JP2010515488A - 心臓特徴の再構成 - Google Patents
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- 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
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- 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
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00743—Type of operation; Specification of treatment sites
- A61B2017/00778—Operations on blood vessels
- A61B2017/00783—Valvuloplasty
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- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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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
- A61B2017/00831—Material properties
- A61B2017/00867—Material properties shape memory effect
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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
- A61B2017/0409—Instruments for applying 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
- A61B17/04—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
- A61B2017/0414—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors having a suture-receiving opening, e.g. lateral opening
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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
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B2017/0647—Surgical staples, i.e. penetrating the tissue having one single leg, e.g. tacks
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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
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12009—Implements for ligaturing other than by clamps or clips, e.g. using a loop with a slip knot
- A61B2017/12018—Elastic band ligators
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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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/243—Deployment by mechanical expansion
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Abstract
Description
本説明は、心臓特徴(feature)の再構成に関する。
一般に、一態様においては、心臓弁輪に向けてツールに力を印加することにより、輪を拡張させる。輪が拡張する間に、輪に沿う位置にある組織に弁支持体を取り付ける。取り付けた後に、支持体を収縮させる。
Claims (52)
- 心臓弁輪に向けてツールに力を印加して該輪を拡張させる工程と、
輪が拡張する間に、輪に沿う位置にある組織に弁支持体を取り付ける工程と、
取り付けた後に、支持体を収縮させる工程と、
を含む、方法。 - 弁支持体が、輪が拡張する前にツールに取り付けられる、請求項1記載の方法。
- 弁支持体が、取り付け用の送達構成(configuration)に適合される、請求項1記載の方法。
- 弁支持体が、ツールに取り付けられる前に伸張される、請求項2記載の方法。
- 弁支持体が、輪に対して軸方向に力をツールに印加することによって組織に取り付けられる、請求項1記載の方法。
- 弁支持体を組織に取り付ける前に、弁支持体をツールに取り付ける工程も含む、請求項1記載の方法。
- 弁支持体が、1つもしくは複数の破壊可能な接続によってツールに取り付けられる、請求項6記載の方法。
- 破壊可能な接続が縫合を含む、請求項7記載の方法。
- 破壊可能な接続が指(finger)を含む、請求項7記載の方法。
- 弁支持体をツールに取り付ける工程が、弁支持体をツール上の保持要素に係合させる工程を含む、請求項6記載の方法。
- 弁支持体を取り付ける工程が、1つもしくは複数のフックを使用して弁支持体を固定する工程を含む、請求項1記載の方法。
- 力を印加する工程によって、ツールのテーパ状の(tapered)表面が輪に係合する、請求項1記載の方法。
- 支持体を収縮させる工程が、テーパ状のヘッドを輪から後退(retract)させる工程を含む、請求項11記載の方法。
- 支持体を収縮させる工程が、支持体自体が収縮することを可能にする工程を含む、請求項1記載の方法。
- 心臓弁輪を既定の構成に拡張させる工程と、
該輪が拡張する間に、該輪に沿う位置にある組織に弁支持体を取り付ける工程と、
取り付けた後に、支持体を収縮させる工程と、
を含む、方法。 - 弁支持体を組織に取り付ける前に、弁支持体を伸張させて送達構成にする工程も含む、請求項15記載の方法。
- 弁支持体を伸張させる工程が、弁支持体を送達ツールのテーパ状のヘッドに沿って軸方向に移動させる工程を含む、請求項16記載の方法。
- 弁支持体を送達ツールのテーパ状のヘッド上に位置付ける工程も含む、請求項15記載の方法。
- 弁支持体をテーパ状のヘッドに解放可能に取り付ける工程も含む、請求項18記載の方法。
- 心臓弁輪を拡張させる工程が、輪に対して軸方向に送達ツールのテーパ状のヘッドを心臓弁に押し入れる工程を含む、請求項15記載の方法。
- 支持体の収縮を可能にする工程が、テーパ状のヘッドを心臓弁から後退させる工程を含む、請求項20記載の方法。
- 後退させる工程が、弁支持体を解放する工程を含む、請求項21記載の方法。
- 弁支持体を解放する工程が、弁支持体とツールのテーパ状のヘッドとの間の接続を破壊する工程を含む、請求項22記載の方法。
- 組織に弁支持体を取り付ける工程が、フックを組織に押し入れる工程を含む、請求項15記載の方法。
- 弁支持体を心臓弁輪に向けて押し、該支持体のフックが該輪に沿う位置にある組織に押し込まれるようにする工程と、
支持体を引っ張ることにより、より安定してフックを組織に埋め込む工程と、
を含む、方法。 - 弁支持体が輪状体を含み、フックをより安定して埋め込む工程が、該輪状体を中心にフックを回転させる工程を含む、請求項25記載の方法。
- 弁支持体を押し進める工程が、弁支持体を担持する送達ツールを押し進める工程を含む、請求項25記載の方法。
- 支持体を引っ張る工程が、支持体を担持する送達ツールを引っ張る工程を含む、請求項25記載の方法。
- フックをより安定して埋め込んだ後に、弁支持体を解放する工程も含む、請求項25記載の方法。
- カテーテルを身体管腔に通して、弁支持体を担持する送達ツールを心臓弁輪に配置する工程と、
カテーテルを心臓弁輪に向けて押し進め、送達ツールに該輪を拡張させる工程と、
を含む、方法。 - カテーテルを前記輪に向けて押し進め、弁支持体を該輪に取り付ける工程も含む、請求項30記載の方法。
- 前記輪に取り付けた後に、カテーテルを引っ張って弁支持体を解放する工程も含む、請求項30記載の方法。
- 弁支持体を解放する工程によって、弁支持体を収縮させる、請求項32記載の方法。
- カテーテルを身体管腔に通す前に弁支持体を被覆する工程と、心臓弁の周辺において弁支持体を露出させる工程も含む、請求項30記載の方法。
- 被覆および露出させる工程が、カテーテルおよびシース(sheath)を関連して動かして、弁支持体をそれぞれ圧縮および伸張させる工程を含む、請求項34記載の方法。
- 輪状心臓弁支持体と、
該支持体に接続された、該支持体を心臓弁輪に沿って取り付けるためのフックであって、
そのそれぞれが、(a)第1の方向に面する鋭利な遊離端と、(b)該フックが支持体に取り付けられている接続端と、(c)遊離端と接続端との間に位置する屈曲であって、第1の方向に概して対向する第2の方向に面する鋭利な形体(feature)を画定する屈曲とを有するフックと、
を備える、機器。 - 支持体が伸張および収縮可能である、請求項36記載の機器。
- 支持体が、ステンレス鋼、金、ニチノール、および生物学的に適合したエラストマーのうちの少なくとも1つを含む、請求項36記載の機器。
- 支持体がらせん状のねじりバネを含む、請求項36記載の機器。
- フックが支持体を中心に回転可能である、請求項36記載の機器。
- フックが、プラチナ、金、パラジウム、レニウム、タンタル、タングステン、モリブデン、ニッケル、コバルト、ステンレス鋼、ニチノール、およびその合金のうちの少なくとも1つを含む、請求項36記載の機器。
- テーパ状の外面を支えるツールと、
心臓弁支持体と、
心臓弁の軸に沿って対向する2つの方向のそれぞれに、ツールから支持体へ力を移動し、軸方向のうちの1つに沿う力が既定の閾値を超えると解放する、ツールと支持体との間の接続と、
を備える、機器。 - ツールがテーパ状の外面を含む、請求項42記載の機器。
- テーパ状の外面が、開口を画定する相互接続した支柱を含む、請求項43記載の機器。
- 接続が、ツールの外面上に少なくとも1つの保持要素を含む、請求項42記載の機器。
- 弁支持体が、それぞれ第1の方向に面する鋭利な遊離端を有するフックと、フックが支持体に取り付けられる接続端と、遊離端と接続端との間に位置する屈曲であって、第1の方向に概して対向する第2の方向に面する鋭利な形体を画定する屈曲と、を含む、請求項42記載の機器。
- ツールがテーパ状の外面の狭端に先端を含み、先端をテーパ状の外面の広端に向けて引くとテーパ状の外面を裏返すことができる、請求項42記載の機器。
- 前記先端に接続される可動要素であって、該先端を引いてテーパ状の外面を裏返すように構成される可動要素も含む、請求項47記載の機器。
- テーパ状の外面を被覆し、被覆される際にテーパ状の外面を折り畳むシースも含む、請求項42記載の機器。
- ツールが自己伸張型半剛性ネットを含む、請求項42記載の機器。
- 心臓の輪形体に向けてツール上に力を印加し、該形体を拡張させる工程と、
該形体が拡張する間に、該輪形体の周囲に沿う位置にある組織に支持体を取り付ける工程と、
取り付けた後に、支持体を収縮させて該形体を再構成する工程と、
を含む、方法。 - 形体が左心耳を含む、請求項51記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US11/620,955 US9192471B2 (en) | 2007-01-08 | 2007-01-08 | Device for translumenal reshaping of a mitral valve annulus |
US11/620,955 | 2007-01-08 | ||
PCT/US2008/050224 WO2008086172A2 (en) | 2007-01-08 | 2008-01-04 | Reconfiguring heart features |
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JP2010515488A true JP2010515488A (ja) | 2010-05-13 |
JP2010515488A5 JP2010515488A5 (ja) | 2012-02-16 |
JP5281016B2 JP5281016B2 (ja) | 2013-09-04 |
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EP (1) | EP2106248A4 (ja) |
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Cited By (4)
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JP2012510879A (ja) * | 2008-12-04 | 2012-05-17 | ジョージア テック リサーチ コーポレーション | 低侵襲心臓弁処置のための方法及び装置 |
JP2015500696A (ja) * | 2011-12-12 | 2015-01-08 | デイヴィッド・アロン | 心臓弁修復デバイス |
KR20150143414A (ko) * | 2013-01-25 | 2015-12-23 | 메드텐티아 인터내셔날 엘티디 오와이 | 심장 판막 회복을 위한 시스템 |
JP2016154909A (ja) * | 2011-09-13 | 2016-09-01 | アボット、カーディオバスキュラー、システムズ、インコーポレーテッドAbbott Cardiovascular Systems Inc. | 組織近置システム用のグリッパ型プッシャ |
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US8992567B1 (en) | 2001-04-24 | 2015-03-31 | Cardiovascular Technologies Inc. | Compressible, deformable, or deflectable tissue closure devices and method of manufacture |
US8961541B2 (en) | 2007-12-03 | 2015-02-24 | Cardio Vascular Technologies Inc. | Vascular closure devices, systems, and methods of use |
US20080109030A1 (en) | 2001-04-24 | 2008-05-08 | Houser Russell A | Arteriotomy closure devices and techniques |
WO2006097931A2 (en) | 2005-03-17 | 2006-09-21 | Valtech Cardio, Ltd. | Mitral valve treatment techniques |
US8951285B2 (en) | 2005-07-05 | 2015-02-10 | Mitralign, Inc. | Tissue anchor, anchoring system and methods of using the same |
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JP2015500696A (ja) * | 2011-12-12 | 2015-01-08 | デイヴィッド・アロン | 心臓弁修復デバイス |
KR20150143414A (ko) * | 2013-01-25 | 2015-12-23 | 메드텐티아 인터내셔날 엘티디 오와이 | 심장 판막 회복을 위한 시스템 |
JP2016504136A (ja) * | 2013-01-25 | 2016-02-12 | メドテンシア インターナショナル エルティーディー オーワイ | 心臓弁修復用のシステム |
KR102370065B1 (ko) * | 2013-01-25 | 2022-03-04 | 메드텐티아 인터내셔날 엘티디 오와이 | 심장 판막 회복을 위한 시스템 |
Also Published As
Publication number | Publication date |
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WO2008086172A2 (en) | 2008-07-17 |
WO2008086172A3 (en) | 2008-09-12 |
US20080167713A1 (en) | 2008-07-10 |
US20120109289A1 (en) | 2012-05-03 |
EP2106248A2 (en) | 2009-10-07 |
JP5281016B2 (ja) | 2013-09-04 |
US20090182419A1 (en) | 2009-07-16 |
US9192471B2 (en) | 2015-11-24 |
US20120109288A1 (en) | 2012-05-03 |
EP2106248A4 (en) | 2013-11-06 |
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