DE10049812A1 - Blood-filter consists of two filter screens placed on connecting axis with facing concave sides and operated by catheter - Google Patents

Blood-filter consists of two filter screens placed on connecting axis with facing concave sides and operated by catheter

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Publication number
DE10049812A1
DE10049812A1 DE2000149812 DE10049812A DE10049812A1 DE 10049812 A1 DE10049812 A1 DE 10049812A1 DE 2000149812 DE2000149812 DE 2000149812 DE 10049812 A DE10049812 A DE 10049812A DE 10049812 A1 DE10049812 A1 DE 10049812A1
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Prior art keywords
filter
filter screens
characterized
device according
screens
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Granted
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DE2000149812
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German (de)
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DE10049812B4 (en
Inventor
Ulrich Matern
Rico Bergmann
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Universitaetsklinikum Freiburg
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Universitaetsklinikum Freiburg
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Publication of DE10049812B4 publication Critical patent/DE10049812B4/en
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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/01Filters implantable into blood vessels
    • A61F2002/018Filters implantable into blood vessels made from tubes or sheets of material, e.g. by etching or laser-cutting
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0002Two-dimensional shapes, e.g. cross-sections
    • A61F2230/0004Rounded shapes, e.g. with rounded corners
    • A61F2230/0006Rounded shapes, e.g. with rounded corners circular
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0069Three-dimensional shapes cylindrical
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0073Quadric-shaped
    • A61F2230/0076Quadric-shaped ellipsoidal or ovoid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0073Quadric-shaped
    • A61F2230/008Quadric-shaped paraboloidal

Abstract

At least one, preferably two filter-screen(s) (3,4) is/are placed on a shared connecting axis (1) along which the filter-screens lie when folded up and from which the filter screens extend radially when tensioned. The filter screen is o operated by an operating catheter (2). The concave sides of the filter screens are opposite each other when tensioned. The filter screens are made of material through which natural blood constituents can pass unhindered.

Description

Technisches Gebiet technical field

Die Erfindung bezieht sich auf eine Vorrichtung zum Ausfiltern makroskopischer Teilchen aus einer Blutbahn beim lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz mit wenigstens einem schirmartig aufspannbaren Filterschirm, der aus einem zusammengefalteten Zustand in einen aufgespannten Zustand aufspannbar ist und mittels eines Arbeitskatheters betätigbar ist. The invention relates to a device for filtering of macroscopic particles from a bloodstream at the local removal of an aortic valve on the human or animal heart with at least one umbrella-like clampable filter screen which is clamped from a collapsed state to a clamped state and operable by means of a working catheter.

Stand der Technik State of the art

Bei einer Vielzahl von Patienten kommt es vor, dass sich im Laufe der Zeit Ablagerungen an der Herzklappe bilden, insbesondere an der Aortenklappe, häufig in Form von Kalkablagerungen oder sonstigen Materialdepositionen. In a large number of patients, it happens that over time form deposits on the heart valve, especially the aortic valve, often in the form of calcium deposits or other material deposition. Durch derartige Materialablagerungen an der Aortenklappe, die in einem gesunden Zustand als ein feines flexibles Gewebesegel ausgebildet ist, kommt es zu einer irreversiblen Versteifung der Aortenklappe, wodurch insbesondere der Blutabfluss aus dem Herz erheblich in Mitleidenschaft gezogen wird. By such material deposits on the aortic valve, which is designed as a fine flexible fabric sail in a healthy condition, there is an irreversible stiffening of the aortic valve, whereby in particular the flow of blood is drawn from the heart significantly affected. Blutunterversorgung im gesamten Körper ist die Folge, so dass in einem derart fortgeschrittenen Stadium ein akuter Handlungsbedarf besteht, will man schwerwiegende Folgen für den Patienten vermeiden. Low blood supply throughout the body is the result, so that in such an advanced stage there is an acute need for action, wants to avoid serious consequences for the patient. Bisher bekannte medikamentöse Behandlungsmethoden zeigen jedoch nur begrenzten Erfolg, so dass nach heutiger Kenntnis einer Verkalkung von Aortenklappen lediglich durch einen schwerwiegende chirurgischen Eingriff begegnet werden kann. However, previously known drug treatments show limited success, so that can only be met by a serious surgical procedure now known to calcification of the aortic valve.

Üblicherweise wird in diesem Fall im Rahmen einer Sternotomie der Brustkorb eines Menschen geöffnet um Zugang zum Herz und insbesondere zu den verkalkten Aortenklappen zu erhalten, die mit bekannten Schneidewerkzeugen aus dem Körper extrahiert wird. Typically, the chest of a human being is opened to access the heart and in particular to the calcified aortic valve to obtain in this case as part of a sternotomy, which is extracted with known cutting tools from the body. Beispielsweise eignen sich hierzu Extraktionswerkzeuge wie sie in den amerikanischen Druckschriften US 6,033,419 sowie US 5,827,316 beschrieben sind. For example, this suitable extraction tools as described in the American documents US 6,033,419 and US 5,827,316. Nach erfolgtem operativen Eingriff und Wiederverschluss des Brustkorbes steht dem Patienten eine langwierige Heilungsdauer bevor, die in den meisten Fällen mit einer ebenso langwierigen Rehabilitationszeit gefolgt ist. After the surgery and re-closure of the thorax the patient is facing a lengthy healing period that is followed in most cases with an equally lengthy rehabilitation period.

Nun sind auch Operationstechniken bekannt geworden, die unter Einsatz von Kathetern und Endoskopen eine Behandlung der Aortenklappe auch mit weit geringeren Belastungen für den Patienten ermöglichen. Now surgical techniques have been disclosed which allow using catheters and endoscopes treatment of the aortic valve with far less stress for the patient. Dies jedoch setzt voraus, dass die verkalkte Aortenklappe mit Hilfe geeigneter Katheterwerkzeuge vor Ort abgetragen wird. This presupposes that the calcified aortic valve is removed with the aid of suitable catheters tools on site. Ein derartiger Abtrag der verkalkten Aortenklappe, unabhängig davon mit welchen Abtragungstechniken gearbeitet wird, führt jedoch nahezu unvermeidbar zu zerkleinerten, abgetragenen, dh abgetrennten und losgelösten Gewebebruchstücken, die in die freie Blutbahn gelangen können, sofern sie nicht durch entsprechende Absaugtechniken extrakorporal extrahiert werden können. Such a removal of the calcified aortic valve, working regardless of what removal techniques, but leads almost inevitably to crushed, worn, that is separated and detached tissue fragments that can get into the free bloodstream, if they can not be extracted outside the body by appropriate suction techniques. Derartige, sich in der Blutbahn befindliche Bruchstücke mit makroskopischen Teilchendurchmessern von < 7,5 µm erhöhen jedoch drastisch die Thrombose- und Emboliegefahr des Patienten, so dass nach Maßnahmen gesucht wird, eben jene, bei der Extraktion der verkalkten Aortenklappe möglicherweise entstehenden Abbruchstücke vollständig aus der Blutbahn zu entfernen. However, increase such, be present in the bloodstream fragments with macroscopic particle diameters of <7.5 microns dramatically thrombosis and embolism risk of the patient, so that searched for measures just those that may arise in the extraction of calcified aortic valve demolition pieces completely from the remove bloodstream.

Darstellung der Erfindung Summary of the Invention

Der Erfindung liegt die Aufgabe zugrunde, eine Vorrichtung zum Ausfiltern bzw. Auffangen makroskopischer Teilchen aus einer Blutbahn für den lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz mit wenigstens einem schirmartig aufspannbaren Filterschirm, der aus einem zusammengefalteten Zustand in einen aufgespannten Zustand aufspannbar ist und mittels eines Arbeitskatheters betätigbar ist, derart weiterzubilden, dass während des chirurgischen Eingriffes zum Abtrag der Aortenklappe entstehende makroskopisch große Teilchen, die nicht entsprechend entsorgt werden und in die Blutbahn gelangen, vollständig aufgefangen werden sollen. The object of the invention is to provide a device for filtering and collecting the macroscopic particles from a bloodstream for the local removal of an aortic valve on the human or animal heart with at least one umbrella-like clampable filter screen which is clamped from a collapsed state to a clamped state, and means a working catheter is operable to further develop such a way that formed during the surgical procedure for the removal of the aortic valve macroscopically large particles which are not disposed of and pass into the bloodstream, should be completely absorbed. Es soll insbesondere erreicht werden, dass der chirurgische Eingriff zur Ablation der Aortenklappe sicherer durchführbar ist. It is to be achieved in particular that the surgery for ablation of the aortic valve is safer to perform. Insbesondere soll die Vorrichtung auch einen minimal invasiven Eingriff zur Ablation der Aortenklappe nicht hinderlich im Wege stehen, sondern überdies den Eingriff erleichtern. In particular, the device should not be even a minimally invasive procedure for ablation of the aortic valve in the way of an obstacle, but also facilitate the engagement.

Die Lösung der Aufgabe ist im Anspruch 1 angegeben. The solution of the problem is defined in claim. 1 Vorteilhafte Weiterbildungen des Erfindungsgedankens sind Gegenstand der Unteransprüche sowie dem Beschreibungstext unter Bezugnahme auf das Ausführungsbeispiel zu entnehmen. Advantageous further developments of the invention are the subject matter of the subclaims and the description text with reference to the embodiment can be seen.

Erfindungsgemäß ist eine Vorrichtung zum Ausfiltern makroskopischer Teilchen aus einer Blutbahn beim lokalen Abtrag einer Aortenklappe, insbesondere am menschlichen Herz, gemäß dem Oberbegriff des Anspruchs 1 derart ausgebildet, dass zwei Filterschirme vorgesehen sind, die derart in Wirkverbindung stehen, dass im aufgespannten Zustand ihre konkav ausgebildeten Filterschirmseiten gegenüberliegen. According to the invention an apparatus for filtering macroscopic particles from a bloodstream at the local removal of an aortic valve, especially on the human heart, in accordance with the preamble of claim 1 configured such that two filter screens are provided which are in operative connection, that in the clamped state their concaved The filter screen of sides opposite each other.

Der Erfindung liegt die Idee zugrunde, dass durch die Kombination zweier Filterschirme, deren Konkavseiten sich gegenüberliegen, ein Volumen einbeschrieben wird, das in Art eines Käfigs von den Filterschirmen umgeben wird und in dem die chirurgischen Maßnahmen an der Aortenklappe durchgeführt werden kann. The invention is based on the idea that by combining two filter screens, their concave sides opposite to each other, a volume is inscribed, which is in the manner of a cage surrounded by the filter screens and in which the surgical procedure on the aortic valve can be performed. Hierzu ist es erforderlich, dass ein Filterschirm vor und der andere Filterschirm hinter der Aortenklappe angeordnet wird. For this purpose, it is necessary that a filter screen in front and the other filter screen is arranged behind the aortic valve. Nach entsprechendem Aufspannen der Filterschirme kann innerhalb des durch die Filterschirme einbeschriebenen Volumens die Ablation der Aortenklappe vorgenommen werden. After appropriate clamping of the filter screens ablation of the aortic valve can be made within the inscribed by the filter screens volume. Während der Ablation entstehende makroskopische Bruchstücke werden von den Filterschirmflächen aufgefangen und daran gehindert, in die übrige Blutbahn zu gelangen. During ablation, resulting macroscopic fragments are caught by the filter screen areas and prevented from entering the rest of the bloodstream. Nach Vollendung der Ablation und sonstiger chirurgischer Maßnahmen werden die Filterschirme zusammengefaltet und die darin gefangenen makroskopischen Teilchen wie auch evtl. die als Ganzes entfernte Aortenklappe eingeschlossen. Upon completion of the ablation and other surgical procedures, the filter screens are folded and trapped inside macroscopic particles as well as possibly including the aortic valve removed as a whole. Die Dimensionierung der Filterschirmchen ist dabei derart gewählt, dass sie durch übliche Arbeitshohlkatheter geschoben werden können, so dass nach Beendigung der chirurgischen Maßnahme die mit makroskopischen Teilchen gefüllten Filterschirmchen durch einen entsprechenden Arbeitskanal extrakorporal verbracht werden können. The dimensioning of the Filterschirmchen is chosen such that they can be pushed by the usual work hollow catheter so that after completion of the surgical procedure, the Filterschirmchen filled with macroscopic particles can be introduced extracorporeally through a corresponding working channel.

Das Filtermaterial, aus dem die einzelnen Filterschirme bestehen, ist derart gewählt, dass die natürlichen Blutbestandteile ungehindert durch das Filtermaterial hindurchtreten können. The filter material of which the individual filter screens are made, is selected such that the natural blood components can pass through the filter material unhindered. Makroskopische Teilchen mit Teilchengrößen von mehr als 7,5 µm bleiben jedoch im Filtermaterial hängen und können entsprechend entsorgt werden. However, macroscopic particles with particle sizes greater than 7.5 microns are caught in the filter material and can be disposed of.

Kurze Beschreibung der Erfindung Summary of the Invention

Die Erfindung wird nachstehend ohne Beschränkung des allgemeinen Erfindungsgedankens anhand von Ausführungsbeispielen unter Bezugnahme auf die Zeichnung exemplarisch beschrieben. The invention is described below, without limiting the general inventive idea with reference to embodiments with reference to the accompanying drawing. Es zeigen: Show it:

Fig. 1a, b schematisierte Darstellung der Filterschirmanordnung im zusammen gefalteten sowie entspannten Zustand, sowie Fig. 1a, b schematic representation of the filter screen assembly in the folded as well as relaxed state, and

Fig. 2 Filterschirmanordnung innnerhalb eines Blutgefäßes. Fig. 2 filter screen assembly made within a blood vessel.

Wege zur Ausführung der Erfindung, gewerbliche Verwendbarkeit WAYS OF IMPLEMENTING THE INVENTION, INDUSTRIAL APPLICABILITY

In Fig. 1a sind schematisiert zwei alternative Filterschirmanordnungen in zusammengefaltetem Zustand dargestellt. In Fig. 1a, two alternative filter screen arrangements are shown in collapsed condition schematically. Entlang einer Verbindungsachse 1 , die mit einem Arbeitskatheter 2 verbunden ist, sind zwei zusammengefaltete Filterschirme 3 und 4 angeordnet. Along a connection axis 1, which is connected to a working catheter 2, two collapsed filter screens 3 and 4 are arranged. Die Filterschirme 3 , 4 liegen im zusammengefalteten Zustand eng an der Verbindungsachse 1 an, so dass sie durch einen dünnen Arbeitshohlkanal 7 eines Katheters geschoben werden können. The filter screens 3, 4 are in the folded state close to the connecting shaft 1, so that they can be pushed by a thin hollow working channel 7 of a catheter. Mittig zur Filterschirmfläche sind beide Filterschirme 3 und 4 mit der Verbindungsachse 1 fest verbunden, so dass sie im aufgespannten Zustand gemäß Fig. 1b mit ihren konkaven Seiten spiegelsymmetrisch relativ zu einer senkrecht zur Verbindungsachse ausgebildet sind. Centrally to the filter screen surface both filter screens 3 and 4 are fixedly connected to the connecting shaft 1, so that they are formed perpendicular to the connection axis whilst clamped as shown in FIG. 1b with their concave sides mirror-symmetrically relative to a.

Alternativ zur der in Fig. 1a oben dargestellten zweigeteilten Ausführungsform der Filterschirme 3 und 4 ist es auch möglich durch entsprechende Wahl des Filterschirmmaterials die Filterschirme 3 und 4 an ihren Randbereichen zusammenzufügen, so dass sie im zusammengefalteten Zustand lediglich einen geschlossenen zusammenhängenden Schlauch darstellen, der auch ohne die Verwendung eines Arbeitshohlkanals 2 in das Gefäß eingeführt werden kann. As an alternative to that shown in Fig. 1a shown above, two divided embodiment, the filter screens 3 and 4 it is also possible by appropriate choice of the filter screen material, the filter screens 3 and 4 put together at their edge regions, so that they represent only a closed continuous tube in the collapsed state, which is also can be introduced into the vessel without the use of a work hollow channel. 2 Hierbei ist insbesondere darauf zu achten, dass das disale Ende der zusammengefalteten Filterschirmanordnung über eine Abrundung 8 verfügt, so dass die Gefäßwand während des Einführvorganges nicht beschädigt wird. Here is particularly important to ensure that the disale end of the folded filter screen assembly has a rounded portion 8 so that the vessel wall is not damaged during the insertion.

Zum Aufspannen der beiden Filterschirme ist jeweils ein Schlittenelement 5 vorgesehen, das längs der Verbindungsachse 1 beweglich angeordnet ist. To clamp the two filter screens, a slide member 5 is in each case provided which is movably arranged along the connection axis. 1 Mit dem Schlittenelement 5 sind Spreizstreben 6 verbunden, die am Randbereich der Filterschirme angelenkt sind. With the slide member 5 expansion braces 6 are connected, are hinged on the edge region of the filter screens. Durch entsprechendes Verschieben der Schlittenelemente 5 in Richtung der Fixierstellen, an denen das Filtermaterial fest an der Verbindungsachse 1 angebracht ist, entfalten sich die Spreizstreben 6 , wodurch die Filterschirme radial zur Verbindungsachse 1 gespreizt werden. By appropriate shifting of the slide members 5 in the direction of the fixing points at which the filter material is firmly attached to the connecting shaft 1, the expansion braces unfold 6, whereby the filter screens are spread radially to the connecting axis. 1

Im gespannten Zustand der Filterschirmanordnung umschließen beide Filterschirme 3 und 4 ein inneres Volumen, in dem die Ablation der Aortenklappe vorgenommen werden kann. In the clamped state of the filter screen assembly both filter screens 3 and 4 enclose an interior volume in which the ablation of the aortic valve can be made. Selbstverständlich ist es möglich, beide Randbereiche der Filterschirme derart miteinander zu verbinden, so dass das innere Volumen vollständig umschlossen ist. It is of course possible to connect both edge portions of the filter screens in such a manner so that the internal volume is completely enclosed. Entsprechende Öffnungen innerhalb des Filtermaterials sind vorzusehen, um die für die Ablation erforderlichen Werkzeugkatheter einzuführen. Corresponding openings within the filter material to be provided in order to introduce the required tool for the ablation catheter. Diese können jedoch auch längs zur Verbindungsachse 1 in das Innere der aufgespannten Filterschirme hineinreichen. However, these can also extend longitudinally to the connecting shaft 1 in the interior of the clamped filter screens.

Zur Durchführung der Ablation einer verkalkten Aortenklappe wird die Filterschirmanordnung im zusammengefalteten Zustand durch eine, in der Aortenklappe vorhandene Öffnung hindurchgeschoben, so dass ein Filterschirm 3 auf der einen Seite der Aortenklappe zu liegen kommt und der andere Filterschirm 4 auf der gegenüberliegenden Seite. To carry out the ablation of a calcified aortic valve, the filter screen assembly is pushed in the folded state by one, in the aortic valve existing opening, so that a filter screen 3 on one side of the aortic valve comes to rest and the other filter screen 4 on the opposite side. Im aufgeklappten Zustand vermögen die Filterschirme die zu ablatierende Aortenklappe vollständig zu umschließen. In the unfolded state, the filter screens are able to completely enclose the to be ablated aortic valve. Da das Filtermaterial für die natürlichen Blutbestandteils durchlässig ist, können die chirurgischen Maßnahmen trotz andauernder Herztätigkeit unternommen werden. Since the filter material for the natural blood component is permeable, the surgical measures can be undertaken despite ongoing cardiac activity.

Nach entsprechender Positionierung und Zentrierung der Filterschirmanordnung innerhalb des Aortenbogens respektive nach Justierung relativ zur ablatierenden Aortenklappe zentriert sich die Filterschirmanordnung selbständig durch Aufspreizen der einzelnen Filterschirme an der Innenwandung der Aorta. After appropriate positioning and centering the filter screen assembly within the aortic arch, respectively, relative to adjustment to be ablated aortic valve, the filter screen assembly is centered automatically by spreading apart of the individual filter screens on the inner wall of the aorta. Die Filterschirmanordnung dient in diesem Fall auch zugleich als mechanischer Fixpunkt bzw. Auflagemöglichkeit für die für die Ablation einzusetzenden mikrochirurgischen Instrumente. The filter screen assembly in this case serves at the same time as a mechanical fixture or support option for employed for ablation microsurgical instruments. Auf diese Weise ist eine Mikronavigation der für die Ablation erforderlichen Katheterwerkzeuge erheblich vereinfacht im Vergleich zu bisherigen Techniken, bei denen eine derartige Justierhilfe nicht vorhanden ist. In this way, a micro navigation required for the ablation catheter tools is greatly simplified compared to previous techniques in which such an adjustment aid does not exist.

In Fig. 2 ist nochmals die Filterschirmanordnung innerhalb des Aortenbogens in zwei Stellungen 1 und 2 gezeigt. In Fig. 2 the filter screen assembly positions 1 and 2 is shown again within the aortic arch into two. In Stellung 1 ist die stark schematisiert dargestellte Filterschirmanordnung im zusammengefalteten Zustand dargestellt und wird in dieser Weise durch das Innere der Aorta geschoben. In position 1, the filter screen assembly shown highly schematically represented in the folded state and is slid in this manner through the interior of the aorta. Die Filterschirmanordnung ist proximal mit einem elastischen Arbeitskatheter verbunden, der zugleich auch für die Navigation der Filterschirmanordnung innerhalb der Aorta sorgt. The filter screen assembly is proximally connected to an elastic working catheter, at the same time also provides for the navigation of the filter screen assembly within the aorta. Besonders vorteilhaft ist die distalseits abgerundete Form der Filterschirmanordnung im zusammengefalteten Zustand, die dafür sorgt, dass keine traumatischen Gewebeirritationen während des Einbringvorgangs der Filterschirmanordnung in den Körper entstehen. Particularly advantageous is the distalseits rounded shape of the filter screen assembly in the folded state, which ensures that no traumatic tissue irritation occur in the body during Einbringvorgangs the filter screen assembly. In der Position 2 gemäß Fig. 2 ist die Filterschirmanordnung im aufgespannten Zustand dargestellt und es wird deutlich, dass die Filterschirmrandbereiche an die Innenwandung der Aorta anstoßen. In the position 2 in FIG. 2, the filter screen assembly is shown in the clamped state, and it is clear that the filter screen edge portions abut against the inner wall of the aorta. Hierdurch ist gewährleistet, dass eine Selbstzentrierung der Filterschirmanordnung erfolgt. This ensures that a self-centering of the filter screen assembly takes place.

Neben dem in Fig. 1 dargestellten Ausführungsbeispiel sind auch andere Lösungen zum Aufspannen der Filterschirme denkbar, wie beispielsweise ein Aufspannmechanismus der durch Rotation der Filterschirmanordnung um die Längsachse des Arbeitskatheters erfolgt. In addition to the example shown in Fig. 1 embodiment, other solutions for clamping the filter screens are also conceivable, such as a chuck mechanism takes place about the longitudinal axis of the working catheter by rotation of the filter screen assembly. Ebenso kann der Arbeitskatheter gemäß Fig. 2 auch als Durchführkanal für die für die Ablation erforderlichen Katheterwerkzeuge dienen, so dass diese unmittelbar nach Austritt aus dem Arbeitskatheter in das Innenvolumen der aufgespannten Filterschirme gelangen. Likewise, the working catheter shown in FIG. 2 can also serve as lead-through channel for the required for the ablation catheter tools so that they pass directly after leaving the working catheter in the internal volume of the clamped filter screens.

Bezugszeichenliste LIST OF REFERENCE NUMBERS

1 1

Verbindungsachse connecting axis

2 2

Arbeitskatheter working catheter

3 3

, .

4 4

Filterschirm filter screen

5 5

Schlittenelement carriage element

6 6

Spreizstreben expansion braces

Claims (9)

1. Vorrichtung zum Ausfiltern makroskopischer Teilchen aus einer Blutbahn beim lokalen Abtrag einer Aortenklappe am menschlichen oder tierischen Herz mit wenigstens einem schirmartig aufspannbaren Filterschirm, der aus einem zusammengefalteten Zustand in einen aufgespannten Zustand aufspannbar ist und mittels eines Arbeitskatheters betätigbar ist, dadurch gekennzeichnet , dass zwei Filterschirme vorgesehen sind, die derart in Wirkverbindung stehen, dass im aufgespannten Zustand ihre konkav ausgebildeten Seiten gegenüberliegen. 1. An apparatus for filtering of macroscopic particles from a bloodstream at the local removal of an aortic valve on the human or animal heart with at least one umbrella-like clampable filter screen which is clamped from a collapsed state to a clamped state and operable by means of a working catheter, characterized in that two filter screens are provided which are in operative connection that whilst clamped opposite their concave sides.
2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass die Filterschirme auf einer gemeinsamen Verbindungsachse angebracht sind, entlang der die Filterschirme im zusammengefalteten Zustand anliegen und von der sich die Filterschirme radial im aufgespannten Zustand erstrecken. 2. Device according to claim 1, characterized in that the filter screens are mounted on a common connection axis along which the filter screens abut in the folded state and from which the filter screens extend radially in the clamped.
3. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet, dass die Filterschirme bezogen auf eine die Verbindungsachse senkrecht schneidenden Achse spiegelsymmetrisch ausgebildet sind. 3. A device according to claim 2, characterized in that the filter screens with respect to a connection axis perpendicularly intersecting the axis are mirror symmetrical.
4. Vorrichtung nach einem der Ansprüche 1 bis 3, dadurch gekennzeichnet, dass die Filterschirme aus einem Filtermaterial bestehen, durch das die natürlichen Blutbestandteile ungehindert hindurchtreten aber makroskopische Teilchen mit Teilchengrößen von 7,5 µm und mehr das Filtermaterial nicht passieren. 4. Device according to one of claims 1 to 3, characterized in that the filter screens are made of a filter material through which pass unhindered but the natural blood components do not pass through the filter material macroscopic particles having particle sizes of 7.5 microns and more.
5. Vorrichtung nach einem der Ansprüche 2 bis 4, dadurch gekennzeichnet, dass die Filterschirme mittig zu ihrer Filterschirmfläche an der Verbindungsachse befestigt sind und mit jeweils einem Schlittenelement, das längs zur Verbindungsachse beweglich ist, über Spreizstreben, die jeweils mit dem Randbereich der Filterschirmfläche, verbunden sind. 5. Device according to one of claims 2 to 4, characterized in that the filter screens are mounted centrally with respect to their filter screen surface to the connection axis and each having a slide member which is movable longitudinally to the connecting axis, over expansion braces, which, in each case with the edge area of ​​the filter screen surface are connected.
6. Vorrichtung nach Anspruch 5, dadurch gekennzeichnet, dass der Arbeitskatheter mit den Schlittenelementen in Wirkverbindung steht. 6. Apparatus according to claim 5, characterized in that the working catheter with the slide elements is in operative connection.
7. Vorrichtung nach einem der Ansprüche 1 bis 6, dadurch gekennzeichnet, dass die Filterschirme im aufgespannten Zustand ein nahezu vollständig umschlossenes Volumen mit den Filterschirmen einschließen. 7. Device according to one of claims 1 to 6, characterized in that the filter screens whilst clamped include an almost completely enclosed volume with the filter screens.
8. Vorrichtung nach einem der Ansprüche 1 bis 7, dadurch gekennzeichnet, dass die Filterschirme im aufgespannten Zustand einen Filterschirmdurchmesser von bis zu 2,9 cm aufweisen und im zusammengefalteten Zustand längs durch einen Hohlkatheter mit einem Arbeitskanaldurchmesser von maximal 1 cm Durchmesser schiebbar sind. 8. Device according to one of claims 1 to 7, characterized in that the filter screens in the clamped state have a filter screen diameter of up to 2.9 cm, and in the folded state can be pushed lengthwise through a hollow catheter having a working channel diameter of a maximum of 1 cm in diameter.
9. Vorrichtung nach einem der Ansprüche 1 bis 8, dadurch gekennzeichnet, dass die Filterschirme mit ihren Randbereichen der Filterschirmfläche peripher verbunden sind. 9. Device according to one of claims 1 to 8, characterized in that the filter screens are connected peripherally with their edge regions of the filter screen surface.
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