JP5386664B2 - 生物学的に植え込み可能なプロテーゼおよびその使用方法 - Google Patents
生物学的に植え込み可能なプロテーゼおよびその使用方法 Download PDFInfo
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- JP5386664B2 JP5386664B2 JP2010151246A JP2010151246A JP5386664B2 JP 5386664 B2 JP5386664 B2 JP 5386664B2 JP 2010151246 A JP2010151246 A JP 2010151246A JP 2010151246 A JP2010151246 A JP 2010151246A JP 5386664 B2 JP5386664 B2 JP 5386664B2
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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
- A61F2/2409—Support rings therefor, e.g. for connecting valves to tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
-
- 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
-
- 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
- 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
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0406—Pledgets
-
- A—HUMAN NECESSITIES
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- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
- A61B2017/0417—T-fasteners
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B2017/0496—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials for tensioning sutures
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
- A61B17/06—Needles ; Sutures; Needle-suture combinations; Holders or packages for needles or suture materials
- A61B17/06066—Needles, e.g. needle tip configurations
- A61B2017/0608—J-shaped
-
- 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
- A61F2/2415—Manufacturing methods
-
- 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
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/30545—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting a diameter
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0008—Fixation appliances for connecting prostheses to the body
- A61F2220/0016—Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
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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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0041—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using additional screws, bolts, dowels or rivets, e.g. connecting screws
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0066—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements stapled
-
- 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
- A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0004—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable
- A61F2250/001—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof adjustable for adjusting a diameter
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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
- Y10S623/909—Method or apparatus for assembling prosthetic
- Y10S623/91—Heart
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Surgery (AREA)
- Rheumatology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Prostheses (AREA)
Description
本発明は、概して、生物学的に植え込み可能なプロテーゼ(または人工器官もしくは補綴)、当該プロテーゼを使用する心臓弁アセンブリ、およびそれを身体の環状部(または環もしくは弁輪)内で使用する方法に関する。
人工心臓弁は、患者の欠陥のあるヒトの弁に代わり得る。人工弁は一般に、人工弁のオリフィスの外周に取り付けられ、それに沿って延びる、縫合リングまたは縫合カフを含む。
開示されるプロテーゼの1つの形態は、外周が伸張可能な(または外側に膨張可能な、あるいは外周もしくは周線が伸び得る)壁を有する、生物学的に植え込み可能な心臓弁用の第1のプロテーゼである。壁は、長さ方向の軸に対して垂直な横方向の断面を有し、長さ方向の軸と平行な縦方向の断面を有する。プロテーゼはまた、第2のプロテーゼと自己係合するように構成された係合要素を有する。
図1および2は、生物学的に植え込み可能な第1のプロテーゼ2の一形態を示す。第1のプロテーゼ2は、壁4を有し得る。壁4は、第1のプロテーゼを弾性的に伸張可能とするように、当業者に公知の材料強度および寸法(またはディメンション)を有し得る。壁4は、図1に示すように、開口形態またはスパイル状の横方向の断面を有し得る。横方向の断面は、中央の長さ方向の軸6に対して垂直であり得る。
壁4は、当業者に公知の方法で作成することができる。例えば、壁4は、成形され又は機械的に加工され得る。係合要素148、波形、および壁4における他の任意の折り曲げを、当業者に公知の方法で、壁4内に、形成する(例えば加圧成形)、成形する、又は機械加工して壁4とすることができ、あるいは、金属内に折り曲げることができる。
第1のプロテーゼ2は、ターゲットとする弁輪204に隣接する小室202に、伸張していない状態で、当業者に公知の方法で導入することができる。図53は、矢印で示されているように、第1のプロテーゼ2を弁輪204に配置し、降下させることを示している。第1のプロテーゼ2が折り畳み可能であり、また伸張可能であるという性質を有するために、第1のプロテーゼ2を植え込む手順は、胸腔鏡、内視鏡および/または内部発光(endolumina)を用いて、実施することができる。第1のプロテーゼ2は、それが弁輪204に隣接する小室内部の管の開口(例えば冠血管の開口)を塞ぐことのないように、また、弁輪204から(例えば、心臓の室、例えば心室内に)落ちることがないように、弁輪204内に十分に正確に配置することができる。弁輪204は、初期の環径206を有し得る。図54は、第1のプロテーゼ2を配置し、設置することを示す。
(態様1)
外周が伸張可能な壁、および
第2のプロテーゼと自己係合するように構成された係合要素
を含み、
当該壁が、長手方向の軸を有し、当該壁が長手方向の軸に垂直な横方向の断面有し、かつ壁が長手方向の軸と平行である縦方向の断面を有する、
心臓弁用の生物学的に植え込み可能な第1のプロテーゼ。
(態様2)
さらに止めを有し、当該止めが壁の外周の縮小を防止する、態様1の第1のプロテーゼ。
(態様3)
止めが、壁の外周の伸張を防止する、態様2の第1のプロテーゼ。
(態様4)
壁が弾性的に伸張し得る、態様2の第1のプロテーゼ。
(態様5)
壁が変形可能に伸張し得る、態様2の第1のプロテーゼ。
(態様6)
壁が機械的に伸張し得る、態様2の第1のプロテーゼ。
(態様7)
横方向の断面が開口形態を含む、態様2の第1のプロテーゼ。
(態様8)
横方向の断面がスパイラルを含む、態様2の第1のプロテーゼ。
(態様9)
壁が第1の端部を含む、態様2の第1のプロテーゼ。
(態様10)
壁が第2の端部を含む、態様9の第1のプロテーゼ。
横方向の断面がスパイラルを含む、態様9の第1のプロテーゼ。
(態様12)
第1の突起をさらに含む、態様9の第1のプロテーゼ。
(態様13)
第1の突起が壁に取り付けられている、態様12の第1のプロテーゼ。
(態様14)
第1の突起が、長手方向の軸に対して半径方向の成分を有するベクトルで、壁から延びている、態様13の第1のプロテーゼ。
(態様15)
第1の突起が窪みを含む、態様14の第1のプロテーゼ。
(態様16)
第1の突起がタブを含む、態様15の第1のプロテーゼ。
(態様17)
受入れ要素をさらに含む、態様16の第1のプロテーゼ。
(態様18)
受入れ要素が壁に要素を含む、態様17の第1のプロテーゼ。
(態様19)
第1の突起が、長手方向の軸に対して角度成分を有するベクトルで、壁から延びている、態様12の第1のプロテーゼ。
(態様20)
第1の突起部が、ボールを含む、態様19の第1のプロテーゼ。
受入れ要素をさらに含む、態様20の第1のプロテーゼ。
(態様22)
受入れ要素がカラーを含む、態様21の第1のプロテーゼ。
(態様23)
受入れ要素をさらに含む、態様9の第1のプロテーゼ。
(態様24)
受入れ要素が、長手方向の軸に対して半径方向の成分を有するベクトルで壁から延びる突起を受け入れるように構成されている、態様23の第1のプロテーゼ。
(態様25)
受け入れ要素が、長手方向の軸に対して角度成分を有するベクトルで壁から延びる突起を受け入れるように構成されている、態様24の第1のプロテーゼ。
(態様26)
第2の突起をさらに含む、態様12の第1のプロテーゼ。
(態様27)
第1の突起および第2の突起が、長手方向の軸に沿って第1の長さにて配置され、第2の突起が長手方向の軸に沿って第2の長さにて配置されている、態様26の第1のプロテーゼ。
(態様28)
第1の突起および第2の突起が長手方向の軸に沿って第1の長さにて配置されている、態様26の第1のプロテーゼ。
(態様29)
第1の突起が第1のタブを含み、第1のプロテーゼが、第1のタブを受け入れるために第1のポートを壁においてさらに含んでいる、態様26の第1のプロテーゼ。
(態様30)
第2の突起が第2のタブ、および第2のタブを受け入れるために第2のポートを壁において含んでいる、態様29の第1のプロテーゼ。
第2の突起がボールを含み、第1のプロテーゼがボールを受け入れるカラーをさらに含んでいる、態様29の第1のプロテーゼ。
(態様32)
固定デバイスコネクタを更に含む、態様1の第1のプロテーゼ。
(態様33)
固定デバイスコネクタが壁においてポートを含む、態様32の第1のプロテーゼ。
(態様34)
壁が波形である、態様1の第1のプロテーゼ。
(態様35)
壁が前縁および裾縁を有し、さらに、前縁にて、曲げられたリップをさらに含む、態様1の第1のプロテーゼ。
(態様36)
態様1の第1のプロテーゼ、および
第1のプロテーゼが受け入れている第2のプロテーゼ
を含む、心臓弁アセンブリ。
(態様37)
第2のプロテーゼが冠である、態様36のアセンブリ。
(態様38)
冠が係合要素により係合されている、態様37のアセンブリ。
(態様39)
冠が弁葉を含む、態様37のアセンブリ。
(態様40)
第1のプロテーゼがリングである、態様36のアセンブリ。
第2のプロテーゼが第1のプロテーゼに固定して接続されている、態様36のアセンブリ。
(態様42)
第2のプロテーゼが取り外し可能なように第1のプロテーゼに接続される、態様36のアセンブリ。
(態様43)
第2のプロテーゼが第1のプロテーゼにスナップ嵌めされている、態様36のアセンブリ。
(態様44)
態様32の第1のプロテーゼ、および
固定デバイスコネクタに取り付けられた固定デバイスであって、第1のプロテーゼを生体塊に固定する、固定デバイス
を含む、心臓弁用の生物学的に植え込み可能なプロテーゼのアセンブリ。
(態様45)
固定デバイスが縫合糸を含む、態様44のアセンブリ。
(態様46)
固定デバイスがクリップを含む、態様44のアセンブリ。
(態様47)
固定デバイスがステープルを含む、態様44のアセンブリ。
(態様48)
固定デバイスがピンを含む、態様44のアセンブリ。
(態様49)
固定デバイスが半径方向に伸張可能なワイヤを含む、態様44のアセンブリ。
(態様50)
第1のエッジおよび第2のエッジを含む壁を含み、
壁が第1のプロテーゼの中心にて長手方向の軸を有し、壁の少なくとも一部が長手方向の軸から遠ざかるように又は長手方向の軸に向かって傾斜しており、第1のエッジが第2のプロテーゼと係合する係合要素を含む、
生物学的に植え込み可能な心臓弁用の第1のプロテーゼ。
係合要素が第2のエッジに向かって曲げられている、態様50の第1のプロテーゼ。
(態様52)
第1のエッジが前縁である、態様50の第1のプロテーゼ。
(態様53)
係合要素が長手方向の軸に向かって曲げられている、態様50の第1のプロテーゼ。
(態様54)
係合要素が長手方向の軸から遠ざかるように曲げられている、態様50の第1のプロテーゼ。
(態様55)
係合要素が、第1のセグメントおよび第2のセグメントを含み、第1のセグメントが長手方向の軸から遠ざかるように曲げられており、第2のセグメントが長手方向の軸に向かって曲げられている、態様50の第1のプロテーゼ。
(態様56)
固定デバイスコネクタをさらに含む、態様50の第1のプロテーゼ。
(態様57)
固定デバイスコネクタが壁においてポートを有する、態様56の第1のプロテーゼ。
(態様58)
壁が波形である態様50の第1のプロテーゼ。
(態様59)
縦方向の断面が、長手方向の軸に対して凸形状の湾曲部を含む、態様50の第1のプロテーゼ。
(態様60)
縦方向の断面が、長手方向の軸に対して凸形状の湾曲である、態様50の第1のプロテーゼ。
壁が、外周が伸張可能である、態様50の第1のプロテーゼ。
(態様62)
態様50の第1のプロテーゼ、および
第2のプロテーゼ
を含み、第2のプロテーゼが係合要素に接続されている
心臓弁アセンブリ。
(態様63)
第2のプロテーゼが冠である、態様62のアセンブリ。
(態様64)
冠が係合要素により係合されている、態様63のアセンブリ。
(態様65)
冠が弁葉を含む、態様63のアセンブリ。
(態様66)
第1のプロテーゼがリングである、態様62のアセンブリ。
(態様67)
第2のプロテーゼが第1のプロテーゼに固定して接続されている、態様62のアセンブリ。
(態様68)
第2のプロテーゼが取り外し可能なように第1のプロテーゼに接続されている、態様62のアセンブリ。
(態様69)
第2のプロテーゼが第1のプロテーゼに自己係合している、態様62のアセンブリ。
(態様70)
第1のプロテーゼ;
第1のプロテーゼにおける第1の磁石;
第2のプロテーゼ;および
第2のプロテーゼにおける第2の磁石
を含み、第1の磁石と第2の磁石との間の引力が、第1のプロテーゼを第2のプロテーゼに係合させている、
心臓弁アセンブリ。
弁輪に心臓弁を植え込む方法であって、
外周が伸張可能である壁を含む第1のプロテーゼであって、壁が長手方向の軸を有し、壁が長手方向の軸に垂直な横方向の断面を有する、第1のプロテーゼを弁輪に取り付けること、および
第2のプロテーゼを第1のプロテーゼに自己装着させること
を含む方法。
(態様72)
第1のプロテーゼがリングである態様71の方法。
(態様73)
第2のプロテーゼが冠である態様71の方法。
(態様74)
壁が第1の端部を含む、態様71の方法。
(態様75)
壁が第2の端部を含む、態様74の方法。
(態様76)
横方向の断面がスパイラルを含む、態様71の方法。
(態様77)
第1のプロテーゼを取り付けることが、第1のプロテーゼを弁輪内で位置決めし、第1のプロテーゼの外周を伸張させることを含む、態様71の方法。
(態様78)
第1のプロテーゼを取り付けることが、第1のプロテーゼを固定デバイスにより生体塊に固定することを含む、態様71の方法。
(態様79)
第1のプロテーゼを取り付けることが第1のプロテーゼを弁輪内で位置決めすることを含む、態様71の方法。
(態様80)
第1のプロテーゼを取り付けることが第2のプロテーゼを第1のプロテーゼにスナップ嵌めすることを含む、態様71の方法。
第2のプロテーゼを取り除くことをさらに含む、態様71の方法。
(態様82)
第2のプロテーゼを、態様1の第1のプロテーゼである第1のプロテーゼから取り除くことを含む、心臓弁を交換する方法。
(態様83)
第2のプロテーゼを別のプロテーゼと取り替えることをさらに含む、態様82の方法。
(態様84)
弁輪に心臓弁を植え込む方法であって、
第1のプロテーゼを弁輪に取り付けること、および
第2のプロテーゼを第1のプロテーゼに取り付けること
を含み、
第1のプロテーゼが、壁を含み、壁が第1のエッジおよび第2のエッジを含み、壁が長手方向の軸を有し、壁の少なくとも一部が長手方向の軸から遠ざかるように又は長手方向の軸に向かって傾斜しており、第1のエッジが係合要素を含む、
方法。
(態様85)
係合要素が、長手方向の軸から遠ざかるように曲げられている、態様84の方法。
(態様86)
第1のプロテーゼがリングである、態様85の方法。
(態様87)
第2のプロテーゼが冠である、態様86の方法。
(態様88)
第1のエッジが前縁であり、第2のエッジが裾縁である、態様87の方法。
(態様89)
冠を取り付けることが、第1のプロテーゼに冠をスナップ嵌めすることを含む、態様88の方法。
(態様90)
第2のエッジが保持要素を含む、態様89の方法。
生体の弁輪の寸法を大きくし、且つ保持する方法であって、
外周が伸張可能である第1のプロテーゼを弁輪に配置すること、
第1のプロテーゼの外周を伸張させて、伸張した寸法にすること、および
第1のプロテーゼの外周を伸張した寸法に保持すること
を含む方法。
(態様92)
外周を伸張させることが、弁輪の半径を約0.1mmから約2.0mmに増加させることを含む、態様91の方法。
(態様93)
第1のプロテーゼが、第2のプロテーゼを受け入れるように構成された係合要素を含む態様91の方法。
(態様94)
心臓弁アセンブリを生体塊に固定する方法であって、
アセンブリを塊の付近に位置決めすること、
第1の端部、第2の端部および中間部を含み、第1の端部が伸張可能であり、第1の端部および第2の端部がアセンブリおよび塊の両端部に位置する固定デバイスを、アセンブリおよび塊を経由させて挿入すること、および
第1の端部を伸張させること
を含む方法。
(態様95)
心臓弁用の生物学的に植え込み可能なシステムであって、
ティシューを含む第1のプロテーゼ、および
係合要素を含む第2のプロテーゼであって、係合要素が第1のプロテーゼと1または複数の平行な面で係合するように構成されている、第2のプロテーゼ。
を含むシステム。
(態様96)
第1のプロテーゼがティシューの弁葉を含む、態様95のシステム。
(態様97)
ティシューを含む第1のプロテーゼ、および
長手方向の軸を有し、第1のプロテーゼに自己係合するように構成されている係合要素を含む、第2のプロテーゼ
を含む、心臓弁用の生物学的に植え込み可能なシステム。
(態様98)
第1のプロテーゼがティシューの弁葉を含む、態様97のシステム。
(態様99)
係合要素が、第1のプロテーゼが第2のプロテーゼに対して、長手方向の軸と平行に移動したときに、第1のプロテーゼと自己係合するように構成されている、態様97のシステム。
(態様100)
第2のプロテーゼの外周が伸張可能である壁を含む、態様97のシステム。
ティシューを含む第1のプロテーゼ、および
第2のプロテーゼと自己係合するように構成されている係合要素
を含む、心臓弁用の生物学的に植え込み可能な第1のプロテーゼ。
(態様102)
第1のプロテーゼがティシューの弁葉を含む、態様101のプロテーゼ。
(態様103)
係合要素が、第1のプロテーゼが第2のプロテーゼに対して、第2のプロテーゼの長手方向の軸と平行に移動したときに、第2のプロテーゼと自己係合するように構成されている、態様101のプロテーゼ。
(態様104)
ニードル本体、ならびにニードル第1端部およびニードル第2端部を含むニードル、
固定デバイス第1端部、固定デバイス第2端部を含む固定デバイス
を含み、
ニードル第2端部が容器を含み、
固定デバイス第1端部の少なくとも一部が、容器によって保持され、容器から取り外し可能である、
固定アセンブリ。
(態様105)
ニードルが湾曲部を含む、態様104のアセンブリ。
(態様106)
ニードル第2端部が直接的に容器に取り付けられている、態様104のアセンブリ。
(態様107)
ニードル第2端部が容器として形成されている、態様104のアセンブリ。
(態様108)
固定デバイス第2端部が、締まりばめピースを含む、態様104のアセンブリ。
(態様109)
締まりばめピースが綿撤糸を含む、態様108のアセンブリ。
(態様110)
締まりばめピースがボールを含む、態様108のアセンブリ。
ボールにより保持されている綿撤糸をさらに含む、態様110のアセンブリ。
(態様112)
固定デバイス第1端部が半径方向に伸張可能な部分を含む、態様104のアセンブリ。
(態様113)
半径方向に伸張可能な部分が、固定デバイス第1端部が容器から取り外されるときに、伸張する、態様112のアセンブリ。
(態様114)
ニードル第2端部を含むニードル、
容器第1端部を含む容器
ライン第1端部およびライン第2端部を含むラインであって、ライン第1端部がニードル第2端部に取り付けられ、ライン第2端部が容器第1端部に取り付けられている、ライン、および
固定デバイス第1端部および固定デバイス第2端部を含む固定デバイスであって、固定デバイス第1端部の少なくとも一部が、摩擦により容器と係合しており、且つ容器から取り外し可能である、固定デバイス
を含む、固定アセンブリ。
(態様115)
ラインが縫合糸である、態様114のアセンブリ。
(態様116)
容器が可撓性を有するセクションを含む、態様114のアセンブリ。
(態様117)
可撓性を有するセクションがコイルを含む、態様116のアセンブリ。
(態様118)
固定デバイス第2端部に取り付けられた締まりばめピースを更に含む、態様114のアセンブリ。
(態様119)
締まりばめピースが綿撤糸を含む、態様118のアセンブリ。
(態様120)
締まりばめピースがボールを含む、態様118のアセンブリ。
球により保持されている綿撤糸をさらに含む、態様120のアセンブリ。
(態様122)
固定デバイス第1端部が半径方向に伸張可能な部分を含む、態様114のアセンブリ。
(態様123)
固定デバイス第1端部が容器から取り外されるときに、半径方向に伸張可能な部分が伸張する、態様122のアセンブリ。
(態様124)
第1の塊および第2の塊を固定する方法であって、
態様104の固定アセンブリを、第1の塊および第2の塊を経由させて、移動させること、および
固定デバイスを容器から展開させて、固定デバイスで第1の塊および第2の塊を固定すること
を含む方法。
(態様125)
固定デバイスを摩擦により容器と係合させる、態様124の方法。
(態様126)
展開させることが、スライドにより固定デバイスを容器から開放することをさらに含む、態様124の方法。
(態様127)
固定デバイスが締まりばめピースをさらに含み、前記方法が締まりばめピースを第1の塊で捕捉することを含む、態様124の方法。
(態様128)
固定デバイス第1端部が、伸張可能な部分を含み、
展開させることが、固定デバイス第1端部を容器から展開させるときに、伸張可能な部分を伸張させることをさらに含む、態様124の方法。
(態様129)
第1の塊および第2の塊を固定する方法であって、
態様111の固定アセンブリを、第1の塊および第2の塊を経由させて移動させること、および
固定デバイスを容器から展開して、固定デバイスで第1の塊および第2の塊を固定すること
を含む方法。
(態様130)
固定デバイスを摩擦により容器と係合させる、態様129の方法。
(態様131)
展開させることが、スライドにより固定デバイスを容器から開放することをさらに含む、態様129の方法。
(態様132)
固定デバイスが締まりばめピースをさらに含み、前記方法が締まりばめピースを第1の塊で捕捉することを含む、態様129の方法。
(態様133)
固定デバイス第1端部が、伸張可能な部分を含み、
展開させることが、固定デバイス第1端部を容器から展開させるときに、伸張可能な部分を伸張させることをさらに含む、態様129の方法。
Claims (6)
- 第1のプロテーゼ;
第1のプロテーゼにおける第1のマグネット;
第2のプロテーゼ;および
第2のプロテーゼにおける第2のマグネット
を含み、
第1のマグネットと第2のマグネットとの間の引力が、第1のプロテーゼを第2のプロテーゼに係合する、
心臓弁アセンブリ。 - 第2のプロテーゼが心臓弁冠を含む、請求項1に記載の心臓弁アセンブリ。
- 第1および第2のマグネットが、第1および第2のプロテーゼの外周に沿って配置された複数の磁石を含む、請求項1に記載の心臓弁アセンブリ。
- 1または複数の磁石が、他の磁石とは異なる極性を与えるように配置されている、請求項3に記載の心臓弁アセンブリ。
- 1または複数の磁石が、他の磁石とは異なる極性を与えるように配置されて、第2のプロテーゼが挿入されて第1のプロテーゼと係合するときに、第2のプロテーゼを角度に関して第1のプロテーゼと整列させる、請求項4に記載の心臓弁アセンブリ。
- 第1のプロテーゼが、テーパーを有する壁を含み、第1のプロテーゼ内への挿入の間、第2のプロテーゼをガイドする、請求項1〜5のいずれか1項に記載の心臓弁アセンブリ。
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AU (1) | AU2003299886A1 (ja) |
CA (1) | CA2509211C (ja) |
WO (1) | WO2004058106A2 (ja) |
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AU2003299886A1 (en) | 2004-07-22 |
US8025695B2 (en) | 2011-09-27 |
US20040122514A1 (en) | 2004-06-24 |
JP2006511279A (ja) | 2006-04-06 |
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US20140088697A1 (en) | 2014-03-27 |
WO2004058106A2 (en) | 2004-07-15 |
EP2476394B1 (en) | 2013-11-20 |
WO2004058106A3 (en) | 2004-08-19 |
JP4635122B2 (ja) | 2011-02-16 |
EP1585463A4 (en) | 2006-09-06 |
EP2476394A1 (en) | 2012-07-18 |
US20120053688A1 (en) | 2012-03-01 |
CA2509211A1 (en) | 2004-07-15 |
US8623080B2 (en) | 2014-01-07 |
US10595991B2 (en) | 2020-03-24 |
EP1585463A2 (en) | 2005-10-19 |
US7981153B2 (en) | 2011-07-19 |
CA2509211C (en) | 2014-07-15 |
US6939365B1 (en) | 2005-09-06 |
US8551162B2 (en) | 2013-10-08 |
US8460373B2 (en) | 2013-06-11 |
US20160250021A1 (en) | 2016-09-01 |
US20040122516A1 (en) | 2004-06-24 |
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