JP2005511203A - アンカー・アンド・プル僧帽弁治療具および方法 - Google Patents
アンカー・アンド・プル僧帽弁治療具および方法 Download PDFInfo
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- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2451—Inserts in the coronary sinus for correcting the valve shape
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
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Abstract
に効果がある。前記治療具は、心臓内の僧帽弁輪に隣接する心臓冠状静脈に定位固定されるように形作られた第1のアンカーを含む。ケーブル(34)が、第1のアンカー(32)に固定され、これから近位方向に伸びて、第1のアンカー(32)より近位方向の心臓内に定位固定された第2のアンカー(36)を摺動可能に貫通する。僧帽弁輪の幾何学的配置に効果を与えるために張力が前記ケーブルに加えられるとき、ロックが前記ケーブルを第2のアンカー(36)に固定する。
Description
本発明は、心臓の僧帽弁輪の幾何学的配置(geometry)に効果がある器具を提供する。前記器具は、心臓内部の僧帽弁輪に隣接する心臓の冠状静脈の中に定位固定されるように形作られた、第1のアンカーと、第1にアンカーに固定され、第1のアンカーから心臓内に近位方向に伸びるケーブルと、第1のアンカーより近位方向の心臓内に定位固定されるように形作られて、前記ケーブルを摺動可能に受け入れるように配列された、第2のアンカーと、第2のアンカー上で前記ケーブルを固定するロックとを含む。その結果、第1および第2のアンカーが心臓内で固定されるとき、前記ケーブルは近位方向に引かれ、該ケーブルが第2のアンカー上にロックされて、僧帽弁の幾何学的配置に効果が及ぶ。
12 僧帽弁
13 右心室
14 冠状静脈
20 僧帽弁輪
23 右心房
25 右心房の内壁
30 僧帽弁治療具
32 第1のアンカー
33 圧力分散器
34 ケーブル
36 第2のアンカー
38 連結部
40 対応連結部
42 テンション・ケーブル
44 ロック機構
46 ラチェットまたはラチェット様機構
50 配設装置
52 カテーテル
58 第1のプッシュ・チューブ
60 第2のプッシュ・チューブ
62 シース
70 僧帽弁治療具
76 第2のアンカー
Claims (43)
- 第1のアンカー、ケーブル、第2のアンカーおよびロックを含む、心臓の僧帽弁輪の幾何学的配置に効果がある治療具であって、
第1のアンカーは、心臓内の僧帽弁輪に隣接する心臓冠状静脈に定位固定されるように形作られ、
前記ケーブルは、第1のアンカーに固定され、心臓内の第1のアンカーから近位方向に伸び、
第2のアンカーは、第1のアンカーより近位方向の心臓内に定位固定されるように形作られ、前記ケーブルを摺動可能に受け入れるように配置され、
前記ロックは、第2のアンカーで前記ケーブルを固定され、
第1および第2のアンカーが心臓内で固定されるとき、前記ケーブルは近位方向に引かれ、前記ケーブルは第2のアンカーにロックされ、僧帽弁の幾何学的配置に効果がある、治療具。 - 第2のアンカーは前記冠状静脈内に定位固定されるように形作られる、請求項1に記載の治療具。
- 第2のアンカーは右心房内に定位固定されるように形作られる、請求項1に記載の治療具。
- 第1のアンカーは、自動的に伸展して第1のアンカーを前記冠状静脈内に固定する、請求項1に記載の治療具。
- 第2のアンカーは、自動的に伸展して第2のアンカーを心臓内に固定する、請求項1に記載の治療具。
- 前記ケーブルは圧力分散器を含む、請求項1に記載の治療具。
- 第2のアンカーは前記ロックを含む、請求項1に記載の治療具。
- 前記ロックはラチェットを含む、請求項7に記載の治療具。
- 前記ケーブルは、ケーブル・テンション装置を含む、請求項1に記載の治療具。
- 心臓の僧帽弁輪の幾何学的配置に効果がある治療具であって、
僧帽弁輪に隣接する心臓冠状静脈内に繋止するための第1のアンカー手段と、
第1のアンカー手段より近位方向の心臓内に繋止するための第2のアンカー手段と、
第1のアンカー手段に固定され、第1のアンカー手段から近位方向に伸びて、第1および第2のアンカー手段の間を繋げるために、第2のアンカー手段によって摺動可能に受け入れられるケーブル手段と、
第2のアンカー手段を前記ケーブル手段に固定するためのロック手段とを含む、心臓の僧帽弁輪の幾何学的配置に効果がある治療具。 - 第2のアンカー手段は冠状静脈内に定位および繋止されるように形作られる、請求項10に記載の治療具。
- 第2のアンカー手段は右心房内に定位および繋止されるように形作られる、請求項10に記載の治療具。
- 第1のアンカー手段は、冠状静脈内に繋止されるために自動的に伸展する、請求項10に記載の治療具。
- 第2のアンカー手段は、心臓内に繋止されるために自動的に伸展する、請求項10に記載の治療具。
- 前記ケーブル手段は、加えられた圧力を分散するための圧力分散手段を含む、請求項10に記載の治療具。
- 前記ロック手段は第2のアンカー手段によって運ばれる、請求項10に記載の治療具。
- 前記ロック手段はラチェットを含む、請求項16に記載の治療具。
- 前記ケーブルは、ケーブル・テンション装置に連結するための連結手段を含む、請求項10に記載の治療具。
- 心臓の僧帽弁輪の幾何学的配置に効果がある方法であって、
僧帽弁輪に隣接する心臓冠状静脈内に第1のアンカーを固定するステップと、
第1のアンカーより近位方向の心臓内に第2のアンカーを繋止するステップと、
第1のアンカーにケーブルを固定するステップと、
前記ケーブルを第1のアンカーから近位方向に伸ばして、第2のアンカーを摺動可能に貫通させるステップと、
前記ケーブルに張力を発生させるために、前記ケーブルを第2のアンカーに対して近位方向に変位させるステップと、
第2のアンカーを前記ケーブルにロックするステップとを含む、心臓の僧帽弁輪の幾何学的配置に効果がある方法。 - 前記繋止するステップは、第2のアンカーを冠状静脈内に繋止することを含む、請求項19に記載の方法。
- 前記繋止するステップは、第2のアンカーを右心房内に繋止することを含む、請求項19に記載の方法。
- 前記変位させるステップは、前記ケーブルをケーブル・テンション装置に着脱可能に連結することを含む、請求項19に記載の方法。
- 僧帽弁輪治療具および送達装置を含む、僧帽弁輪の幾何学的配置に効果があるシステムであって、
前記僧帽弁輪治療具は、第1のアンカー、ケーブル、第2のアンカーおよびロックを含み、
第1のアンカーは、心臓内の僧帽弁輪に隣接する心臓冠状静脈に定位固定されるように形作られ、
前記ケーブルは、第1のアンカーに固定され、第1のアンカーから近位方向に心臓内に伸び、
第2のアンカーは、第1のアンカーより近位方向の心臓内に定位固定され、前記ケーブルを摺動可能に受け入れるように配置され、
前記ロックは、前記ケーブルを第2のアンカーに固定し、
前記送達装置は、前記僧帽弁輪治療具を配設し、第1のプッシュ・ツール、第2のプッシュ・ツールおよびテンション部材を含み、
第1のプッシュ・ツールは、第1のアンカーと係合して、第1のアンカーを冠状静脈内に定位させ、
第2のプッシュ・ツールは、第2のアンカーと係合して、第2のアンカーを心臓内に定位させ、
前記テンション部材は、前記ケーブルと連結可能で、第1および第2のアンカーの間の前記ケーブルに張力を与える、僧帽弁輪の幾何学的配置に効果があるシステム。 - 前記送達装置は、前記僧帽弁輪治療具を冠状静脈内に案内するガイド・カテーテルを含む、請求項23に記載のシステム。
- 第1のプッシュ・ツールは、第1のプッシュ・チューブを含む、請求項24に記載のシステム。
- 第2のプッシュ・ツールは第2のプッシュ・チューブを含む、請求項25に記載のシステム。
- 前記ガイド・カテーテル、第1のプッシュ・チューブおよび第2のプッシュ・チューブは同軸に配置される、請求項26に記載のシステム。
- 前記治療具のケーブルを前記テンション部材に連結する着脱可能な連結部を含む、請求項23に記載のシステム。
- 前記テンション部材はテンション・ケーブルである、請求項28に記載のシステム。
- 第2のアンカーは冠状静脈に定位固定される、請求項23に記載のシステム。
- 第2のアンカーは右心房内に定位固定される、請求項23に記載のシステム。
- 第1のアンカーは、自動的に伸展して第1のアンカーを冠状静脈内に固定する、請求項23に記載のシステム。
- 第2のアンカーは、自動的に伸展して第2のアンカーを心臓内に固定する、請求項23に記載のシステム。
- 前記ケーブルは圧力分散器を含む、請求項23に記載のシステム。
- 第2のアンカーは前記ロックを含む、請求項23に記載のシステム。
- 前記ロックはラチェットを含む、請求項35に記載のシステム。
- 心臓の僧帽弁輪の幾何学的配置に効果がある方法であって、
僧帽弁輪に隣接する心臓冠状静脈内にガイド・カテーテルを前進させるステップと、
自動的に配設する第1のアンカーを押して前記ガイド・カテーテルの外に出して、僧帽弁輪に隣接する冠状静脈内に第1のアンカーを配設するステップと、
第1のアンカーから近位方向に伸びて、自動的に配設する第2のアンカーを貫通するケーブルを第1のアンカーに供給するステップと、
自動的に配設する第2のアンカーを、ガイド・カテーテルを通して第1のアンカーより近位方向の位置まで変位させるステップと、
第2のアンカーを配設するため、第2のアンカーを保持する間に前記ガイド・カテーテルを取り出すステップと、
前記ケーブルに張力を発生させるために該ケーブルを引くステップと、
前記ケーブルを第2のアンカーにロックするステップとを含む、心臓の僧帽弁輪の幾何学的配置に効果がある方法。 - 前記押すステップは、前記ガイド・カテーテル内を摺動するような寸法のプッシュ・チューブで第1のアンカーを押すステップを含む、請求項37に記載の方法。
- 前記変位させるステップは、前記ガイド・カテーテル内を摺動するような寸法の第2のプッシュ・チューブを用いて、前記ケーブルに沿って第2のアンカーを押すステップを含む、請求項37に記載の方法。
- 前記引くステップの前に、テンション・ケーブルに前記ケーブルを着脱可能に連結するステップを含む、請求項37に記載の方法。
- 前記変位させるステップは、冠状静脈内に第2のアンカーを配設するステップを含む、請求項37に記載の方法。
- 前記変位させるステップは、心臓の右心房内に第2のアンカーを配設するステップを含む、請求項37に記載の方法。
- 前記押すステップは、冠状静脈内で回旋枝より近位方向に第1のアンカーを定位するステップを含む、請求項37に記載の方法。
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US10/011,867 US6908478B2 (en) | 2001-12-05 | 2001-12-05 | Anchor and pull mitral valve device and method |
PCT/US2002/038586 WO2003049648A2 (en) | 2001-12-05 | 2002-12-03 | Anchor and pull mitral valve device and method |
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JP2005511203A5 JP2005511203A5 (ja) | 2006-01-19 |
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EP (1) | EP1450733B1 (ja) |
JP (1) | JP4326954B2 (ja) |
AT (1) | ATE497739T1 (ja) |
AU (1) | AU2002364130B2 (ja) |
CA (1) | CA2468787A1 (ja) |
DE (1) | DE60239145D1 (ja) |
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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 |
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- 2002-12-03 AT AT02799204T patent/ATE497739T1/de not_active IP Right Cessation
- 2002-12-03 AU AU2002364130A patent/AU2002364130B2/en not_active Ceased
- 2002-12-03 ES ES02799204T patent/ES2359398T3/es not_active Expired - Lifetime
-
2004
- 2004-04-06 US US10/819,499 patent/US20040193260A1/en not_active Abandoned
-
2005
- 2005-02-28 US US11/069,847 patent/US20050149182A1/en not_active Abandoned
Also Published As
Publication number | Publication date |
---|---|
ES2359398T3 (es) | 2011-05-23 |
AU2002364130A1 (en) | 2003-06-23 |
WO2003049648A8 (en) | 2003-07-24 |
DE60239145D1 (de) | 2011-03-24 |
US20030105520A1 (en) | 2003-06-05 |
US20040193260A1 (en) | 2004-09-30 |
US20050149182A1 (en) | 2005-07-07 |
JP4326954B2 (ja) | 2009-09-09 |
WO2003049648A3 (en) | 2003-09-18 |
WO2003049648A2 (en) | 2003-06-19 |
EP1450733A2 (en) | 2004-09-01 |
EP1450733B1 (en) | 2011-02-09 |
ATE497739T1 (de) | 2011-02-15 |
AU2002364130B2 (en) | 2008-10-30 |
US6908478B2 (en) | 2005-06-21 |
CA2468787A1 (en) | 2003-06-19 |
EP1450733A4 (en) | 2009-07-29 |
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