JP2022044042A - 心臓弁を修復するための経皮的クリップ - Google Patents
心臓弁を修復するための経皮的クリップ Download PDFInfo
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Abstract
【解決手段】弁尖クリップが、近位端部分および遠位端部分を含む細長部材と、開位置と閉位置との間で移動可能な第1のクリッピングアームおよび第2のクリッピングアームとを有する。クリッピングアームは、細長部材の近位端部分に結合されたそれぞれの近位端部分と、細長部材に対し遠位方向かつ径方向に外側に延びるそれぞれの遠位端部分とを含む。弁尖クリップは、細長部材の周りに同軸で配置された管状部材を更に備える。細長部材に対する管状部材の軸方向運動または管状部材に対する細長部材の軸方向運動によって、開位置と閉位置との間でクリッピングアームの対応する動きが生じる。
【選択図】図1
Description
[項1]
弁尖クリップであって、
近位端部分および遠位端部分を含む細長部材と、
開位置と閉位置との間で移動可能な第1のクリッピングアームおよび第2のクリッピングアームであって、前記第1及び第2のクリッピングアームは、前記細長部材の前記近位端部分に結合されたそれぞれの近位端部分と、前記細長部材に対し遠位方向かつ径方向に外側に延びるそれぞれの遠位端部分とを含む、第1のクリッピングアームおよび第2のクリッピングアームと、
前記細長部材の周りに同軸で配置された管状部材と、
を備え、前記細長部材に対する前記管状部材の軸方向運動または前記管状部材に対する前記細長部材の軸方向運動によって、前記開位置と前記閉位置との間で前記第1及び第2のクリッピングアームの対応する動きが生じることを特徴とする弁尖クリップ。
[項2]
前記管状部材の近位端部分は、送達デバイスへ取り付けるように構成される、項1に記載の弁尖クリップ。
[項3]
前記細長部材の前記遠位端部分に配置された弁尖係合機構を更に備える、項1または2に記載の弁尖クリップ。
[項4]
前記弁尖係合機構は、前記第1及び第2のクリッピングアームが前記開位置から前記閉位置まで動かされるときに、心臓弁の生来の弁尖に係合するように構成されたポリマーまたは布地の覆いである、項3に記載の弁尖クリップ。
[項5]
前記覆いは、第2の保持部材の近位の前記細長部材上に固定して配置された第1の保持部材によって前記細長部材上に保持され、前記第2の保持部材は、前記第1の保持部材に対する前記第2の保持部材の近位方向の動きによって、前記覆いの径方向の拡張が生じるように、前記第1の保持部材に対して移動可能である、項4に記載の弁尖クリップ。
[項6]
前記覆いは、天然材料または合成繊維材料から構成され、織られるか、編まれるか、またはそれらの任意の組み合わせである、項4に記載の弁尖クリップ。
[項7]
前記弁尖係合機構は、前記細長部材の前記遠位端部分に配置され、互いから離間された1つ以上の突起を含む、項3に記載の弁尖クリップ。
[項8]
前記細長部材の前記近位端部分は、前記管状部材を前記細長部材に対し遠位方向に延びた位置に保持するように構成された保持機構を備え、前記遠位方向に延びた位置において、前記管状部材は前記第1及び第2のクリッピングアームの上に延び、前記第1及び第2のクリッピングアームを前記閉位置に保持する、項1から7のいずれか一項に記載の弁尖クリップ。
[項9]
前記第1及び第2のクリッピングアームは、前記細長部材の前記近位端部分上に配置されたカラーと一体形成される、項1から8のいずれか一項に記載の弁尖クリップ。
[項10]
前記管状部材は、前記管状部材の軸方向に動くときに、それぞれ前記第1のクリッピングアームおよび前記第2のクリッピングアームに接触するように構成された第1の延長部分および第2の延長部分を含む、項1から9のいずれか一項に記載の弁尖クリップ。
[項11]
前記細長部材の前記近位端部分は、送達デバイスに取り付けるように構成される、項1から10のいずれか一項に記載の弁尖クリップ。
[項12]
前記細長部材は、ガイドワイヤを受けるように構成された管腔を画定する、項1から11のいずれか一項に記載の弁尖クリップ。
[項13]
前記弁尖クリップは、僧帽弁、大動脈弁、三尖弁またはそれらの任意の組み合わせと共に使用するように構成される、項1から12のいずれか一項に記載の弁尖クリップ。
[項14]
組織圧縮領域および組織収集領域を更に備える、項1から13のいずれか一項に記載の弁尖クリップ。
102、1006、1106、1202、1402、1502、2110、2202、2624 細長部材、シャフト
104、2204、2408 第1のクリッピングアーム
106、2206、2410 第2のクリッピングアーム
108、1010、1316、2108、2208、2618 管状部材
110、120、1702、2210、2404 近位端部分
112、906、908、1704、2212、2406 遠位端部分
114 管腔
116 環状カラー
118、163、165、2118、2120、2614、2616 タブ
122 第1の延長部分
124 第2の延長部分
126 スロット
128、130、1108、1110、1312、1314、1420、1422、1522、1524、2411 弁尖受け領域
132 ロック機構、保持機構
134、1512 突起
136 ノッチ
138、1410 覆い
150、1902、2002、2102 送達システム
152 主要ハンドル本体
154、2608 外側導管、シャフト
156、158 制御ボタン
160 把持部分
162 アクチュエータ部材、アクチュエータ導管、シャフト
260 アクチュエータ導管
163A、165A 角度付き部分
165、1602、2122、2124、2132、2134 開口部
168、1802 内側シャフト、内側部材
200、400 大動脈弁
210、212、214、504、506、604、606、1302、1304、1416、1418、1518、1520、2302、2416、2418、2510、2512 弁尖
216 弁輪
218 第1の交連部
220 第2の交連部
222 第3の交連部
300、1306 心臓弁
408 支持リング
410 円柱部
500 僧帽弁
508、702、704、802、804、902、9041002、1004、1102、1104、1204、1206、1308、1310、1404、1406、1504、1506、1600、1700、1800、1904、1906、2004、2006、2104、2106、2204、2206、2306、2408、2410、2504、2506、2510、2512、2626、2628 クリッピングアーム
600 三尖弁
802、804 クリッピングポイント
806、808、1006、1008、2636 遠位部分
1604、1804 覆い
1606 縫合糸
1208、1510 チューブ、スリーブ、管状部材
1408 能動弁尖係合機構
1412 近位保持部材
1414 遠位保持部材
1516 エッジ部分
1526 シース
2112 アクチュエータ部材
2114 結合デバイス
2128、2130 タブ、延長部分
2214、2215、2314 組織収集領域
2220、2222 組織圧縮領域
2224、2226、2304 自由端部分
2310 弁尖圧縮領域
2312 中央部分
2402 中央部材
2412 外側部材
2414、2514 螺旋部材
2602、2630 ハンドル本体、ハンドル部分
2604 近位ハンドル部分
2606 遠位ハンドル部分
2610 中間導管、クリップ解放導管
2612 クリップ保持導管
2614、2616 タブ部分
2622 内側シャフト、導管
2632 突出部
2634 トラック、ガイド
2638 中間部分
2640 近位部分
Claims (20)
- 心臓弁の二つの弁尖に取り付けるためのクリップであって、
前記心臓弁の前記二つの弁尖の間に位置するように構成された細長部材と;
前記細長部材の第1部分に結合されるとともに前記細長部材の第2部分に向かって延びる、第1クリッピングアーム及び第2クリッピングアームであって、
前記第1クリッピングアームは、前記第1クリッピングアームが開位置にあるときに第1弁尖受け領域を形成するように、前記第1クリッピングアームが前記第1部分から前記第2部分に向かって延びるにつれて前記細長部材から径方向に離れるように延び、
前記第2クリッピングアームは、前記第2クリッピングアームが前記開位置にあるときに第2弁尖受け領域を形成するように、前記第2クリッピングアームが前記第1部分から前記第2部分に向かって延びるにつれて前記細長部材から径方向に離れるように延びる、
第1クリッピングアーム及び第2クリッピングアームと;
前記細長部材上に配置された受動弁尖係合機構と、
を備える、クリップ。 - 前記受動弁尖係合機構は、前記第1クリッピングアーム及び前記第2クリッピングアームが前記開位置から閉位置に動かされるときに、それぞれの第1弁尖受け領域及び第2弁尖受け領域における前記心臓弁の弁尖に係合するとともにこれらを保持するのに役立つように構成される、請求項1に記載のクリップ。
- 前記受動弁尖係合機構は、前記細長部材上に配置された覆いを備える、請求項1に記載のクリップ。
- 前記覆いは、ポリエチレンテレフタレート、発泡体、又は縫合材料から作製されている、請求項3に記載のクリップ。
- 前記第1クリッピングアーム及び前記第2クリッピングアームは、ヒンジ接続されている、請求項1に記載のクリップ。
- 前記第2部分の幅は、前記第1部分の幅より大きい、請求項1に記載のクリップ。
- 送達システムに結合された請求項1に記載のクリップを備える、アセンブリ。
- 心臓弁の二つの弁尖に取り付けるためのクリップであって、
前記心臓弁の前記二つの弁尖の間に位置するように構成された細長部材と;
前記細長部材の第1部分に結合されるとともに前記細長部材の第2部分に向かって延びる第1クリッピングアーム及び第2クリッピングアームであって、
前記第1クリッピングアームは、前記第1クリッピングアームが開位置にあるときに第1弁尖受け領域を形成するように、前記第1クリッピングアームが前記第1部分から前記第2部分に向かって延びるにつれて前記細長部材から径方向に離れるように延び、
前記第2クリッピングアームは、前記第2クリッピングアームが前記開位置にあるときに第2弁尖受け領域を形成するように、前記第2クリッピングアームが前記第1部分から前記第2部分に向かって延びるにつれて前記細長部材から径方向に離れるように延びる、
第1クリッピングアーム及び第2クリッピングアームと;
前記細長部材上に配置された、織られたまたは編まれた覆いであって、前記細長部材から径方向に離れるように膨張する覆いと、
を備える、クリップ。 - 前記織られたまたは編まれた覆いは、近位保持部材と遠位保持部材との間に配置される、請求項8に記載のクリップ。
- 前記覆いは、ポリエチレンテレフタレート、発泡体、又は縫合材料から作製されている、請求項8に記載のクリップ。
- 前記第1クリッピングアーム及び前記第2クリッピングアームは、ヒンジ接続されている、請求項8に記載のクリップ。
- 前記第2部分の幅は、前記第1部分の幅より大きい、請求項8に記載のクリップ。
- 送達システムに結合された請求項8に記載のクリップを備える、アセンブリ。
- 心臓弁の二つの弁尖に取り付けるためのクリップであって、
前記心臓弁の前記二つの弁尖の間に位置するように構成された細長部材であって、前記細長部材は、第1部分及び前記第1部分から延びる第2部分を有し、前記第2部分の幅は、前記第1部分の幅より大きい、細長部材と;
前記第1部分に結合されるとともに前記第2部分に向かって延びる、一対のアームと、
を備え、
前記一対のアームが開位置にあるときに、前記一対のアームは、前記第1部分から離れるように前記第2部分に向かって延びるにつれて、前記細長部材から径方向に離れるように延び;
前記一対のアームが閉位置にあるときに、組織収集領域が、前記第1部分と前記一対のアームとの間に画定され;
前記一対のアームが前記閉位置にあるときに、組織圧縮領域が、前記第2部分と前記一対のアームとの間に画定される、
クリップ。 - 前記組織収集領域は、前記一対のアームが閉鎖されているときに前記組織収集領域における弁尖の一部が圧縮されないように構成される、請求項14に記載のクリップ。
- 前記組織圧縮領域は、前記一対のアームが閉鎖されているときに前記組織圧縮領域における弁尖の一部が前記第2部分と前記一対のアームとの間で圧縮されるように構成される、請求項14に記載のクリップ。
- 前記組織収集領域は、前記一対のアームが閉じているときに前記組織収集領域における弁尖の一部が圧縮されないように構成され、前記組織圧縮領域は、前記一対のアームが閉じているときに前記組織圧縮領域における弁尖の一部が前記第2部分と前記一対のアームとの間で圧縮されるように構成される、請求項14に記載のクリップ。
- 請求項14に記載のクリップであって、僧帽弁に取り付けるためのクリップ。
- 前記一対のアームは、ヒンジ接続されている、請求項14に記載のクリップ。
- 送達システムに結合された請求項14に記載のクリップを備える、アセンブリ。
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