JP5921023B2 - 心臓組織の治療 - Google Patents
心臓組織の治療 Download PDFInfo
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- JP5921023B2 JP5921023B2 JP2011115382A JP2011115382A JP5921023B2 JP 5921023 B2 JP5921023 B2 JP 5921023B2 JP 2011115382 A JP2011115382 A JP 2011115382A JP 2011115382 A JP2011115382 A JP 2011115382A JP 5921023 B2 JP5921023 B2 JP 5921023B2
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- 210000003748 coronary sinus Anatomy 0.000 claims description 234
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- 239000012530 fluid Substances 0.000 claims description 30
- 208000006440 Open Bite Diseases 0.000 claims description 12
- 208000001778 Coronary Occlusion Diseases 0.000 claims description 2
- 206010011086 Coronary artery occlusion Diseases 0.000 claims description 2
- 230000003213 activating effect Effects 0.000 claims 1
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Classifications
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- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
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- A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
- A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
- A61M60/135—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting
- A61M60/143—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel inside a blood vessel, e.g. using grafting inside the coronary sinus, e.g. for pressure-controlled intermittent coronary sinus occlusion
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- A61M60/30—Medical purposes thereof other than the enhancement of the cardiac output
- A61M60/31—Medical purposes thereof other than the enhancement of the cardiac output for enhancement of in vivo organ perfusion, e.g. retroperfusion
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- 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
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- 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
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- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgery (AREA)
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- Anesthesiology (AREA)
- Cardiology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Reproductive Health (AREA)
- Mechanical Engineering (AREA)
- Child & Adolescent Psychology (AREA)
- Biophysics (AREA)
- Pulmonology (AREA)
- Physics & Mathematics (AREA)
- Optics & Photonics (AREA)
- Transplantation (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Surgical Instruments (AREA)
Description
7秒の閉塞状態(バルーン装置122は膨張)、
3秒の非閉塞状態(バルーン装置122は収縮)、
10秒の閉塞状態、
4秒の非閉塞状態、
12秒の閉塞状態、
3秒の非閉塞状態、
6秒の閉塞状態、
3秒の非閉塞状態、
20秒の閉塞状態、
5秒の非閉塞状態、
14秒の閉塞状態、
3秒の非閉塞状態、
7秒の閉塞状態、
3秒の非閉塞状態、
16秒の閉塞状態、
3秒の非閉塞状態、
10秒の閉塞状態、及び
4秒の非閉塞状態。
初期段階のこれらの期間中に、冠状静脈洞の圧力測定値は制御システム140によって記録される(及びユーザインタフェース142上に表示される)が、閉塞状態及び非閉塞状態の期間は予め決定され、冠状静脈洞の圧力測定値に基づいて変化しない。初期段階における閉塞及び非閉塞のこれらの期間を使用して冠状静脈洞の圧力データを収集し、これによって様々な時間における圧力曲線を比較することができ、制御システム140は次の段階(圧力制御下での冠状静脈洞閉塞)中のサイクルの長さを調節又は最適化することができる。幾つかの場合、制御システム140は、治療した心臓内の変化の推定定量を提供するように、閉塞期間及び解除期間の所定のパターンを繰り返す。
Claims (5)
- 心筋組織を治療するシステムであって、
遠位先端部分と、近位ハブ部分と、圧力センサ管腔と、バルーン流体管腔とを含む冠状静脈洞閉塞カテーテルを備え、前記冠状静脈洞閉塞カテーテルの前記遠位先端部分が、前記バルーン流体管腔を介して流体で膨張した場合に、冠状静脈洞を閉塞するように構成された膨張式バルーン装置を備え、さらに、
圧力制御下での断続的な冠状静脈洞閉塞のために前記膨張式バルーン装置の前記膨張及び収縮を制御する制御システムを備え、前記制御システムが、表示装置と、冠状静脈洞の圧力を示す圧力信号を受信する圧力信号入力部と、心電図(ECG)信号入力部と、少なくとも部分的に前記冠状静脈洞の圧力を示す前記圧力信号に基づき、選択された期間だけ空気圧サブシステムを作動させて前記冠状静脈洞閉塞カテーテルの前記膨張式バルーン装置を膨張又は収縮させる制御回路とを備え、
前記制御システムが、初期動作期間中に、前記冠状静脈洞閉塞カテーテルの前記膨張式バルーン装置を作動させ、前記冠状静脈洞の圧力を示す前記圧力信号に関係なく複数の閉塞期間及び解除期間を繰り返す所定のパターンで前記冠状静脈洞を断続的に閉塞させ、第2の動作期間中に、前記冠閉塞カテーテルの前記膨張式バルーン装置を作動させ、前記冠状静脈洞の圧力を示す前記圧力信号に部分的に依存するパターンで前記冠状静脈洞を断続的に閉塞するシステム。 - 前記第2の期間後の第3の期間中に、前記制御システムが、前記冠状静脈洞の圧力を示す前記圧力信号に関係ない閉塞期間及び解除期間の前記所定のパターンを繰り返す、請求項1に記載のシステム。
- 前記制御装置が、前記第3の期間中の閉塞期間及び解除期間の前記所定のパターンに起因する冠状静脈洞の圧力特徴を、前記初期期間中の閉塞期間及び解除期間の前記所定のパターンに起因する冠状静脈洞の圧力特徴と比較するように構成される、請求項2に記載のシステム。
- 前記制御システムが、圧力制御下での断続的な冠状静脈洞閉塞治療を前記心臓に提供するために、前記冠状静脈洞閉塞カテーテルの前記膨張式バルーン装置の自動制御を提供し、前記制御システムが、前記冠状静脈洞の前記断続的閉塞中に前記冠状静脈洞の圧力を示す前記圧力信号のグラフを示す表示装置を備える、請求項1に記載のシステム。
- 前記制御システムの前記表示装置が、前記冠状静脈洞の閉塞期間を示す第1の時間値、及び前記冠状静脈洞の非閉塞期間を示す第2の時間値を示し、前記第1及び第2の時間値が、前記冠状静脈洞の圧力を示す前記圧力信号の前記グラフと同時に表示される、請求項4に記載のシステム。
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US11337707B2 (en) | 2022-05-24 |
EP2465423B1 (en) | 2015-10-14 |
US11291455B2 (en) | 2022-04-05 |
PL2465423T3 (pl) | 2016-04-29 |
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US11241238B2 (en) | 2022-02-08 |
PT2465423E (pt) | 2016-02-08 |
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US20130282042A1 (en) | 2013-10-24 |
US20120277786A1 (en) | 2012-11-01 |
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