JP2006506183A - 心臓ハーネス送給装置 - Google Patents
心臓ハーネス送給装置 Download PDFInfo
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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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
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- 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
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- 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
-
- 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
- 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
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
- A61B2017/308—Surgical pincettes without pivotal connections holding by means of suction with suction cups
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00392—Transmyocardial revascularisation
-
- 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
- A61F2/2478—Passive devices for improving the function of the heart muscle, i.e. devices for reshaping the external surface of the heart, e.g. bags, strips or bands
- A61F2/2481—Devices outside the heart wall, e.g. bags, strips or bands
- A61F2002/2484—Delivery devices therefor
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Vascular Medicine (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Transplantation (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgical Instruments (AREA)
Abstract
Description
本発明は、全般的に、患者の心臓上に心臓ハーネスを送給するための装置および方法に関する。
鬱血性心不全(「CHF」)は、組織の代謝性需要、特に酸素需要を満たすために充分な流量の血液をポンプ送りするという心臓機能が故障することによって特徴づけられる。受動的な巻付け、あるいは心臓ハーネスが、鬱血性心疾患によって影響を受けている心臓の効率を高めうる結論付けられてきた。心臓ハーネスの技術は進歩してきたが、患者の心臓上に心臓ハーネスを送給し位置決めするための満足がいく装置および方法は未だに提供されていない。
したがって、先行技術の短所を克服する心臓ハーネス送給装置の必要性が存在している。好ましくは、この装置は、遠隔地からの心臓ハーネスの解放を可能とする。したがって、好ましい送給装置は、1つの構成において、患者を比較的小さく切開することによる最小限に侵襲性な心臓ハーネスの供給を可能にするために、圧縮された形状において心臓ハーネスを支持するように形成される。好ましくは、この送給装置は複数のプッシュロッドを有し、かつ心臓ハーネスは、プッシュロッドの長手方向軸に沿った少なくとも2つの離間位置において各プッシュロッドに固定される。したがって、そのような構成により、負荷される荷重は心臓ハーネスの長手方向に沿って拡げられ、それによって供給の間にハーネスが損傷を受ける可能性を減少させる。
図1〜図11は、全般的に参照番号30によって示された心臓ハーネス送給装置の好ましい実施例を示している。好ましい実施例において、この送給装置30は、心臓ハーネスのような心臓補強装置(CRD)を解放可能に支持するとともに、この心臓ハーネスの患者の心臓上への前進を助けるように構成されている。この送給装置30は、心臓ハーネスが心臓上に配置されると、好ましくは心臓ハーネスの心臓に対する不必要な変位を生じさせることなしにハーネスを解放し、かつ引き抜くことができるように構成されている。
例えば、先端部は、折りたたみ、概ね涙滴形状に形作り、あるいは概ね円柱状とすることができる。
Claims (17)
- 心臓ハーネスを供給するための装置であって、
近位側部分および遠位側部分を有するとともに、圧縮された状態の前記ハーネスを収容するように寸法決めされたキャビティを有した細長い本体と、
前記本体に対して長手方向に動くことができる複数の細長いプッシュロッドであり、前記プッシュロッドの遠位方向の前進が、前記キャビティ内において圧縮された状態から前記キャビティの外側で展開された形状へと前記ハーネスを移動させるように、前記心臓ハーネスが前記プッシュロッドのそれぞれに着脱自在に接続されるプッシュロッドと、
を備え、
ユーザが操作すると前記プッシュロッドと前記ハーネスとの間の接続を解放する解放部材をさらに備えることを特徴とする装置。 - 長手方向に間隔が開けられている少なくとも第1および第2の位置において、前記心臓ハーネスが前記プッシュロッドのそれぞれに着脱自在に接続されていることを特徴とする請求項1に記載の装置。
- 心臓に対し所望の位置において前記装置を固定する配置構造を備えていることを特徴とする請求項1に記載の装置。
- 前記配置構造が吸着カップ部材を有していることを特徴とする請求項3に記載の装置。
- ハンドルおよび制御組立体をさらに備え、
前記ハンドルが前記細長い本体の近位側部分に取り付けられ、
前記制御組立体が前記複数の細長いプッシュロッドを支持していることを特徴とする請求項1に記載の装置。 - 心臓ハーネスを供給するための装置であって、
支持部材を備え、
前記心臓ハーネスは、前記支持部材に予め装着されるとともにラインによって前記支持部材に取り付けられ、
前記ラインは、解放可能なステッチを形成する相互に連結された一連のループから構成されていることを特徴とする装置。 - 前記ステッチの前記相互に連結されたループの一端が、前記一連のループの解けを防止する固定部材によって保持され、
前記固定部材からの前記ループの解放が前記相互に連結されているループの解けを可能にすることを特徴とする請求項6に記載の装置。 - 前記固定部材は解放部材と動くように取り付けられ、
前記ラインの端部は前記解放部材に取り付けられ、
前記支持部材から離間する方向における前記解放部材の動きが、前記ループを前記固定部材から解放し、前記相互に連結された一連のループを解くことを特徴とする請求項7に記載の装置。 - 心臓ハーネスを送給するための装置であって、
近位側部分および遠位側部分を有している細長い本体と、
前記本体に対して長手方向に動くことができる複数のプッシュロッドであり、前記プッシュロッドの遠位方向への動きが前記ハーネスを前記心臓上へと前進させるように前記心臓ハーネスは前記プッシュロッドのそれぞれに着脱自在に接続され、前記ハーネスを前記心臓上に残したまま前記プッシュロッドを引き抜き経路に沿って近位側を前記ハーネスから引き抜くことができるように前記ハーネスは前記プッシュロッドから解放可能であり、前記プッシュロッドの前記遠位側部分は前記引き抜きの間に前記ハーネスを押圧する内側を向いた表面を有しており、前記内側を向いた表面は、前記経路と平行で、かつ前記内側を向いた表面によって前記ハーネス上に負荷される力に由来する非摩擦性の力の成分が、近位側に向けられた実質的に非摩擦性の力の成分なしに遠位側に向けられるように構成されているプッシュロッドと、
を備えることを特徴とする装置。 - 前記プッシュロッドの遠位側部分は、前進の間に外側に広がることを特徴とする請求項9に記載の装置。
- 前記プッシュロッドの遠位側部分は、外側に傾けられていることを特徴とする請求項9に記載の装置。
- 患者の心膜に通路を作成して心臓ハーネス送給装置の心臓へのアクセスを可能にする装置であって、
近位端および遠位端を画成する外壁を有した導入器スリーブであり、前記外壁が前記遠位端に隣接して縮径部を有し、かつ前記縮径部が第1の直径を有した縮径状態を画成する導入器スリーブと、
前記第1の直径より大きい第2の直径を有した拡径状態へと前記縮径部を押圧するために前記導入器スリーブ内へと挿入できるように寸法決めされかつ形作られており、前記第2の直径はこの装置をそこに挿通するために充分なサイズである拡張器スリーブと、
を備えることを特徴とする装置。 - 前記導入器スリーブの前記外壁を囲む付勢部材をさらに備え、
前記付勢部材は、前記縮径部を前記縮径状態へと付勢するように構成されていることを特徴とする請求項12に記載の装置。 - 前記導入器スリーブの前記外壁は、前記外壁の長手方向軸と平行に延びる複数の切り出し部分を有しており、
前記切り出し部分は、前記外壁の縮径部分の少なくとも一部を通って延びていることを特徴とする請求項12に記載の装置。 - 複数の細長いプッシュロッドを有した送給装置への心臓ハーネスの装着を助ける装置であって、
概ね漏斗形の部分を画成している外壁を備え、
前記漏斗形の部分は、前記複数の細長いプッシュロッドを受け入れるように構成された複数のチャンネルを有しており、
前記外壁は、外側に拡がった配向で前記プッシュロッドを支持するように構成されていることを特徴とする装置。 - 前記複数のチャンネルのそれぞれの一部が、前記外壁の内側を向いた表面および外側を向いた表面の少なくとも一方に開いていることを特徴とする請求項15に記載の装置。
- 前記外壁が、前記漏斗形の部分の下端部から延びている概ね円筒状の部分をさらに有し、
前記円筒状の部分は、前記送給装置の遠位端部を受け入れるように構成されていることを特徴とする請求項15に記載の装置。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US42707902P | 2002-11-15 | 2002-11-15 | |
PCT/US2003/036476 WO2004045456A2 (en) | 2002-11-15 | 2003-11-17 | Cardiac harness delivery device |
Publications (1)
Publication Number | Publication Date |
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JP2006506183A true JP2006506183A (ja) | 2006-02-23 |
Family
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2004553700A Pending JP2006506183A (ja) | 2002-11-15 | 2003-11-17 | 心臓ハーネス送給装置 |
Country Status (6)
Country | Link |
---|---|
US (6) | US7189203B2 (ja) |
EP (1) | EP1560541A2 (ja) |
JP (1) | JP2006506183A (ja) |
AU (1) | AU2003291541A1 (ja) |
CA (1) | CA2504555C (ja) |
WO (1) | WO2004045456A2 (ja) |
Cited By (1)
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2003
- 2003-11-17 AU AU2003291541A patent/AU2003291541A1/en not_active Abandoned
- 2003-11-17 CA CA2504555A patent/CA2504555C/en not_active Expired - Fee Related
- 2003-11-17 WO PCT/US2003/036476 patent/WO2004045456A2/en active Application Filing
- 2003-11-17 JP JP2004553700A patent/JP2006506183A/ja active Pending
- 2003-11-17 EP EP03768947A patent/EP1560541A2/en not_active Withdrawn
- 2003-11-17 US US10/715,150 patent/US7189203B2/en not_active Expired - Fee Related
-
2004
- 2004-05-03 US US10/838,002 patent/US7572219B2/en not_active Expired - Fee Related
- 2004-09-13 US US10/939,721 patent/US7500946B2/en not_active Expired - Fee Related
- 2004-10-18 US US10/967,955 patent/US7338435B2/en not_active Expired - Fee Related
- 2004-11-23 US US10/995,695 patent/US7361139B2/en not_active Expired - Fee Related
-
2005
- 2005-04-19 US US11/109,175 patent/US20050182290A1/en not_active Abandoned
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
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CN106890012A (zh) * | 2015-10-09 | 2017-06-27 | 埃瓦尔维公司 | 输送导管的把手及其使用方法 |
CN106890012B (zh) * | 2015-10-09 | 2021-02-02 | 埃瓦尔维公司 | 输送导管的把手及其使用方法 |
US11931263B2 (en) | 2015-10-09 | 2024-03-19 | Evalve, Inc. | Delivery catheter handle and methods of use |
Also Published As
Publication number | Publication date |
---|---|
US20050033322A1 (en) | 2005-02-10 |
US20050090707A1 (en) | 2005-04-28 |
CA2504555A1 (en) | 2004-06-03 |
US7189203B2 (en) | 2007-03-13 |
US20050182290A1 (en) | 2005-08-18 |
WO2004045456A2 (en) | 2004-06-03 |
US20050049611A1 (en) | 2005-03-03 |
EP1560541A2 (en) | 2005-08-10 |
US20050055032A1 (en) | 2005-03-10 |
US7500946B2 (en) | 2009-03-10 |
AU2003291541A1 (en) | 2004-06-15 |
US7338435B2 (en) | 2008-03-04 |
US7572219B2 (en) | 2009-08-11 |
US20040210104A1 (en) | 2004-10-21 |
US7361139B2 (en) | 2008-04-22 |
CA2504555C (en) | 2012-09-04 |
WO2004045456A3 (en) | 2004-11-04 |
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