JP2012521222A5 - - Google Patents
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- JP2012521222A5 JP2012521222A5 JP2012500990A JP2012500990A JP2012521222A5 JP 2012521222 A5 JP2012521222 A5 JP 2012521222A5 JP 2012500990 A JP2012500990 A JP 2012500990A JP 2012500990 A JP2012500990 A JP 2012500990A JP 2012521222 A5 JP2012521222 A5 JP 2012521222A5
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- Prior art keywords
- support
- tissue
- configuration
- gripping
- elements
- Prior art date
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- 210000001519 tissues Anatomy 0.000 claims description 60
- 238000009434 installation Methods 0.000 claims description 19
- 210000003709 Heart Valves Anatomy 0.000 claims description 8
- 230000023298 conjugation with cellular fusion Effects 0.000 claims description 7
- 230000013011 mating Effects 0.000 claims description 7
- 230000021037 unidirectional conjugation Effects 0.000 claims description 7
- 230000000747 cardiac effect Effects 0.000 claims description 6
- 230000014759 maintenance of location Effects 0.000 claims description 6
- PCHJSUWPFVWCPO-UHFFFAOYSA-N gold Chemical compound [Au] PCHJSUWPFVWCPO-UHFFFAOYSA-N 0.000 claims description 4
- 229910052737 gold Inorganic materials 0.000 claims description 4
- 239000010931 gold Substances 0.000 claims description 4
- PXHVJJICTQNCMI-UHFFFAOYSA-N nickel Chemical compound [Ni] PXHVJJICTQNCMI-UHFFFAOYSA-N 0.000 claims description 4
- 229910001000 nickel titanium Inorganic materials 0.000 claims description 4
- KDLHZDBZIXYQEI-UHFFFAOYSA-N palladium Chemical compound [Pd] KDLHZDBZIXYQEI-UHFFFAOYSA-N 0.000 claims description 4
- 229910001220 stainless steel Inorganic materials 0.000 claims description 4
- 239000010935 stainless steel Substances 0.000 claims description 4
- 239000000463 material Substances 0.000 claims description 3
- WUAPFZMCVAUBPE-UHFFFAOYSA-N Rhenium Chemical compound [Re] WUAPFZMCVAUBPE-UHFFFAOYSA-N 0.000 claims description 2
- 210000000080 chela (arthropods) Anatomy 0.000 claims description 2
- GUTLYIVDDKVIGB-UHFFFAOYSA-N cobalt Chemical compound [Co] GUTLYIVDDKVIGB-UHFFFAOYSA-N 0.000 claims description 2
- 229910052803 cobalt Inorganic materials 0.000 claims description 2
- 239000010941 cobalt Substances 0.000 claims description 2
- 229920001971 elastomer Polymers 0.000 claims description 2
- 239000000806 elastomer Substances 0.000 claims description 2
- 230000029578 entry into host Effects 0.000 claims description 2
- 239000000203 mixture Substances 0.000 claims description 2
- ZOKXTWBITQBERF-UHFFFAOYSA-N molybdenum Chemical compound [Mo] ZOKXTWBITQBERF-UHFFFAOYSA-N 0.000 claims description 2
- 229910052750 molybdenum Inorganic materials 0.000 claims description 2
- 239000011733 molybdenum Substances 0.000 claims description 2
- 229910052759 nickel Inorganic materials 0.000 claims description 2
- 229910052763 palladium Inorganic materials 0.000 claims description 2
- -1 polyethylene terephthalate Polymers 0.000 claims description 2
- 229920000139 polyethylene terephthalate Polymers 0.000 claims description 2
- 239000005020 polyethylene terephthalate Substances 0.000 claims description 2
- 230000002441 reversible Effects 0.000 claims description 2
- 229910052702 rhenium Inorganic materials 0.000 claims description 2
- GUVRBAGPIYLISA-UHFFFAOYSA-N tantalum Chemical compound [Ta] GUVRBAGPIYLISA-UHFFFAOYSA-N 0.000 claims description 2
- 229910052715 tantalum Inorganic materials 0.000 claims description 2
- WFKWXMTUELFFGS-UHFFFAOYSA-N tungsten Chemical compound [W] WFKWXMTUELFFGS-UHFFFAOYSA-N 0.000 claims description 2
- 229910052721 tungsten Inorganic materials 0.000 claims description 2
- 239000010937 tungsten Substances 0.000 claims description 2
- 229910001260 Pt alloy Inorganic materials 0.000 claims 1
- 238000003780 insertion Methods 0.000 description 2
- 230000000149 penetrating Effects 0.000 description 2
- BASFCYQUMIYNBI-UHFFFAOYSA-N platinum Chemical compound [Pt] BASFCYQUMIYNBI-UHFFFAOYSA-N 0.000 description 2
- 229910045601 alloy Inorganic materials 0.000 description 1
- 239000000956 alloy Substances 0.000 description 1
- 230000000875 corresponding Effects 0.000 description 1
- 230000003247 decreasing Effects 0.000 description 1
- 229910052697 platinum Inorganic materials 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
Description
[本発明1001]
把持要素を有する心臓組織支持体を含み、
各把持要素が、心臓組織に対して押しつけられる際に組織に侵入できるほど十分に鋭い自由端と、鋭い自由端が組織に侵入した後に組織からの把持要素の引き出しに抵抗する特徴とを有する、装置。
[本発明1002]
把持要素の自由端が支持体の表面から離れた方に突出する、本発明1001の装置。
[本発明1003]
組織からの把持要素の引き出しに抵抗する特徴が、把持要素から横方向に突出するフィンガーを含む、本発明1001の装置。
[本発明1004]
心臓組織支持体が、把持要素を有する輪状表面を含む、本発明1001の装置。
[本発明1005]
支持体が拡張可能および収縮可能である、本発明1001の装置。
[本発明1006]
支持体が、設定可能な固有サイズを有する、本発明1005の装置。
[本発明1007]
ワイヤが固有サイズを設定する、本発明1006の装置。
[本発明1008]
支持体がステンレス鋼、金、ニチノールまたは生体適合性エラストマーの少なくとも1つを含む、本発明1001の装置。
[本発明1009]
支持体がトーラスを含む、本発明1001の装置。
[本発明1010]
支持体が、螺旋状に巻き付けられた部分を含む、本発明1001の装置。
[本発明1011]
支持体のいくつかの部分が把持要素を有さない、本発明1001の装置。
[本発明1012]
把持要素がパターンとして組織されている、本発明1001の装置。
[本発明1013]
パターンが列を含む、本発明1012の装置。
[本発明1014]
パターンが、把持要素がより高密度で配置されている群と、把持要素がより低密度で配置されている群とを含む、本発明1012の装置。
[本発明1015]
パターンが弧を含む、本発明1012の装置。
[本発明1016]
パターンがクラスターを含む、本発明1012の装置。
[本発明1017]
パターンがランダム配置を含む、本発明1012の装置。
[本発明1018]
把持要素の少なくともいくつかが白金、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、およびそれらの任意の組み合わせの合金の少なくとも1つを含む、本発明1001の装置。
[本発明1019]
把持要素が同一のサイズを有する、本発明1001の装置。
[本発明1020]
把持要素のいくつかが異なるサイズを有する、本発明1001の装置。
[本発明1021]
把持要素の少なくともいくつかが、引き出しに抵抗する2つ以上の特徴を有する、本発明1001の装置。
[本発明1022]
把持要素の少なくともいくつかが表面から直交して突出する、本発明1002の装置。
[本発明1023]
把持要素の少なくともいくつかが曲線状である、本発明1001の装置。
[本発明1024]
組織がそれを通じて成長可能なスリーブをさらに含む、本発明1001の装置。
[本発明1025]
スリーブがポリエチレンテレフタレートを含む、本発明1024の装置。
[本発明1026]
約15個〜100万個の把持要素が支持体上に存在する、本発明1001の装置。
[本発明1027]
約100個〜約100,000個の把持要素が存在する、本発明1001の装置。
[本発明1028]
把持要素がバーフックを含む、本発明1001の装置。
[本発明1029]
把持要素が矢状体を含む、本発明1001の装置。
[本発明1030]
把持要素がフックを含む、本発明1001の装置。
[本発明1031]
把持要素を有する心臓組織支持体を保つカテーテルの先端を心臓弁輪に配向させ、カテーテルの先端において構造を開口することで弁輪に対してカテーテルからの半径方向力を適用し、構造が開口している間に弁輪上に支持体を押し込むことで、カテーテル検査室内で弁輪の形状を補正する段階
を含む方法。
[本発明1032]
把持要素を有する心臓組織支持体を心臓弁輪上に押しつけることで、外科手技中に弁輪の形状を補正する段階
を含む方法。
[本発明1033]
取り付けの準備中に拡張可能であり、弁輪上の定位置にある際に通常の緩和された非拡張の固有サイズに収縮可能である支持体を、異なる患者における異なるサイズの心臓弁輪に取り付ける段階、および
異なる患者の異なるサイズの心臓弁輪を収容するために、定位置にある少なくともいくつかの支持体のサイズを減少させて通常の緩和された非拡張の固有サイズよりも小さくする段階
を含む方法。
[本発明1034]
組織侵入特徴および保持特徴を各々が有する多数の小さい把持体を含み、
支持体が力により取り付けられるべき心臓組織の所与の区域の構成に対する把持体の構成が、
(1) 失敗する一組の把持体の侵入特徴が組織に侵入することに失敗し、
(2) 第2の組の把持体の侵入特徴が組織に侵入することに成功し、
(3) 第2の組の把持体のサブセットの保持特徴が組織内に把持体を保持することに失敗し、
(4) 第2の組の残りの把持体の保持特徴が組織内に把持体を保持することおよび意図される構成で組織上にて支持体を保つことに成功する、構成である、
心臓組織支持体。
[本発明1035]
支持体上のいくつかの小さい把持体の一部であって支持体を心臓組織にしっかり取り付けるために十分な一部のみを組織内に埋め込みかつ保持するために、支持体を心臓組織の一領域上に押しつける段階
を含む方法。
[本発明1036]
拡張可能および収縮可能でありかつ把持要素を有し、把持要素が心臓組織に侵入しかつ侵入後は組織内に該要素を保持するように構成されている、輪状の心臓弁支持体
を含む装置。
[本発明1037]
支持体を心臓弁輪に取り付ける器具であって、取り付け前に拡張構成で支持体を保ち、取り付け前に心臓弁輪を拡張させ、拡張した弁輪に支持体をその拡張構成で取り付けることを可能にし、かつ取り付け後に拡張した支持体を解放して収縮構成にする機構を含む器具。
[本発明1038]
カテーテルの端部に取り付けられる、本発明1037の器具。
[本発明1039]
可膨張性バルーンをさらに含む、本発明1037の器具。
[本発明1040]
バルーンが器具を位置決めする役割を果たす、本発明1039の器具。
[本発明1041]
機構が、取り付け後に心臓から器具を取り外す機構でもある、本発明1037の器具。
[本発明1042]
支持体を心臓弁輪に取り付ける器具であって、操作者の制御下で心臓の弁輪を所定形状に拡張させる構造を含む器具。
[本発明1043]
構造が円錐形の外面を有し、外面の少なくとも一部が所定形状に一致する、本発明1042の器具。
[本発明1044]
構造が、所定形状に拡張可能な外面を有する、本発明1042の器具。
[本発明1045]
生体組織に付着しかつ支持体を定位置にしっかり保つ把持要素と、
把持要素に結合し、
支持体を設置するための第1の構成と支持体が設置後に定位置にしっかり保たれる第2の構成との間で支持体を調整し、かつ
第1および第2の構成において自立型である、
輪状構造と
を有する生体組織用の支持体を含む、装置。
[本発明1046]
生体組織が心臓組織を含む、本発明1045の装置。
[本発明1047]
生体組織が心臓弁輪を含む、本発明1045の装置。
[本発明1048]
把持要素が、設置中に組織に侵入しかつ設置後に組織を把持するように構成されている、本発明1045の装置。
[本発明1049]
輪状構造が円形である、本発明1045の装置。
[本発明1050]
輪状構造が、互いに対して輪状に移動することで第1の構成と第2の構成との間で支持体を調整する要素を有する、本発明1045の装置。
[本発明1051]
輪状構造が、支持体が第2の構成である場合よりも支持体が第1の構成である場合の方が大きい、本発明1045の装置。
[本発明1052]
輪状構造がその形状を変化させて支持体を調整する、本発明1045の装置。
[本発明1053]
輪状構造が、生体組織に対する把持要素の場所を変更することなく設置中にその形状を変化させる、本発明1045の装置。
[本発明1054]
輪状構造が、把持要素が取り付けられる第1の要素と、輪状構造が第1の構成と第2の構成との間で支持体を調整する際に第1の要素に対して摺動可能な第2の要素とを含む、本発明1045の装置。
[本発明1055]
第1の要素が、把持要素が取り付けられる弾性の輪状管を含み、第2の要素が、該管内で摺動可能である剛性の調整可能な部片を含む、本発明1054の装置。
[本発明1056]
第2の要素が自立コイルを含む、本発明1054の装置。
[本発明1057]
自立コイルが、互いに対して動くことで第1の構成と第2の構成との間で支持体を調整することが可能な2つの自由端を有する剛性のストリップ材料を含む、本発明1055の装置。
[本発明1058]
輪状構造が、輪状構造に結合した把持要素の間隔を規定する特徴を含む、本発明1045の装置。
[本発明1059]
把持要素が、支持体を設置するための第1の配設と支持体が設置後に定位置にしっかり保たれる第2の配設との間で調整可能である、本発明1045の装置。
[本発明1060]
輪状構造および把持要素が、支持体が第1の構成と第2の構成との間で調整される際に把持要素が第1の配設と第2の配設との間で自動的に調整されるように構成されている、本発明1059の装置。
[本発明1061]
輪状構造が、支持体が第1の構成と第2の構成との間で調整される際に増加する断面積を含み、把持要素が輪状構造に結合することで、輪状構造の断面積が減少する際に把持要素が第1の配設と第2の配設との間で調整される、本発明1060の装置。
[本発明1062]
把持要素の各々がループ、およびループに取り付けられた貫通要素を含み、ループの構成が第1の配設と第2の配設との間で変化するに従って貫通要素の配向が変化する、本発明1059の装置。
[本発明1063]
把持要素が組織を損傷することなく、第1の構成と第2の構成との間での支持体の調整が可逆的である、本発明1045の装置。
[本発明1064]
輪状構造が、支持体の構成の変化を防止するロックを含む、本発明1045の装置。
[本発明1065]
ロックが一対の嵌合要素を含む、本発明1064の装置。
[本発明1066]
嵌合要素の一方がタブを含み、他方がスロットを含む、本発明1065の装置。
[本発明1067]
嵌合要素の一方がピンを含み、他方がピン用の孔を含む、本発明1065の装置。
[本発明1068]
輪状構造が、中心軸を有しており、嵌合要素が嵌合する位置に向けて中心軸の周りで互いに対して移動可能な2つの部分を含む、本発明1064の装置。
[本発明1069]
生体組織に侵入する尖端と、
尖端を支持する弾性ループであって、緩和構成および非緩和構成を有する弾性ループと
を含む把持体を含み、
尖端が、緩和構成および非緩和構成にそれぞれ関連する異なる配向を有する、装置。
[本発明1070]
尖端が少なくとも1つの針状突起を有する、本発明1069の装置。
[本発明1071]
把持体が2つ以上の前記尖端を含む、本発明1069の装置。
[本発明1072]
尖端の配向、以下の構成を有する弾性支持体、本発明1069の装置。
[本発明1073]
把持体がワイヤを含む、本発明1069の装置。
[本発明1074]
ループが円形である、本発明1069の装置。
[本発明1075]
把持体が材料の形成ストリップを含む、本発明1069の装置。
[本発明1076]
互いに対向しかつ緩和構成および非緩和構成の少なくとも一方においてはさみ（pincer）として作用する2つの前記尖端が存在する、本発明1069の装置。
[本発明1077]
健康な心臓弁に対応する緩和直径と挿入器具に適合する拡大直径とを有する円形で自立型の弾性リングと、
弾性リングに取り付けられており、設置中に挿入配向と設置配向との間で自動的に変化する方向に配向している把持体と
を含む心臓弁修復リング。
[本発明1078]
心臓弁輪の形状を補正するため、弁輪の組織に侵入しかつ支持体を弁輪上にしっかり保つように、支持体上の尖った把持体を押し込む段階、および
心臓弁輪を損傷することなく、尖った把持体の少なくともいくつかを引き出すことで、弁輪から支持体の少なくとも一部を取り外す段階
を含む方法。
[本発明1079]
拡張した弾性支持体を心臓弁輪上に装着する段階、
支持体を健康な弁輪の直径まで収縮させる段階、および
支持体の要素を嵌合させることで、収縮した支持体をその収縮直径でロックする段階
を含む方法。
[本発明1080]
設置中に支持リングを拡張サイズからより小さいサイズに収縮させることにより、心臓弁輪支持リングに結合した把持要素を弁輪の組織内に着座させる段階
を含む方法。
[本発明1081]
支持体が輪状要素を含み、輪状要素の対が該要素の縁部に沿って接続されることでリングを形成する、
本発明1001の装置。
[本発明1082]
輪状要素の各々が把持体の少なくとも1つを有する、
本発明1081の装置。
[本発明1083]
輪状要素の各々が、把持体から反対方向に向かう尖った要素をさらに有する、本発明1082の装置。
[本発明1084]
輪状要素の各々が六角形を含む、本発明1081の装置。
他の特徴および利点は、明細書および特許請求の範囲から明らかであろう。
[Invention 1001]
Comprising a cardiac tissue support having a grasping element;
Each gripping element has a free end that is sufficiently sharp to allow entry into the tissue when pressed against the heart tissue and a feature that resists withdrawal of the gripping element from the tissue after the sharp free end has entered the tissue; apparatus.
[Invention 1002]
The device of the present invention 1001, wherein the free end of the gripping element protrudes away from the surface of the support.
[Invention 1003]
The device of the present invention 1001, wherein the feature that resists withdrawal of the grasping element from the tissue includes fingers that project laterally from the grasping element.
[Invention 1004]
The device of the present invention 1001, wherein the cardiac tissue support includes an annular surface having a grasping element.
[Invention 1005]
The device of the present invention 1001 wherein the support is expandable and contractible.
[Invention 1006]
The device of the present invention 1005, wherein the support has a configurable intrinsic size.
[Invention 1007]
The device of the present invention 1006, wherein the wire sets a unique size.
[Invention 1008]
The device of the present invention 1001, wherein the support comprises at least one of stainless steel, gold, nitinol or a biocompatible elastomer.
[Invention 1009]
The device of the present invention 1001, wherein the support comprises a torus.
[Invention 1010]
The device of the present invention 1001, wherein the support comprises a spirally wound portion.
[Invention 1011]
The device of the present invention 1001 wherein some parts of the support have no gripping elements.
[Invention 1012]
The device of the present invention 1001, wherein the gripping elements are organized as a pattern.
[Invention 1013]
The device of the present invention 1012 wherein the pattern comprises a row.
[Invention 1014]
The apparatus of the present invention 1012 wherein the pattern comprises a group in which the gripping elements are arranged at a higher density and a group in which the gripping elements are arranged at a lower density.
[Invention 1015]
The device of the present invention 1012 wherein the pattern comprises an arc.
[Invention 1016]
The device of the present invention 1012 wherein the pattern comprises clusters.
[Invention 1017]
The device of the present invention 1012 wherein the pattern comprises a random arrangement.
[Invention 1018]
The apparatus of the present invention 1001, wherein at least some of the gripping elements comprise at least one of platinum, gold, palladium, rhenium, tantalum, tungsten, molybdenum, nickel, cobalt, stainless steel, nitinol, and alloys of any combination thereof .
[Invention 1019]
The device of the present invention 1001, wherein the gripping elements have the same size.
[Invention 1020]
The device of the present invention 1001 wherein some of the gripping elements have different sizes.
[Invention 1021]
The device of the present invention 1001, wherein at least some of the gripping elements have more than one feature that resists withdrawal.
[Invention 1022]
The device of the present invention 1002, wherein at least some of the gripping elements protrude orthogonally from the surface.
[Invention 1023]
The device of the present invention 1001, wherein at least some of the gripping elements are curvilinear.
[Invention 1024]
The device of the present invention 1001, further comprising a sleeve through which the tissue can grow.
[Invention 1025]
The device of invention 1024, wherein the sleeve comprises polyethylene terephthalate.
[Invention 1026]
The device of the present invention 1001, wherein about 15 to 1 million gripping elements are present on a support.
[Invention 1027]
The device of the present invention 1001, wherein there are about 100 to about 100,000 gripping elements.
[Invention 1028]
The device of the present invention 1001, wherein the gripping element comprises a bar hook.
[Invention 1029]
The device of the present invention 1001, wherein the gripping element comprises a sagittal body.
[Invention 1030]
The device of the present invention 1001, wherein the gripping element comprises a hook.
[Invention 1031]
Orienting the tip of the catheter holding the cardiac tissue support with the grasping element to the heart annulus and opening the structure at the tip of the catheter applies a radial force from the catheter to the annulus, opening the structure. Correct the shape of the annulus in the catheterization chamber by pushing the support onto the annulus during
Including methods.
[Invention 1032]
Correcting the shape of the annulus during a surgical procedure by pressing a cardiac tissue support with a grasping element onto the heart annulus
Including methods.
[Invention 1033]
A support that is expandable in preparation for attachment and contractible to the normal relaxed, unexpanded native size when in place on the annulus is attached to different sized heart annulus in different patients Stages, and
Decreasing the size of at least some supports in place to be smaller than the normal relaxed non-expanded inherent size to accommodate different sized heart annulus of different patients
Including methods.
[Invention 1034]
Including a number of small grasping bodies each having tissue invasion and retention features;
The configuration of the gripper for the configuration of a given area of heart tissue to which the support is to be attached by force is
(1) The intrusion feature of a pair of gripping bodies that fail fails to invade the tissue,
(2) The intrusion feature of the second set of grasping bodies successfully penetrates the tissue,
(3) the retention feature of the subset of the second set of grasping bodies fails to retain the grasping bodies in the tissue;
(4) The second set of remaining gripper retention features is a configuration that is successful in retaining the gripper in tissue and maintaining the support on the tissue in the intended configuration.
Heart tissue support.
[Invention 1035]
In order to embed and retain in the tissue only a portion of several small grips on the support that are sufficient to secure the support to the heart tissue, Pressing up
Including methods.
[Invention 1036]
An annular heart valve support that is expandable and contractible and has a gripping element, the gripping element entering the heart tissue and configured to hold the element in the tissue after entry
Including the device.
[Invention 1037]
An instrument that attaches a support to a heart valve annulus, keeping the support in an expanded configuration prior to installation, allowing the heart annulus to expand before installation, and attaching the support to the expanded annulus in its expanded configuration And a mechanism including a mechanism that releases the expanded support after installation to a contracted configuration.
[Invention 1038]
The device of the invention 1037 attached to the end of a catheter.
[Invention 1039]
The device of the present invention 1037 further comprising an inflatable balloon.
[Invention 1040]
The device of the invention 1039 wherein the balloon serves to position the device.
[Invention 1041]
The device of the invention 1037, wherein the mechanism is also a mechanism for removing the device from the heart after attachment.
[Invention 1042]
An instrument for attaching a support to a heart valve annulus, the instrument comprising a structure for expanding the heart annulus to a predetermined shape under the control of an operator.
[Invention 1043]
The device of the present invention 1042 wherein the structure has a conical outer surface, wherein at least a portion of the outer surface conforms to a predetermined shape.
[Invention 1044]
The device of the present invention 1042 wherein the structure has an outer surface expandable to a predetermined shape.
[Invention 1045]
A gripping element that adheres to the biological tissue and holds the support firmly in place;
Coupled to the gripping element,
Adjusting the support between a first configuration for installing the support and a second configuration in which the support is securely held in place after installation; and
Is self-supporting in the first and second configurations,
With ring-shaped structure
A device comprising a support for biological tissue having:
[Invention 1046]
The device of the present invention 1045 wherein the biological tissue comprises heart tissue.
[Invention 1047]
The device of the present invention 1045 wherein the biological tissue comprises a heart valve annulus.
[Invention 1048]
The apparatus of the present invention 1045, wherein the gripping element is configured to invade the tissue during installation and grip the tissue after installation.
[Invention 1049]
The device of the present invention 1045 wherein the annular structure is circular.
[Invention 1050]
The apparatus of the present invention 1045, wherein the annular structure has elements that adjust the support between the first configuration and the second configuration by moving in an annular fashion relative to each other.
[Invention 1051]
The apparatus of the present invention 1045 wherein the ring-shaped structure is greater when the support is in the first configuration than when the support is in the second configuration.
[Invention 1052]
The apparatus of the present invention 1045, wherein the ring-shaped structure changes its shape to adjust the support.
[Invention 1053]
The apparatus of the present invention 1045, wherein the annular structure changes its shape during installation without changing the location of the grasping element relative to the living tissue.
[Invention 1054]
A ring-shaped structure is slidable relative to the first element when the gripping element is attached and the ring-shaped structure is slidable relative to the first element when adjusting the support between the first configuration and the second configuration; The device of the present invention 1045 comprising two elements.
[Invention 1055]
The apparatus of the present invention 1054, wherein the first element comprises a resilient annular tube to which a gripping element is attached and the second element comprises a rigid adjustable piece slidable within the tube.
[Invention 1056]
The device of the invention 1054 wherein the second element comprises a free standing coil.
[Invention 1057]
The apparatus of the present invention 1055, wherein the free standing coil comprises a rigid strip material having two free ends capable of adjusting the support between the first configuration and the second configuration by moving relative to each other .
[Invention 1058]
The apparatus of the present invention 1045, wherein the annular structure includes features that define a spacing between gripping elements coupled to the annular structure.
[Invention 1059]
The apparatus of the present invention 1045, wherein the gripping element is adjustable between a first arrangement for installing the support and a second arrangement in which the support is held securely in place after installation.
[Invention 1060]
The ring-shaped structure and the gripping element are automatically adjusted between the first and second arrangements when the support is adjusted between the first and second arrangements The apparatus of the present invention 1059 configured to be
[Invention 1061]
The annular structure includes a cross-sectional area that increases when the support is adjusted between the first and second configurations, and the gripping element is coupled to the annular structure, thereby reducing the cross-sectional area of the annular structure. The apparatus of the present invention 1060 wherein the gripping element is adjusted between the first and second arrangements when doing so.
[Invention 1062]
Each of the gripping elements includes a loop and a penetrating element attached to the loop, the orientation of the penetrating element changing as the configuration of the loop changes between the first arrangement and the second arrangement 1059 devices.
[Invention 1063]
The device of the present invention 1045 wherein the adjustment of the support between the first and second configurations is reversible without the gripping element damaging the tissue.
[Invention 1064]
The device of the present invention 1045 wherein the ring-shaped structure includes a lock that prevents changes in the configuration of the support.
[Invention 1065]
The device of the present invention 1064 wherein the lock includes a pair of mating elements.
[Invention 1066]
The device of the present invention 1065, wherein one of the mating elements includes a tab and the other includes a slot.
[Invention 1067]
The device of the present invention 1065, wherein one of the mating elements includes a pin and the other includes a hole for the pin.
[Invention 1068]
The device of the present invention 1064, wherein the ring-shaped structure includes a central axis and includes two portions that are movable relative to each other about the central axis toward a position where the mating element mates.
[Invention 1069]
A tip that invades living tissue;
An elastic loop for supporting a tip, the elastic loop having a relaxed configuration and a non-relaxed configuration;
Including a gripping body including
The device, wherein the tip has a different orientation associated with each of a relaxed configuration and a non-relaxed configuration.
[Invention 1070]
The device of the present invention 1069 wherein the tip has at least one acicular protrusion.
[Invention 1071]
The device of the present invention 1069 wherein a gripping body includes two or more of said tips.
[Invention 1072]
Pointer orientation, elastic support having the following configuration, apparatus of the present invention 1069.
[Invention 1073]
The device of the present invention 1069 wherein the gripper comprises a wire.
[Invention 1074]
The device of the present invention 1069 wherein the loop is circular.
[Invention 1075]
The device of the present invention 1069 wherein the gripper comprises a forming strip of material.
[Invention 1076]
The device of the present invention 1069 wherein there are two said apexes facing each other and acting as a pincer in at least one of a relaxed configuration and a non-relaxed configuration.
[Invention 1077]
A circular, self-supporting elastic ring having a relaxed diameter corresponding to a healthy heart valve and an enlarged diameter adapted to the insertion instrument;
A gripping body attached to the elastic ring and oriented in a direction that automatically changes between insertion orientation and installation orientation during installation;
Including heart valve repair ring.
[Invention 1078]
Pushing the pointed grip on the support so as to penetrate the annulus tissue and keep the support firmly on the annulus to correct the shape of the heart annulus; and
Removing at least a portion of the support from the annulus by withdrawing at least some of the pointed grips without damaging the heart annulus
Including methods.
[Invention 1079]
Mounting an expanded elastic support on the heart annulus,
Shrinking the support to a healthy annulus diameter, and
Locking the contracted support at its contracted diameter by fitting the elements of the support
Including methods.
[Invention 1080]
Seating the grasping element coupled to the heart annulus support ring within the annulus tissue by retracting the support ring from an expanded size to a smaller size during installation
Including methods.
[Invention 1081]
The support includes an annular element, and a pair of annular elements are connected along the edges of the elements to form a ring;
The device of the present invention 1001.
[Invention 1082]
Each of the annular elements has at least one of the gripping bodies;
The device of the present invention 1081.
[Invention 1083]
The device of the present invention 1082, wherein each annular element further comprises a pointed element facing away from the gripper.
[Invention 1084]
The device of the present invention 1081 wherein each annular element comprises a hexagon.
Other features and advantages will be apparent from the description and the claims.
Claims (30)
各把持要素が、心臓組織に対して押しつけられる際に組織に侵入できるほど十分に鋭い自由端と、鋭い自由端が組織に侵入した後に組織からの把持要素の引き出しに抵抗する特徴とを有する、装置。 Comprising a cardiac tissue support having a grasping element;
Each gripping element has a free end that is sufficiently sharp to allow entry into the tissue when pressed against the heart tissue and a feature that resists withdrawal of the gripping element from the tissue after the sharp free end has entered the tissue; apparatus.
支持体が力により取り付けられるべき心臓組織の所与の区域の構成に対する把持体の構成が、
（１）失敗する一組の把持体の侵入特徴が組織に侵入することに失敗し、
（２）第２の組の把持体の侵入特徴が組織に侵入することに成功し、
（３）第２の組の把持体のサブセットの保持特徴が組織内に把持体を保持することに失敗し、
（４）第２の組の残りの把持体の保持特徴が組織内に把持体を保持することおよび意図される構成で組織上にて支持体を保つことに成功する、構成である、
心臓組織支持体。 Including a number of small grasping bodies each having tissue invasion and retention features;
The configuration of the gripper for the configuration of a given area of heart tissue to which the support is to be attached by force is
(1) the intrusion feature of the set of gripping bodies that fail fails to invade the tissue;
(2) the intrusion feature of the second set of grasping bodies has successfully invaded the tissue;
(3) the retention feature of the second set of graspers fails to retain the graspers in the tissue;
(4) A configuration wherein the second set of remaining gripper retention features succeeds in retaining the gripper in the tissue and maintaining the support on the tissue in the intended configuration.
Heart tissue support.
把持要素に結合し、
支持体を設置するための第１の構成と支持体が設置後に定位置にしっかり保たれる第２の構成との間で支持体を調整し、かつ
第１および第２の構成において自立型である、
輪状構造と
を有する生体組織用の支持体を含む、装置。 A gripping element that adheres to the biological tissue and holds the support firmly in place;
Coupled to the gripping element,
Adjusting the support between a first configuration for installing the support and a second configuration in which the support is securely held in place after installation, and is self-supporting in the first and second configurations is there,
An apparatus comprising a support for biological tissue having an annular structure.
尖端を支持する弾性ループであって、緩和構成および非緩和構成を有する弾性ループと
を含む把持体を含み、
尖端が、緩和構成および非緩和構成にそれぞれ関連する異なる配向を有する、装置。 A tip that invades living tissue;
An elastic loop that supports the tip, comprising a gripping body that includes a relaxed configuration and an elastic loop having a non-relaxed configuration;
The device, wherein the tip has a different orientation associated with each of a relaxed configuration and a non-relaxed configuration.
Applications Claiming Priority (5)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US12/407,656 US20090182419A1 (en) | 2007-01-08 | 2009-03-19 | Reconfiguring heart features |
| US12/407,656 | 2009-03-19 | ||
| US12/563,293 US20100121433A1 (en) | 2007-01-08 | 2009-09-21 | Reconfiguring heart features |
| US12/563,293 | 2009-09-21 | ||
| PCT/US2010/027943 WO2010108079A1 (en) | 2009-03-19 | 2010-03-19 | Reconfiguring heart features |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| JP2012521222A JP2012521222A (en) | 2012-09-13 |
| JP2012521222A5 true JP2012521222A5 (en) | 2013-10-24 |
Family
ID=45439709
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2012500990A Pending JP2012521222A (en) | 2009-03-19 | 2010-03-19 | Reconstruction of cardiac features |
Country Status (3)
| Country | Link |
|---|---|
| JP (1) | JP2012521222A (en) |
| CN (1) | CN102438552A (en) |
| AU (1) | AU2010226495A1 (en) |
Families Citing this family (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10500038B1 (en) | 2011-05-20 | 2019-12-10 | Tel Hashomer Medical Research Infrastructure And Services Ltd. | Prosthetic mitral valve, and methods and devices for deploying the prosthetic mitral valve |
| SI2852354T1 (en) | 2012-05-20 | 2020-09-30 | Tel Hashomer Medical Research Infrastructure And Services Ltd. | Prosthetic mitral valve |
| US10206776B2 (en) | 2013-06-06 | 2019-02-19 | Cardiac Implants, Llc | Heart valve repair and replacement |
| CN113616381A (en) * | 2013-08-12 | 2021-11-09 | 米特拉尔维尔福科技有限责任公司 | Apparatus and method for implanting a replacement heart valve |
| US10188392B2 (en) * | 2014-12-19 | 2019-01-29 | Abbott Cardiovascular Systems, Inc. | Grasping for tissue repair |
| ES2894132T3 (en) * | 2015-06-01 | 2022-02-11 | Edwards Lifesciences Corp | Heart valve repair devices configured for percutaneous delivery |
| US10555813B2 (en) * | 2015-11-17 | 2020-02-11 | Boston Scientific Scimed, Inc. | Implantable device and delivery system for reshaping a heart valve annulus |
Family Cites Families (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US6334873B1 (en) * | 1998-09-28 | 2002-01-01 | Autogenics | Heart valve having tissue retention with anchors and an outer sheath |
| US20080067713A1 (en) * | 2004-12-14 | 2008-03-20 | Robert Bordener | Method of producing and business model for applying a thin laminate sheet of a decorative material |
| WO2006086135A2 (en) * | 2005-01-21 | 2006-08-17 | Innovia, Llc | Stent-valve and deployment catheter for use therewith |
-
2010
- 2010-03-19 CN CN201080022151.7A patent/CN102438552A/en active Pending
- 2010-03-19 JP JP2012500990A patent/JP2012521222A/en active Pending
- 2010-03-19 AU AU2010226495A patent/AU2010226495A1/en not_active Abandoned
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