JP5919380B2 - 経カテーテル式人工弁 - Google Patents
経カテーテル式人工弁 Download PDFInfo
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- JP5919380B2 JP5919380B2 JP2014528906A JP2014528906A JP5919380B2 JP 5919380 B2 JP5919380 B2 JP 5919380B2 JP 2014528906 A JP2014528906 A JP 2014528906A JP 2014528906 A JP2014528906 A JP 2014528906A JP 5919380 B2 JP5919380 B2 JP 5919380B2
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- Health & Medical Sciences (AREA)
- Cardiology (AREA)
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- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Transplantation (AREA)
- Oral & Maxillofacial Surgery (AREA)
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Description
Claims (24)
- 心臓の心房(15)と心室(20)の間の、外周の接続チャンネル壁構造(25)を有する接続チャンネル(10)内で心臓の房室弁を機能的に置換するための、経カテーテル式人工房室弁(1)であって、
前記接続チャンネル(10)の内側に設置され、軸(35)に沿って伸びている、半径方向に拡張可能な筒状体(30)と、
前記筒状体(30)内に設置されて取り付けられる弁(40)を有し、
前記筒状体(30)は、該筒状体(30)の半径方向の外側に向かって開口し、溝の底部(46)が定まる外周溝(45)を有し、
該外周溝によって前記筒状体(30)が第1部分(31)と第2部分(32)に分けられており、
前記筒状体は、前記第1部分(31)又は前記第2部分(32)から前記筒状体(30)の前記軸の方向に伸びている第1の突起群(50、55)であって、前記外周溝(45)を覆う位置に自由端(60、65)をそれぞれ持つ前記第1の突起群(50、55)を有し、
前記経カテーテル式人工房室弁(1)は、前記接続チャンネル壁構造(25)の外側の、前記外周溝(45)に対応する位置に設置される、前記筒状体の周方向に延びる細長い外部部材(75)をさらに有し、
前記接続チャンネル壁構造(25)をなす生体弁の組織が、対応する外周において前記筒状体(30)と前記細長い外部部材(75)の間に、かつ前記接続チャンネル壁構造(25)をなす前記生体弁の組織が少なくとも部分的に前記突起群(50、55)の半径方向に内側にあるように前記外周溝(45)に半径方向に押し込まれるような前記筒状体(30)の前記軸(35)からの半径方向の距離(R5)に位置しながら、前記細長い外部部材(75)が前記筒状体(30)の周りに少なくとも部分的に伸びることができる経カテーテル式人工房室弁(1)。 - 前記第1部分(31)は、前記接続チャンネル(10)内で前記心房(15)の側に取り付けられるように適合され、前記第2部分(32)は、前記接続チャンネル(10)内で前記心室(20)の側に取り付けられるように適合され、前記第1の突起群(50)が前記第2部分(32)から伸びるものであることを特徴とする請求項1に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、前記外周溝(45)の中で前記筒状体(30)の外周方向に伸び、長手方向の中心軸を有する筒状の構造を有し、該細長い外部部材(75)は前記長手方向の中心軸に直交する断面径(D2)を有し、該断面径(D2)は2mmより大きく、及び/又は15mmより小さいものであることを特徴とする請求項1又は請求項2に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、物質によって膨張させて前記細長い外部部材(75)を拡張させることができるように適合された膨張可能な部材(75)によって形成され、又は該膨張可能な部材(75)を含むものであることを特徴とする請求項1から請求項3のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、その前記断面径(D2)の方向に拡張可能及び/又は縮小可能なように設置されたものであることを特徴とする請求項3に記載の経カテーテル式人工房室弁(1)。
- 前記物質は、前記膨張可能な部材(75)中で硬化して前記細長い外部部材(75)に剛性を与えることができるように適合された硬化可能な物質であることを特徴とする請求項4に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、前記筒状体(30)の周りに部分的に、少なくとも180°又は少なくとも270°伸び、その自由端同士は間隔をおき隣接しないものであることを特徴とする請求項1から請求項6のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、メッシュ型の構造からなるものであることを特徴とする請求項1から請求項7のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記筒状体(30)は、交差部(34)で互いに交差する複数の細長いメッシュ構成部(33)を有するメッシュ型の本体を有し、前記突起群(50、55)は、前記筒状体(30)と統合され一体形成されたものであることを特徴とする請求項1から請求項8のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記軸(35)に対する半径方向の前記第1部分(31)の直径は、前記軸(35)に対する半径方向の前記第2部分(32)のいずれの直径よりも大きいことを特徴とする請求項1から請求項9に記載の経カテーテル式人工房室弁(1)。
- 前記筒状体(30)は、前記第1部分(31)から伸びている第1の突起群(50)及び第2部分(32)から伸びている第2の突起群(55)を有し、前記第1の突起群(50)及び前記第2の突起群(55)はそれぞれ前記筒状体(30)の前記軸に沿って反対の方向に伸びており、前記外周溝(45)を覆う位置に自由端(60、65)を持つものであることを特徴とする請求項1から請求項10に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)がそれぞれ直線的な形状を有するものであることを特徴とする請求項1から請求項11のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)がそれぞれ前記第1部分(31)及び前記第2部分(32)から前記第1及び第2の突起群(50、55)と前記溝の底部(46)の間の中空の空間(66)を定めるように、前記溝の底部(46)からの半径方向の距離を置いて伸びているものであることを特徴とする請求項1から請求項12のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)が、前記外周溝(45)の半径方向の外周部に隣接する領域においてそれぞれ前記第1部分(31)及び前記第2部分(32)から伸びているものであることを特徴とする請求項1から請求項13のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)が前記筒状体(30)の前記軸(35)に対して角度(β)で前記外周溝(45)の半径方向の内側に向かって伸びるものであり、前記角度(β)は45°以下、30°以下、又は15°以下であることを特徴とする請求項1から請求項14のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1及び第2の突起群(50、55)は、前記筒状体(30)の前記軸を含む平面内に実質的に伸びているものであることを特徴とする請求項1から請求項15のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)の前記自由端(60、65)は、鋭角の及び/又は鋭い形状を有するものであることを特徴とする請求項1から請求項16のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記第1の突起群(50)及び/又は第2の突起群(55)の前記自由端(60、65)は、掛かり又は鉤(71)の形状を有するものであることを特徴とする請求項1から請求項17のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記筒状体(30)は、前記交差部(34)で互いに交差する前記複数の前記細長いメッシュ構成部(33)を有し、又は前記交差部(34)で互いに交差する前記複数の前記細長いメッシュ構成部(33)であり、前記第1及び第2の突起群(50、55)は前記外周溝(45)と隣接する前記交差部(34)から伸びているものであることを特徴とする請求項9に記載の経カテーテル式人工房室弁(1)。
- 前記筒状体の前記軸方向に沿った断面で見たとき、前記外周溝(45)と前記第1部分(31)及び/又は前記第2部分(32)の移行部で、前記外周溝(45)と前記第1部分(31)及び/又は前記第2部分(32)との間の前記軸に対する湾曲又は屈曲の方向が、前記外周溝(45)の凹状の湾曲から凸状の湾曲に変化することを特徴とする請求項1から請求項19のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材は、1つ以上のクランプ機構(80)を有し、又は1つ以上の前記クランプ機構(80)からなり、該クランプ機構(80)は筒状のクランプ機構本体を有し、該クランプ機構本体は、前記筒状体(30)の外周方向に伸びる軸に沿って広がり、前記接続チャンネル壁構造(25)の組織を前記筒状体(30)の半径方向の内側に向かって前記外周溝(45)に押し込むように、前記クランプ機構(80)の前記軸に対して半径方向に拡張可能なものであることを特徴とする請求項1から請求項20のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記外周溝(45)の中に設置され、前記第1の突起群及び/又は第2の突起群(50、55)の半径方向の内側に位置する1つ以上のクランプ機構(80)をさらに有し、前記第1の突起群及び/又は第2の突起群とそれぞれの前記クランプ機構(80)の間に前記接続チャンネル壁構造(25)をなす前記生体弁の組織が位置し、それぞれの前記クランプ機構(80)は、前記生体弁の組織を前記溝の底部(46)に向かって半径方向に押しつけるように半径方向のクランプ力(85)を前記溝の底部(46)及び前記生体弁の組織に対してかけるものであることを特徴とする請求項1から請求項21のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記心臓の弁輪の、前記心室(20)の側に、前記弁輪と距離を置いて前記外周溝(45)が位置するように移植され、弁輪下に埋め込まれる人工弁であることを特徴とする請求項1から請求項22のいずれか1項に記載の経カテーテル式人工房室弁(1)。
- 前記細長い外部部材(75)は、前記軸(35)に対して概して半径方向に、前記外周溝(45)に向かって伸びており角張った断面形状を持つ第1角状脚(75a)と、前記筒状体(30)の外側で前記筒状体(30)の前記軸(35)に対して概して平行に、前記筒状体(30)の前記第2部分(32)と前記心臓の心室壁の間に位置するように伸びている第2角状脚(75b)を有するものであることを特徴とする請求項1から請求項23のいずれか1項に記載の経カテーテル式人工房室弁(1)。
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DE102011053520 | 2011-09-12 | ||
DE102011053520.9 | 2011-09-12 | ||
DE102011054172A DE102011054172A1 (de) | 2011-09-12 | 2011-10-04 | Transkatheter-Klappenprothese |
DE102011054172.1 | 2011-10-04 | ||
US201161543331P | 2011-10-05 | 2011-10-05 | |
US61/543,331 | 2011-10-05 | ||
PCT/EP2012/061237 WO2013037519A1 (en) | 2011-09-12 | 2012-06-13 | Transcatheter valve prosthesis |
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JP5919380B2 true JP5919380B2 (ja) | 2016-05-18 |
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DE102014102725A1 (de) * | 2014-02-28 | 2015-09-17 | Highlife Sas | Transkatheter-Klappenprothese |
US9358108B2 (en) | 2011-09-12 | 2016-06-07 | Highlife Sas | Transcatheter valve prosthesis |
DE102014102653A1 (de) * | 2014-02-28 | 2015-09-03 | Highlife Sas | Transkatheter-Klappenprothese |
DE102014102721A1 (de) * | 2014-02-28 | 2015-09-03 | Highlife Sas | Transkatheter-Klappenprothese |
US9387075B2 (en) | 2011-09-12 | 2016-07-12 | Highlife Sas | Transcatheter valve prosthesis |
US9662206B2 (en) | 2011-09-12 | 2017-05-30 | Highlife Sas | Transcatheter valve prosthesis |
US9763779B2 (en) | 2014-03-11 | 2017-09-19 | Highlife Sas | Transcatheter valve prosthesis |
CN106470641B (zh) * | 2014-02-28 | 2018-11-30 | 高品质生活简化股份公司 | 经导管瓣膜假体 |
US10064719B2 (en) | 2014-03-11 | 2018-09-04 | Highlife Sas | Transcatheter valve prosthesis |
US9889003B2 (en) | 2014-03-11 | 2018-02-13 | Highlife Sas | Transcatheter valve prosthesis |
DE102014102650A1 (de) * | 2014-02-28 | 2015-09-03 | Highlife Sas | Transkatheter-Klappenprothese |
US9687343B2 (en) | 2014-03-11 | 2017-06-27 | Highlife Sas | Transcatheter valve prosthesis |
DE102014114464A1 (de) * | 2014-10-06 | 2016-04-07 | Xpand Medical SAS | Aortenventilersatz-Prothese |
US11938022B2 (en) | 2020-06-26 | 2024-03-26 | Highlife Sas | Transcatheter valve prosthesis and method for implanting the same |
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EP2926767B2 (en) * | 2003-12-23 | 2023-03-08 | Boston Scientific Scimed, Inc. | Repositionable heart valve |
DE102005052628B4 (de) * | 2005-11-04 | 2014-06-05 | Jenavalve Technology Inc. | Selbstexpandierendes, flexibles Drahtgeflecht mit integrierter Klappenprothese für den transvaskulären Herzklappenersatz und ein System mit einer solchen Vorrichtung und einem Einführkatheter |
US8834564B2 (en) * | 2006-09-19 | 2014-09-16 | Medtronic, Inc. | Sinus-engaging valve fixation member |
US8876894B2 (en) * | 2006-09-19 | 2014-11-04 | Medtronic Ventor Technologies Ltd. | Leaflet-sensitive valve fixation member |
CA2978267A1 (en) * | 2007-08-23 | 2009-02-23 | Dfm, Llc | Translumenally implantable heart valve with formed in place support |
EP2429455B8 (en) * | 2009-04-29 | 2021-12-15 | Edwards Lifesciences Corporation | Apparatus for replacing a diseased cardiac valve |
US8845722B2 (en) * | 2009-08-03 | 2014-09-30 | Shlomo Gabbay | Heart valve prosthesis and method of implantation thereof |
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