JP2011528257A - 軸線方向に固定する、潰れ可能かつ再膨張可能な多種症状用人工心臓弁 - Google Patents
軸線方向に固定する、潰れ可能かつ再膨張可能な多種症状用人工心臓弁 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
- A61F2/2412—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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
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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
- A61F2/2412—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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0073—Quadric-shaped
- A61F2230/008—Quadric-shaped paraboloidal
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (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
本出願は、2008年7月15日出願の米国仮出願61/135076号優先権の利益を主張し、この内容全体を本明細書において援用する。
Claims (31)
- 潰れ形態および膨張形態を有する膨張可能な不織ステント体を有し、自然心臓弁置換用の人工心臓弁で用いるステントであって、
前記ステント体は、少なくとも1つの膨張可能なセル列を有する輪状部、および該輪状部と一体的に形成された少なくとも1つの係止部材を含み、
前記輪状部は、前記膨張形態の際にほぼ管状であるとともに、該輪状部の近位端部が前記自然心臓弁の弁輪に隣接し、かつ、該輪状部の遠位端部が該自然心臓弁の弁尖の遠位端部に隣接するように該自然心臓弁の該弁尖および該自然心臓弁の該弁輪に係合するようにされており、
前記係止部材の各々は、前記輪状部の前記遠位端部に隣接して該輪状部に接続されており、前記係止部材の各々は、前記自然心臓弁の前記弁尖の外面に係合するようにされた係合部を有している、
ステント。 - 前記膨張形態の際に、各係合部は近位方向において外方に傾斜している、請求項1に記載のステント。
- 各係止部材は、前記輪状部から遠位方向に延びる1以上の接続ストラットを含み、
各係止部材の前記係合部は、該係止部材の前記1以上の接続ストラットから近位方向に延びている、
請求項1に記載のステント。 - 各係止部材は、前記輪状部上の周方向に離間した位置から遠位方向に突出する一対の接続ストラットと、遠位端部が隣接した該接続ストラットに接続され、該接続ストラットとの接続部から近位方向に突出する一対の係合ストラットと、を含み、
前記接続ストラットは、前記輪状部より遠位の遠位端部を有し、
前記係合ストラットは、その近位端部が隣接するように互いに接続されており、各係止部材の前記係合部は、前記係合ストラットを含んでいる、
請求項1に記載のステント。 - 前記少なくとも1つの膨張可能なセル列は、相互に接続した複数のセルストラットを含み、該複数のセルストラットは、頂部で互いに接合しているとともにセルを画定しており、該頂部は、前記輪状部の前記遠位端部での遠位頂部列を含み、前記接続ストラットは、該遠位頂部列の頂部に接続されている、請求項4に記載のステント。
- 各係止部材の前記接続ストラットは、相互に隣接していない前記遠位頂部列の頂部に接続されている、請求項5に記載のステント。
- 各係止部材の前記係合ストラットは、周方向において互いの方向に向かって突出している、請求項4に記載のステント。
- 各係止部材は、前記係合ストラットの前記近位端部間を延びる近位端部材を含んでいる、請求項4に記載のステント。
- 前記近位端部材の各々はほぼ弧状である、請求項8に記載のステント。
- 各近位端部材は、前記係合ストラットの前記近位端部から遠位方向に突出する湾曲部を含んでいる、請求項9に記載のステント。
- 複数の前記膨張可能なセル列は前記輪状部を有している、請求項1に記載のステント。
- 少なくとも1つの前記係止部材は、前記輪状部の周りに周方向に離間して配された複数の前記係止部材を含んでいる、請求項1に記載のステント。
- 前記輪状部は、互いに周方向に離間して配された複数の接合柱を含んでいる、請求項1に記載のステント。
- 膨張形態を有する膨張可能なステント体を有し、自然大動脈弁置換用の人工心臓弁で用いるステントであって、
前記ステント体は、近位遠位方向に延びるほぼ管状の輪状部と、該輪状部より直径が大きく、該輪状部から遠位方向に離間して配されたほぼ管状の大動脈部と、該大動脈部と前記輪状部を相互接続させ、互いに周方向に離間して配された複数の支持ストラットと、を含み、
前記ステント体は、前記輪状部に隣接して前記ステント体に接続された少なくとも1つの係止部材を更に含み、該少なくとも1つの係止部材は、前記膨張形態の際に前記輪状部の外方に配置される係合部を有し、
前記ステント体は、前記輪状部が前記自然弁の弁輪に隣接して配され、かつ、前記自然心臓弁の弁尖内に少なくとも部分的に配されるようにされており、
前記大動脈部は自然バルサルバ洞−上行大動脈移行部に隣接し、前記支持ストラットは少なくとも部分的に自然バルサルバ洞を横切って延び、
前記少なくとも1つの係止部材の前記係合部は、少なくとも1つの自然弁尖に係合する、
ステント。 - 前記ステント体は金属製管から切り出される、請求項14に記載のステント。
- 前記輪状部は、周方向に互いに離間して配された複数の接合柱を含んでいる、請求項14に記載のステント。
- 前記複数の支持ストラットは、前記複数の接合柱の各々に付随した支持ストラットのグループを含み、各グループの前記支持ストラットは、該グループに付随した前記接合柱に周方向において隣接するように配置されている、請求項16に記載のステント。
- 前記係止部材は、周方向において前記接合柱および前記支持ストラットからずれている、請求項17に記載のステント。
- 前記ステント体は潰れ形態を有し、該潰れ形態の際には、各係止部材は、異なる接合柱に付随した支持ストラット間を前記輪状部から遠位方向に延びている、請求項18に記載のステント。
- 前記輪状部は1以上の膨張可能なセル列を有し、前記大動脈部は1以上の膨張可能なセル列を有している、請求項19に記載のステント。
- 3つの前記係止部材を含み、該3つの係止部材は、前記輪状部周りに周方向等間隔に配されている、請求項14に記載のステント。
- 前記輪状部は3つの接合柱を含み、該3つの接合柱は、前記3つの係止部材と交互に前記輪状部周りに周方向等間隔に配されている、請求項21に記載のステント。
- 請求項1から22のいずれか1項に記載のステントと、該ステントが前記膨張形態にある際に前記輪状部内に少なくとも部分的に配置される複数の可撓性人工弁尖と、を有する弁。
- 前記自然弁の1以上の弁尖が前記ステント体の前記輪状部および該ステント体の1以上の係止部材に係合されるように、患者の自然弁内に請求項23に記載の弁を埋め込むステップを有する、患者の治療方法。
- 膨張形態を有する膨張可能なステント体を有し、自然弁置換用の人工心臓弁で用いるステントであって、
前記ステント体は複数のセルを有する輪状部を含み、該複数のセルは近位遠位軸線周りを周方向に延びるほぼ管状の壁を協働して画定し、該壁は、周方向に離間して配された複数のくぼみ部と、該くぼみ部より遠位に延び、周方向に離間して配された複数の突起部と、を含む波状の遠位縁部を有し、該突起部は、前記管状の壁の周囲周りの前記くぼみ部間に組み入れられている、
ステント。 - 請求項25に記載のステントと、自由縁部および基縁部を有する複数の可撓性人工弁尖と、を有する弁であって、
前記弁尖は、前記ステントが膨張形態にある際に前記輪状部内に少なくとも部分的に配置され、前記弁尖は、それらの前記自由縁部に沿って互いに接合するようにされており、該弁尖の該自由縁部は、前記壁の前記くぼみ部と周方向において並ぶ接合位置にて前記輪状部に接続されている、
弁。 - 潰れ形態および完全膨張、非拘束形態を有する膨張可能なステント体を有する、自然弁置換用の人工心臓弁であって、
前記ステント体は近位遠位軸線周りを周方向に延びる構造物を含み、該構造物は、前記完全膨張形態の際に前記近位遠位軸線に垂直な平面において非円形断面を有する領域を有し、3つの人工弁尖が、自由縁部を有して該自由縁部で互いに接合するようにされており、該人工弁尖の該自由縁部は、前記近位遠位軸線周りに周方向に離間して配された接合位置にて前記領域内の前記構造物に接続されている、
人工心臓弁。 - 前記非円形断面を有する領域は楕円形状である、請求項27に記載の人工心臓弁。
- 自然心臓弁置換用の人工心臓弁で用いるステントであって、
該ステントは、完全膨張形態を有する膨張可能体を有し、該膨張可能体は複数のセルを有する輪状部を含み、該複数のセルは近位遠位軸線周りを周方向に延びるほぼ管状の壁を協働して画定し、該壁が3つの側部領域および該3つの側部領域に互いに隣接して接続した角部領域を含むように、該壁の少なくとも一部は、前記完全膨張形態の際に前記近位遠位軸線に垂直な平面においてほぼ三角形断面を有する、
ステント。 - 請求項29に記載のステントと、前記輪状部内に少なくとも部分的に配置された複数の人工弁尖と、を有し、該複数の人工弁尖が互いに接合するようにされている、弁。
- 3つの自然弁尖を備えた自然弁を有する患者の治療方法であって、
前記輪状部の壁の前記側部領域が前記天然弁尖と並ぶように請求項29に記載の弁を取り付けるステップを有する、
患者の治療方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US13507608P | 2008-07-15 | 2008-07-15 | |
US61/135,076 | 2008-07-15 | ||
PCT/US2009/004095 WO2010008549A1 (en) | 2008-07-15 | 2009-07-15 | Axially anchoring collapsible and re-expandable prosthetic heart valves for various disease states |
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JP2011528257A true JP2011528257A (ja) | 2011-11-17 |
JP5379853B2 JP5379853B2 (ja) | 2013-12-25 |
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JP (1) | JP5379853B2 (ja) |
AU (1) | AU2009271574B2 (ja) |
BR (1) | BRPI0915773A2 (ja) |
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EP2331016A1 (en) | 2011-06-15 |
EP2331016B8 (en) | 2020-06-03 |
EP2331016B1 (en) | 2020-04-22 |
US9226820B2 (en) | 2016-01-05 |
WO2010008549A1 (en) | 2010-01-21 |
AU2009271574B2 (en) | 2015-05-21 |
US20110098800A1 (en) | 2011-04-28 |
ES2792354T3 (es) | 2020-11-11 |
CR11778A (es) | 2011-02-07 |
BRPI0915773A2 (pt) | 2015-11-03 |
AU2009271574A1 (en) | 2010-01-21 |
JP5379853B2 (ja) | 2013-12-25 |
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