority Date Filing Date
CN202010099177.7A Active CN111297517B (zh) 2014-12-19 2015-10-20 用于组织修复的改进的抓持器

Country Status (5)

Country Link
US (7) US10188392B2 (zh)
EP (2) EP3628243A1 (zh)
JP (3) JP6685306B2 (zh)
CN (2) CN111297517B (zh)
WO (1) WO2016099650A1 (zh)

Families Citing this family (104)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8652202B2 (en) 2008-08-22 2014-02-18 Edwards Lifesciences Corporation Prosthetic heart valve and delivery apparatus
US8449599B2 (en) 2009-12-04 2013-05-28 Edwards Lifesciences Corporation Prosthetic valve for replacing mitral valve
US8475525B2 (en) 2010-01-22 2013-07-02 4Tech Inc. Tricuspid valve repair using tension
US10058323B2 (en) 2010-01-22 2018-08-28 4 Tech Inc. Tricuspid valve repair using tension
US9307980B2 (en) 2010-01-22 2016-04-12 4Tech Inc. Tricuspid valve repair using tension
US8945177B2 (en) 2011-09-13 2015-02-03 Abbott Cardiovascular Systems Inc. Gripper pusher mechanism for tissue apposition systems
US9011468B2 (en) 2011-09-13 2015-04-21 Abbott Cardiovascular Systems Inc. Independent gripper
WO2014108903A1 (en) 2013-01-09 2014-07-17 4Tech Inc. Soft tissue anchors
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
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
US10390943B2 (en) 2014-03-17 2019-08-27 Evalve, Inc. Double orifice device for transcatheter mitral valve replacement
US9572666B2 (en) 2014-03-17 2017-02-21 Evalve, Inc. Mitral valve fixation device removal devices and methods
JP6559161B2 (ja) 2014-06-19 2019-08-14 ４テック インコーポレイテッド 心臓組織の緊締
US9700445B2 (en) 2014-11-04 2017-07-11 Abbott Cardiovascular Systems, Inc. One-way actuator knob
EP3284412A1 (en) 2014-12-02 2018-02-21 4Tech Inc. Off-center tissue anchors
CN107205817B (zh) 2014-12-04 2020-04-03 爱德华兹生命科学公司 用于修复心脏瓣膜的经皮夹具
US10188392B2 (en) * 2014-12-19 2019-01-29 Abbott Cardiovascular Systems, Inc. Grasping for tissue repair
RU2708222C2 (ru) 2015-01-05 2019-12-04 Стрейт Эксесс Текнолоджиз Холдингз (Пти) Лтд Устройство захвата створки клапана сердца
US10524912B2 (en) 2015-04-02 2020-01-07 Abbott Cardiovascular Systems, Inc. Tissue fixation devices and methods
JP6755888B2 (ja) 2015-05-14 2020-09-16 エドワーズ ライフサイエンシーズ コーポレイションＥｄｗａｒｄｓ Ｌｉｆｅｓｃｉｅｎｃｅｓ Ｃｏｒｐｏｒａｔｉｏｎ 心臓弁封止デバイスおよびその送達デバイス
US10376673B2 (en) 2015-06-19 2019-08-13 Evalve, Inc. Catheter guiding system and methods
US10238494B2 (en) 2015-06-29 2019-03-26 Evalve, Inc. Self-aligning radiopaque ring
US10667815B2 (en) 2015-07-21 2020-06-02 Evalve, Inc. Tissue grasping devices and related methods
US10413408B2 (en) 2015-08-06 2019-09-17 Evalve, Inc. Delivery catheter systems, methods, and devices
US10238495B2 (en) 2015-10-09 2019-03-26 Evalve, Inc. Delivery catheter handle and methods of use
US10799677B2 (en) 2016-03-21 2020-10-13 Edwards Lifesciences Corporation Multi-direction steerable handles for steering catheters
US10835714B2 (en) 2016-03-21 2020-11-17 Edwards Lifesciences Corporation Multi-direction steerable handles for steering catheters
US10799675B2 (en) 2016-03-21 2020-10-13 Edwards Lifesciences Corporation Cam controlled multi-direction steerable handles
US11219746B2 (en) 2016-03-21 2022-01-11 Edwards Lifesciences Corporation Multi-direction steerable handles for steering catheters
US10799676B2 (en) 2016-03-21 2020-10-13 Edwards Lifesciences Corporation Multi-direction steerable handles for steering catheters
JP7008910B2 (ja) 2016-06-20 2022-01-25 エバルブ，インコーポレイティド 経心尖除去装置
US10736632B2 (en) 2016-07-06 2020-08-11 Evalve, Inc. Methods and devices for valve clip excision
US10973638B2 (en) 2016-07-07 2021-04-13 Edwards Lifesciences Corporation Device and method for treating vascular insufficiency
US10478304B2 (en) 2016-07-20 2019-11-19 Abbott Cardiovascular Systems Inc. Independent system for tricuspid valve repair
CN106175986B (zh) * 2016-07-26 2017-12-01 复旦大学附属中山医院 一种瓣膜夹合器
US11071564B2 (en) 2016-10-05 2021-07-27 Evalve, Inc. Cardiac valve cutting device
US10653862B2 (en) 2016-11-07 2020-05-19 Edwards Lifesciences Corporation Apparatus for the introduction and manipulation of multiple telescoping catheters
US10363138B2 (en) 2016-11-09 2019-07-30 Evalve, Inc. Devices for adjusting the curvature of cardiac valve structures
US10398553B2 (en) 2016-11-11 2019-09-03 Evalve, Inc. Opposing disk device for grasping cardiac valve tissue
US10426616B2 (en) 2016-11-17 2019-10-01 Evalve, Inc. Cardiac implant delivery system
US10779837B2 (en) 2016-12-08 2020-09-22 Evalve, Inc. Adjustable arm device for grasping tissues
US10314586B2 (en) 2016-12-13 2019-06-11 Evalve, Inc. Rotatable device and method for fixing tricuspid valve tissue
US10905554B2 (en) 2017-01-05 2021-02-02 Edwards Lifesciences Corporation Heart valve coaptation device
JP7280194B2 (ja) * 2017-01-25 2023-05-23 セダーズ－シナイ メディカル センター 心臓弁尖を固定するデバイス
US11224511B2 (en) 2017-04-18 2022-01-18 Edwards Lifesciences Corporation Heart valve sealing devices and delivery devices therefor
BR112019021267A2 (pt) 2017-04-18 2020-05-19 Edwards Lifesciences Corp dispositivos de vedação de válvula cardíaca e dispositivos de liberação dos mesmos
US10799312B2 (en) 2017-04-28 2020-10-13 Edwards Lifesciences Corporation Medical device stabilizing apparatus and method of use
US10959846B2 (en) * 2017-05-10 2021-03-30 Edwards Lifesciences Corporation Mitral valve spacer device
IT201700052909A1 (it) * 2017-05-16 2018-11-16 Star Tric S R L Protesi articolata per valvola tricuspide o mitrale e relativo dispositivo di afferraggio
AU2018280236B2 (en) 2017-06-07 2024-06-06 Shifamed Holdings, Llc Intravascular fluid movement devices, systems, and methods of use
CN111050668A (zh) * 2017-07-06 2020-04-21 拉古维尔·巴苏德 组织抓取装置及相关方法
US11051940B2 (en) 2017-09-07 2021-07-06 Edwards Lifesciences Corporation Prosthetic spacer device for heart valve
US11065117B2 (en) 2017-09-08 2021-07-20 Edwards Lifesciences Corporation Axisymmetric adjustable device for treating mitral regurgitation
US11040174B2 (en) 2017-09-19 2021-06-22 Edwards Lifesciences Corporation Multi-direction steerable handles for steering catheters
CN109717987B (zh) * 2017-10-30 2024-06-14 北京领健医疗科技有限公司 一种瓣膜修复装置
JP7319266B2 (ja) 2017-11-13 2023-08-01 シファメド・ホールディングス・エルエルシー 血管内流体移動デバイス、システム、および使用方法
CN109953778B (zh) * 2017-12-26 2022-02-22 先健科技(深圳)有限公司 夹合装置及固定组织的系统
MX2020005397A (es) * 2018-01-09 2020-08-17 Edwards Lifesciences Corp Dispositivos y procedimientos de reparacion de valvulas nativas.
US10245144B1 (en) 2018-01-09 2019-04-02 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10076415B1 (en) 2018-01-09 2018-09-18 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10105222B1 (en) 2018-01-09 2018-10-23 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10130475B1 (en) * 2018-01-09 2018-11-20 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10123873B1 (en) 2018-01-09 2018-11-13 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10136993B1 (en) 2018-01-09 2018-11-27 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10973639B2 (en) 2018-01-09 2021-04-13 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10238493B1 (en) 2018-01-09 2019-03-26 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10507109B2 (en) 2018-01-09 2019-12-17 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10159570B1 (en) 2018-01-09 2018-12-25 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10111751B1 (en) 2018-01-09 2018-10-30 Edwards Lifesciences Corporation Native valve repair devices and procedures
US10231837B1 (en) 2018-01-09 2019-03-19 Edwards Lifesciences Corporation Native valve repair devices and procedures
JP7410034B2 (ja) 2018-02-01 2024-01-09 シファメド・ホールディングス・エルエルシー 血管内血液ポンプならびに使用および製造の方法
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
US11207181B2 (en) * 2018-04-18 2021-12-28 Edwards Lifesciences Corporation Heart valve sealing devices and delivery devices therefor
FR3085835B1 (fr) * 2018-09-13 2020-08-28 Univ Compiegne Tech Implant pour valve cardiaque
US10945844B2 (en) 2018-10-10 2021-03-16 Edwards Lifesciences Corporation Heart valve sealing devices and delivery devices therefor
CN111437065A (zh) * 2019-01-17 2020-07-24 TauPNU医疗有限公司 位置可调节的三尖瓣返流手术用器械
AU2020223047A1 (en) 2019-02-14 2021-08-19 Edwards Lifesciences Corporation Heart valve sealing devices and delivery devices therefor
US11534303B2 (en) 2020-04-09 2022-12-27 Evalve, Inc. Devices and systems for accessing and repairing a heart valve
JP2022540616A (ja) 2019-07-12 2022-09-16 シファメド・ホールディングス・エルエルシー 血管内血液ポンプならびに製造および使用の方法
WO2021011655A1 (en) 2019-07-15 2021-01-21 Evalve, Inc. Proximal element actuator fixation and release mechanisms
JP2022541221A (ja) 2019-07-15 2022-09-22 エバルブ，インコーポレイティド 非変形ウィングを持つワイドクリップ
WO2021016372A1 (en) 2019-07-22 2021-01-28 Shifamed Holdings, Llc Intravascular blood pumps with struts and methods of use and manufacture
EP4005532A4 (en) * 2019-07-31 2022-09-28 Hangzhou Valgen Medtech Co., Ltd. VALVE CLAMP WITH DIAPHRAGM AND VALVE CLAMPING DEVICE
WO2021062265A1 (en) 2019-09-25 2021-04-01 Shifamed Holdings, Llc Intravascular blood pump systems and methods of use and control thereof
EP4033970A1 (en) 2019-09-26 2022-08-03 Evalve, Inc. Systems for intra-procedural cardiac pressure monitoring
US11464636B2 (en) 2019-10-11 2022-10-11 Evalve, Inc. Repair clip for variable tissue thickness
EP4054491B1 (en) 2019-11-08 2023-12-20 Evalve, Inc. Medical device delivery system with locking system
WO2021097089A1 (en) 2019-11-14 2021-05-20 Evalve, Inc. Kit with coaptation aid and fixation system and methods for valve repair
WO2021097124A1 (en) 2019-11-14 2021-05-20 Evalve, Inc. Catheter assembly with coaptation aid and methods for valve repair
CN114786595A (zh) * 2019-12-09 2022-07-22 波士顿科学国际有限公司 用于瓣膜的边对边修复装置
US11969347B2 (en) 2020-05-13 2024-04-30 Evalve, Inc. Methods, systems, and devices for deploying an implant
WO2022037084A1 (zh) * 2020-08-21 2022-02-24 杭州德晋医疗科技有限公司 组织夹持件及瓣膜夹合装置
US11617587B2 (en) * 2020-09-29 2023-04-04 Shanghai Hanyu Medical Technology Co., Ltd. Clamp
US20220117737A1 (en) * 2020-10-15 2022-04-21 Evalve, Inc. Biased distal assemblies with locking mechanism
CN114681142B (zh) * 2020-12-30 2023-05-09 沛嘉医疗科技(苏州)有限公司 一种用于夹合组织的固定装置
CN114681144B (zh) * 2020-12-30 2024-06-07 沛嘉医疗科技(苏州)有限公司 一种用于夹合组织的系统
US20220346954A1 (en) * 2021-04-30 2022-11-03 Evalve, Inc. Fixation Device Having a Flexure Portion
EP4122425A1 (en) * 2021-07-23 2023-01-25 The Provost, Fellows, Foundation Scholars, and the other members of Board, of the College of the Holy & Undiv. Trinity of Queen Elizabeth near Dublin A fixation device for implantation
KR20240034758A (ko) * 2021-07-23 2024-03-14 에드워즈 라이프사이언시스 코포레이션 심장 판막 보수 장치
WO2023086024A1 (en) * 2021-11-10 2023-05-19 Spectrumedics International Pte Ltd System for determining implant-tissue contact
CN118000972A (zh) * 2024-04-08 2024-05-10 杭州德晋医疗科技有限公司 房室瓣夹合装置

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006037073A2 (en) * 2004-09-27 2006-04-06 Evalve, Inc. Methods and devices for tissue grasping and assessment

Family Cites Families (530)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2097018A (en) 1936-07-17 1937-10-26 Coleman R Chamberlin Multiple purpose guide and retention clip
US2108206A (en) 1937-03-09 1938-02-15 Lillian Pearl Mecker Tenaculum
US3296668A (en) 1965-03-03 1967-01-10 Winthrop J Aiken Clip for sheets and the like
US3378010A (en) 1965-07-28 1968-04-16 Coldling Surgical clip with means for releasing the clamping pressure
US3557780A (en) 1967-04-20 1971-01-26 Olympus Optical Co Mechanism for controlling flexure of endoscope
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
US3675639A (en) 1970-05-11 1972-07-11 Hugo S Cimber Device for and method of temporary sterilizing a female
US3874338A (en) 1972-10-09 1975-04-01 Fritz Happel Milking cup
US3874388A (en) 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
FR2306671A1 (fr) 1975-04-11 1976-11-05 Rhone Poulenc Ind Implant valvulaire
US4340091A (en) 1975-05-07 1982-07-20 Albany International Corp. Elastomeric sheet materials for heart valve and other prosthetic implants
GB1486351A (en) 1975-06-06 1977-09-21 Rocket Of London Ltd Surgical clip applicator
US4007743A (en) 1975-10-20 1977-02-15 American Hospital Supply Corporation Opening mechanism for umbrella-like intravascular shunt defect closure device
US4112951A (en) 1976-01-26 1978-09-12 Research Corporation Surgical clip
US4091815A (en) 1976-07-06 1978-05-30 Larsen Otis M Flexible tube clamp
US4056854A (en) 1976-09-28 1977-11-08 The United States Of America As Represented By The Department Of Health, Education And Welfare Aortic heart valve catheter
AU521676B2 (en) 1977-02-23 1982-04-22 Clark, Richard Edwin Heart valve prosthesis
US4297749A (en) 1977-04-25 1981-11-03 Albany International Corp. Heart valve prosthesis
US4235238A (en) 1978-05-11 1980-11-25 Olympus Optical Co., Ltd. Apparatus for suturing coeliac tissues
NL7906691A (nl) 1979-09-07 1981-03-10 Jansen Anton Medische inrichting vor het koppelen van twee darm- gedeelten, hulpinrichting ten gebruike daarbij en werk- wijze voor het leggen van een darmknoop met behulp van deze inrichting.
US4327736A (en) 1979-11-20 1982-05-04 Kanji Inoue Balloon catheter
US4657024A (en) 1980-02-04 1987-04-14 Teleflex Incorporated Medical-surgical catheter
US4578061A (en) 1980-10-28 1986-03-25 Lemelson Jerome H Injection catheter and method
US4498476A (en) 1981-08-27 1985-02-12 Ethicon, Inc. Non-metallic, bio-compatible hemostatic clips with interlocking latch means
US4809695A (en) 1981-10-21 1989-03-07 Owen M. Gwathmey Suturing assembly and method
US4944295A (en) 1981-10-21 1990-07-31 Owen Gwathmay Suturing assembly
US4425908A (en) 1981-10-22 1984-01-17 Beth Israel Hospital Blood clot filter
US4487205A (en) 1982-04-26 1984-12-11 Ethicon, Inc. Non-metallic, bio-compatible hemostatic clips
US4484579A (en) 1982-07-19 1984-11-27 University Of Pittsburgh Commissurotomy catheter apparatus and method
US4458682A (en) 1982-08-02 1984-07-10 Ethicon, Inc. Non-metallic, bio-compatible hemostatic clips (ring lock clips)
US4510934A (en) 1983-05-13 1985-04-16 Batra Subhash K Suture
US4531522A (en) 1983-06-20 1985-07-30 Ethicon, Inc. Two-piece tissue fastener with locking top and method for applying same
US4693248A (en) 1983-06-20 1987-09-15 Ethicon, Inc. Two-piece tissue fastener with deformable retaining receiver
DE3344934A1 (de) 1983-12-13 1985-06-20 Richard Wolf Gmbh, 7134 Knittlingen Endoskop mit distal ablenkbarem hilfsinstrument
GB8424582D0 (en) 1984-09-28 1984-11-07 Univ Glasgow Heart valve prosthesis
JPS6187434A (ja) 1984-10-04 1986-05-02 Nec Corp 携帯無線機
DE3504292C1 (de) 1985-02-08 1986-07-24 Richard Wolf Gmbh, 7134 Knittlingen Instrument fuer endoskopische Eingriffe,insbesondere zur perkutanen Gallensteinentfernung oder Gallenblasenveroedung
US4716886A (en) 1986-05-01 1988-01-05 Norman Schulman Umbilical cord clamp and cutters
US5125895A (en) 1986-07-22 1992-06-30 Medtronic Versaflex, Inc. Steerable catheter
CA1303298C (en) 1986-08-06 1992-06-16 Alain Carpentier Flexible cardiac valvular support prosthesis
US4777951A (en) 1986-09-19 1988-10-18 Mansfield Scientific, Inc. Procedure and catheter instrument for treating patients for aortic stenosis
US5478353A (en) 1987-05-14 1995-12-26 Yoon; Inbae Suture tie device system and method for suturing anatomical tissue proximate an opening
US5542949A (en) 1987-05-14 1996-08-06 Yoon; Inbae Multifunctional clip applier instrument
US5059211A (en) 1987-06-25 1991-10-22 Duke University Absorbable vascular stent
US4795458A (en) 1987-07-02 1989-01-03 Regan Barrie F Stent for use following balloon angioplasty
JPH088933B2 (ja) 1987-07-10 1996-01-31 日本ゼオン株式会社 カテ−テル
US5019096A (en) 1988-02-11 1991-05-28 Trustees Of Columbia University In The City Of New York Infection-resistant compositions, medical devices and surfaces and methods for preparing and using same
US5002562A (en) 1988-06-03 1991-03-26 Oberlander Michael A Surgical clip
WO1989009029A1 (en) 1989-02-16 1989-10-05 Taheri Syde A Method and apparatus for removing venous valves
US5447966A (en) 1988-07-19 1995-09-05 United States Surgical Corporation Treating bioabsorbable surgical articles by coating with glycerine, polalkyleneoxide block copolymer and gelatin
US4917089A (en) 1988-08-29 1990-04-17 Sideris Eleftherios B Buttoned device for the transvenous occlusion of intracardiac defects
US5108368A (en) 1990-01-04 1992-04-28 Pilot Cardiovascular System, Inc. Steerable medical device
US4930674A (en) 1989-02-24 1990-06-05 Abiomed, Inc. Surgical stapler
US4994077A (en) 1989-04-21 1991-02-19 Dobben Richard L Artificial heart valve for implantation in a blood vessel
US5620461A (en) 1989-05-29 1997-04-15 Muijs Van De Moer; Wouter M. Sealing device
US5092872A (en) 1989-07-28 1992-03-03 Jacob Segalowitz Valvulotome catheter
US5047041A (en) 1989-08-22 1991-09-10 Samuels Peter B Surgical apparatus for the excision of vein valves in situ
GB8924806D0 (en) 1989-11-03 1989-12-20 Neoligaments Ltd Prosthectic ligament system
US5049153A (en) 1989-12-26 1991-09-17 Nakao Naomi L Endoscopic stapling device and method
US5015249A (en) 1989-12-26 1991-05-14 Nakao Naomi L Endoscopic stapling device and method
US6033378A (en) 1990-02-02 2000-03-07 Ep Technologies, Inc. Catheter steering mechanism
US5195968A (en) 1990-02-02 1993-03-23 Ingemar Lundquist Catheter steering mechanism
CA2057018C (en) 1990-04-02 1997-12-09 Kanji Inoue Device for nonoperatively occluding a defect
DK124690D0 (da) 1990-05-18 1990-05-18 Henning Rud Andersen Klapprotes til implantering i kroppen for erstatning af naturlig klap samt kateter til brug ved implantering af en saadan klapprotese
US5411552A (en) 1990-05-18 1995-05-02 Andersen; Henning R. Valve prothesis for implantation in the body and a catheter for implanting such valve prothesis
US5001136A (en) 1990-06-07 1991-03-19 Pfizer Inc. Leukotriene-synthesis-inhibiting 2-substitutedmethylamino-5-(hydroxy or alkoxy)pyridines
US5098440A (en) 1990-08-14 1992-03-24 Cordis Corporation Object retrieval method and apparatus
US5389102A (en) 1990-09-13 1995-02-14 United States Surgical Corporation Apparatus and method for subcuticular stapling of body tissue
US5282845A (en) 1990-10-01 1994-02-01 Ventritex, Inc. Multiple electrode deployable lead
US5611794A (en) 1990-10-11 1997-03-18 Lasersurge, Inc. Clamp for approximating tissue sections
US5042707A (en) 1990-10-16 1991-08-27 Taheri Syde A Intravascular stapler, and method of operating same
US5125758A (en) 1990-12-06 1992-06-30 Dewan Thomas E Piercing clamp
US5275578A (en) 1991-01-11 1994-01-04 Adams Andy W Clip
US5222963A (en) 1991-01-17 1993-06-29 Ethicon, Inc. Pull-through circular anastomosic intraluminal stapler with absorbable fastener means
US5163955A (en) 1991-01-24 1992-11-17 Autogenics Rapid assembly, concentric mating stent, tissue heart valve with enhanced clamping and tissue alignment
US5171252A (en) 1991-02-05 1992-12-15 Friedland Thomas W Surgical fastening clip formed of a shape memory alloy, a method of making such a clip and a method of using such a clip
US5329923A (en) 1991-02-15 1994-07-19 Lundquist Ingemar H Torquable catheter
US5251611A (en) 1991-05-07 1993-10-12 Zehel Wendell E Method and apparatus for conducting exploratory procedures
US5330501A (en) 1991-05-30 1994-07-19 United States Surgical Corporation Tissue gripping device for use with a cannula and a cannula incorporating the device
US5147370A (en) 1991-06-12 1992-09-15 Mcnamara Thomas O Nitinol stent for hollow body conduits
US5226429A (en) 1991-06-20 1993-07-13 Inamed Development Co. Laparoscopic gastric band and method
US5304131A (en) 1991-07-15 1994-04-19 Paskar Larry D Catheter
US5452733A (en) 1993-02-22 1995-09-26 Stanford Surgical Technologies, Inc. Methods for performing thoracoscopic coronary artery bypass
US5571215A (en) 1993-02-22 1996-11-05 Heartport, Inc. Devices and methods for intracardiac procedures
US5370685A (en) 1991-07-16 1994-12-06 Stanford Surgical Technologies, Inc. Endovascular aortic valve replacement
US5769812A (en) 1991-07-16 1998-06-23 Heartport, Inc. System for cardiac procedures
GR920100358A (el) 1991-08-23 1993-06-07 Ethicon Inc Οργανο συρραφής χειρουργικής αναστομώσεως.
CA2078530A1 (en) 1991-09-23 1993-03-24 Jay Erlebacher Percutaneous arterial puncture seal device and insertion tool therefore
US5226911A (en) 1991-10-02 1993-07-13 Target Therapeutics Vasoocclusion coil with attached fibrous element(s)
CA2082090C (en) 1991-11-05 2004-04-27 Jack Fagan Improved occluder for repair of cardiac and vascular defects
US5363861A (en) 1991-11-08 1994-11-15 Ep Technologies, Inc. Electrode tip assembly with variable resistance to bending
DE4137218C1 (zh) 1991-11-13 1993-02-11 Heidmueller, Harald, 5000 Koeln, De
US5271381A (en) 1991-11-18 1993-12-21 Vision Sciences, Inc. Vertebrae for a bending section of an endoscope
US5242456A (en) 1991-11-21 1993-09-07 Kensey Nash Corporation Apparatus and methods for clamping tissue and reflecting the same
US5234437A (en) 1991-12-12 1993-08-10 Target Therapeutics, Inc. Detachable pusher-vasoocclusion coil assembly with threaded coupling
US5261916A (en) 1991-12-12 1993-11-16 Target Therapeutics Detachable pusher-vasoocclusive coil assembly with interlocking ball and keyway coupling
US5522873A (en) 1991-12-26 1996-06-04 Webster Laboratories, Inc. Catheter having electrode with annular recess and method of using same
AU3803193A (en) 1991-12-30 1994-09-26 Wellesley Research Associates, Inc. Dental implant system and apparatus
JP3393383B2 (ja) 1992-01-21 2003-04-07 リージェンツ オブ ザ ユニバーシティ オブ ミネソタ 中隔欠損閉鎖装置
US5489297A (en) 1992-01-27 1996-02-06 Duran; Carlos M. G. Bioprosthetic heart valve with absorbable stent
US5327905A (en) 1992-02-14 1994-07-12 Boaz Avitall Biplanar deflectable catheter for arrhythmogenic tissue ablation
US5417700A (en) 1992-03-30 1995-05-23 Thomas D. Egan Automatic suturing and ligating device
US5314424A (en) 1992-04-06 1994-05-24 United States Surgical Corporation Surgical instrument locking mechanism
US5190554A (en) 1992-04-08 1993-03-02 Eastern Virginia Medical School Appendix extractor
US5318525A (en) 1992-04-10 1994-06-07 Medtronic Cardiorhythm Steerable electrode catheter
US5254130A (en) 1992-04-13 1993-10-19 Raychem Corporation Surgical device
US5368601A (en) 1992-04-30 1994-11-29 Lasersurge, Inc. Trocar wound closure device
US5332402A (en) 1992-05-12 1994-07-26 Teitelbaum George P Percutaneously-inserted cardiac valve
US5389098A (en) 1992-05-19 1995-02-14 Olympus Optical Co., Ltd. Surgical device for stapling and/or fastening body tissues
US5658300A (en) 1992-06-04 1997-08-19 Olympus Optical Co., Ltd. Tissue fixing surgical instrument, tissue-fixing device, and method of fixing tissues
US5325845A (en) 1992-06-08 1994-07-05 Adair Edwin Lloyd Steerable sheath for use with selected removable optical catheter
US5306283A (en) 1992-06-30 1994-04-26 American Cyanamid Company Two-part surgical ligation clip
US5782239A (en) 1992-06-30 1998-07-21 Cordis Webster, Inc. Unique electrode configurations for cardiovascular electrode catheter with built-in deflection method and central puller wire
US5368606A (en) 1992-07-02 1994-11-29 Marlow Surgical Technologies, Inc. Endoscopic instrument system
US5342393A (en) 1992-08-27 1994-08-30 Duke University Method and device for vascular repair
US5383886A (en) 1992-10-13 1995-01-24 Kensey Nash Corporation Methods and instruments for performing medical procedures percutaneously without a trocar
US5713910A (en) 1992-09-04 1998-02-03 Laurus Medical Corporation Needle guidance system for endoscopic suture device
US6048351A (en) 1992-09-04 2000-04-11 Scimed Life Systems, Inc. Transvaginal suturing system
US5342373A (en) 1992-09-14 1994-08-30 Ethicon, Inc. Sterile clips and instrument for their placement
US5312415A (en) 1992-09-22 1994-05-17 Target Therapeutics, Inc. Assembly for placement of embolic coils using frictional placement
US5350397A (en) 1992-11-13 1994-09-27 Target Therapeutics, Inc. Axially detachable embolic coil assembly
US5250071A (en) 1992-09-22 1993-10-05 Target Therapeutics, Inc. Detachable embolic coil assembly using interlocking clasps and method of use
CA2106126A1 (en) 1992-09-23 1994-03-24 Ian M. Scott Bipolar surgical instruments
US5500180A (en) 1992-09-30 1996-03-19 C. R. Bard, Inc. Method of making a distensible dilatation balloon using a block copolymer
US5601224A (en) 1992-10-09 1997-02-11 Ethicon, Inc. Surgical instrument
US5330442A (en) 1992-10-09 1994-07-19 United States Surgical Corporation Suture retaining clip
US6283127B1 (en) 1992-12-03 2001-09-04 Wesley D. Sterman Devices and methods for intracardiac procedures
US5814097A (en) 1992-12-03 1998-09-29 Heartport, Inc. Devices and methods for intracardiac procedures
US5718725A (en) 1992-12-03 1998-02-17 Heartport, Inc. Devices and methods for intracardiac procedures
US5462527A (en) 1993-06-29 1995-10-31 C.R. Bard, Inc. Actuator for use with steerable catheter
US5417699A (en) 1992-12-10 1995-05-23 Perclose Incorporated Device and method for the percutaneous suturing of a vascular puncture site
US6036699A (en) 1992-12-10 2000-03-14 Perclose, Inc. Device and method for suturing tissue
US5403312A (en) 1993-07-22 1995-04-04 Ethicon, Inc. Electrosurgical hemostatic device
US5702825A (en) 1992-12-22 1997-12-30 Essilor International (Compagnie Generale D'optique) Low yellow index polymer compositions, polymerizable compositions and lenses using said compositions
US5368564A (en) 1992-12-23 1994-11-29 Angeion Corporation Steerable catheter
US5403326A (en) 1993-02-01 1995-04-04 The Regents Of The University Of California Method for performing a gastric wrap of the esophagus for use in the treatment of esophageal reflux
US5980455A (en) 1993-02-22 1999-11-09 Heartport, Inc. Method for manipulating a tissue structure within a thoracic cavity
JPH08502438A (ja) 1993-02-22 1996-03-19 ヴァリーラブ・インコーポレーテッド 腹腔鏡切開緊張開創器装置及び方法
US5797960A (en) 1993-02-22 1998-08-25 Stevens; John H. Method and apparatus for thoracoscopic intracardiac procedures
US5425705A (en) 1993-02-22 1995-06-20 Stanford Surgical Technologies, Inc. Thoracoscopic devices and methods for arresting the heart
US5972030A (en) 1993-02-22 1999-10-26 Heartport, Inc. Less-invasive devices and methods for treatment of cardiac valves
US5569274A (en) 1993-02-22 1996-10-29 Heartport, Inc. Endoscopic vascular clamping system and method
US6346074B1 (en) 1993-02-22 2002-02-12 Heartport, Inc. Devices for less invasive intracardiac interventions
US5389077A (en) 1993-03-03 1995-02-14 Uresil Corporation Minimally invasive body cavity penetrating instruments
US5636634A (en) 1993-03-16 1997-06-10 Ep Technologies, Inc. Systems using guide sheaths for introducing, deploying, and stabilizing cardiac mapping and ablation probes
NL9300572A (nl) 1993-03-31 1994-10-17 Cordis Europ Werkwijze voor het vervaardigen van een extrusieprofiel met over de lengte varierende eigenschappen en daarmee vervaardigde catheter.
US5456400A (en) 1993-04-22 1995-10-10 United States Surgical Corporation Apparatus and clip for fastening body tissue
DE4319829C1 (de) 1993-06-16 1994-08-25 Lerch Karl Dieter Set zur Behandlung von Gefäßmißbildungen
US5715817A (en) 1993-06-29 1998-02-10 C.R. Bard, Inc. Bidirectional steering catheter
US5549565A (en) 1993-07-13 1996-08-27 Symbiosis Corporation Reusable surgical trocar with disposable valve assembly
US5527321A (en) 1993-07-14 1996-06-18 United States Surgical Corporation Instrument for closing trocar puncture wounds
US5391182A (en) 1993-08-03 1995-02-21 Origin Medsystems, Inc. Apparatus and method for closing puncture wounds
US5507755A (en) 1993-08-03 1996-04-16 Origin Medsystems, Inc. Apparatus and method for closing puncture wounds
FR2708458B1 (fr) 1993-08-03 1995-09-15 Seguin Jacques Anneau prothétique pour chirurgie cardiaque.
US5450860A (en) 1993-08-31 1995-09-19 W. L. Gore & Associates, Inc. Device for tissue repair and method for employing same
US5607462A (en) 1993-09-24 1997-03-04 Cardiac Pathways Corporation Catheter assembly, catheter and multi-catheter introducer for use therewith
US5423858A (en) 1993-09-30 1995-06-13 United States Surgical Corporation Septoplasty fasteners and device for applying same
US5472044A (en) 1993-10-20 1995-12-05 E. I. Du Pont De Nemours And Company Method and apparatus for interacting a gas and liquid on a convoluted array of tubes
US5496333A (en) 1993-10-20 1996-03-05 Applied Medical Resources Corporation Laparoscopic surgical clamp
US5423857A (en) 1993-11-02 1995-06-13 Ethicon, Inc. Three piece surgical staple
US6203531B1 (en) 1993-11-03 2001-03-20 Daig Corporation Guiding introducers for use in the treatment of accessory pathways around the mitral valve using a retrograde approach
US5640955A (en) 1995-02-14 1997-06-24 Daig Corporation Guiding introducers for use in the treatment of accessory pathways around the mitral valve using a retrograde approach
US5527322A (en) 1993-11-08 1996-06-18 Perclose, Inc. Device and method for suturing of internal puncture sites
US5437681A (en) 1994-01-13 1995-08-01 Suturtek Inc. Suturing instrument with thread management
GB9400739D0 (en) 1994-01-15 1994-03-16 Femcare Ltd Medical clip
US5741280A (en) 1994-01-18 1998-04-21 Coral Medical Knot tying method and apparatus
US5452837A (en) 1994-01-21 1995-09-26 Ethicon Endo-Surgery, Inc. Surgical stapler with tissue gripping ridge
US5359994A (en) 1994-01-24 1994-11-01 Welch Allyn, Inc. Proximal steering cable adjustment
US5501698A (en) 1994-02-14 1996-03-26 Heartport, Inc. Endoscopic microsurgical instruments and methods
CA2141911C (en) 1994-02-24 2002-04-23 Jude S. Sauer Surgical crimping device and method of use
US5431666A (en) 1994-02-24 1995-07-11 Lasersurge, Inc. Surgical suture instrument
US5476470A (en) 1994-04-15 1995-12-19 Fitzgibbons, Jr.; Robert J. Trocar site suturing device
AU697233B2 (en) 1994-04-21 1998-10-01 Medchem Products, Inc. Skin stretching device
US5478309A (en) 1994-05-27 1995-12-26 William P. Sweezer, Jr. Catheter system and method for providing cardiopulmonary bypass pump support during heart surgery
DE4418766C2 (de) 1994-05-28 1996-11-07 Karlsruhe Forschzent Chirurgischer Faden zum Anlegen einer chirurgischen Naht
US5732872A (en) 1994-06-17 1998-03-31 Heartport, Inc. Surgical stapling instrument
US5554185A (en) 1994-07-18 1996-09-10 Block; Peter C. Inflatable prosthetic cardiovascular valve for percutaneous transluminal implantation of same
US5593435A (en) 1994-07-29 1997-01-14 Baxter International Inc. Distensible annuloplasty ring for surgical remodelling of an atrioventricular valve and nonsurgical method for post-implantation distension thereof to accommodate patient growth
US5593424A (en) 1994-08-10 1997-01-14 Segmed, Inc. Apparatus and method for reducing and stabilizing the circumference of a vascular structure
US5601576A (en) 1994-08-10 1997-02-11 Heartport Inc. Surgical knot pusher and method of use
US5456684A (en) 1994-09-08 1995-10-10 Hutchinson Technology Incorporated Multifunctional minimally invasive surgical instrument
US5496332A (en) 1994-10-20 1996-03-05 Cordis Corporation Wound closure apparatus and method for its use
US5599305A (en) 1994-10-24 1997-02-04 Cardiovascular Concepts, Inc. Large-diameter introducer sheath having hemostasis valve and removable steering mechanism
US5814029A (en) 1994-11-03 1998-09-29 Daig Corporation Guiding introducer system for use in ablation and mapping procedures in the left ventricle
US5487746A (en) 1994-11-23 1996-01-30 Yu; George W. Surgical clip having a longitudinal opening through which clamped tissue protrudes
US5690671A (en) 1994-12-13 1997-11-25 Micro Interventional Systems, Inc. Embolic elements and methods and apparatus for their delivery
US5620452A (en) 1994-12-22 1997-04-15 Yoon; Inbae Surgical clip with ductile tissue penetrating members
US5643295A (en) 1994-12-29 1997-07-01 Yoon; Inbae Methods and apparatus for suturing tissue
US5609598A (en) 1994-12-30 1997-03-11 Vnus Medical Technologies, Inc. Method and apparatus for minimally invasive treatment of chronic venous insufficiency
US6540755B2 (en) 1995-02-14 2003-04-01 Daig Corporation Guiding introducers for use in the treatment of accessory pathways around the mitral valve using a retrograde approach
US5976159A (en) 1995-02-24 1999-11-02 Heartport, Inc. Surgical clips and methods for tissue approximation
US5695504A (en) 1995-02-24 1997-12-09 Heartport, Inc. Devices and methods for performing a vascular anastomosis
JPH08231444A (ja) 1995-02-28 1996-09-10 Daikin Ind Ltd １，１，１，３，３−ペンタフルオロプロパンの製造方法
US5695505A (en) 1995-03-09 1997-12-09 Yoon; Inbae Multifunctional spring clips and cartridges and applicators therefor
US5571085A (en) 1995-03-24 1996-11-05 Electro-Catheter Corporation Steerable open lumen catheter
US5849005A (en) 1995-06-07 1998-12-15 Heartport, Inc. Method and apparatus for minimizing the risk of air embolism when performing a procedure in a patient's thoracic cavity
EP0819013B1 (en) 1995-03-30 2004-06-23 Heartport, Inc. System for performing endovascular procedures
US5626607A (en) 1995-04-03 1997-05-06 Heartport, Inc. Clamp assembly and method of use
US5639277A (en) 1995-04-28 1997-06-17 Target Therapeutics, Inc. Embolic coils with offset helical and twisted helical shapes
US5540705A (en) 1995-05-19 1996-07-30 Suturtek, Inc. Suturing instrument with thread management
US5562678A (en) 1995-06-02 1996-10-08 Cook Pacemaker Corporation Needle's eye snare
US5716417A (en) 1995-06-07 1998-02-10 St. Jude Medical, Inc. Integral supporting structure for bioprosthetic heart valve
US5846253A (en) 1995-07-14 1998-12-08 C. R. Bard, Inc. Wound closure apparatus and method
US6117144A (en) 1995-08-24 2000-09-12 Sutura, Inc. Suturing device and method for sealing an opening in a blood vessel or other biological structure
US6562052B2 (en) 1995-08-24 2003-05-13 Sutura, Inc. Suturing device and method
US5860990A (en) 1995-08-24 1999-01-19 Nr Medical, Inc. Method and apparatus for suturing
DE19534112A1 (de) 1995-09-14 1997-03-20 Wolf Gmbh Richard Endoskopisches Instrument
US5722421A (en) 1995-09-15 1998-03-03 Symbiosis Corporation Clevis having deflection limiting stops for use in an endoscopic biopsy forceps instrument
US5797927A (en) 1995-09-22 1998-08-25 Yoon; Inbae Combined tissue clamping and suturing instrument
US5810876A (en) 1995-10-03 1998-09-22 Akos Biomedical, Inc. Flexible forceps device
US5634932A (en) 1995-10-10 1997-06-03 Industrial & Scientific Designs, Ltd. Cantilever aneurysm clip system
US6283951B1 (en) 1996-10-11 2001-09-04 Transvascular, Inc. Systems and methods for delivering drugs to selected locations within the body
JP3293118B2 (ja) 1995-10-18 2002-06-17 ニプロ株式会社 心腔内縫合手術用カテーテル組立体
EP0861049B1 (en) 1995-10-30 2001-04-11 Children's Medical Center Corporation Self-centering umbrella-type septal closure device
US5855271A (en) 1995-11-03 1999-01-05 T. K. F., Inc. Noise and wear reducing apparatus for endless conveyors
US5704898A (en) 1995-11-17 1998-01-06 Circon Corporation Articulation mechanism for an endoscope
US5823955A (en) 1995-11-20 1998-10-20 Medtronic Cardiorhythm Atrioventricular valve tissue ablation catheter and method
JP2963037B2 (ja) 1995-11-30 1999-10-12 三洋電機株式会社 ディスク記録再生装置
US5662704A (en) 1995-12-01 1997-09-02 Medtronic, Inc. Physiologic mitral valve bioprosthesis
US5725556A (en) 1995-12-15 1998-03-10 M & R Medical, Inc. Suture locking apparatus
US5749828A (en) 1995-12-22 1998-05-12 Hewlett-Packard Company Bending neck for use with invasive medical devices
CN1142351A (zh) 1996-01-09 1997-02-12 郑宏 房间隔缺损闭合器
US5810853A (en) 1996-01-16 1998-09-22 Yoon; Inbae Knotting element for use in suturing anatomical tissue and methods therefor
US6015417A (en) 1996-01-25 2000-01-18 Reynolds, Jr.; Walker Surgical fastener
US5860992A (en) 1996-01-31 1999-01-19 Heartport, Inc. Endoscopic suturing devices and methods
US6182664B1 (en) 1996-02-19 2001-02-06 Edwards Lifesciences Corporation Minimally invasive cardiac valve surgery procedure
US5891160A (en) 1996-02-23 1999-04-06 Cardiovascular Technologies, Llc Fastener delivery and deployment mechanism and method for placing the fastener in minimally invasive surgery
US6162233A (en) 1996-02-23 2000-12-19 Cardiovascular Technologies, Llc Wire fasteners for use in minimally invasive surgery and means and methods for handling those fasteners
US6402780B2 (en) 1996-02-23 2002-06-11 Cardiovascular Technologies, L.L.C. Means and method of replacing a heart valve in a minimally invasive manner
US5879307A (en) 1996-03-15 1999-03-09 Pulse Metric, Inc. Non-invasive method and apparatus for diagnosing and monitoring aortic valve abnormalities, such a aortic regurgitation
JP3661267B2 (ja) 1996-03-18 2005-06-15 フジノン株式会社 内視鏡の可撓管
US5853422A (en) 1996-03-22 1998-12-29 Scimed Life Systems, Inc. Apparatus and method for closing a septal defect
US5769859A (en) 1996-04-09 1998-06-23 Dorsey; William R. Umbilical scissors
US6110145A (en) 1996-04-16 2000-08-29 Cardeon Corporation Catheter system for surgical access and circulatory support of the heart
US5738649A (en) 1996-04-16 1998-04-14 Cardeon Corporation Peripheral entry biventricular catheter system for providing access to the heart for cardiopulmonary surgery or for prolonged circulatory support of the heart
US6149660A (en) 1996-04-22 2000-11-21 Vnus Medical Technologies, Inc. Method and apparatus for delivery of an appliance in a vessel
US5662681A (en) 1996-04-23 1997-09-02 Kensey Nash Corporation Self locking closure for sealing percutaneous punctures
US5706824A (en) 1996-05-20 1998-01-13 Symbiosis Corporation Endoscopic biopsy forceps instrument having a constant force spring biasing the jaws closed
US6059757A (en) 1996-06-18 2000-05-09 Cardeon Single lumen catheter with controlled antegrade and retrograde flow
US5827237A (en) 1996-06-17 1998-10-27 Cardeon Corporation Dual lumen catheter with controlled antegrade and retrograde fluid flow
EP0914064A2 (en) 1996-06-17 1999-05-12 Cardeon Corporation Externally valved catheter for controlled antegrade and retrograde fluid flow
US5833671A (en) 1996-06-17 1998-11-10 Cardeon Corporation Triple lumen catheter with controllable antegrade and retrograde fluid flow
US5843178A (en) 1996-06-20 1998-12-01 St. Jude Medical, Inc. Suture guard for annuloplasty ring
US5855601A (en) 1996-06-21 1999-01-05 The Trustees Of Columbia University In The City Of New York Artificial heart valve and method and device for implanting the same
US6001796A (en) 1996-07-03 1999-12-14 Alliedsignal Inc. Azeotrope-like compositions of 1,1,1,3,3-pentafluoropropane and hydrogen fluoride
US5820592A (en) 1996-07-16 1998-10-13 Hammerslag; Gary R. Angiographic and/or guide catheter
US5782845A (en) 1996-07-31 1998-07-21 Shewchuk; Dwight Trocar site suturing device
US5820631A (en) 1996-08-01 1998-10-13 Nr Medical, Inc. Device and method for suturing tissue adjacent to a blood vessel
US6068628A (en) 1996-08-20 2000-05-30 Oratec Interventions, Inc. Apparatus for treating chondromalacia
US6482224B1 (en) 1996-08-22 2002-11-19 The Trustees Of Columbia University In The City Of New York Endovascular flexible stapling device
US5741297A (en) 1996-08-28 1998-04-21 Simon; Morris Daisy occluder and method for septal defect repair
US5713911A (en) 1996-10-03 1998-02-03 United States Surgical Corporation Surgical clip
US5755778A (en) 1996-10-16 1998-05-26 Nitinol Medical Technologies, Inc. Anastomosis device
US5861003A (en) 1996-10-23 1999-01-19 The Cleveland Clinic Foundation Apparatus and method for occluding a defect or aperture within body surface
CA2273149A1 (en) 1996-12-02 1998-06-11 Angiotrax, Inc. Apparatus and methods for percutaneously performing surgery
US6332880B1 (en) 1996-12-19 2001-12-25 Ep Technologies, Inc. Loop structures for supporting multiple electrode elements
IL119911A (en) 1996-12-25 2001-03-19 Niti Alloys Tech Ltd Surgical clip
EP0850607A1 (en) 1996-12-31 1998-07-01 Cordis Corporation Valve prosthesis for implantation in body channels
US6077214A (en) 1998-07-29 2000-06-20 Myocor, Inc. Stress reduction apparatus and method
US6406420B1 (en) 1997-01-02 2002-06-18 Myocor, Inc. Methods and devices for improving cardiac function in hearts
US6050936A (en) 1997-01-02 2000-04-18 Myocor, Inc. Heart wall tension reduction apparatus
US6074401A (en) 1997-01-09 2000-06-13 Coalescent Surgical, Inc. Pinned retainer surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery
US6149658A (en) 1997-01-09 2000-11-21 Coalescent Surgical, Inc. Sutured staple surgical fasteners, instruments and methods for minimally invasive vascular and endoscopic surgery
US5928224A (en) 1997-01-24 1999-07-27 Hearten Medical, Inc. Device for the treatment of damaged heart valve leaflets and methods of using the device
US5916213A (en) 1997-02-04 1999-06-29 Medtronic, Inc. Systems and methods for tissue mapping and ablation
US6056769A (en) 1997-02-11 2000-05-02 Biointerventional Corporation Expansile device for use in blood vessels and tracts in the body and tension application device for use therewith and method
US5972020A (en) 1997-02-14 1999-10-26 Cardiothoracic Systems, Inc. Surgical instrument for cardiac valve repair on the beating heart
US5989284A (en) 1997-02-18 1999-11-23 Hearten Medical, Inc. Method and device for soft tissue modification
US5885271A (en) 1997-03-14 1999-03-23 Millennium Cardiac Strategies, Inc. Device for regional immobilization of a compliant body
US6017358A (en) 1997-05-01 2000-01-25 Inbae Yoon Surgical instrument with multiple rotatably mounted offset end effectors
US5957949A (en) 1997-05-01 1999-09-28 World Medical Manufacturing Corp. Percutaneous placement valve stent
US5876399A (en) 1997-05-28 1999-03-02 Irvine Biomedical, Inc. Catheter system and methods thereof
US5810849A (en) 1997-06-09 1998-09-22 Cardiologics, L.L.C. Device and method for suturing blood vessels and the like
WO1999000059A1 (en) 1997-06-27 1999-01-07 The Trustees Of Columbia University In The City Of New York Method and apparatus for circulatory valve repair
IT1293068B1 (it) 1997-07-01 1999-02-11 Kempro Italiana S R L Procedimento per ottenere una sospensione di silice colloidale ad elevata concentrazione e prodotto cosi' ottenuto
IL121316A (en) 1997-07-15 2001-07-24 Litana Ltd A medical device for planting in an alloy body with memory properties
US5944733A (en) 1997-07-14 1999-08-31 Target Therapeutics, Inc. Controlled detachable vasoocclusive member using mechanical junction and friction-enhancing member
US5910148A (en) 1997-08-06 1999-06-08 Mitek Surgical Products, Inc. Suture retrograder
WO1999007354A2 (en) 1997-08-08 1999-02-18 Duke University Compositions, apparatus and methods for facilitating surgical procedures
US6088889A (en) 1997-09-03 2000-07-18 Edward Elson Clamp operable as a hemostasis valve
US20030105519A1 (en) 1997-09-04 2003-06-05 Roland Fasol Artificial chordae replacement
US6123699A (en) 1997-09-05 2000-09-26 Cordis Webster, Inc. Omni-directional steerable catheter
US5954732A (en) 1997-09-10 1999-09-21 Hart; Charles C. Suturing apparatus and method
FR2768324B1 (fr) 1997-09-12 1999-12-10 Jacques Seguin Instrument chirurgical permettant, par voie percutanee, de fixer l'une a l'autre deux zones de tissu mou, normalement mutuellement distantes
US6019722A (en) 1997-09-17 2000-02-01 Guidant Corporation Device to permit offpump beating heart coronary bypass surgery
US6063106A (en) 1997-09-19 2000-05-16 Gibson; William Frits Stewart Surgical spacer
JPH1189937A (ja) 1997-09-19 1999-04-06 Atsuo Mori 僧帽弁逆流試験用カテーテル
US5916147A (en) 1997-09-22 1999-06-29 Boury; Harb N. Selectively manipulable catheter
WO1999015223A1 (en) 1997-09-26 1999-04-01 Cardeon Corporation Multi-function aortic catheterization and bumper instrument
US6120496A (en) 1998-05-05 2000-09-19 Scimed Life Systems, Inc. Surgical method and apparatus for positioning a diagnostic or therapeutic element within the body and coupling device for use with same
US6086600A (en) 1997-11-03 2000-07-11 Symbiosis Corporation Flexible endoscopic surgical instrument for invagination and fundoplication
US6187003B1 (en) 1997-11-12 2001-02-13 Sherwood Services Ag Bipolar electrosurgical instrument for sealing vessels
US6332893B1 (en) 1997-12-17 2001-12-25 Myocor, Inc. Valve to myocardium tension members device and method
US6200315B1 (en) 1997-12-18 2001-03-13 Medtronic, Inc. Left atrium ablation catheter
US6193734B1 (en) 1998-01-23 2001-02-27 Heartport, Inc. System for performing vascular anastomoses
JP4187411B2 (ja) 1998-01-30 2008-11-26 セント ジュード メディカル エーティージー， インコーポレイテッド 中隔欠損を閉じる際に使用するためのデバイス
US6562037B2 (en) 1998-02-12 2003-05-13 Boris E. Paton Bonding of soft biological tissues by passing high frequency electric current therethrough
US6126658A (en) 1998-02-19 2000-10-03 Baker; James A. Radiofrequency medical instrument and methods for vessel welding
US20020095175A1 (en) 1998-02-24 2002-07-18 Brock David L. Flexible instrument
US6190408B1 (en) 1998-03-05 2001-02-20 The University Of Cincinnati Device and method for restructuring the heart chamber geometry
US6099553A (en) 1998-05-21 2000-08-08 Applied Medical Resources Corporation Suture clinch
US6143024A (en) 1998-06-04 2000-11-07 Sulzer Carbomedics Inc. Annuloplasty ring having flexible anterior portion
US6165164A (en) 1999-03-29 2000-12-26 Cordis Corporation Catheter for injecting therapeutic and diagnostic agents
US6599311B1 (en) 1998-06-05 2003-07-29 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US6283962B1 (en) 1998-06-08 2001-09-04 Quantum Therapeutics Corp. Device for valvular annulus treatment and methods thereof
US6250308B1 (en) 1998-06-16 2001-06-26 Cardiac Concepts, Inc. Mitral valve annuloplasty ring and method of implanting
US6630001B2 (en) 1998-06-24 2003-10-07 International Heart Institute Of Montana Foundation Compliant dehyrated tissue for implantation and process of making the same
US6066146A (en) 1998-06-24 2000-05-23 Carroll; Brendan J. Laparascopic incision closure device
US6322559B1 (en) 1998-07-06 2001-11-27 Vnus Medical Technologies, Inc. Electrode catheter having coil structure
ATE420595T1 (de) 1998-07-08 2009-01-15 Axya Medical Inc Vorrichtungen zur sicherung von nahtmaterial und abbindungen ohne knoten
US6379345B1 (en) 1998-07-15 2002-04-30 Corazon Technologies, Inc. Methods and devices for reducing the mineral content of vascular calcified lesions
US7569062B1 (en) 1998-07-15 2009-08-04 St. Jude Medical, Inc. Mitral and tricuspid valve repair
US6165183A (en) 1998-07-15 2000-12-26 St. Jude Medical, Inc. Mitral and tricuspid valve repair
US6547821B1 (en) 1998-07-16 2003-04-15 Cardiothoracic Systems, Inc. Surgical procedures and devices for increasing cardiac output of the heart
US6260552B1 (en) 1998-07-29 2001-07-17 Myocor, Inc. Transventricular implant tools and devices
US6159240A (en) 1998-08-31 2000-12-12 Medtronic, Inc. Rigid annuloplasty device that becomes compliant after implantation
US6267781B1 (en) 1998-08-31 2001-07-31 Quantum Therapeutics Corp. Medical device and methods for treating valvular annulus
AU5903599A (en) 1998-09-01 2000-03-21 Cardeon Corporation System and methods for catheter procedures with circulatory support in high riskpatients
US6203553B1 (en) 1999-09-08 2001-03-20 United States Surgical Stapling apparatus and method for heart valve replacement
US6355030B1 (en) 1998-09-25 2002-03-12 Cardiothoracic Systems, Inc. Instruments and methods employing thermal energy for the repair and replacement of cardiac valves
US6368326B1 (en) 1998-09-28 2002-04-09 Daos Limited Internal cord fixation device
US7972323B1 (en) 1998-10-02 2011-07-05 Boston Scientific Scimed, Inc. Steerable device for introducing diagnostic and therapeutic apparatus into the body
US6544215B1 (en) 1998-10-02 2003-04-08 Scimed Life Systems, Inc. Steerable device for introducing diagnostic and therapeutic apparatus into the body
US6685627B2 (en) 1998-10-09 2004-02-03 Swaminathan Jayaraman Modification of properties and geometry of heart tissue to influence heart function
US6319250B1 (en) 1998-11-23 2001-11-20 C.R. Bard, Inc Tricuspid annular grasp catheter
US6210419B1 (en) 1998-12-18 2001-04-03 Aesculap Ag & Co. Kg Surgical clip
US6558418B2 (en) 1999-01-26 2003-05-06 Edwards Lifesciences Corporation Flexible heart valve
WO2000044313A1 (en) 1999-01-27 2000-08-03 Viacor Incorporated Cardiac valve procedure methods and devices
US6217528B1 (en) 1999-02-11 2001-04-17 Scimed Life Systems, Inc. Loop structure having improved tissue contact capability
US8118822B2 (en) 1999-03-01 2012-02-21 Medtronic, Inc. Bridge clip tissue connector apparatus and methods
US6701929B2 (en) 1999-03-03 2004-03-09 Hany Hussein Device and method for treatment of congestive heart failure
US6136010A (en) 1999-03-04 2000-10-24 Perclose, Inc. Articulating suturing device and method
US6267746B1 (en) 1999-03-22 2001-07-31 Biosense Webster, Inc. Multi-directional steerable catheters and control handles
JP3425387B2 (ja) 1999-03-29 2003-07-14 有限会社タカタデザインラボ 物品の固定具
WO2000059382A1 (en) 1999-04-01 2000-10-12 Bjerken David B Vacuum-assisted remote suture placement system
CA2369641C (en) 1999-04-09 2009-02-10 Evalve, Inc. Methods and apparatus for cardiac valve repair
US7563267B2 (en) 1999-04-09 2009-07-21 Evalve, Inc. Fixation device and methods for engaging tissue
US6752813B2 (en) 1999-04-09 2004-06-22 Evalve, Inc. Methods and devices for capturing and fixing leaflets in valve repair
US20040044350A1 (en) 1999-04-09 2004-03-04 Evalve, Inc. Steerable access sheath and methods of use
US8216256B2 (en) 1999-04-09 2012-07-10 Evalve, Inc. Detachment mechanism for implantable fixation devices
US7811296B2 (en) 1999-04-09 2010-10-12 Evalve, Inc. Fixation devices for variation in engagement of tissue
US10327743B2 (en) 1999-04-09 2019-06-25 Evalve, Inc. Device and methods for endoscopic annuloplasty
US6860179B2 (en) 1999-05-03 2005-03-01 Irwin Industrial Tool Company Clamp device
US6709382B1 (en) 1999-05-04 2004-03-23 Simon Marcus Horner Cardiac assist method and apparatus
US6206907B1 (en) 1999-05-07 2001-03-27 Cardia, Inc. Occlusion device with stranded wire support arms
CA2373636A1 (en) 1999-05-11 2000-11-16 Craig Berky Surgical clamp devices and methods especially useful in cardiac surgery
US6165204A (en) 1999-06-11 2000-12-26 Scion International, Inc. Shaped suture clip, appliance and method therefor
EP1198213B1 (en) 1999-06-25 2010-06-09 Vahid Saadat Apparatus for treating tissue
US6626899B2 (en) 1999-06-25 2003-09-30 Nidus Medical, Llc Apparatus and methods for treating tissue
SE514718C2 (sv) 1999-06-29 2001-04-09 Jan Otto Solem Anordning för behandling av bristande tillslutningsförmåga hos mitralisklaffapparaten
US7192442B2 (en) 1999-06-30 2007-03-20 Edwards Lifesciences Ag Method and device for treatment of mitral insufficiency
US6997951B2 (en) 1999-06-30 2006-02-14 Edwards Lifesciences Ag Method and device for treatment of mitral insufficiency
DE19932565A1 (de) 1999-07-13 2001-01-18 Henkel Kgaa Mittel zum Färben von keratinhaltigen Fasern
US7887477B2 (en) 1999-08-09 2011-02-15 Cardiokinetix, Inc. Method of improving cardiac function using a porous membrane
US6299637B1 (en) 1999-08-20 2001-10-09 Samuel M. Shaolian Transluminally implantable venous valve
US6231561B1 (en) 1999-09-20 2001-05-15 Appriva Medical, Inc. Method and apparatus for closing a body lumen
US20030069570A1 (en) 1999-10-02 2003-04-10 Witzel Thomas H. Methods for repairing mitral valve annulus percutaneously
US6306133B1 (en) 1999-10-02 2001-10-23 Quantum Cor Incorporated Ablation catheter system and methods for repairing a valvular annulus
US6485489B2 (en) 1999-10-02 2002-11-26 Quantum Cor, Inc. Catheter system for repairing a mitral valve annulus
FR2799364B1 (fr) 1999-10-12 2001-11-23 Jacques Seguin Dispositif d'annuloplastie utilisable par voie mini-invasive
WO2001026588A2 (en) 1999-10-13 2001-04-19 Yeung Jeffrey E Methods and devices for treating urinary incontinence or obstruction
US6312447B1 (en) 1999-10-13 2001-11-06 The General Hospital Corporation Devices and methods for percutaneous mitral valve repair
US6352708B1 (en) 1999-10-14 2002-03-05 The International Heart Institute Of Montana Foundation Solution and method for treating autologous tissue for implant operation
US6491511B1 (en) 1999-10-14 2002-12-10 The International Heart Institute Of Montana Foundation Mold to form stent-less replacement heart valves from biological membranes
US7004970B2 (en) 1999-10-20 2006-02-28 Anulex Technologies, Inc. Methods and devices for spinal disc annulus reconstruction and repair
WO2001028455A1 (en) 1999-10-21 2001-04-26 Myocor, Inc. Methods and devices for improving cardiac function in hearts
EP1674040A3 (en) 1999-10-21 2007-09-19 Edwards Lifesciences Corporation Minimally invasive mitral valve repair
US6626930B1 (en) 1999-10-21 2003-09-30 Edwards Lifesciences Corporation Minimally invasive mitral valve repair method and apparatus
US6533767B2 (en) 2000-03-20 2003-03-18 Corazon Technologies, Inc. Methods for enhancing fluid flow through an obstructed vascular site, and systems and kits for use in practicing the same
US6551303B1 (en) 1999-10-27 2003-04-22 Atritech, Inc. Barrier device for ostium of left atrial appendage
US6926730B1 (en) 2000-10-10 2005-08-09 Medtronic, Inc. Minimally invasive valve repair procedure and apparatus
US6387104B1 (en) 1999-11-12 2002-05-14 Scimed Life Systems, Inc. Method and apparatus for endoscopic repair of the lower esophageal sphincter
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
US6641592B1 (en) 1999-11-19 2003-11-04 Lsi Solutions, Inc. System for wound closure
EP1239795B1 (en) 1999-12-23 2006-12-06 Edwards Lifesciences Corporation Enhanced visualization of medical implants
CN1806775A (zh) 2000-01-14 2006-07-26 维亚科公司 组织瓣环成形术带
US20010010005A1 (en) 2000-01-24 2001-07-26 Kammerer Gene W. Meniscal repair device
US7011682B2 (en) 2000-01-31 2006-03-14 Edwards Lifesciences Ag Methods and apparatus for remodeling an extravascular tissue structure
US6402781B1 (en) 2000-01-31 2002-06-11 Mitralife Percutaneous mitral annuloplasty and cardiac reinforcement
US6540782B1 (en) 2000-02-02 2003-04-01 Robert V. Snyders Artificial heart valve
US6797002B2 (en) 2000-02-02 2004-09-28 Paul A. Spence Heart valve repair apparatus and methods
EP2319428B1 (en) 2000-03-03 2014-12-10 C. R. Bard, Inc. Suture clip
TW465542U (en) 2000-03-14 2001-11-21 Tange Seiki Taichung Co Ltd Improved structure for bearing alignment of concealed operation head joint of bicycle
AU2001245468A1 (en) 2000-03-20 2001-10-03 Corazon Technologies, Inc. Methods and systems for enhancing fluid flow through an obstructed vascular site
US6858005B2 (en) 2000-04-03 2005-02-22 Neo Guide Systems, Inc. Tendon-driven endoscope and methods of insertion
US6530897B2 (en) 2000-04-28 2003-03-11 Mahase Nardeo Steerable medical catheter with bendable encapsulated metal spring tip fused to polymeric shaft
US7083628B2 (en) 2002-09-03 2006-08-01 Edwards Lifesciences Corporation Single catheter mitral valve repair device and method for use
US6743239B1 (en) 2000-05-25 2004-06-01 St. Jude Medical, Inc. Devices with a bendable tip for medical procedures
US6902522B1 (en) 2000-06-12 2005-06-07 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
US6730016B1 (en) 2000-06-12 2004-05-04 Acorn Cardiovascular, Inc. Cardiac disease treatment and device
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
ATE381291T1 (de) 2000-06-23 2008-01-15 Viacor Inc Automatische ringförmige faltung zur mitralklappenreparatur
AU2001271667A1 (en) 2000-06-30 2002-01-14 Viacor Incorporated Method and apparatus for performing a procedure on a cardiac valve
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
US6572652B2 (en) 2000-08-29 2003-06-03 Venpro Corporation Method and devices for decreasing elevated pulmonary venous pressure
WO2002019951A1 (en) 2000-09-07 2002-03-14 Viacor, Inc. Fixation band for affixing a prosthetic heart valve to tissue
US20020035381A1 (en) 2000-09-18 2002-03-21 Cameron Health, Inc. Subcutaneous electrode with improved contact shape for transthoracic conduction
WO2004030570A2 (en) 2002-10-01 2004-04-15 Ample Medical, Inc. Devices for retaining native heart valve leaflet
US20060106456A9 (en) 2002-10-01 2006-05-18 Ample Medical, Inc. Devices, systems, and methods for reshaping a heart valve annulus
US20050228422A1 (en) 2002-11-26 2005-10-13 Ample Medical, Inc. Devices, systems, and methods for reshaping a heart valve annulus, including the use of magnetic tools
US8784482B2 (en) 2000-09-20 2014-07-22 Mvrx, Inc. Method of reshaping a heart valve annulus using an intravascular device
US8956407B2 (en) 2000-09-20 2015-02-17 Mvrx, Inc. Methods for reshaping a heart valve annulus using a tensioning implant
US7033374B2 (en) 2000-09-26 2006-04-25 Microvention, Inc. Microcoil vaso-occlusive device with multi-axis secondary configuration
US6723038B1 (en) 2000-10-06 2004-04-20 Myocor, Inc. Methods and devices for improving mitral valve function
US6616684B1 (en) 2000-10-06 2003-09-09 Myocor, Inc. Endovascular splinting devices and methods
US6918917B1 (en) 2000-10-10 2005-07-19 Medtronic, Inc. Minimally invasive annuloplasty procedure and apparatus
US6533796B1 (en) 2000-10-11 2003-03-18 Lsi Solutions, Inc. Loader for surgical suturing instrument
US6936058B2 (en) 2000-10-18 2005-08-30 Nmt Medical, Inc. Over-the-wire interlock attachment/detachment mechanism
US6508828B1 (en) 2000-11-03 2003-01-21 Radi Medical Systems Ab Sealing device and wound closure device
US20020077687A1 (en) 2000-12-14 2002-06-20 Ahn Samuel S. Catheter assembly for treating ischemic tissue
US7591826B2 (en) 2000-12-28 2009-09-22 Cardiac Dimensions, Inc. Device implantable in the coronary sinus to provide mitral valve therapy
JP4195612B2 (ja) 2001-01-30 2008-12-10 エドワーズ ライフサイエンシーズ アーゲー 管外組織構造を改善する医療システム及び方法
US6810882B2 (en) 2001-01-30 2004-11-02 Ev3 Santa Rosa, Inc. Transluminal mitral annuloplasty
CA2437824C (en) 2001-02-05 2008-09-23 Viacor, Inc. Apparatus and method for reducing mitral regurgitation
CA2437387A1 (en) 2001-02-05 2002-08-15 Viacor, Inc. Method and apparatus for improving mitral valve function
US20020107531A1 (en) 2001-02-06 2002-08-08 Schreck Stefan G. Method and system for tissue repair using dual catheters
JP2001239212A (ja) 2001-02-06 2001-09-04 Matsushita Electric Ind Co Ltd 振動発生モータ
US6723109B2 (en) 2001-02-07 2004-04-20 Karl Storz Endoscopy-America, Inc. Deployable surgical clamp with delivery/retrieval device and actuator
US7842050B2 (en) 2001-02-26 2010-11-30 Diduch David R Suture passing devices
US6585761B2 (en) 2001-03-01 2003-07-01 Syde A. Taheri Prosthetic vein valve and method
JP4295925B2 (ja) 2001-03-01 2009-07-15 Ｈｏｙａ株式会社 内視鏡用バイポーラ高周波処置具
ATE397426T1 (de) 2001-03-29 2008-06-15 Viacor Inc Gerät zur verbesserung der mitralklappenfunktion
DE10116168A1 (de) 2001-03-31 2001-11-29 Joachim Heinzl Verfahren und Einrichtung zum Klippsen mit dem Endoskop
US20060069429A1 (en) 2001-04-24 2006-03-30 Spence Paul A Tissue fastening systems and methods utilizing magnetic guidance
US6619291B2 (en) 2001-04-24 2003-09-16 Edwin J. Hlavka Method and apparatus for catheter-based annuloplasty
US6837867B2 (en) 2001-04-30 2005-01-04 Biosense Webster, Inc. Steerable catheter with reinforced tip
US6858039B2 (en) 2002-07-08 2005-02-22 Edwards Lifesciences Corporation Mitral valve annuloplasty ring having a posterior bow
AU2002311944A1 (en) 2001-05-17 2002-11-25 The Regents Of The University Of California Retrieval catheter
US7338514B2 (en) 2001-06-01 2008-03-04 St. Jude Medical, Cardiology Division, Inc. Closure devices, related delivery methods and tools, and related methods of use
DE10129525A1 (de) 2001-06-21 2003-01-09 Basf Ag Multimodale Polyamide, Polyester und Polyesteramide
US20030078654A1 (en) 2001-08-14 2003-04-24 Taylor Daniel C. Method and apparatus for improving mitral valve function
US6726716B2 (en) 2001-08-24 2004-04-27 Edwards Lifesciences Corporation Self-molding annuloplasty ring
ATE387160T1 (de) 2001-08-31 2008-03-15 Mitral Interventions Vorrichtung für eine herzklappenreperatur
US20030050693A1 (en) 2001-09-10 2003-03-13 Quijano Rodolfo C. Minimally invasive delivery system for annuloplasty rings
FR2829922B1 (fr) 2001-09-21 2004-06-18 Sofradim Production Implant complet et universel pour la reparation des hernies par voie anterieure
CA2455444A1 (en) 2001-10-01 2003-04-10 Ample Medical, Inc. Methods and devices for heart valve treatments
US7144363B2 (en) 2001-10-16 2006-12-05 Extensia Medical, Inc. Systems for heart treatment
US7052487B2 (en) 2001-10-26 2006-05-30 Cohn William E Method and apparatus for reducing mitral regurgitation
US6949122B2 (en) 2001-11-01 2005-09-27 Cardiac Dimensions, Inc. Focused compression mitral valve device and method
US6805710B2 (en) 2001-11-13 2004-10-19 Edwards Lifesciences Corporation Mitral valve annuloplasty ring for molding left ventricle geometry
US6575971B2 (en) 2001-11-15 2003-06-10 Quantum Cor, Inc. Cardiac valve leaflet stapler device and methods thereof
AU2002228753A1 (en) 2001-12-04 2003-06-17 Edwards Lifesciences Corporation Minimally-invasive annuloplasty repair segment delivery template system
US6976995B2 (en) 2002-01-30 2005-12-20 Cardiac Dimensions, Inc. Fixed length anchor and pull mitral valve device and method
US6908478B2 (en) 2001-12-05 2005-06-21 Cardiac Dimensions, Inc. Anchor and pull mitral valve device and method
US6978176B2 (en) 2001-12-08 2005-12-20 Lattouf Omar M Treatment for patient with congestive heart failure
US6740107B2 (en) 2001-12-19 2004-05-25 Trimedyne, Inc. Device for treatment of atrioventricular valve regurgitation
US20030120341A1 (en) 2001-12-21 2003-06-26 Hani Shennib Devices and methods of repairing cardiac valves
US20030120340A1 (en) 2001-12-26 2003-06-26 Jan Liska Mitral and tricuspid valve repair
US6764510B2 (en) 2002-01-09 2004-07-20 Myocor, Inc. Devices and methods for heart valve treatment
US7150750B2 (en) 2002-01-10 2006-12-19 Boston Scientific Scimed, Inc. Method and device for endoscopic suturing
US7125420B2 (en) 2002-02-05 2006-10-24 Viacor, Inc. Method and apparatus for improving mitral valve function
US20030170589A1 (en) 2002-02-27 2003-09-11 Novak Eugene J. Dental handpiece with improved grease retention
US7048754B2 (en) 2002-03-01 2006-05-23 Evalve, Inc. Suture fasteners and methods of use
ATE423217T1 (de) 2002-03-01 2009-03-15 Siemens Healthcare Diagnostics Assays zur überwachung von krebspatienten auf grundlage der spiegel von analytenkomponenten des plasminogen-aktivator-systems in proben von körperflüssigkeiten
US7004958B2 (en) 2002-03-06 2006-02-28 Cardiac Dimensions, Inc. Transvenous staples, assembly and method for mitral valve repair
US6855137B2 (en) 2002-03-07 2005-02-15 Visionary Biomedical, Inc. Catheter shaft with coextruded stiffener
US6797001B2 (en) 2002-03-11 2004-09-28 Cardiac Dimensions, Inc. Device, assembly and method for mitral valve repair
US7588585B2 (en) 2002-03-26 2009-09-15 Novare Surgical Systems, Inc. Handleless clamping device
US7094244B2 (en) 2002-03-26 2006-08-22 Edwards Lifesciences Corporation Sequential heart valve leaflet repair device and method of use
US7335221B2 (en) 2002-04-12 2008-02-26 Ethicon, Inc. Suture anchoring and tensioning device and method for using same
US7497822B1 (en) 2003-04-10 2009-03-03 Torax Medical, Inc. Stomach reduction methods and apparatus
US7101395B2 (en) 2002-06-12 2006-09-05 Mitral Interventions, Inc. Method and apparatus for tissue connection
AU2003245507A1 (en) 2002-06-13 2003-12-31 Guided Delivery Systems, Inc. Devices and methods for heart valve repair
US8287555B2 (en) 2003-02-06 2012-10-16 Guided Delivery Systems, Inc. Devices and methods for heart valve repair
US8348963B2 (en) 2002-07-03 2013-01-08 Hlt, Inc. Leaflet reinforcement for regurgitant valves
EP1545371B1 (en) 2002-08-01 2016-04-13 Robert A. Levine Cardiac devices and methods for minimally invasive repair of ischemic mitral regurgitation
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
US20040034365A1 (en) 2002-08-16 2004-02-19 Lentz David J. Catheter having articulation system
AU2003268220B8 (en) 2002-08-28 2010-01-21 Hlt, Inc. Method and device for treating diseased valve
RU2005108673A (ru) 2002-08-29 2006-01-20 Митралсолюшнз, Инк. (Us) Имплантируемые устройства для регулирования внутренней окружности анатомического отверстия или просвета
US7734316B2 (en) 2002-08-30 2010-06-08 Motorola, Inc. User-specified outputs in mobile wireless communication devices and methods therefor
US20040133062A1 (en) 2002-10-11 2004-07-08 Suresh Pai Minimally invasive cardiac force transfer structures
US7087064B1 (en) 2002-10-15 2006-08-08 Advanced Cardiovascular Systems, Inc. Apparatuses and methods for heart valve repair
EP1555949A4 (en) 2002-10-21 2009-07-01 Mitralign Inc METHOD AND DEVICE FOR IMPLEMENTING A CATHETER BASE ANNULOPLASTY WITH LOCAL FOLDINGS
DE10249415B3 (de) 2002-10-23 2004-03-25 Siemens Ag System zur medizinischen Unterstützung der Insassen eines Kraftfahrzeugs
EP1553897A1 (en) 2002-10-24 2005-07-20 Boston Scientific Limited Venous valve apparatus and method
US20040097979A1 (en) 2002-11-14 2004-05-20 Oleg Svanidze Aortic valve implantation 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
US7485143B2 (en) 2002-11-15 2009-02-03 Abbott Cardiovascular Systems Inc. Apparatuses and methods for heart valve repair
US6945978B1 (en) 2002-11-15 2005-09-20 Advanced Cardiovascular Systems, Inc. Heart valve catheter
US20040133240A1 (en) 2003-01-07 2004-07-08 Cardiac Dimensions, Inc. Electrotherapy system, device, and method for treatment of cardiac valve dysfunction
US7381210B2 (en) 2003-03-14 2008-06-03 Edwards Lifesciences Corporation Mitral valve repair system and method for use
US20040186566A1 (en) 2003-03-18 2004-09-23 Hindrichs Paul J. Body tissue remodeling methods and apparatus
US20040210240A1 (en) 2003-04-21 2004-10-21 Sean Saint Method and repair device for treating mitral valve insufficiency
US20040220593A1 (en) 2003-05-01 2004-11-04 Secant Medical, Llc Restraining clip for mitral valve repair
US20040220657A1 (en) 2003-05-02 2004-11-04 Cardiac Dimensions, Inc., A Washington Corporation Tissue shaping device with conformable anchors
WO2004112651A2 (en) 2003-06-20 2004-12-29 Medtronic Vascular, Inc. Chordae tendinae girdle
EP1648346A4 (en) 2003-06-20 2006-10-18 Medtronic Vascular Inc SYSTEM FOR REDUCING ANNULAR SPACE OF A PROSTHESIS VALVE
WO2005002424A2 (en) 2003-07-02 2005-01-13 Flexcor, Inc. Annuloplasty rings and methods for repairing cardiac valves
US20050004665A1 (en) 2003-07-02 2005-01-06 Lishan Aklog Annuloplasty rings and methods for repairing cardiac valves
CA2533020A1 (en) 2003-07-18 2005-03-03 Ev3 Santa Rosa, Inc. Remotely activated mitral annuloplasty system and methods
US7160322B2 (en) 2003-08-13 2007-01-09 Shlomo Gabbay Implantable cardiac prosthesis for mitigating prolapse of a heart valve
WO2005032421A2 (en) 2003-09-15 2005-04-14 Medtronic Vascular, Inc. Apparatus and method for elongation of a papillary muscle
WO2005027797A1 (en) 2003-09-23 2005-03-31 Ersin Erek A mitral web apparatus for mitral valve insufficiencies
WO2005069850A2 (en) 2004-01-15 2005-08-04 Macoviak John A Trestle heart valve replacement
US20050159810A1 (en) 2004-01-15 2005-07-21 Farzan Filsoufi Devices and methods for repairing cardiac valves
ITTO20040135A1 (it) 2004-03-03 2004-06-03 Sorin Biomedica Cardio Spa Protesi valvolare cardiaca
US7641686B2 (en) 2004-04-23 2010-01-05 Direct Flow Medical, Inc. Percutaneous heart valve with stentless support
EP1750592B1 (en) 2004-05-14 2016-12-28 Evalve, Inc. Locking mechanisms for fixation devices
US7601117B2 (en) 2004-06-30 2009-10-13 Ethicon, Inc. Systems and methods for assisting cardiac valve coaptation
US7556632B2 (en) 2004-07-09 2009-07-07 Reza Zadno Device and method for repairing tissue
US7402134B2 (en) 2004-07-15 2008-07-22 Micardia Corporation Magnetic devices and methods for reshaping heart anatomy
AU2005284739B2 (en) 2004-09-14 2011-02-24 Edwards Lifesciences Ag Device and method for treatment of heart valve regurgitation
US7651502B2 (en) 2004-09-24 2010-01-26 Jackson Roger P Spinal fixation tool set and method for rod reduction and fastener insertion
US8052592B2 (en) 2005-09-27 2011-11-08 Evalve, Inc. Methods and devices for tissue grasping and assessment
US20060089711A1 (en) 2004-10-27 2006-04-27 Medtronic Vascular, Inc. Multifilament anchor for reducing a compass of a lumen or structure in mammalian body
AU2006212750B2 (en) 2005-02-07 2011-11-17 Evalve, Inc. Methods, systems and devices for cardiac valve repair
EP1865887A1 (en) 2005-03-25 2007-12-19 Ample Medical, Inc. Device, systems, and methods for reshaping a heart valve annulus
US20060241746A1 (en) 2005-04-21 2006-10-26 Emanuel Shaoulian Magnetic implants and methods for reshaping tissue
US7753934B2 (en) 2005-04-22 2010-07-13 Wilk Patent, Llc Medical closure method and associated device
EP1874217A4 (en) * 2005-04-25 2014-11-19 Evalve Inc DEVICE AND METHOD FOR ENDOSCOPIC ANNULOPLASTY
EP1959865B1 (en) 2005-12-15 2014-12-10 The Cleveland Clinic Foundation Apparatus for treating a regurgitant valve
US7798953B1 (en) 2006-01-04 2010-09-21 Wilk Patent, Llc Method and device for improving cardiac function
US20080039935A1 (en) 2006-08-14 2008-02-14 Wally Buch Methods and apparatus for mitral valve repair
US7533790B1 (en) 2007-03-08 2009-05-19 Cardica, Inc. Surgical stapler
US20090105815A1 (en) * 2007-10-19 2009-04-23 Matthew Krever Push-in retainer system for use in the direct plication annuloplasty treatment of mitral valve regurgitation
US8808368B2 (en) 2008-12-22 2014-08-19 Valtech Cardio, Ltd. Implantation of repair chords in the heart
AU2010226495A1 (en) * 2009-03-19 2011-09-29 Millipede Llc Reconfiguring heart features
US9011522B2 (en) * 2009-04-10 2015-04-21 Lon Sutherland ANNEST Device and method for temporary or permanent suspension of an implantable scaffolding containing an orifice for placement of a prosthetic or bio-prosthetic valve
CN105640606B (zh) 2009-06-17 2018-10-09 科赫里克斯医疗股份有限公司 用于修正左心耳的医疗装置以及相关的系统和方法
US10335157B2 (en) * 2010-10-02 2019-07-02 Covidien Lp Asymmetrical surgical clip with penetrating lock, non-slip clamping surface, severable hinge, hinge boss and pivoting applicator tip
WO2012051188A2 (en) * 2010-10-11 2012-04-19 Cook Medical Technologies Llc Medical devices with detachable pivotable jaws
US8945177B2 (en) * 2011-09-13 2015-02-03 Abbott Cardiovascular Systems Inc. Gripper pusher mechanism for tissue apposition systems
FR2985019B1 (fr) 2011-12-21 2014-01-24 Irsn Fluxmetre auto-etalonne
JP6049761B2 (ja) * 2012-01-31 2016-12-21 マイトラル・ヴァルヴ・テクノロジーズ・エス・アー・エール・エル 僧帽弁ドッキングデバイス、システム、および方法
CN104023654B (zh) * 2012-07-20 2017-05-17 奥林巴斯株式会社 止血夹具
US10188392B2 (en) * 2014-12-19 2019-01-29 Abbott Cardiovascular Systems, Inc. Grasping for tissue repair

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006037073A2 (en) * 2004-09-27 2006-04-06 Evalve, Inc. Methods and devices for tissue grasping and assessment

Also Published As

Publication number Publication date
CN107106176A (zh) 2017-08-29
WO2016099650A1 (en) 2016-06-23
JP2017538510A (ja) 2017-12-28
US20220104819A1 (en) 2022-04-07
US20160174979A1 (en) 2016-06-23
US10188392B2 (en) 2019-01-29
US20200205831A1 (en) 2020-07-02
US20200205830A1 (en) 2020-07-02
JP7072098B2 (ja) 2022-05-19
US20200205829A1 (en) 2020-07-02
US20200163672A1 (en) 2020-05-28
EP3628243A1 (en) 2020-04-01
JP2020032197A (ja) 2020-03-05
US11109863B2 (en) 2021-09-07
US20190133581A1 (en) 2019-05-09
US11229435B2 (en) 2022-01-25
EP3232948A1 (en) 2017-10-25
EP3232948B1 (en) 2019-11-20
CN111297517A (zh) 2020-06-19
JP6874090B2 (ja) 2021-05-19
CN111297517B (zh) 2022-05-10
JP6685306B2 (ja) 2020-04-22
JP2021112600A (ja) 2021-08-05
US11006956B2 (en) 2021-05-18

Similar Documents

Publication Publication Date Title
CN107106176B (zh) 用于组织修复的改进的抓持器
US11666433B2 (en) Double orifice device for transcatheter mitral valve replacement
US11141158B2 (en) Independent gripper
EP1804686B1 (en) Fixation devices for variation in engagement of tissue
US11850151B2 (en) Proximal element actuator fixation and release mechanisms
US12029425B2 (en) Independent gripper

Legal Events

Date Code Title Description
PB01 Publication
PB01 Publication
SE01 Entry into force of request for substantive examination
SE01 Entry into force of request for substantive examination
GR01 Patent grant
GR01 Patent grant