JP2016530005A - 置換心臓弁装置および方法 - Google Patents
置換心臓弁装置および方法 Download PDFInfo
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- A—HUMAN NECESSITIES
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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
- A61F2/2409—Support rings therefor, e.g. for connecting valves to tissue
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- A—HUMAN NECESSITIES
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- 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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- 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
- 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
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- 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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- 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
- A61F2/2436—Deployment by retracting a sheath
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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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0014—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof using shape memory or superelastic materials, e.g. nitinol
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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
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0076—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof multilayered, e.g. laminated structures
-
- 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
- A61F2230/0069—Three-dimensional shapes cylindrical
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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
- 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
- A61F2230/0091—Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
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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
- 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
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
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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
- 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
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/006—Additional features; Implant or prostheses properties not otherwise provided for modular
- A61F2250/0063—Nested prosthetic parts
Abstract
Description
本願は、2013年8月14日に出願された(係属中)米国特許仮出願第61/865,657号、2014年2月20日に出願された(係属中)米国特許仮出願第61/942,300号、および2014年2月21日に出願された(係属中)米国特許仮出願第61/943,125号の優先権を主張するものである。これらの仮出願の開示は、ここに参照により本明細書に組み込まれる。
10a 遠位先端部
12 らせん状アンカー
12a 内部ワイヤコイル
12b 外部コーティング
12c 軟質先端部
14 交連
16 天然僧帽弁
18 天然弁葉、人工弁葉
20 天然弁葉、人工弁葉
22 巻線またはコイル
24 索、腱索
26 ワイヤ
30 らせん状送達ツール
31 コイル
32 外方チューブ
34 縫合糸
36 縫合糸
38 ループ
40 心臓
42 メス
44 鉗子
50 押し棒
52 カップ状端部
60 置換心臓弁
62 弁葉
64 弁葉
66 本体
70 ブレット形状ヘッド
72 スリット
80 緩衝体構造体
82 発泡体
84 封止層
86 開ステント構造体
90 生体組織シール
91 間隙
92 繊維層
100 送達シース
101 送達シース、送達カテーテル
102 右心房
104 心房中隔
106 左心房
108 左心室
110 アーム
120 ループ
126 天然僧帽弁輪
140 らせん状アンカー送達チューブ、チューブ状アーム
152 面
160 繊維カバー
162 発泡層、発泡体
170 組織束ねデバイス
172 一時的リングまたはループ
180 上方らせん状アンカー部分、心房らせん状アンカー部分
182 下方らせん状アンカー部分、心室らせん状アンカー部分
184 圧着接合部
200 間隙
202 弁輪シール
210 バルーンカテーテル
Claims (45)
- 天然心臓弁を置換するためのシステムであって、
心臓弁プロテーゼを支持するように構成された複数のコイルとして形成された拡張可能らせん状アンカーであって、前記コイルのうちの少なくとも1つが、通常は第1の直径にあり、前記らせん状アンカー内からの径方向外方力を印加されると、より大きな第2の直径に拡張可能であり、隣接し合うコイルのうちの少なくとも1つによる前記天然心臓弁との係合を防止するのに十分な間隙が、前記隣接し合うコイル間に画定される、拡張可能らせん状アンカーと、
前記らせん状アンカー内に送達され、前記複数のコイルの内部で拡張されて前記少なくとも1つのコイルと係合することが可能であり、それにより前記第1の直径から前記第2の直径へと前記少なくとも1つのコイルを動かしつつ、前記らせん状アンカーおよび前記心臓弁プロテーゼを共に固定する、拡張可能心臓弁プロテーゼと、
前記らせん状アンカーに係合し、前記らせん状アンカー内への前記心臓弁プロテーゼの植込み後に前記心臓弁プロテーゼを通過する血液漏れを防止するように構成された、前記拡張可能心臓弁プロテーゼ上のシールと、
を備える、システム。 - 前記らせん状アンカーは、前記心臓弁プロテーゼが前記複数のコイルの内部で拡張されることによって、より大きな直径からより小さな直径へと動く別のコイルを備える、請求項1に記載のシステム。
- 前記シールは、前記らせん状アンカーを通るおよび前記心臓弁プロテーゼを通過する血液漏れを防止するために隣接し合うコイル間に延在する部分を備える、請求項2に記載のシステム。
- 前記シールは、生体材料をさらに含む、請求項1に記載のシステム。
- 前記らせん状アンカーは、形状記憶材料をさらに含む、請求項1に記載のシステム。
- 前記シールは、前記らせん状アンカー内への前記心臓弁プロテーゼの植込み後に前記らせん状アンカーの少なくとも2つのコイル間に延在する膜またはパネルをさらに備える、請求項1に記載のシステム。
- 前記心臓弁プロテーゼは、血液流入端部および血液流出端部を備え、前記血液流入端部および血液流出端部のうちの少なくとも一方が、非フレア状であり、ほぼ円筒形状である、請求項1に記載のシステム。
- 前記血液流出端部は、径方向に外方にフレア状をなし、植込み後の心臓内の組織構造体に対する損傷を防止するための緩衝体を備える、請求項7に記載のシステム。
- 前記間隙は、前記らせん状アンカーの隣接し合うコイル部分に対して非平行に延在する前記らせん状アンカーのコイル部分によって形成される、請求項1に記載のシステム。
- 天然心臓弁を置換するためのシステムであって、
心臓弁プロテーゼを支持するように構成された複数のコイルとして形成された拡張可能らせん状アンカーであって、前記コイルのうちの少なくとも1つが、通常は第1の直径にあり、前記らせん状アンカー内からの径方向外方力を印加されると、より大きな第2の直径に拡張可能であり、隣接し合うコイルのうちの少なくとも1つによる前記天然心臓弁との係合を防止するのに十分な間隙が、前記隣接し合うコイル間に画定される、拡張可能らせん状アンカーと、
前記らせん状アンカー内に送達され、前記複数のコイルの内部で拡張されて前記少なくとも1つのコイルと係合することが可能であり、それにより前記第1の直径から前記第2の直径へと前記少なくとも1つのコイルを動かしつつ、前記らせん状アンカーおよび前記心臓弁プロテーゼを共に固定する、拡張可能心臓弁プロテーゼと、
前記らせん状アンカー上に位置し、前記らせん状アンカーに係合し、前記らせん状アンカー内への前記心臓弁プロテーゼの植込み後に前記心臓弁プロテーゼを通過する血液漏れを防止するように構成されたシールと、
を備える、システム。 - 前記らせん状アンカーは、前記心臓弁プロテーゼが前記複数のコイルの内部で拡張されることによって、より大きな直径からより小さな直径へと動く別のコイルを備える、請求項10に記載のシステム。
- 前記シールは、前記らせん状アンカーを通るおよび前記心臓弁プロテーゼを通過する血液漏れを防止するために隣接し合うコイル間に延在する部分を備える、請求項11に記載のシステム。
- 前記らせん状アンカーは、形状記憶材料をさらに含む、請求項10に記載のシステム。
- 前記シールは、前記らせん状アンカー内への前記心臓弁プロテーゼの植込み後に前記らせん状アンカーの少なくとも2つのコイル間に延在する膜またはパネルをさらに備える、請求項10に記載のシステム。
- 前記心臓弁プロテーゼは、血液流入端部および血液流出端部を備え、前記血液流入端部および血液流出端部のうちの少なくとも一方が、非フレア状であり、ほぼ円筒形状である、請求項10に記載のシステム。
- 前記間隙は、前記らせん状アンカーの隣接し合うコイル部分に対して非平行に延在する前記らせん状アンカーのコイル部分によって形成される、請求項10に記載のシステム。
- 心臓弁プロテーゼをドッキングするためのシステムであって、
コイル部分が心臓弁輪の上方および/または下方に位置決めされた状態で心臓弁プロテーゼを支持するように構成された複数のコイルとして形成されたらせん状アンカーと、
前記らせん状アンカーの前記コイルを有してアセンブリを形成する外方可撓性らせん状チューブと、
前記アセンブリを搬送し、天然心臓弁を通り定位置に回転されるように構成されたらせん状送達ツールと、
を備える、システム。 - 患者の心臓弁位置に送達され、前記複数のコイルの内部で拡張されることが可能な心臓弁プロテーゼをさらに備える、請求項17に記載のシステム。
- 前記らせん状アンカーは、形状記憶材料をさらに含む、請求項17に記載のシステム。
- 外方チューブは、前記天然心臓弁を通り定位置に回転した後に、前記らせん状アンカーの前記複数のコイルから外れるようになされた低摩擦材料から形成される、請求項17に記載のシステム。
- 外方チューブは、縫合糸により前記らせん状送達ツールに固定される、請求項17に記載のシステム。
- 前記らせん状送達ツールは、複数のコイルと共に形成され、前記コイルの遠位端部をさらに備え、外方チューブは、前記遠位端部にさらに固定される、請求項17に記載のシステム。
- 前記遠位端部は、ブレット形状またはテーパ形状をさらに備える、請求項22に記載のシステム。
- 前記遠位端部は、弾性要素をさらに備え、前記外方チューブおよびらせん状送達チューブの遠位端部は、前記弾性要素に固定される、請求項23に記載のシステム。
- 天然心臓弁を置換するためのシステムであって、
前記天然心臓弁にて心臓弁プロテーゼを支持するように構成された複数のコイルとして形成されたらせん状アンカーと、
前記らせん状アンカー内に送達され、前記複数のコイルの内部で拡張されて少なくとも1つのコイルと係合することが可能であり、それにより前記らせん状アンカーおよび前記心臓弁プロテーゼを共に固定する拡張可能心臓弁プロテーゼと、
前記らせん状アンカーがらせん状アンカー送達カテーテルから押し出される際に、前記らせん状アンカーを定位置に案内するように構成された、前記拡張可能心臓弁プロテーゼ上のガイド構造体と、
を備える、システム。 - 前記ガイド構造体は、前記拡張可能心臓弁プロテーゼの一部分内に開口をさらに備える、請求項25に記載のシステム。
- 開口は、前記らせん状アンカー送達カテーテルを受けるように構成された、請求項25に記載のシステム。
- 開口は、前記拡張可能心臓弁プロテーゼのアーム上のループ内に含まれる、請求項27に記載のシステム。
- 前記拡張可能心臓弁プロテーゼは、前記天然心臓弁の下方に係合するように構成された複数のアームをさらに備える、請求項25に記載のシステム。
- 前記ガイド構造体は、前記拡張可能心臓弁プロテーゼのチューブ状アームをさらに備え、前記チューブ状アームは、前記天然心臓弁への押出しおよび送達のために中で前記らせん状アンカーを搬送する、請求項25に記載のシステム。
- 僧帽弁プロテーゼをドッキングし、天然僧帽弁を置換するためのシステムであって、
コイルガイドカテーテルと、
前記コイルガイドカテーテル内に受けられ前記コイルガイドカテーテルから送達されるように構成されたらせん状アンカーであって、前記コイルガイドカテーテルから送達された後にコイル状構成を有する、および前記コイルガイドカテーテルから完全に送達され前記天然僧帽弁に植え込まれると前記僧帽弁プロテーゼを支持するように構成された、複数のコイルとして形成されたらせん状アンカーと、
左心室内への前記らせん状アンカーのより容易な送り込みを可能にするために天然腱索を囲み束ねるために展開されるように構成されたループ構造体を備える組織束ねカテーテルと、
を備える、システム。 - 上方らせん状コイル部分と、
下方らせん状コイル部分と、
前記下方らせん状コイル部分に前記上方らせん状コイル部分を固定する固定具と、
を備える、心臓弁プロテーゼをドッキングするためのアンカー。 - 患者の心臓内に心臓弁プロテーゼを植え込む方法であって、
外方可撓性チューブ内に複数のコイルの形態のらせん状アンカーを保持するステップと、
らせん状送達ツールに前記外方可撓性チューブおよび前記らせん状アンカーのアセンブリを固定するステップと、
前記患者の天然心臓弁に隣接して前記らせん状送達ツールを回転させて、前記天然心臓弁の一方または両方の側に前記アセンブリを位置決めするステップと、
前記らせん状送達ツールから前記アセンブリを除去するステップと、
前記らせん状アンカーから外方チューブを除去するステップと、
前記らせん状アンカー内に前記心臓弁プロテーゼを植え込むステップと、
を含む、方法。 - 前記アセンブリを固定するステップは、前記らせん状送達ツールの隣接し合うコイルにほぼ沿って前記アセンブリのコイルを位置決めするステップをさらに含む、請求項33に記載の方法。
- 前記外方チューブを除去するステップは、プッシャ要素により前記らせん状アンカーを保持し、前記らせん状アンカーから前記外方チューブを引き離すステップをさらに含む、請求項33に記載の方法。
- 患者の心臓内に拡張可能心臓弁プロテーゼを植え込む方法であって、
天然心臓弁の近傍に複数のコイルの形態の拡張可能らせん状アンカーを送達するステップと、
前記拡張可能心臓弁プロテーゼおよび前記拡張可能らせん状アンカーが非拡張状態にある状態で、前記拡張可能らせん状アンカーの前記複数のコイル内に前記拡張可能心臓弁プロテーゼを位置決めするステップと、
前記拡張可能らせん状アンカーに対して前記拡張可能心臓弁プロテーゼを拡張させ、それにより前記拡張可能心臓弁プロテーゼを拡張しつつ、前記拡張可能らせん状アンカーに前記拡張可能心臓弁プロテーゼを固定するステップと、
前記らせん状アンカー上に位置する、ならびに前記らせん状アンカーを通るおよび前記拡張可能心臓弁プロテーゼを通過する血液漏れを防止するために少なくとも2つの隣接し合うコイル間に延在するシールを担持するステップと、
を含む、方法。 - 患者の心臓内に拡張可能心臓弁プロテーゼを植え込む方法であって、
天然心臓弁の近傍に複数のコイルの形態の拡張可能らせん状アンカーを送達するステップと、
前記拡張可能心臓弁プロテーゼおよび前記拡張可能らせん状アンカーが非拡張状態にある状態で、前記拡張可能らせん状アンカーの前記複数のコイル内に前記拡張可能心臓弁プロテーゼを位置決めするステップと、
前記拡張可能らせん状アンカーに対して前記拡張可能心臓弁プロテーゼを拡張させ、それにより前記拡張可能心臓弁プロテーゼを拡張しつつ、前記拡張可能らせん状アンカーに前記拡張可能心臓弁プロテーゼを固定するステップと、
前記拡張可能心臓弁プロテーゼ上にシールを担持し、前記らせん状アンカーを通るおよび前記拡張可能心臓弁プロテーゼを通過する血液漏れを防止するために少なくとも2つの隣接し合うコイル間を拡張させるステップと、
を含む、方法。 - 患者の天然心臓弁を置換するために拡張可能心臓弁プロテーゼを植え込む方法であって、
前記天然心臓弁の近傍に複数のコイルの形態のらせん状アンカーを送達するステップと、
前記天然心臓弁の近傍に前記拡張可能心臓弁プロテーゼを送達するステップと、
前記拡張可能心臓弁プロテーゼ上に担持されたガイド構造体を使用して前記拡張可能心臓弁プロテーゼの外周部のほぼ周囲に前記らせん状アンカーを案内するステップと、
前記らせん状アンカーに対して前記拡張可能心臓弁プロテーゼを拡張させるステップと、
を含む、方法。 - 前記らせん状アンカーを案内するステップは、前記天然心臓弁の下方に延在するアームのガイド構造体を通して前記らせん状アンカーを送るステップをさらに含む、請求項38に記載の方法。
- 前記らせん状アンカーを案内するステップは、前記拡張可能心臓弁プロテーゼの開口に通して前記らせん状アンカーを送るステップをさらに含む、請求項38に記載の方法。
- 前記開口は、前記天然心臓弁の下方に延在するアームのループ中に位置する、請求項40に記載の方法。
- 前記開口は、前記天然心臓弁の下方に延在するチューブ状アーム中に位置する、請求項40に記載の方法。
- 患者内に僧帽心臓弁プロテーゼをドッキングするためのらせん状アンカーを植え込む方法であって、
組織束ねカテーテルを使用して腱索を束ねるステップと、
天然心臓弁の近傍におよび前記束ねられた腱索の周囲に複数のコイルの形態のらせん状アンカーを送達するステップと、
を含む、方法。 - 患者内に心臓弁プロテーゼをドッキングするためのらせん状アンカーを植え込む方法であって、
天然心臓弁の上方の位置に上方コイルから構成された上方らせん状アンカー部分を送達するステップと、
前記天然心臓弁の下方の位置に下方コイルから構成された下方らせん状アンカー部分を送達するステップと、
固定具を用いて前記上方らせん状アンカー部分および前記下方らせん状アンカー部分を共に固定するステップと、
を含む、方法。 - 天然心臓弁を置換するためのシステムであって、
心臓弁プロテーゼを支持するように構成された複数のコイルとして形成された拡張可能らせん状アンカーであって、前記コイルのうちの少なくとも1つが、通常は第1の直径にあり、前記らせん状アンカー内からの径方向外方力を印加されると、より大きな第2の直径に拡張可能であり、隣接し合うコイルのうちの少なくとも1つによる前記天然心臓弁との係合を防止するのに十分な間隙が、前記隣接し合うコイル間に画定される、拡張可能らせん状アンカーと、
前記らせん状アンカー内に送達され、前記複数のコイルの内部で拡張されて前記少なくとも1つのコイルと係合することが可能であり、それにより前記第1の直径から前記第2の直径へと前記少なくとも1つのコイルを動かしつつ、前記らせん状アンカーおよび前記心臓弁プロテーゼを共に固定する、拡張可能心臓弁プロテーゼであって、流入端部および流出端部を備え、前記流入端部は、非フレア状であり、ほぼ円筒状であり、前記流出端部は、径方向外方にフレア状である、拡張可能心臓弁プロテーゼと、
を備える、システム。
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