JP4616665B2 - Patent application for patent foramen ovale and instrument for patent foramen ovale - Google Patents

Description

  The present invention relates to a device for treating a patent foramen ovale for treating a patent foramen ovale by locking an overflap of a patent foramen ovale (PFO) in a biological septum, for example, a heart septum. And a device for treatment of patent foramen ovale.

In the atrial septum, there is a foramen ovale, and in the embryonic period, this foramen acts as a valve, but the foramen usually closes in the first few months of life. The case where it does not close after birth is called patent foramen ovale, and it is said that it is seen in adults by about 20%. Normally, the internal pressure of the left atrium is higher than that of the right atrium, and the primary septum (Septum Primum) covers the foramen ovale as a valve, so that no blood flows from the left atrium to the right atrium. However, when the right atrial pressure exceeds the left atrial pressure during tension, the primary septum opens to the left atrium, and blood flows from the right atrium to the left atrium. If the flowing venous blood contains a thrombus, the thrombus flows from left atrium → left ventricle → aorta → brain. For this reason, patent foramen ovale is cited as a cardiogenic factor for stroke and migraine.
Treatments for patent foramen ovale include drug therapy (aspirin, warfarin), percutaneous catheterization, and open-heart surgery with extracorporeal circulation.

Although drug therapy is the first-line treatment, it is difficult to manage the dose, and it is difficult to stop bleeding during administration. Although percutaneous catheterization and open heart surgery are invasive, they are radical and eliminate the risk of recurrence. At this stage, open-heart surgery is more reliable for the procedure of occlusion, but if the risk of extracorporeal circulation and the size of the skin incision are taken into account, it may be percutaneous. If the same effect as open heart surgery can be obtained, that is the preferred method.
As a device for closure using a percutaneous catheter, a device for filling a congenital septal defect is used. Such a device usually employs a technique in which two disc-shaped membranes are placed between the left atrial side and the right atrial side in order to close the hole.
For the purpose of closing the normally closed primary septum, such as stroke or migraine, no membrane is required and the structure can be simplified. Placing a device to fill the defect can cause a clot to adhere to the left atrial side due to the large foreign body area, which can cause stroke, and a thin primary septum. As a result, there is a demand for development of a dedicated device.

For example, JP 2002-355248 A (patented Japanese Patent Application Laid-Open No. 2002-355248 (patent document) discloses a technique for blocking holes in congenital diseases such as atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA). There is a core defect occlusion material in literature 1). This core-deficient occlusion material can be applied to flap-shaped foramen ovale patency, but there is a risk of damaging the primary septum to insert a member through the normally closed flap . Moreover, since the foreign substance area is large, there is a risk of thrombus adhesion and thrombus release on the left atrial side, and it is necessary to perform antiplatelet therapy to prevent this thrombus formation. Further, since the disk-shaped one is folded and stored in the catheter, the catheter size increases. On the other hand, since this method is a device specialized for flap-shaped PFO, the risk of thrombus formation is reduced by minimizing the indwelling member, and even if antiplatelet therapy is performed, effects such as shortening the period and reducing dosage are expected. it can. The catheter size can also be reduced.
In addition, US Patent Publication No. 2003/225421 (Patent Document 2) shows a clip-type patent foramen ovale obturator that locks a flap. In this obturator, not only the primary septum but also the secondary septum (Septum Secundum) that is susceptible to damage is clipped. Further, in this obturator, since the spring moves so as to close immediately after being deployed on the left atrial side, an additional means for sandwiching the primary septum is necessary.

JP 2002-355248 A US Patent Publication No. 2003/225421

  It is an object of the present invention to substantially prevent damage and load to the secondary septum that normally closes the foramen ovale and to suppress the opening of the primary septum (flap) to the left atrial side, It is intended to provide a patent foramen ovale treatment device and a patent foramen ovale treatment device that can prevent blood flow from the right atrium to the left atrium due to the patent foramen ovale.

What achieves the above object is as follows.
(1) a main linear portion having a curved portion located in the center, a right linear portion located on the right side of the curved portion, and a left linear portion located on the left side of the curved portion; A foramen ovale having a spring elasticity made of a linear body comprising a right-hand linear extension extending inward of the bent portion and a left-hand linear extension extending inward of the bent portion from the left-hand linear portion. An existing treatment device, attachable to the upper end of the primary septum by the right side linear portion and the right side linear extension, and the upper end of the primary septum by the left side linear portion and the left side linear extension The repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at the two locations prevents deformation of the primary septum in the direction away from the secondary septum The patent foramen ovale treatment tool.
(2) The patent foramen ovale treatment device is attached to the patent foramen ovale treatment tool due to the repulsive force against the twist of the patent foramen ovale treatment device when the device is attached to the primary septum at the two locations. The device for treating patent foramen ovale according to (1), wherein the primary septum is pressed against the secondary septum.
(3) When the device for treating the patent foramen ovale is attached to the primary septum at the two locations, the right side linear part and the left side linear part are separated by both sides of the patent foramen ovale. (1) or (1) or (1) or (1) or (1), wherein the device for treating a patent foramen ovale is held in the patent foramen ovale by a repulsive force against the pressure. The patent foramen ovale treatment device according to 2).

(4) The right side linear extension portion is configured by a right side linear loop portion extending inward of the curved portion from the right side linear portion, and the left side linear extension portion is formed from the left side linear portion. The right side linear loop part is formed on the back side of the right side linear part while forming a loop above the right side linear part. The left linear loop part intersects the left linear part on the back side of the left linear part and forms a loop above the left linear part. The device for treating patent foramen ovale according to any one of (1) to (3).
(5) The right-side linear loop portion is obliquely above the end of the right-side linear portion and extends inward of the curved portion, and is bent downward from the first linear portion. A second linear portion that extends to the right and intersects the right linear portion, and a third linear portion that is bent from the second linear portion and extends to the right front, and the left linear loop portion includes: A first linear portion that is obliquely above the end of the left linear portion and extends inward of the curved portion, and extends downward from the first linear portion and intersects the left linear portion. The patent foramen ovale treatment device according to (4), comprising a second linear portion and a third linear portion that bends from the second linear portion and extends to the left front.
(6) The right-side linear loop portion includes a first linear portion extending upward from an end portion of the right-side linear portion, and a second portion extending from the first linear portion and extending inward of the curved portion. And a third linear portion that is bent downward from the second linear portion and extends downward and intersects the right linear portion, and the left linear loop portion is the left linear portion. A first linear portion extending upward from an end of the first portion, a second linear portion extending from the first linear portion and extending inward of the curved portion, and bent from the second linear portion. The patent foramen ovale treatment device according to (4), comprising a third linear portion extending downward and intersecting the left linear portion.

(7) The right-side linear extension portion includes a first linear portion that extends inward and downward of the curved portion from the right-side linear portion, and bends from the first linear portion, obliquely upward to the right or on the right side. The left linear extension portion includes a first linear portion extending inward and downward of the curved portion from the left linear portion, and a second linear portion extending obliquely downward. The patent foramen ovale treatment device according to any one of (1) to (3), comprising a second linear portion that bends from the linear portion of 1 and goes diagonally upward to the left or diagonally downward to the left.
(8) The right-side linear extension portion includes a first linear portion that extends inward and upward of the curved portion from the right-side linear portion, and a first linear portion that is bent from the first linear portion and is directed downward. The left linear extension includes a first linear portion extending inward and upward of the curved portion from the left linear portion, and the first linear portion. The patent foramen ovale treatment device according to any one of (1) to (3), further comprising a second linear portion that bends further toward the lower side.
(9) The patent foramen ovale treatment device includes a right-side drop-preventing linear portion that extends to the right side of the curved portion or the vicinity thereof and a front side of the right-side linear portion, and a left side of the curved portion or the vicinity thereof. The device for treating patent foramen ovale according to any one of (1) to (8), comprising a left-side drop-off preventing linear portion extending forward and forward of the left-side linear portion.
(10) The free end of the linear body constituting the patent foramen ovale treatment device is a small loop portion or a spherical object is fixed according to any one of (1) to (9) Patent application for patent foramen ovale.
(11) The foramen ovale treatment device according to any one of (1) to (10), wherein the right side linear part and the left side linear part are substantially linear.
(12) The right side linear extension part and the left side linear extension part have a form in which a plurality of linear parts are connected by a plurality of bent parts, according to any one of (1) to (11). Patent application for patent foramen ovale.
(13) The patent foramen ovale treatment device according to any one of (1) to (11), wherein the right side linear extension and the left side linear extension are curved.

Moreover, what achieves the said objective is as follows.
(14) An outer tube in which the foramen ovale treatment device according to any one of (1) to (13) is housed in a distal end portion, and the outer foramen treatment device is housed in the outer tube. A device for operating the patent foramen ovale having a discharge operation member for discharging more and a holding part that is housed in the outer tube and that removably holds the device for patent foramen ovale at the distal end. An instrument for treatment of patent foramen ovale comprising a wire for placement operation.
(15) The curved portion of the patent foramen ovale treatment tool is sandwiched between the holding portion of the placement operation wire and the distal end portion of the discharge operation member. Device for patent foramen ovale treatment.
(16) The apparatus for treating the foramen ovale may be operated by operating the arrangement operation wire after the device for treating the patent foramen ovale is detached from the arrangement operation wire. The device for treating patent foramen ovale according to (14) or (15), which can be held again.
(17) The foramen ovale treatment instrument operates the placement operation wire and the discharge operation member after detachment of the foramen ovale treatment tool from the placement operation wire, The bending portion of the patent foramen ovale treatment tool can be sandwiched again between the holding portion of the arrangement operation wire and the distal end portion of the discharge operation member. For patent foramen ovale treatment.

According to the patent foramen ovale treatment device of the present invention, the secondary septum that normally closes the foramen ovale is not retained, the secondary septum is not substantially loaded, and the primary septum ( Can be pressed against the secondary septum. For this reason, the opening of the primary septum to the left atrium side in the patent foramen ovale (PFO Track) can be suppressed, and the flow of blood from the right atrium to the left atrium due to the patent foramen ovale can be prevented.
Moreover, according to the device for patent foramen ovale treatment of the present invention, the device for treatment for patent foramen ovale having the above-described effect can be disposed in the primary septum in the patent foramen ovale (PFO Track), Prevents blood flow from right to left chamber due to patent foramen ovale.

The foramen ovale treatment device and the foramen ovale treatment device of the present invention will be described with reference to the embodiments shown in the drawings.
FIG. 1 is a front view of an embodiment of the patent foramen ovale treatment device of the present invention. FIG. 2 is a plan view of the patent foramen ovale treatment device of FIG. Fig. 3 is a right side view of the patent foramen ovale treatment device of Fig. 1.
The patent foramen ovale treatment device 1 of the present invention includes a curved portion 5 located at the center, a right linear portion 2a located on the right side of the curved portion, and a left linear portion 2b located on the left side of the curved portion 5. The main linear portion 2, the right linear extension 3 extending inward of the curved portion 5 from the right linear portion 2 a (the curved portion 5 side and the curved portion inside), and the inner side of the curved portion 5 from the left linear portion 2 b. It consists of a linear body provided with the left side linear extension part 4 extended in the direction (the curved part 5 side and the curved part inside), and has spring elasticity. It can be attached to the upper end portion of the primary septum 51 by the right linear portion 2a and the right linear extension portion 3, and can be attached to the upper end portion of the primary septum 51 by the left linear portion 2b and the left linear extension portion 4. The deformation of the primary septum 51 in the direction away from the secondary septum 52 can be caused by the repulsive force against the twist of the patent foramen ovale treatment device 1 when attached to the primary septum at these two locations. It is to suppress.

And the patent foramen ovale treatment device 1 was mounted with the patent foramen ovale treatment device due to the repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at the above two locations. It is preferable that the primary septum is pressed against the secondary septum.
Furthermore, when the patent foramen ovale treatment device 1 is mounted on the primary septum at the above two locations, the right side linear part 2a and the left side linear part 2b are bent at both sides of the patent foramen ovale. 5, and the foramen ovale treatment tool 1 is held by the foramen ovale part 53 by a repulsive force against the press.
1 to FIG. 3, the right-side linear extension portion is inward of the curved portion 5 (the curved portion 5 side and the curved portion inside) from the right-side linear portion 2a. It is comprised by the right side linear loop part 3 extended. Similarly, the left side linear extension part is comprised by the left side linear loop part 4 extended in the inner side direction (the curved part 5 side and curved part inside) of the curved part 5 from the left side linear part 2b.

The right linear loop portion 3 forms a loop above the right linear portion 2a and intersects the right linear portion 2a on the back side of the right linear portion 2a. They may be in contact at the intersection, or may be slightly separated. Similarly, the left linear loop portion 4 forms a loop above the left linear portion 2b and intersects the left linear portion 2b on the back side of the left linear portion 2b. They may be in contact at the intersection, or may be slightly separated.
The patent foramen ovale treatment device 1 of this embodiment is composed of a linear body including a main linear portion 2, a right linear loop portion 3, and a left linear loop portion 4, and has spring elasticity. And in this embodiment of the patent foramen ovale treatment device 1 of this embodiment, it is formed symmetrically about the curved portion 5. In this embodiment, the curved portion 5 is the bent portion 5, but may be a curved portion.

In the patent foramen ovale treatment device 1 of this embodiment, as shown in FIGS. 1 to 3, the right-side linear loop portion 3 is obliquely above the end of the right-side linear portion 2 a and is inside the curved portion 5. From the first linear portion 31 extending in the direction, the second linear portion 32 bent downward from the first linear portion 31 and intersecting the right linear portion 2a, and the second linear portion 32 And a third linear portion 33 that extends to the right and forward. Similarly, the left linear loop portion 4 is bent from the first linear portion 41 and the first linear portion 41 extending obliquely above the end of the left linear portion 2 b and extending inward of the curved portion 5. A second linear portion 42 that extends downward and intersects the left linear portion 2b and a third linear portion 43 that is bent from the second linear portion 42 and extends to the left front are provided. And the patent foramen ovale treatment device 1 is symmetrical with respect to the curved portion 5. However, it is not limited to a symmetrical thing.
In the patent foramen ovale treatment device 1, as shown in FIG. 2, the main linear portion 2 is bent inward by a bent portion 5, and a right linear loop portion 3 and a left linear loop portion 4. Both have first linear portions 31 and 41 extending a predetermined length (shorter than the right linear portion 2a and the left linear portion 2b) in the bent portion 5 direction and the bent portion inner direction. The second linear portions 32 and 42 that are bent and extend from the first linear portions 31 and 41 intersect at the back side of the main linear portions (the right linear portion 2a and the left linear portion 2b). And extends further downward.

Furthermore, in this patent foramen ovale treatment device 1, as shown in FIGS. 1 to 3, both the right side linear loop portion 3 and the left side linear loop portion 4 are bent obliquely from the second linear portions 32 and 42. It has the 3rd linear part 33 and 43 extended ahead. By having the third linear portions 33 and 43, the state of attachment to the primary septum becomes favorable.
Since this patent foramen ovale treatment device 1 is made of a linear body and has spring elasticity, when the foramen ovale treatment device 1 is pressed from both sides, it is shown in FIG. The angle of the bent portion 5 (the angle of the bent portion in the front view) can be reduced. Further, since the patent foramen ovale treatment device 1 is made of a linear body and has spring elasticity, when the foramen ovale treatment device 1 is pressed from both sides, the device shown in FIG. The angle of the bent portion 5 (the angle of the bent portion in plan view) can be reduced. In the foramen ovale treatment tool 1, the foramen ovale part 53 is held by the repulsive force in a state of being pressed and deformed from both sides. The size of this deformation corresponds to the size of the patent foramen ovale. For this reason, this patent foramen ovale treatment device 1 can block the foramen ovale having different sizes.

  And this patent foramen ovale treatment device 1 can be attached to the upper end of the primary septum by the right side linear part 2a and the right side linear loop part 3, and the left side linear part 2b and the left side linear loop part 4 Can be attached to the upper end of the primary septum, and the secondary septum can be attached to the primary septum by the repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at these two locations. It is to push against the gap. For this reason, even if it does not hold | maintain a secondary septum, a primary septum is pressed on a secondary septum. In addition, it is preferable that the primary septum to be gripped is pressed against the secondary septum by the repulsive force in this way, but in the state where the foramen ovale treatment device 1 is attached to the primary septum, the primary septum What is necessary is just to suppress the separation from the secondary septum. Suppressing the separation means that when the primary septum is separated from the secondary septum, the primary septum is deformed, so that the attached foramen ovale treatment device 1 is also deformed, and the repulsion against this deformation is caused. It shows that the separation is suppressed as a result by suppressing the deformation by the force. Since it is comprised as mentioned above, even if it does not hold | maintain a secondary septum, the opening between a primary septum and a secondary septum can be suppressed.

And as an angle (angle in front view) in FIG. 1 of the bending part 5 of the main linear part 2, about 30-150 degree is suitable, and 60-120 degree is especially suitable. Moreover, as an angle (angle in planar view) in FIG. 2 of the bending part 5 of the main linear part 2, about 90 to 180 degree | times is suitable, and 150 to 180 degree | times is especially suitable. The distance between both ends of the main linear portion (the width of the main linear portion in front view) is preferably about 3 to 50 mm, and particularly preferably 5 to 20 mm. The area of the closed loop portion formed by the right linear portion 2a and the right linear loop portion 3 and the area of the closed loop portion formed by the left linear portion 2b and the left linear loop portion 4 are about 1 to 50 mm ^2. In particular, ² to 20 mm ² is preferable. Moreover, as a length of the part extended below the cross | intersection part with the main linear part 2 of the 2nd linear parts 32 and 42, about 0.1-5 mm is suitable, and 0.5-2 mm is especially preferable. preferable. Moreover, as length of the 3rd linear parts 33 and 43, about 0-50 mm is suitable, and 5-20 mm is especially preferable.
In the above embodiment, each linear portion is substantially linear, but may be curved. Moreover, although the inflection point in each linear part is a bending point, a bending point may be sufficient.

Next, the action of the patent foramen ovale treatment device of the present invention will be described with reference to FIGS.
FIG. 4 is an explanatory view for explaining the vicinity of the foramen ovale forming part in the heart where the patent foramen ovale treatment device of the present invention is placed. FIG. 5 is an explanatory diagram for explaining a state where the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale (a state seen from the side of the foramen ovale). FIG. 6 is an explanatory diagram for explaining a state where the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale (a state seen from the primary septum side). FIG. 7 is an explanatory diagram for explaining a state (cross-sectional state) in which the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale. FIG. 8 is an explanatory diagram for explaining a state in which the patent foramen ovale treatment device of FIG. 1 is placed in the primary septum of another foramen ovale (a state seen from the primary septum side).

  In the example shown in FIG. 4, the foramen ova 50 is formed in the secondary septum 52 that forms the inner wall of the right atrium, and this foramen 50 is closed by the primary septum 51 on the left atrial side. . However, the upper end 51 a of the primary septum is close to the foramen ovale, and a foramen ovale (PFO Track) 53 is formed between the upper end 51 a and the foramen ova 50. When the pressure on the left atrial side is high, the primary septum 51 is pressed against the secondary septum 52 by the pressure, so that blood does not circulate through the patent foramen ovale 53, When the pressure is lower than the right atrial side, blood flows from the right atrial side to the left atrial side via the foramen ovale 53.

The patent foramen ovale treatment device 1 of the present invention is placed at the upper end of the primary septum as shown in FIGS. Specifically, as shown in FIG. 5 to FIG. 7, in the indwelling patent foramen ovale treatment device 1, the vicinity of the bent portion 5 is located at the upper part of the foramen ovale 50 (right oval side). The middle portion of the main linear portion 2 (the right linear portion 2a and the left linear portion 2b) is exposed between the secondary septum 52 and the primary septum 51 (in other words, the foramen ovale patency) 53), the ends of the main linear portion 2 (right linear portion 2a, left linear portion 2b), right linear loop portion 3 and left linear loop portion 4 are exposed to the left atrial side It has become.
The right linear portion 2 a and the right linear loop portion 3 are attached to the right side portion of the upper end portion 51 a of the primary septum 51, and the left linear portion 2 b and the left linear loop portion 4 are connected to the primary septum 51. It is attached to the left part of the upper end 51a. Further, the right linear portion 2a and the left linear portion 2b are pushed inward of the bent portion 5 by both side edges of the foramen ovale portion 53, whereby the right linear loop portion 3 and the left linear loop are pressed. The patent foramen ovale treatment tool 1 is elastically deformed in the direction in which the portion 4 approaches. And by the repulsive force of this elastic deformation, the right linear loop part 3 of the patent foramen ovale treatment device 1 presses one side edge of the patent foramen ovale part 53, and the left linear loop part 4 , Press the other side edge. With this pressing force, the foramen ovale treatment device 1 is held by the foramen ovale part 53.

In addition, the primary septum 51 is pressed against the secondary septum 52 by the repulsive force against the twist of the patent foramen ovale treatment device 1 by attaching the upper end portion 51a of the primary septum 51 to the two locations. 7, the separation of the primary septum 51 from the secondary septum 52 is suppressed.
Further, when the foramen ovale and the foramen ovale are smaller than those shown in FIGS. 5 to 7, as shown in FIG. 8, the right linear loop part 3 and the left linear loop part 4 are closer to each other. To correspond to the size of the foramen ovale 53a.
And, in the above-mentioned type of patent foramen ovale treatment device, at the portion that becomes the free end of the linear body, specifically, at the end portion of the right linear loop portion 3 and the end portion of the left linear loop portion 4 Spherical bodies 23 and 24 may be provided as in the patent foramen ovale treatment device 20 shown in FIG. Further, instead of providing a spherical body, as in the patent foramen ovale treatment device 30 shown in FIG. 10, the end of the right linear loop 3 and the end of the left linear loop 4 are connected to the small loop 25, 26 may be used. By doing in this way, it prevents that the free end of a linear body damages a biological tissue.
Further, in the above embodiment, the main linear portion and the linear loop are configured by substantially linear elements, and a plurality of linear portions are connected by a plurality of bent portions. You may comprise by a curvilinear element like the patent foramen ovale treatment device 40 shown in FIG.

Next, a patent foramen ovale treatment tool 60 according to another embodiment of the present invention will be described.
FIG. 12 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 13 is a plan view of the patent foramen ovale treatment device shown in FIG. 14 is a right side view of the patent foramen ovale treatment device of FIG.
The difference between the patent foramen ovale treatment device 60 of this embodiment and the above-described patent foramen ovale treatment device 1 is the shape of a linear loop, and the others are the same.
In the patent foramen ovale treatment device 60 of this embodiment, as shown in FIGS. 12 to 14, the right linear loop portion 3 is a first linear portion extending upward from the end of the right linear portion 2a. 3a, a second linear portion 3b extending from the first linear portion 3a to the inside of the bent portion 5, and a second linear portion 3b bent from the first linear portion 3a, extending downward and intersecting the right linear portion 2a. And a third linear portion 3c. Similarly, the left linear loop portion 4 includes a first linear portion 4a extending upward from an end portion of the left linear portion 2b, and a first linear portion 4a extending inward of the bent portion 5 from the first linear portion 4a. 2 linear portions 4b, and a third linear portion 4c that bends from the second linear portion 4b, extends downward, and intersects the left linear portion 2b.

Since the patent foramen ovale treatment device 60 is also composed of a linear body and has spring elasticity, like the patent foramen ovale treatment device 1, the patent foramen ovale treatment device 60 is When pressed from both sides, the angle of the curved portion 5 in FIG. 12 (the angle of the bent portion in the front view) can be reduced, and the angle of the curved portion 5 in FIG. The angle of the portion can be reduced. For this reason, it is possible to block the patent foramen ovale having different sizes.
And also in this patent foramen ovale treatment tool 60, it can be attached to the upper end of the primary septum by the right side linear part 2a and the right side linear loop part 3, and the left side linear part 2b and the left side linear loop part 4 can be attached to the upper end of the primary septum, and the secondary septum can be attached to the primary septum by the repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at these two locations. It is to be pressed against the septum. For this reason, even if it does not hold | maintain a secondary septum, a primary septum is pressed on a secondary septum.

And as an angle (angle in front view) in FIG. 12 of the bending part 5 of the main-line-shaped part 2, about 30-150 degree is suitable, and 60-120 degree is especially suitable. Moreover, as an angle (angle in planar view) in FIG. 13 of the bending part 5 of the main linear part 2, about 90 to 180 degree | times is suitable, and 150 to 180 degree | times is especially suitable. The distance between both ends of the main linear portion (the width of the main linear portion in front view) is preferably about 3 to 50 mm, and particularly preferably 5 to 20 mm. The area of the closed loop portion formed by the right linear portion 2a and the right linear loop portion 3 and the area of the closed loop portion formed by the left linear portion 2b and the left linear loop portion 4 are about 1 to 50 mm ^2. In particular, ² to 20 mm ² is preferable. Moreover, as a length of the part extended below the cross | intersection part with the main linear part 2 of 3rd linear part 3c, 4c, about 0-50 mm is suitable, and 5-20 mm is especially preferable.

Further, in the above embodiment, the main linear portion and the linear loop are constituted by substantially linear elements, but the main portion of the loop is curved as in the patent foramen ovale treatment device 70 shown in FIG. You may comprise by a shape element. In this patent foramen ovale treatment device 70, the right linear loop portion 3 includes a semicircular arc-shaped curved portion 37a extending from one end of the right linear portion 2a and a lower portion extending from one end of the curved portion 37a. It has the linear part 37b which cross | intersects the shape part 2a. Similarly, the left linear loop portion 4 includes a semi-arc-shaped curved portion 47a extending from one end of the left linear portion 2b, and a linear shape extending downward from one end of the curved portion 47a and intersecting the right linear portion 2b. It has a portion 47b.
Furthermore, like the patent foramen ovale treatment device 80 shown in FIG. 16, the whole foramen ovale treatment device may be constituted by curved elements. In this patent foramen ovale treatment tool 70,
The right side linear part 2a and the left side linear part 2b are curved so as to be gently curved. The right linear loop portion 3 has a semi-elliptical arc-shaped curved portion 38a extending from one end of the right linear portion 2a, and a curved portion 38b extending downward from one end of the curved portion 38a and intersecting the right linear portion 2a. is doing. Similarly, the left linear loop portion 4 includes a semi-elliptical curved portion 48a extending from one end of the left linear portion 2b, and a curved portion extending downward from one end of the curved portion 48a and intersecting the right linear portion 2b. 48b.

Next, a patent foramen ovale treatment device 100 according to another embodiment of the present invention will be described.
FIG. 17 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. 18 is a plan view of the patent foramen ovale treatment device of FIG. 19 is a right side view of the patent foramen ovale treatment device of FIG.
The difference between the patent foramen ovale treatment device 100 of this embodiment and the above-described patent foramen ovale treatment device 60 is that the foramen ovale treatment device 100 is located on the right front and right side of the bent portion 5 or its vicinity. Only in that it includes a right-side drop-off preventing linear portion 7a that extends to the front side from the shape portion, and a left-side drop-off preventing linear portion 7b that extends to the left side forward from the bent portion 5 or the vicinity thereof and to the front side from the left side linear portion 2b. It is.
When a force for moving toward the upper end 51a of the primary septum 51 is applied to the foramen ovale treatment device 100 by including the right-side drop-off prevention linear portion 7a and the left-side drop-off prevention linear portion 7b. Then, it abuts against the edge of the secondary septum and restricts its movement.
In addition, you may provide such a right-side dropout prevention linear part 7a and a left-side dropout prevention linear part 7b in the above-mentioned treatment apparatus for patent foramen ovale of all the embodiments.
Further, instead of the right-side drop-off prevention linear portion 7a and the left-side drop-off prevention linear portion 7b, as shown in the foramen ovale treatment tool 110 shown in FIG. 20, between the main linear portion and the linear loop portion. The loop-shaped protrusions 8a and 8b protruding inside the loop may be formed.

Next, a patent foramen ovale treatment tool 130 according to another embodiment of the present invention will be described.
FIG. 23 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 24 is a plan view of the patent foramen ovale treatment device of FIG.
The only difference between the patent foramen ovale treatment device 130 of this embodiment and the above-described patent foramen ovale treatment device 1 is in the form of the right side linear extension 3 and the left side linear extension 4.
In the patent foramen ovale treatment device 130 of this embodiment, the right-side linear extension 3 includes a first linear portion 131 extending inward and downward of the curved portion 5 from the right-side linear portion 2a, and a first linear portion 131, A second linear portion 132 that is bent from the linear portion 131 and goes diagonally upward to the right is provided. In addition, the 2nd linear part 132 may bend from the 1st linear part 131, and may go to diagonally downward on the right side.
Similarly, the left linear extension portion 4 is bent from the first linear portion 141 and the first linear portion 141 extending inward and downward of the curved portion 5 from the left linear portion 2b, and obliquely upward on the left side. A second linear portion 142 is provided. In addition, the 2nd linear part 142 may bend from the 1st linear part 141, and may go to diagonally downward on the right side.

Next, a patent foramen ovale treatment device 200 according to another embodiment of the present invention will be described.
FIG. 25 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 26 is a plan view of the patent foramen ovale treatment device of FIG. 27 is a right side view of the patent foramen ovale treatment device of FIG.
The only difference between the patent foramen ovale treatment device 200 of this embodiment and the above-mentioned patent foramen ovale treatment device 1 is only in the form of the right side linear extension 3 and the left side linear extension 4.
In the patent foramen ovale treatment device 200 according to this embodiment, the right-side linear extension 3 includes a first linear portion 231 extending inward and upward of the curved portion 5 from the right-side linear portion 2a, and a first linear portion 231. A second linear portion 232 that bends from the linear portion 231 and goes downward is provided. Similarly, the left linear extension portion 4 is bent from the first linear portion 241 that extends inward and upward of the curved portion 5 from the left linear portion 2b, and is bent downward from the first linear portion 241. A second linear portion 242 is provided.

In this patent foramen ovale treatment device 200, the right linear extension 3 is bent from the second linear part 232 and extends in the right direction (inward direction of the right linear extension 3). Part 234. Similarly, the left linear extension 4 includes a third linear part 244 that is bent from the second linear part 242 and extends leftward (inward direction of the left linear extension 4). In this patent foramen ovale treatment device 200, the right-side linear extension 3 and the left-side linear extension 4 are formed in a substantially spiral shape.
In addition, in the above described patent foramen ovale treatment tools 130 and 200, the right linear portion 2a and the right linear extension 3 can be attached to the upper end of the primary septum, and the left linear portion 2b and the left linear It can be attached to the upper end of the primary septum by means of the elongated extension 4, and the secondary of the primary septum due to the repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at these two locations The separation from the septum is suppressed. Specifically, the attached primary septum is pressed against the secondary septum.

Further, in the above embodiment, the main linear portion and the linear extension portion are configured by substantially linear elements, but may be configured by curved elements.
And, in the above-mentioned type of patent foramen ovale treatment device, the portion that becomes the free end of the linear body, specifically, the end portion of the right linear loop portion 3, the end portion of the left linear loop portion 4, Spherical bodies 3d, 4d, 71a, and the like at the end of the right-side dropout prevention linear portion 7a and the end of the left-side dropout prevention linear portion 7b, like the patent foramen ovale treatment tool 120 shown in FIG. 72a may be provided. Further, instead of providing a spherical body, each free end may be a small loop portion as in the patent foramen ovale treatment device 30 shown in FIG. By doing in this way, it prevents that the free end of a linear body damages a biological tissue. Furthermore, the junction between the main linear portion 2 and the drop-preventing linear portion may also be formed by the spherical body 5a.
And also in the above-mentioned type of patent foramen ovale treatment device, as in the above-mentioned patent foramen ovale treatment device 100, it extends to the right side forward from the bent portion 5 or its vicinity and to the near side from the right linear portion 2a. A right-side drop-off preventing linear portion and a left-side drop-off preventing linear portion that extends to the left front from the bent portion 5 or the vicinity thereof and to the front side from the left-side linear portion 2b may be provided. Further, when a portion that is a free end of the linear body, specifically, an end portion of the right-side line extension portion 3, an end portion of the left-side line extension portion 4, and a drop-off prevention portion are provided, a right-side drop-off prevention portion is provided. A spherical body may be provided at the end portion of the linear portion and the end portion of the left-side drop-preventing linear portion as in the patent foramen ovale treatment tool 120 shown in FIG. Further, instead of providing a spherical body, each free end may be a small loop portion as in the patent foramen ovale treatment device 30 shown in FIG. By doing in this way, it prevents that the free end of a linear body damages a biological tissue. Furthermore, the junction between the main linear portion 2 and the drop-preventing linear portion may be formed of a spherical body.

  And in all the embodiments described above, as the material for forming the patent foramen ovale treatment tool, for example, stainless steel, Ni—Ti alloy, Cu—Zn alloy, Ni—Al alloy, tungsten, tungsten alloy, titanium, Examples thereof include various metals such as titanium alloy, cobalt alloy, and tantalum, relatively high-rigidity polymer materials such as polyamide, polyimide, ultrahigh molecular weight polyethylene, polypropylene, and fluororesin, or combinations of these appropriately. In particular, a super elastic molded product is preferable. The super-elastic molded product here refers to the super-elasticity at least when stored in the tube of the patent foramen ovale treatment device described later and when it is discharged into the heart, and is restored to the form at the time of molding. is there. Moreover, although the wire diameter of a linear part is not specifically limited, Usually, about 0.05-1 mm is preferable and about 0.1-0.5 mm is more preferable.

Next, an instrument for treating a patent foramen ovale according to the present invention will be described with reference to an embodiment shown in the drawings.
FIG. 28 is an external view of an embodiment of a patent foramen ovale treatment instrument provided with the patent foramen ovale treatment device of the present invention. FIG. 29 is a partially omitted enlarged cross-sectional view of the device for treating patent foramen ovale of FIG. FIG. 30 is an explanatory view for explaining the distal end portion of the patent foramen ovale treatment instrument of FIG. FIG. 31 to FIG. 34 are explanatory views of a method for using the patent foramen ovale treatment instrument.
A patent foramen ovale treatment device 10 of the present invention includes an outer tube 11 that houses one of the above-mentioned patent foramen ovale treatment devices (for example, a device for treatment of a foramen ovale) at the tip, A discharge operation member 12 for discharging the patent foramen ovale treatment device 1 from the outer tube 11 accommodated in the tube 11 and the foramen ovale treatment device 1 stored in the outer tube 11 and at the tip thereof. And a placement operation wire 13 for a patent foramen ovale treatment tool having a holding part 13a for holding the detachable part.

The patent foramen ovale treatment instrument 10 of the present invention includes an outer tube 11 in which the foramen ovale treatment device 1 is housed in a distal end portion, and is housed in the outer tube 11 and a proximal end is a proximal end of the outer tube 11. A discharge operation member 12 that protrudes further, and an arrangement operation wire 13 that is housed in the outer tube 11 and the discharge operation member 12 and has a proximal end protruding from the discharge operation member 12 are provided.
In the following description, it will be described that the above-described patent foramen ovale treatment device 1 is used as a patent foramen ovale treatment device. It may be.
As shown in FIGS. 28, 29 and 30, the outer tube 11 is a tubular body, and the front end and the rear end are open. The tip opening functions as a discharge port when the foramen ovale treatment device 1 is placed at the upper end of the primary septum of the foramen ovale. The distal end portion of the outer tube 11 serves as a storage site for storing the compressed patent foramen ovale treatment tool.
The outer diameter of the outer tube is preferably about 0.3 to 7.0 mm, and particularly preferably 1.2 to 5.0 mm. Further, the inner diameter of the outer tube 11 is preferably about 0.2 to 6.5 mm. The length of the outer tube 11 is preferably 300 to 2000 mm, particularly about 700 to 1500 mm.

As shown in FIGS. 28 to 30, the discharge operation member 12 is a tubular body, and the front end and the rear end are open. The discharge operation member 12 is housed in the outer tube 11, and the tip can be brought into contact with the patent foramen ovale treatment tool 1, and the foramen ovale treatment device 1 can be pushed out from the tip of the outer tube 11. It is possible. The proximal end of the discharge operation member 12 protrudes from the outer tube 11 and extends toward the proximal end side by a predetermined length. The portion exposed from the outer tube becomes the operation portion of the discharge operation member 12. The discharge operation member 12 is preferably a tubular body, but can be extruded from the outer tube 11 in contact with the patent foramen ovale treatment device 1 housed in the outer tube at the distal end portion 12a. Any thing is acceptable. For example, a plurality of linear bodies extending in the axial direction may be arranged in a cylindrical shape. In this case, the tip is preferably provided with a ring-shaped member for ensuring contact with the patent foramen ovale treatment device 1.
The outer diameter of the discharge operation member 12 is preferably about 0.1 to 5.0 mm, and more preferably 1.0 to 3.0 mm.

An operation wire 13 is inserted into the discharge operation member 12. The operation wire 13 is accommodated in the outer tube 11 and the discharge operation member 12, and holds the foramen ovale treatment tool in a detachable manner by a holding portion 13a provided at the distal end portion.
Specifically, the compressed patent foramen ovale treatment device 1 is housed in the outer tube 11 so that the bent portion 5 becomes the base end, and the holding portion 13a of the operation wire 13 is used for the operation. It is formed in a hook shape that bends so as to extend to the proximal end side of the wire. The hook holding portion 13 a is engaged with the bent portion 5. Specifically, the bent portion 5 is engaged with the holding portion 13a by being caught, and the movement of the foramen ovale treatment tool 1 to the distal end side of the outer tube 11 is restricted. Furthermore, in the instrument 10 of this embodiment, as shown in FIG. 30, the bent portion 5 of the patent foramen ovale treatment device 1 is provided with the holding portion 13 a of the placement operation wire 13 and the distal end portion 12 a of the discharge operation member 12. It is sandwiched between. For this reason, as shown in FIG. 32, the foramen ovale treatment device 1 is retained even when the foramen ovale treatment device 1 and the distal end portion 12a of the discharge operation member 12 are exposed from the outer tube 11. In this way, the detachment of the patent foramen ovale treatment device 1 from the device 10 is prevented.

Furthermore, the foramen ovale treatment device 10 of this embodiment is used for the placement operation by operating the placement operation wire 13 after detachment of the foramen ovale treatment tool 1 from the placement operation wire 13. It can be held again by the wire 13. For example, as shown in FIG. 7, in order to remove the foramen ovale treatment device 1 from the primary septum 51 and then remove it, the placement operation wire 13 is operated and the foramen ovale is established by the holding part 13a. The bent portion 5 of the treatment tool 1 can be held. In the held state, it becomes the same as that shown in FIG.
In particular, in the foramen ovale treatment instrument 10 of this embodiment, after the foramen ovale treatment tool 1 is detached from the placement operation wire 13, the placement operation wire 13 and the discharge operation member 12 are operated. Thus, the bent portion 5 of the patent foramen ovale treatment device 1 can be held again between the holding portion 13a of the placement operation wire 13 and the distal end portion 12a of the discharge operation member 12. For example, as shown in FIG. 7, in order to remove the foramen ovale treatment device 1 from the primary septum 51 and then remove it, the placement operation wire 13 is operated and the foramen ovale is established by the holding part 13a. By pushing the discharge operation member 12 toward the foramen ovale treatment device 1 while holding the bent portion 5 of the treatment device 1 and further holding the position of the placement operation wire 13, the foramen hole The patent treatment device 1 is sandwiched again at the bent portion 5 between the holding portion 13 a of the placement operation wire 13 and the distal end portion 12 a of the discharge operation member 12. In this embodiment, the foramen ovale treatment device 1 can be stored in the outer tube 11 again by pushing the outer tube 11 toward the distal end. In particular, the bent portion between the linear portions 31 and 32 of the right linear extension 3 (for example, the right linear loop portion) of the patent foramen ovale treatment device 1 is relatively close to the right linear portion 2a, and the left line By making the bent part between the linear parts 41 and 42 of the linear extension part 4 (for example, the left linear loop part) relatively close to the left linear part 2b, the storage becomes easier. Moreover, the linear part 31 of the right side linear extension part 3 (for example, right linear loop part) and the linear form of the left side linear extension part 4 (for example, left linear loop part) of the patent foramen ovale treatment device 1 are used. Storage is also facilitated by making the portion 41 relatively short.

In consideration of the physical properties (flexibility, hardness, strength, slipperiness, kink resistance, stretchability) required for the outer tube as the forming material of the outer tube 11 and the discharge operation member 12, for example, polyethylene, polypropylene, Fluorine polymers such as nylon, polyethylene terephthalate, PTFE, and ETFE, and thermoplastic elastomers are preferred. The thermoplastic elastomer is appropriately selected from nylon (for example, polyamide elastomer), urethane (for example, polyurethane elastomer), polyester (for example, polyethylene terephthalate elastomer), and olefin (for example, polyethylene elastomer, polypropylene elastomer). Is done.
Furthermore, it is preferable that the outer surface of the outer tube 11 is subjected to a treatment for exhibiting lubricity. Examples of such treatment include hydrophilic polymers such as poly (2-hydroxyethyl methacrylate), polyhydroxyethyl acrylate, hydroxypropyl cellulose, methyl vinyl ether maleic anhydride copolymer, polyethylene glycol, polyacrylamide, and polyvinylpyrrolidone. Examples of the method include coating or fixing. Moreover, in order to make the slidability good on the inner surface of the outer tube and / or the outer surface of the inner tube, the above may be coated or fixed.
As the arrangement operation wire 13, a wire rod can be preferably used. Moreover, although the wire diameter of a wire is not specifically limited, Usually, about 0.01-1.3 mm is preferable and about 0.1-0.3 mm is more preferable. Examples of the wire forming material include stainless steel, Ni—Ti alloy, Cu—Zn alloy, Ni—Al alloy, tungsten, tungsten alloy, titanium, titanium alloy, cobalt alloy, tantalum, and other metals, polyamide, and polyimide. , Relatively high-rigidity polymer materials such as ultrahigh molecular weight polyethylene, polypropylene, and fluorine-based resins, or combinations of these appropriately.

Next, a method of using the device for treating patent foramen ovale according to the present invention will be described.
FIG. 31 to FIG. 34 are explanatory views of a method for using the patent foramen ovale treatment instrument.
The patent foramen ovale treatment device 10 is inserted from the femoral vein into the inferior vena cava and the right atrium, and as shown in FIG. 31, the distal end of the device 10 is disposed near the foramen ovale 50 in the atrial septum. . Then, as shown in FIG. 32, the discharge operation member 12 is pushed toward the distal end side to expose the foramen ovale treatment tool 1 and the distal end portions of the discharge operation member 12, and the foramen ovale treatment tool 1. Through the patent foramen ovale and reach the left atrial side. Subsequently, in a state where the position of the operation wire 13, that is, the arrangement position of the patent foramen ovale treatment device 1 is maintained, the discharge operation member 12 is pulled to the proximal end side, and as shown in FIG. 13 is exposed, and nipping between the holding portion 13a of the placement operation wire 13 of the bent portion 5 of the patent foramen ovale treatment device 1 and the distal end portion 12a of the discharge operation member 12 is released. As a result, the patent foramen ovale treatment device 1 is held only by the holding portion 13 a of the operation wire 13. And in that state, by pulling the instrument 10 to the proximal end side, as shown in FIG. 34, the upper end of the primary septum 51 is aligned with the right side linear part and the right side linear part of the patent foramen ovale treatment device 1. It is held between the loop portions and between the left linear portion and the left linear portion. Then, by pushing the instrument 10 (or only the operation wire 13 only) slightly toward the distal end, the operation wire 13 is detached from the foramen ovale treatment tool 1 and enters the state shown in FIG. With the existing treatment device 1, the primary septum 51 is pressed against the secondary septum 52, and the opening of the primary septum is prevented. Then, the outer tube 11, the discharge operation member 12, and the operation wire 13 are removed from the living body.

FIG. 1 is a front view of an embodiment of the patent foramen ovale treatment device of the present invention. FIG. 2 is a plan view of the patent foramen ovale treatment device of FIG. Fig. 3 is a right side view of the patent foramen ovale treatment device of Fig. 1. FIG. 4 is an explanatory view for explaining the vicinity of the foramen ovale forming part in the heart where the patent foramen ovale treatment device of the present invention is placed. FIG. 5 is an explanatory diagram for explaining a state where the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale (a state seen from the foramen ovale side). FIG. 6 is an explanatory diagram for explaining a state where the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale (a state seen from the primary septum side). FIG. 7 is an explanatory diagram for explaining a state (cross-sectional state) in which the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of the foramen ovale. FIG. 8 is an explanatory diagram for explaining a state where the device for treating patent foramen ovale of FIG. 1 is placed in the primary septum of another foramen (a state seen from the foramen). FIG. 9 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 10 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 11 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 12 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 13 is a plan view of the patent foramen ovale treatment device of FIG. 14 is a right side view of the patent foramen ovale treatment device of FIG. FIG. 15 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 16 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 17 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. 18 is a plan view of the patent foramen ovale treatment device of FIG. 19 is a right side view of the patent foramen ovale treatment device of FIG. FIG. 20 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 21 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 22 is a plan view of the patent foramen ovale treatment device of FIG. FIG. 23 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 24 is a plan view of the patent foramen ovale treatment device of FIG. FIG. 25 is a front view of another embodiment of the patent foramen ovale treatment device of the present invention. FIG. 26 is a plan view of the patent foramen ovale treatment device of FIG. FIG. 27 is a right side view of the patent foramen ovale treatment device of FIG. FIG. 28 is an external view of an embodiment of a patent foramen ovale treatment instrument provided with the patent foramen ovale treatment device of the present invention. FIG. 29 is a partially omitted enlarged cross-sectional view of the device for treating patent foramen ovale of FIG. FIG. 30 is an explanatory view for explaining the distal end portion of the patent foramen ovale treatment instrument of FIG. FIG. 31 is an explanatory diagram of a method of using the device for treating patent foramen ovale according to the present invention. FIG. 32 is an explanatory diagram of a method of using the device for treating patent foramen ovale according to the present invention. FIG. 33 is an explanatory diagram of a method of using the device for treating patent foramen ovale according to the present invention. FIG. 34 is an explanatory diagram of a method for using the device for treating patent foramen ovale according to the present invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Patent foramen ovale treatment tool 2 Main linear part 2a Right side linear part 2b Left side linear part 3 Right side linear loop part 4 Left side linear loop part 5 Bending part 10 Foramen ovale treatment instrument 11 Outer tube 12 Discharge operation member 13 Arrangement operation wire

Claims (17)

A main linear portion having a curved portion located in the center, a right linear portion located on the right side of the curved portion, and a left linear portion located on the left side of the curved portion; and the curved portion from the right linear portion. A patent foramen ovale treatment device comprising a linear body having a right-side linear extension extending inwardly and a left-side linear extension extending inwardly of the curved portion from the left-side linear portion and having spring elasticity. It can be attached to the upper end of the primary septum by the right side linear part and the right side linear extension, and can be attached to the upper end of the primary septum by the left side linear part and the left side linear extension. The repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at the two locations suppresses deformation of the primary septum in the direction away from the secondary septum. A device for treatment of patent foramen ovale characterized by being. The patent foramen ovale treatment device is in the primary state in which the patent foramen ovale treatment device is attached due to the repulsive force against the twist of the patent foramen ovale treatment device when attached to the primary septum at the two locations. The device for treating patent foramen ovale according to claim 1, wherein the septum is pressed against the secondary septum. When the device for treating the patent foramen ovale is attached to the primary septum at the two locations, the right side linear part and the left side linear part are the curved parts by the both sides of the patent foramen ovale part. The said foramen ovale treatment tool is hold | maintained in the said foramen ovale part by the repulsive force with respect to this press, The said foramen ovale opening part is Claim 1 or 2 Patent application for patent foramen ovale. The right side linear extension part is configured by a right side linear loop part extending inward of the curved part from the right side linear part, and the left side linear extension part is more curved than the left side linear part. The right side linear loop part forms a loop above the right side linear part and the right side line on the back side of the right side linear part. The left linear loop portion intersects the left linear portion on the back side of the left linear portion while forming a loop above the left linear portion. The device for treating patent foramen ovale according to any one of claims 1 to 3. The right-side linear loop portion is obliquely above the end of the right-side linear portion and extends in an inward direction of the curved portion, and extends downward from the first linear portion. A second linear portion that intersects with the right linear portion; and a third linear portion that is bent from the second linear portion and extends to the front right, wherein the left linear loop portion includes the left line A first linear portion that is obliquely above the end portion of the shape portion and extends inward of the curved portion; and a second linear portion that is bent downward from the first linear portion and intersects the left linear portion. The patent foramen ovale treatment device according to claim 4, comprising a linear part and a third linear part that is bent from the second linear part and extends to the left front. The right linear loop portion includes a first linear portion extending upward from an end portion of the right linear portion, and a second linear shape that is bent from the first linear portion and extends inward of the curved portion. And a third linear portion that is bent from the second linear portion, extends downward, and intersects the right linear portion, and the left linear loop portion is an end of the left linear portion. A first linear portion extending upward from the first portion, a second linear portion extending from the first linear portion and extending inward of the curved portion, and bent from the second linear portion, downward 5. A patent foramen ovale treatment device according to claim 4, comprising a third linear portion extending and intersecting the left linear portion. The right linear extension includes a first linear portion that extends inward and downward of the curved portion from the right linear portion, and is bent from the first linear portion, obliquely upward to the right or obliquely downward to the right. The left linear extension includes a first linear portion extending inward and downward of the curved portion from the left linear portion, and the first line. The patent foramen ovale treatment device according to any one of claims 1 to 3, further comprising a second linear portion that bends from the shape portion and extends obliquely upward to the left or obliquely downward to the left. The right linear extension includes a first linear portion extending inward and upward of the curved portion from the right linear portion, and a second line bent downward from the first linear portion and directed downward. The left linear extension portion is bent from the first linear portion, the first linear portion extending inward and upward of the curved portion from the left linear portion, The patent foramen ovale treatment device according to any one of claims 1 to 3, further comprising a second linear portion directed downward. The patent foramen ovale treatment device includes a right-side drop-off preventing linear portion extending to the right front from the curved portion or the vicinity thereof, and a front side from the right linear portion; The device for treating patent foramen ovale according to any one of claims 1 to 8, further comprising a left-side drop-off preventing linear portion extending forward from the left-side linear portion. The patent foramen ovale according to any one of claims 1 to 9, wherein the free end of the linear body constituting the device for treating the patent foramen ovale is a small loop portion or a spherical object is fixed. Treatment tool. 11. The patent foramen ovale treatment device according to any one of claims 1 to 10, wherein the right side linear part and the left side linear part are substantially linear. The patent foramen ovale according to any one of claims 1 to 11, wherein the right-side linear extension portion and the left-side linear extension portion have a plurality of linear portions connected by a plurality of bent portions. Treatment tool. 12. The device for treating patent foramen ovale according to claim 1, wherein the right-side linear extension and the left-side linear extension are curved. An outer tube containing the device for patent foramen ovale according to any one of claims 1 to 13 and a discharge for storing the device for patent foramen ovale contained in the outer tube and discharged from the outer tube. An operation member, and an arrangement operation wire for the patent foramen ovale treatment device that has a holding part that is housed in the outer tube and that removably holds the device for patent foramen ovale at the distal end. An instrument for treating foramen ovale characterized by comprising: 15. The foramen ovale according to claim 14, wherein the curved part of the patent foramen ovale treatment tool is sandwiched between the holding part of the arrangement operation wire and the distal end part of the discharge operation member. Patenting treatment device. The patent foramen ovale treatment instrument can be held again by the placement operation wire by operating the placement operation wire after detachment of the patent foramen ovale treatment tool from the placement operation wire. The device for treating patent foramen ovale according to claim 14 or 15. The foramen ovale treatment instrument operates the placement operation wire and the discharge operation member after the removal of the foramen ovale treatment tool from the placement operation wire, thereby operating the egg circle. The foramen ovale according to any one of claims 14 to 16, wherein the curved portion of the foramen puncture treatment device can be sandwiched again between the holding portion of the placement operation wire and the distal end portion of the discharge operation member. Survival device.

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