JP2008528179A - 後方弓形部を有する僧帽弁輪形成術リング - Google Patents
後方弓形部を有する僧帽弁輪形成術リング 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
- A61F2/2448—D-shaped rings
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0018—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in elasticity, stiffness or compressibility
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
本願は、2002年7月8日に出願された、出願番号10/192,516の一部継続出願であり、この出願は、その全体が本明細書中に参考として援用される。
本発明は、一般に、医療用デバイスに関し、特に、輪形成術リングに関し、そして患者の心臓の僧帽弁輪を外科的に再構成するための手順に関する。より特定すると、本発明は、機能的僧帽弁逆流に遭遇した病理における、後面が前面より下方に凹んでいる異常な輪に一致する、僧帽弁修復デバイスおよび対応する技術に関する。
ヒトの心臓の解剖学的形状において、左心房は、酸素化された血液を、肺静脈を通して肺から受容する。僧帽弁が、この左心房を、左心室から分離する。拡張期の間、洞房結節によって引き起こされる収縮が心房を通って進行すると、酸素化された血液が僧帽弁を通過して左心室に入る。この段階において、大動脈弁は、上行大動脈の閉鎖を導き、左心室が血液で満たされるようにする。静脈血の類似の流れは、右心房から、肺動脈弁を通って、右心室へと生じる。一旦、心室が満たされると、これらの心室は、心収縮段階の間収縮し、そして血液を心臓から送り出す。心収縮期の間、僧帽弁は閉じ、そして大動脈弁は開くので、血液が左心房に逆流することを防止し、そして血液を強制的に大動脈に入れ、そしてこの大動脈から、身体全体へと流す。心収縮期の間の左心室に関連する高い圧力に起因して、血液がこの系を通って逆流することを防止する僧帽弁の適切な機能が、非常に重要である。
本発明は、僧帽弁輪の後面が異常に下方に垂れているような病理学的状態を有する僧帽弁輪における移植のための、輪形成術リングを提供する。この輪形成術リングは、丸みを帯びたリング本体を備え、このリング本体は、前方セクションおよび後方セクションを有する。このリング本体は、中心流れ軸の周りで配向され、この中心流れ軸は、上向き方向および下向き方向を規定し、この下向き方向は、僧帽弁輪を通る血流の方向に対応する。この後方セクションにおいて、このリング本体は、この中心流れ軸に対して垂直な面から下向きに弓形である。
添付の図は、本発明の輪形成術リングの数個の例示的な実施形態を図示し、このリングは、連続的であり、そして前側、後側、ならびに右側および左側を有するように記載され得る。これらの側の全ては、ほぼ曲線であり、これらの側の間の急な移行部を示すための特定の境界を有さない。むしろ、隣接する側の間の滑らかな移行セクションは、曲線の接続部を提供し、これらの接続部は、このリングに、ほぼ丸い(例えば、楕円の)構成を与える。
Claims (20)
- 僧帽弁輪に移植するための輪形成術リングであって、該輪形成術リングは、
丸みを帯びたリング本体であって、該リング本体は、該僧帽弁輪の前面に移植されるように適合された前方セクションと、該僧帽弁輪の後面に移植されるように適合された後方セクションとを有する、リング本体、
を備え、
該リング本体は、中心流れ軸の周りで配向され、該流れ軸は、上向き方向および下向き方向を規定し、該下向き方向は、該僧帽弁輪を通る血流の方向に対応し;そして
該後方セクションにおいて、該リング本体は、該中心流れ軸に対して垂直な面から下向きに弓形になり、そして該下向きの弓形部は、該後方セクションにおいて実質的に中心にあり、そして隣接するリング本体セクションへの滑らかな曲線の移行部を示す、
輪形成術リング。 - 前記後方セクションにおいて、前記リング本体は、前記流れ軸に沿って、該リング本体の周囲の前記下向きの弓形部が開始する地点から、該下向きの弓形部の最下点まで測定される場合に、約4mm〜約8mmだけ下向きに弓形である、請求項1に記載の輪形成術リング。
- 前記リング本体が、展性材料から作製されており、その結果、該リング本体の前記弓形部が、手で再成形され得る、請求項1に記載の輪形成術リング。
- 前記リング本体が、半剛性材料から作製されており、該半剛性材料は、各鼓動周期全体にわたり心臓の筋肉によって付与される応力に対抗して、該リング本体の後方弓形部を保持する、請求項1に記載の輪形成術リング。
- 前記リング本体が、前記後方セクションを除いて実質的に平面状である、請求項1に記載の輪形成術リング。
- 前記リング本体の前記流れ軸に沿って見られる場合の平面図において、短軸に対して垂直である長軸を有する楕円の形状をほぼ規定し、該短軸は、前記前方セクションと前記後方セクションとの両方を二分し、そして該後方セクションにおける前記弓形部が、該リング本体の周囲で該長軸から約0°〜約45°の角度θだけ間隔を空けた、該短軸の両側の対称位置において開始する、請求項1に記載の輪形成術リング。
- 前記リング本体が、前記後方セクションにおいて、前記下向きの弓形部の両側に2つの上向きの弓形部をさらに備える、請求項1に記載の輪形成術リング。
- 前記流れ軸に沿って、前記リング本体の周囲の前記上向きの弓形部のうちのいずれかが開始する地点から、前記下向きの弓形部の最下点まで測定される場合に、該リング本体が、約2mm〜約15mmだけ下向きに弓形である、請求項7に記載の輪形成術リング。
- 前記リング本体の前記流れ軸に沿って見られる場合の平面図において、短軸に対して垂直である長軸を有する楕円の形状をほぼ規定し、該短軸は、前記前方セクションと前記後方セクションとの両方を二分し、そして前記上向きの弓形部が、該リング本体の周囲で該長軸から約0°〜約15°の角度αだけ間隔を空けた、該短軸の両側の対称位置において開始する、請求項7に記載の輪形成術リング。
- 前記リング本体が、同心状に配置された複数のリング要素を備える、請求項1に記載の輪形成術リング。
- 前記リング本体が、不連続であり、前記前方セクションにおける破断部によってC字型が規定されている、請求項1に記載の輪形成術リング。
- 僧帽弁輪における移植のための輪形成術リングであって、該輪形成術リングは、
丸みを帯びたリング本体であって、該リング本体は、該僧帽弁輪の前面に移植されるように適合された前方セクションと、該僧帽弁輪の後面に移植されるように適合された後方セクションとを有し、該後方セクションは、平面図で見られる場合に、前横側三角から反時計回りの方向で連続して、サブセクションP1、P2、およびP3に分割される、リング本体、
を備え、
該リング本体は、中心流れ軸の周りで配向され、該流れ軸は、上向き方向および下向き方向を規定し、該下向き方向は、該僧帽弁輪を通る血流の方向に対応し;そして
該後方セクションにおいて、該リング本体は、該中心流れ軸に対して垂直な面から下向きに弓形であり、該リング本体における該弓形部は、該後方セクションにおいて、該P1セクションの方へと中心がずれている、
輪形成術リング。 - 前記リング本体が、約4mm〜約8mmだけ下向きに弓形である、請求項12に記載の輪形成術リング。
- 前記リング本体が、前記後方セクションにおける前記下向きの弓形部の両側に、2つの上向きの弓形部をさらに備える、請求項12に記載の輪形成術リング。
- 前記後方セクションにおいて、前記リング本体は、前記流れ軸に沿って、該リング本体の周囲の前記上向きの弓形部のいずれかが開始する地点から、前記下向きの弓形部の最下点まで測定される場合に、約2mm〜約15mmだけ下方に弓形である、請求項14に記載の輪形成術リング。
- 前記リング本体が、展性材料から作製されており、その結果、該リング本体における前記弓形部が、手で再成形され得る、請求項12に記載の輪形成術リング。
- 前記リング本体が、半剛性材料から作製されており、該半剛性材料は、各鼓動周期の全体にわたり心臓の筋肉によって付与される応力に対抗して、該リング本体の前記後方弓形部を保持する、請求項12に記載の輪形成術リング。
- 前記リング本体が、同心状に配置された複数のリング要素を備える、請求項12に記載の輪形成術リング。
- 前記リング本体が、不連続であり、前記前方セクションにおける破断部によって、C字型が規定されている、請求項12に記載の輪形成術リング。
- 前記後方弓形部が、実質的に前記P1セクション内に位置する、請求項12に記載の輪形成術リング。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/047,122 US7608103B2 (en) | 2002-07-08 | 2005-01-31 | Mitral valve annuloplasty ring having a posterior bow |
PCT/US2006/001405 WO2006083529A1 (en) | 2005-01-31 | 2006-01-13 | Mitral valve annuloplasty ring having a posterior bow |
Publications (2)
Publication Number | Publication Date |
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JP2008528179A true JP2008528179A (ja) | 2008-07-31 |
JP2008528179A5 JP2008528179A5 (ja) | 2009-03-26 |
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Application Number | Title | Priority Date | Filing Date |
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JP2007553125A Pending JP2008528179A (ja) | 2005-01-31 | 2006-01-13 | 後方弓形部を有する僧帽弁輪形成術リング |
Country Status (5)
Country | Link |
---|---|
US (2) | US7608103B2 (ja) |
EP (1) | EP1850794A1 (ja) |
JP (1) | JP2008528179A (ja) |
CA (1) | CA2594886A1 (ja) |
WO (1) | WO2006083529A1 (ja) |
Cited By (3)
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JP2011520505A (ja) * | 2008-05-13 | 2011-07-21 | エドワーズ ライフサイエンシーズ コーポレイション | 生理学的に調和した三尖弁輪形成リング |
JP2017506988A (ja) * | 2014-03-11 | 2017-03-16 | エピゴン | 心臓ステント弁およびそのような弁のための送達デバイス |
JP7522080B2 (ja) | 2015-06-09 | 2024-07-24 | エドワーズ・ライフサイエンシーズ・エルエルシー | 非対称な僧帽弁形成バンド |
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US20050192666A1 (en) | 2005-09-01 |
US7608103B2 (en) | 2009-10-27 |
US7993396B2 (en) | 2011-08-09 |
WO2006083529A1 (en) | 2006-08-10 |
EP1850794A1 (en) | 2007-11-07 |
US20100010625A1 (en) | 2010-01-14 |
CA2594886A1 (en) | 2006-08-10 |
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