JP2008543365A - 左心室縮小のための乳頭筋装着具 - Google Patents
左心室縮小のための乳頭筋装着具 Download PDFInfo
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
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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
- A61B17/08—Wound clamps or clips, i.e. not or only partly penetrating the tissue ; Devices for bringing together the edges of a wound
- A61B17/083—Clips, e.g. resilient
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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
- A61B17/10—Surgical instruments, devices or methods, e.g. tourniquets for applying or removing wound clamps, e.g. containing only one clamp or staple; Wound clamp magazines
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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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0487—Suture clamps, clips or locks, e.g. for replacing suture knots; Instruments for applying or removing suture clamps, clips or locks
-
- 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
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
-
- 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
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
- A61F2/2457—Chordae tendineae prostheses
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- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Rheumatology (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
Description
を除去するとともに、心臓外科医がより頻繁に用いる方法であり、僧帽弁を横断する必要がなく乳頭筋に直接到達する方法を提供する。
1のクリップと第2のクリップとを有し、それにより付与具を引き出したり再度挿入したりすることなく、それぞれの乳頭筋を係合することができる。付与具を連続的に供給することによりクリップを連続的に装着するか、付与具を連続的に操作するかにかかわらず、それぞれ可撓性ストランドを備えるそれぞれのクリップにより各乳頭筋を係合した後、付与具をガイドカテーテルを介して引き出す。
Claims (21)
- 拡張性心筋症を罹病する患者における心室横断サイズの縮小および心室形状の向上のための方法であって、
患者の心臓の左心室内の第1の乳頭筋と第2の乳頭筋の対向する部分同士に少なくとも1つのテザー構造体を固定する工程と、
前記少なくとも1つのテザー構造体により、前記乳頭筋の対向する部分同士を互いの方向に引き寄せることにより、前記乳頭筋同士の距離を減少させ、患者の心臓の心室横断サイズと外形を減少させる工程とからなり、それにより拡張性心筋症の影響を緩和する方法。 - 前記固定する工程に先立って、心臓から離間した患者の脈管構造を評価する工程と、
患者の脈管構造を介してガイドカテーテルを前進させる工程と、これによりガイドカテーテルの先端は、患者の心臓の左心房および左心室のうちの1つに配置されることとをさらに備える、請求項1に記載の方法。 - 前記ガイドカテーテルを前進させる工程に先立ち、中隔横断の開口を形成する工程をさらに備える、請求項2に記載の方法。
- 前記中隔横断の開口は、カテーテルを介して配置される針状メスにより形成される、請求項3に記載の方法。
- 前記テザー構造体は、縫糸フィラメントが固定されたクリップを備え、前記固定する工程は、各乳頭筋の基部に隣接して少なくとも1つのクリップを固定する工程からなる、請求項1に記載の方法。
- クリップが各乳頭筋に固定される前に、前記縫糸フィラメントはクリップに固定される、請求項5に記載の方法。
- 前記テザー構造体は縫糸フィラメントが固定されたクリップを備え、前記方法はガイドカテーテルを介して少なくとも1つのクリップを有するクリップ付与装置を前進させる工程をさらに備える、請求項2に記載の方法。
- 前記クリップ付与装置がガイドカテーテルを介して前進される前に、前記縫糸フィラメントはクリップに固定される、請求項7に記載の方法。
- ガイドカテーテルの先端を、少なくとも1つの乳頭筋に指向させる工程をさらに備える、請求項2に記載の方法。
- 前記固定する工程と減少させる工程との実施中、乳頭筋および近接する心室構造を可視化する工程をさらに備える、請求項1に記載の方法。
- 前記可視化する工程はX線透視法または心内超音波からなる請求項10に記載の方法。
- 前記乳頭筋同士の距離を減少させる工程は、僧帽弁閉鎖不全症を軽減するように乳頭筋を配置しなおす、請求項1に記載の方法。
- 拡張性心筋症を処置する方法であって、
拡張性心筋症を罹病する患者の心臓の心室内の第1の乳頭筋と第2の乳頭筋の対向する部分同士に少なくとも1つのテザー構造体を固定する工程と、
前記乳頭筋の対向する部分同士を互いの方向に引き寄せて、前記少なくとも1つのテザー構造体の長さを縮小させ、患者の心臓の心室横断サイズを減少させる工程とからなる方法。 - 前記固定する工程に先立って、心臓から離間した患者の脈管構造を評価する工程と、
患者の脈管構造を介してガイドカテーテルを前進させる工程と、これによりガイドカテーテルの先端は、患者の心臓の左心房および左心室のうちの1つに配置されることとをさらに備える、請求項13に記載の方法。 - 前記ガイドカテーテルを前進させる工程に先立ち、中隔横断の開口を形成する工程をさらに備える、請求項14に記載の方法。
- 前記中隔横断の開口は、カテーテルを介して配置される針状メスにより形成される、請求項15に記載の方法。
- 前記テザー構造体は、縫糸フィラメントが固定されたクリップを備え、前記固定する工程は、各乳頭筋の基部に隣接して少なくとも1つのクリップを固定する工程からなる、請求項13に記載の方法。
- クリップが各乳頭筋に固定される前に、前記縫糸フィラメントはクリップに固定される、請求項17に記載の方法。
- 前記テザー構造体は縫糸フィラメントが固定されたクリップを備え、前記方法はガイドカテーテルを介して少なくとも1つのクリップを有するクリップ付与装置を前進させる工程をさらに備える、請求項14に記載の方法。
- 前記クリップ付与装置がガイドカテーテルを介して前進される前に、前記縫糸フィラメントはクリップに固定される、請求項19に記載の方法。
- ガイドカテーテルの先端を、少なくとも1つの乳頭筋に指向させる工程をさらに備える、請求項14に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US68873005P | 2005-06-09 | 2005-06-09 | |
US60/688,730 | 2005-06-09 | ||
PCT/US2006/019496 WO2006135536A2 (en) | 2005-06-09 | 2006-05-19 | Papillary muscle attachement for left ventricular reduction |
Publications (3)
Publication Number | Publication Date |
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JP2008543365A true JP2008543365A (ja) | 2008-12-04 |
JP2008543365A5 JP2008543365A5 (ja) | 2009-07-02 |
JP4987861B2 JP4987861B2 (ja) | 2012-07-25 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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JP2008515727A Expired - Fee Related JP4987861B2 (ja) | 2005-06-09 | 2006-05-19 | 左心室縮小のための乳頭筋装着具 |
Country Status (4)
Country | Link |
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US (1) | US20090099410A1 (ja) |
EP (1) | EP1887981A2 (ja) |
JP (1) | JP4987861B2 (ja) |
WO (1) | WO2006135536A2 (ja) |
Cited By (1)
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Also Published As
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US20090099410A1 (en) | 2009-04-16 |
JP4987861B2 (ja) | 2012-07-25 |
WO2006135536A2 (en) | 2006-12-21 |
EP1887981A2 (en) | 2008-02-20 |
WO2006135536A3 (en) | 2007-02-22 |
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