JP2016533798A - 弁逆流症を経カテーテル治療するシステムおよび方法 - Google Patents
弁逆流症を経カテーテル治療するシステムおよび方法 Download PDFInfo
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Abstract
Description
本出願は、米国特許法第120条に基づいて、2014年6月24日付けの米国特許出願第14/313,975号の継続出願としての利益を主張し、その出願は、米国特許法第119条(e)項に基づいて、2013年10月25日付けの米国仮出願第61/895,647号の本出願としての利益を主張する。上述の優先権出願はそれぞれ、それらの全体を参照により本明細書に組み込む。
ことを要しないので、リボン98は、接合補助デバイス80を組織に非常に迅速に付着させることができる。リボン98の配備は、例えば螺旋状のアンカーを係合するよりも速くすることができる。
イス180をアンカー146上で係止するステップと、カテーテル送達システム106を除去するステップとを含んでもよい。これらの命令は、書面、口頭、または暗示的であることができる。
ほぼ平行であることができる。リボン396の他の形状が想起される。本明細書に開示されるように、接合補助デバイス380は、移植組織送達カテーテル114などの送達カテーテルの内部で折り畳まれる。ばね荷重式のリボン396は送達カテーテル内で折り畳むことができる。カテーテルを出ると、ばね荷重式のリボン396は予め形成された形状へと迅速に拡張する。いくつかの実施形態では、リボン396は心室に付着させるために提供される。リボン396は環状の縫合に依存せず、結び目を作ることを要しないので、リボン396は、接合補助デバイス380を組織に非常に迅速に付着させることができる。リボン396の配備は、例えば、螺旋状のアンカーを係合するよりも速くすることができる。
当接するように構成された丸みのある表面を備える。リボン496のサイズおよび形状は、リボン496が当接することがある後弁尖32の寸法に基づいて決定することができる。リボン496は、後弁尖32の先端に対してほぼ平行であることができる。リボン496の他の形状が想起される。本明細書に開示されるように、接合補助デバイス480は送達カテーテルの内部で折り畳まれる。ばね荷重式のリボン496は、移植組織送達カテーテル114などの送達カテーテル内で折り畳むことができる。カテーテルを出ると、ばね荷重式のリボン496は予め形成された形状へと迅速に拡張する。いくつかの実施形態では、リボン496は心室に付着させるために提供される。リボン496は環状の縫合に依存せず、結び目を作ることを要しないので、リボン496は、接合補助デバイス480を組織に非常に迅速に付着させることができる。リボン496の配備は、例えば、螺旋状のアンカーを係合するよりも速くすることができる。
12 右心房
14 左心室
16 右心室
20 僧帽弁
22 三尖弁
24 大動脈弁
26 肺動脈弁
30 前弁尖
32 後弁尖
34 接合域
36 線維輪
40 腱
42、44 乳頭筋
46 横断面
50、52 交連
56 左線維三角
60 右線維三角
62 中心線維体
64 動揺弁尖
66 心室収縮期
70 弁輪拡張
80 接合補助デバイス
82 本体
84 第1の表面
86 第2の表面
88 フレーム
90 上縁部
92 外側交連アンカー
94 後部アンカー
96 弁輪アンカー
98 リボン
100 カテーテル
102 ストラット
104 移植組織導入器
106 送達システム
110 経中隔シース
112 アンカー送達カテーテル
114 移植組織送達カテーテル
116 クリップ送達カテーテル
120 軸体
122 先端
124 シール
126 内径
130 区画
132 先端
134 マーカバンド
136 洗浄ポート
140 ハブ
142 軸体
144 先端
146 アンカー
150 駆動軸
152 駆動継続部
154 ハンドル
156 ノブ
158 アンカー縫合糸
162 区画
164 軸体
166 先端
170 移植組織導入器
172 スロット
174 ハンドル
176 ノブ
180 接合補助デバイス
182 ポート
184 レール
186 軸体
190 先端
192 クリップ
194 綿ざん糸
196 ハイポチューブ
200 ハンドル
202 ポート
204 ハイポチューブ
208 心室アンカー
210 ガイド縫合糸
280 接合補助デバイス
282 フレーム
284 上縁部
286 アイレット
290 本体
292 第1の表面
294 第2の表面
296 心室アンカー
380 デバイス
382 フレーム
384 上縁部
386 アイレット
390 交連アンカー
392 本体
394 心室アンカー
396 リボン
398 基部
480 接合補助デバイス
482 フレーム
484 上縁部
486 アイレット
490 心房アンカー
492 本体
494 心室アンカー
496 リボン
498 基部
500 リボン
580 接合補助デバイス
582 フレーム
584 上縁部
586 アイレット
590 ハブ
592 本体
594 アンカー
596 第1の表面
598 第2の表面
600 送達カテーテル
602 軸体
604 先端
606 偏向ノブ
610 駆動軸
612 ノブ
614 制御ハンドル
A1、A2、A3 前区域
BF 逆流
CA 弁輪の中心
CL 曲線
CO 開口部
FP 流路
P1、P2、P3 後区域
Claims (20)
- 弁輪と開放構成および閉止構成を有する第1および第2の弁尖とを有する心臓弁の接合不全を治療するための移植組織であって、
後弁尖に対して配設されるように構成された第1の接合表面と、前弁尖に向かって配設されるように構成された反対側の第2の表面とを有する、接合補助体と、
前記接合補助体から延在するように構成された少なくとも1つのリボンであって、少なくとも1つの湾曲を備える予め形成された形状を有する形状記憶材料を含み、第1の圧縮構成から第2の拡張構成へと移動可能であり、前記リボンの第1の表面と、前記リボンの前記第1の表面とは反対側の前記リボンの第2の表面との間で、天然の弁尖に対して圧縮力を提供するように構成され、前記圧縮力が、前記接合補助体を天然の弁輪の近傍で固定するのに十分な力である、リボンとを備える、移植組織。 - 前記リボンがニチノール合金を含む、請求項1に記載の移植組織。
- 前記リボンが自己拡張性である、請求項1に記載の移植組織。
- 複数のリボンをさらに備える、請求項1に記載の移植組織。
- 前記リボンが左心室壁を係合するように構成される、請求項1に記載の移植組織。
- 前記リボンが前記前弁尖を係合せずに前記後弁尖を係合するように構成される、請求項1に記載の移植組織。
- 前記リボンが前記移植組織の移動に抵抗する、請求項1に記載の移植組織。
- アンカーの一部分を貫通させることができるように構成された少なくとも1つのアイレットをさらに備える、請求項1に記載の移植組織。
- 前記アンカーを前記接合補助体に固定するように構成されたクリップおよび綿ざん糸をさらに備える、請求項8に記載の移植組織。
- 心臓弁の接合不全を治療するための移植組織であって、
心臓弁の機能を改善するように構成された移植組織本体と、前記移植組織本体から延在するように構成された少なくとも1つのリボンとを備え、前記リボンが少なくとも1つの湾曲を備える予め形成された形状を有する形状記憶材料を含み、前記リボンが第1の圧縮構成から第2の拡張構成へと移動可能であり、前記リボンが、前記リボンの第1の表面と前記第1の表面とは反対側の第2の表面との間で、天然の弁尖に対して圧縮力を提供するように構成され、前記圧縮力が、前記移植組織を天然の弁輪の近傍で固定するのに十分な力である、移植組織。 - 弁輪と開放構成および閉止構成を有する第1および第2の弁尖とを有する心臓弁の接合不全を治療するための移植組織であって、
後弁尖に対して配設されるように構成された第1の接合表面と、前弁尖に向かって配設されるように構成された反対側の第2の表面とを有する接合補助体と、
第1の標的位置で選択的に配備可能な第1のアンカー、および前記第1のアンカーに連結された第1のレールと、
心臓の第2の位置で、前記第1のアンカーの配備とは無関係に選択的に配備可能な第2のアンカー、および前記第2のアンカーに連結された第2のレールとを備え、
前記接合補助体が、前記第1のレールおよび前記第2のレールに沿って移植部位まで摺動するように構成される、移植組織。 - 前記接合補助体が、折り畳まれると前記第1のレールおよび前記第2のレールに沿って摺動して、送達カテーテル内に嵌合するように構成される、請求項11に記載の移植組織。
- 前記接合補助体が、送達カテーテルを出たときに拡張されると、前記第1のレールおよび前記第2のレールに沿って摺動するように構成される、請求項11に記載の移植組織。
- 前記第1のレールが縫合糸である、請求項11に記載の移植組織。
- 前記第1のレールがガイドワイヤである、請求項11に記載の移植組織。
- 前記接合補助体が前記第1のレールおよび前記第2のレールに沿って摺動すると、心室アンカーが展開され、前記接合補助体に対して保持される、請求項11に記載の移植組織。
- 前記接合補助体が前記第1のレールおよび前記第2のレールに沿って摺動すると、前記心室アンカーが僧帽弁を横断する、請求項16に記載の移植組織。
- 前記第1のアンカーを前記接合補助体に固定するように構成されたクリップおよび綿ざん糸をさらに備える、請求項11に記載の移植組織。
- 前記第2のアンカーを前記接合補助体に固定するように構成されたクリップおよび綿ざん糸をさらに備える、請求項18に記載の移植組織。
- 第1のアンカーが前記接合補助体に固定されると、前記第1のレールが除去されるように構成される、請求項11に記載の移植組織。
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EP3060175A4 (en) | 2017-07-05 |
WO2015061533A1 (en) | 2015-04-30 |
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CA2934182A1 (en) | 2015-04-30 |
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CN106061437A (zh) | 2016-10-26 |
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JP7341199B2 (ja) | 2023-09-08 |
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CN111643226B (zh) | 2023-11-03 |
EP3060175A1 (en) | 2016-08-31 |
US20210298901A1 (en) | 2021-09-30 |
JP2021192843A (ja) | 2021-12-23 |
JP6706200B2 (ja) | 2020-06-03 |
CN106061437B (zh) | 2020-07-10 |
US20190282364A1 (en) | 2019-09-19 |
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