JP2018525080A - 弁膜留め具 - Google Patents
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Abstract
【解決手段】 本発明は、心臓僧帽弁逆流を治療する弁膜留め具を開示し、該弁膜留め具が第1保持部材と第2保持部材と連結部材とを包括し;第1保持部材は、第1保持アームを備え、第2保持部材が第1保持アームの数量に対応する第2保持アームを備え、前記第1保持アームと前記第2保持アームが互いに近付けると共に圧縮して生じた相互作用力を通じてその中の物体を挟持でき;また、該弁膜留め具は、拘束環を更に含み、前記拘束環が第1保持部材及び第2保持部材の外周に嵌め込まれ、保持アームが必要性に応じて閉操作により、クランプを更に緊密にさせる。該弁膜留め具は、低侵襲植え込み、製造が簡単で、操作難易度が低く、効果が良好等の利点を有し、僧帽弁逆流や三尖弁逆流の治療に用いられることができる以外に、数個のシート状組織を保持する必要がある他の低侵襲外科手術にも用いらせることができる。
【選択図】 図3
Description
(2)製造が簡単、成熟:本発明に係る留め具の設計が簡単で、その製造方法は現在常用されている血管ステントとデリバリーシステムに類似するため、製造が相対的に簡単、成熟している。
(3)手術の操作難易度が低い:本発明の一実施形態は、心尖部ルートを経て完成し、前胸部から左心室に入って弁膜箇所まで直接に到達し、手術の入口部から弁膜までの距離が非常に近く、シースのアクセスルートが真っ直ぐで短く、デリバリーシステムの湾曲を調整する必要がないため、調整や制御しやすく、手術操作も比較的容易である。
(4)確実な効果:外科のエッジトゥエッジ縫合技術の僧帽弁逆流に対する治療作用は、明確に実証されている。本発明に係る弁膜留め具は、現在の外科手術のエッジトゥエッジ縫合技術原理に基づいて設計され、留め具が植え込まれた後、最終的に僧帽弁の両弁尖を止め、外科のエッジトゥエッジ縫合手術と同様の効果を奏する。
2)デリバリーシースを左心室に挿入した後、僧帽弁の弁口を横断して左心房に到達し、デリバリーシースを引き戻して第1保持部材をデリバリーシースから離脱させると共に左心房内で開かせ;
3)引き続きデリバリーシースを左心室まで引き戻し、第2保持部材をデリバリーシースから離脱させると共に左心室内で開かせ;
4)第2保持部材を上へ押し上げて、僧帽弁の弁尖を左心房に向かって押すと共に動きを減らさせ、第1保持部材を下へ引っ張り、差込片がロックリングのアイ部を通過した後、2組の保持アームが堅牢に閉じて保持具を形成させ、2組の保持具が2個の僧帽弁の弁尖を挟持し;
5)デリバリーシースを上へ押し上げて2組の保持具の一部をデリバリーシースに収め、デリバリーチューブの回転によって拘束環を回転し、2組の保持具を拘束環内に収納して軸心線へ引き寄せ;
6)デリバリーシースを引き戻し、デリバリーバーを締め出し、拘束環とデリバリーチューブを分離させ、最終的に留め具を解放して手術を完了し、留め具が体内に留置し、僧帽弁の弁尖を保持する。
Claims (13)
- 弁膜留め具であって第1保持部材と第2保持部材と連結部材とを包括し;前記第1保持部材は、少なくとも2個の第1保持アームを含み、前記第2保持部材が前記第1保持アームと対応する第2保持アームとを包括し、各前記第1保持アームが対応する前記第2保持アームと組み立てることで1組の保持具となり、両者は互いに近付けると共に圧縮して生じた相互作用力を通じてその中の物体を挟持し;前記連結部材は、前記第1保持部材と前記第2保持部材を連結するために用いられることを特徴とする弁膜留め具。
- 前記第1保持アームは、前記留め具の前方に向けて傾斜し、前記第2保持アームも前記留め具の前方に向かって傾斜しているが、その傾斜角は前記第1保持アームの傾斜角より大きいことを特徴とする請求項1に記載の弁膜留め具。
- 前記第1保持アームの傾斜角は、20〜30度、前記第2保持アームの傾斜角が25〜35度であることを特徴とする請求項1に記載の弁膜留め具。
- 前記第1保持アームと前記第2保持アームの対向面に若干の突起を有することを特徴とする請求項1に記載の弁膜留め具。
- 前記第1保持アームの数量は、2個或いは3個であることを特徴とする請求項1に記載の弁膜留め具。
- 前記連結部材は、互いにマッチするロック棒とロックリングとを包括し;前記第1保持部材と前記第2保持部材が各々前記ロック棒又は前記ロックリングと連結し、前記ロック棒が前記ロックリングのアイ部内に挿入されることで前記第1保持部材と前記第2保持部材との連結を実現し、かつ前記ロック棒と前記ロックリングの間にロック部材を更に設けることを特徴とする請求項1〜4のいずれか一項に記載の弁膜留め具。
- 前記ロック棒は、角柱形であり、前記ロックリングのアイ部が対応する角柱形孔であることを特徴とする請求項6に記載の弁膜留め具。
- 前記ロック部材は、前記ロック棒上に設けられ、弾性差込片とすることを特徴とする請求項6に記載の弁膜留め具。
- 拘束環を更に含み、前記拘束環が前記第1保持部材及び前記第2保持部材の外周に嵌め込まれ、前記第1保持アーム及び前記第2保持アームが必要性に応じて閉操作により、クランプを更に緊密にさせることを特徴とする請求項6に記載の弁膜留め具。
- 前記拘束環の内表面にメスネジが設けられ、前記ロックリング外表面にオスネジが設けられ、両者が互いにマッチすることを特徴とする請求項9に記載の弁膜留め具。
- 請求項6に記載の弁膜留め具をデリバリーするためのデリバリー装置であって、デリバリーバーとデリバリーチューブとデリバリーシースとを包括し;前記デリバリーバーは、前記ロック棒と互いに連結し、前記ロック棒と連結する第1保持部材或いは第2保持部材をデリバリーするために用いられ;前記デリバリーチューブは、前記ロックリングと互いに連結し、前記ロックリングと連結する第2保持部材或いは第1保持部材をデリバリーするために用いられ;前記デリバリーシースは、前記弁膜留め具を被覆し、同時にデリバリー軌道を提供するために用いられることを特徴とするデリバリー装置。
- 請求項9に記載の弁膜留め具をデリバリーするためのデリバリー装置であって、デリバリーバーと、デリバリーチューブとデリバリーシースとを包括し;前記デリバリーバーは、前記ロック棒と互いに連結し、前記ロック棒と連結する第1保持部材或いは第2保持部材をデリバリーするために用いられ;前記デリバリーチューブは、前記ロックリングと互いに連結し、前記ロックリングと連結する第2保持部材或いは第1保持部材をデリバリーするために用いられ、前記デリバリーチューブ先端に拘束環連結部材を設けており、前記拘束環を取り外し可能に前記デリバリーチューブと接続させることができ;前記デリバリーシースは、前記弁膜留め具を被覆し、同時にデリバリー軌道を提供するために用いられることを特徴とするデリバリー装置。
- 弁膜留め具システムであって、弁膜留め具とデリバリー装置とを包括し;前記弁膜留め具は、第1保持部材と第2保持部材と連結部材とを包括し;前記第1保持部材は、少なくとも2個の第1保持アームを含み、前記第2保持部材が前記第1保持アームと対応する第2保持アームとを包括し、各前記第1保持アームが対応する前記第2保持アームと組み立てることで1組の保持具となり、両者は互いに近付けると共に圧縮して生じた相互作用力を通じてその中の物体を挟持し;前記連結部材は、前記第1保持部材と前記第2保持部材を連結するために用いられ;前記連結部材は、互いにマッチするロック棒とロックリングとを包括し;前記第1保持部材と前記第2保持部材が各々前記ロック棒又は前記ロックリングと連結し、前記ロック棒が前記ロックリングのアイ部内に挿入されることで前記第1保持部材と前記第2保持部材との連結を実現し、かつ前記ロック棒と前記ロックリングの間にロック部材を更に設け;前記デリバリー装置は、デリバリーバーとデリバリーチューブとデリバリーシースとを包括し;前記デリバリーバーは、前記ロック棒と互いに連結し、前記ロック棒と連結する第1保持部材或いは第2保持部材をデリバリーするために用いられ;前記デリバリーチューブは、前記ロックリングと互いに連結し、前記ロックリングと連結する第2保持部材或いは第1保持部材をデリバリーするために用いられ;前記デリバリーシースは、前記弁膜留め具を被覆し、同時にデリバリー軌道を提供するために用いられることを特徴とする弁膜留め具システム。
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JP6928399B1 (ja) * | 2020-06-22 | 2021-09-01 | ネットビジネスコンサルティング株式会社 | 閉塞デバイス及び閉塞デバイスの製造方法 |
WO2021260955A1 (ja) * | 2020-06-22 | 2021-12-30 | ネットビジネスコンサルティング株式会社 | 閉塞デバイス及び閉塞デバイスの製造方法 |
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JP6629956B2 (ja) | 2020-01-15 |
EP3323353B1 (en) | 2021-06-23 |
EP3323353A1 (en) | 2018-05-23 |
US20190000623A1 (en) | 2019-01-03 |
US10603168B2 (en) | 2020-03-31 |
ES2890849T3 (es) | 2022-01-24 |
EP3323353A4 (en) | 2019-11-20 |
WO2018018873A1 (zh) | 2018-02-01 |
CN106175986B (zh) | 2017-12-01 |
CN106175986A (zh) | 2016-12-07 |
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