JP4458845B2 - 医療用デバイス - Google Patents
医療用デバイス Download PDFInfo
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- JP4458845B2 JP4458845B2 JP2003531900A JP2003531900A JP4458845B2 JP 4458845 B2 JP4458845 B2 JP 4458845B2 JP 2003531900 A JP2003531900 A JP 2003531900A JP 2003531900 A JP2003531900 A JP 2003531900A JP 4458845 B2 JP4458845 B2 JP 4458845B2
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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
- A61F2/2412—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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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/50—Supports for surgical instruments, e.g. articulated arms
-
- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
-
- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2454—Means for preventing inversion of the valve leaflets, e.g. chordae tendineae prostheses
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22097—Valve removal in veins
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320052—Guides for cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00392—Transmyocardial revascularisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
-
- 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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/902—Method of implanting
- Y10S623/904—Heart
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Pathology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Description
本特許出願は、ジョン・エイ・マコビアク(John A.Macoviak)により、2001年10月1日に出願された係属中の先行米国仮特許出願第60/326,590号の利益を主張し、この特許は参照により本明細書に組み込まれている。
本発明は、心臓弁の機能を改善する方法と医療用デバイスに関する。より具体的には、本発明は、僧帽弁逆流を治療する方法と医療用デバイスに関する。
心臓弁の開閉は、主として圧力差の結果として生じる。例えば、僧帽弁の開閉は、左心房と左心室との間の圧力差の結果として生じる。心室が弛緩している心室拡張期中、肺静脈から左心房への血液の静脈還流は、心室内の圧を超える心房中の圧力を引き起こす。その結果、僧帽弁が開き、血液が心室に入ることが可能になる。心室は心室収縮期中に収縮するので、心室内圧は、心房内圧を超えて上昇し、僧帽弁を閉じさせる。
本発明は、心臓弁機能を改善するためにデザインされた医療用デバイスの一群である。本医療用デバイスは、損傷弁の補強、損傷弁との代替、または損傷弁の機能改善のために個々に、または組み合わせて使用できる。この医療用デバイスは、小葉維持装置、新輪、新小葉およびフレームワークを含む。さらに、本発明は、心臓弁を外科的に治療する新規な方法を含む。
図1は、患者の心臓100の後方斜位断面図を示す。4つの心臓内腔のうちの2つ、左心房170と左心室140を示す(右心房と右心室は示していない)。左心房170が、肺静脈からの血液で満たされる。次いでその血液は、心室拡張期中、僧帽弁(2尖弁としても知られおり、またより一般的には房室弁として知られている)を通過し、左心室140に入る。心室収縮期中、次に血液は、大動脈弁150を通過して左心室140から排出されて大動脈160に入る。この時点で、血液が左心房に逆流しないように僧帽弁が閉じられる必要がある。僧帽弁は、腱索120(以後、索)に付着した2つの小葉、前小葉110と後小葉115からなり、次いで左心室140内の乳頭筋130に連結している。典型的には、僧帽弁は、三日月型後小葉115と共に、大動脈弁方向に配向しているD型前小葉110を有する。前記小葉は、僧帽弁190で心房170と交差する。
Claims (5)
- 小葉を有する僧帽弁輪の上の左心房内に配置されるような大きさに形成された心臓インプラントであって、僧帽弁の小葉の運動と相互作用して僧帽弁の機能を果たすために僧帽弁輪の上の左心房内の壁と係合するような形状及び大きさに形成された部分を有する心臓インプラントと、
右心房から隔壁を通って左心房内へ延びるアクセス通路を形成する手段と、
前記左心房への前記血管通路を通してインプラントを配置する手段と、
僧帽弁輪の上の左心房内の壁と前記インプラントの前記部分が係合する状態で前記インプラントを左心房内へ位置決めし、該係合する部分が僧帽弁の小葉の運動と相互作用して僧帽弁の機能を果たすようにする手段と
を備える医療用デバイス。 - 前記インプラントは、前記部分が前記左心房を覆うように配置されている請求項1記載の医療用デバイス。
- 前記インプラントは、前記部分が僧帽弁の心臓弁輪の形状を変化するように配置されている請求項1記載の医療用デバイス。
- 前記心臓インプラントが、少なくとも一部分においてニチノール、ダクロン、ポリテトラフルオロエチレン、シリコン、人間の心膜或いは動物の心膜を含む請求項1記載の医療用デバイス。
- 前記心臓インプラントが、少なくとも一部分において超弾性材料を含む請求項1記載の医療用デバイス。
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US32659001P | 2001-10-01 | 2001-10-01 | |
PCT/US2002/031376 WO2003028558A2 (en) | 2001-10-01 | 2002-10-01 | Methods and devices for heart valve treatments |
Publications (2)
Publication Number | Publication Date |
---|---|
JP2005504577A JP2005504577A (ja) | 2005-02-17 |
JP4458845B2 true JP4458845B2 (ja) | 2010-04-28 |
Family
ID=23272862
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP2003531900A Expired - Fee Related JP4458845B2 (ja) | 2001-10-01 | 2002-10-01 | 医療用デバイス |
Country Status (8)
Country | Link |
---|---|
US (2) | US7291168B2 (ja) |
EP (1) | EP1434542A2 (ja) |
JP (1) | JP4458845B2 (ja) |
CN (2) | CN100333704C (ja) |
AU (1) | AU2002362442B2 (ja) |
CA (2) | CA2455444A1 (ja) |
HK (1) | HK1073423A1 (ja) |
WO (1) | WO2003028558A2 (ja) |
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CN101108144A (zh) | 2008-01-23 |
HK1073423A1 (en) | 2005-10-07 |
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US7291168B2 (en) | 2007-11-06 |
US20080140190A1 (en) | 2008-06-12 |
AU2002362442B2 (en) | 2008-08-07 |
JP2005504577A (ja) | 2005-02-17 |
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