JP5978312B2 - 心臓弁を血管内で置換するための装置 - Google Patents
心臓弁を血管内で置換するための装置 Download PDFInfo
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- JP5978312B2 JP5978312B2 JP2014548903A JP2014548903A JP5978312B2 JP 5978312 B2 JP5978312 B2 JP 5978312B2 JP 2014548903 A JP2014548903 A JP 2014548903A JP 2014548903 A JP2014548903 A JP 2014548903A JP 5978312 B2 JP5978312 B2 JP 5978312B2
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Classifications
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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
- A61F2/2427—Devices for manipulating or deploying heart valves during implantation
- A61F2/2436—Deployment by retracting a sheath
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
- A61F2/2418—Scaffolds therefor, e.g. support stents
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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
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
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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
- A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
Description
術後、患者は、塞栓および人工心肺装置に関連するその他の要因により、一時的に錯乱状態になる場合がある。術後の最初の2〜3日は、心臓機能の精密なモニタリングが可能な集中治療室で過ごすことになる。平均入院期間は1〜2週間であり、全快にはさらに数週間〜数か月を要する。
本開示は、患者の心臓弁を血管内で置換するための装置であって、シースと;複数の固定具駆動要素を含む留置ツールと;拡張可能な固定具であって、シース内に配置されるように、かつ、シースからの拡張可能な固定具の留置後に留置ツールによって拡張するようになされた、固定具と、置換弁であって、心臓弁の近辺に送達するためにシース内に配置されるようになされた、置換弁と;複数の固定具駆動要素は、拡張可能な固定具の先端側部分に基端方向の力を加えるようになされていることと;拡張可能な固定具の先端側部分に取り付けられた複数の第1の部材と;第1の部材に個々に解放可能に取り付けられた複数の第2の部材と;拡張可能な固定具の基端側部分に固着して取り付けられ、かつ、拡張可能な固定具を留置形状に錠止するために複数の第1の部材に係合するようになされた、複数の錠止要素と、第1の部材はそれぞれ、拡張可能な固定具の内側で置換弁を支持するようになされていることと、さらに、複数の第2の部材はそれぞれ、第1の部材の解放を防止するようになされた第1の配置状態および第1の部材の解放を可能にするようになされた第2の配置状態を有することと、を含む装置に関する。
以下の説明は図面を参照しながら読まれるべきであり、図中、同様の参照数字はいくつかの図面全体に共通する同様の要素を示している。図面(必ずしも原寸に比例するものではない)は、特許請求の範囲に記載の発明の範囲を限定するようには意図されていない。詳細な説明および図面は、特許請求の範囲に記載の発明の実例の実施形態を例証する。
Claims (9)
- 患者の心臓弁を血管内で置換するための装置であって、
送達用シースと、
複数の固定具駆動要素を含む留置ツールと、
拡張可能な固定具であって、シース内に配置されるように、かつ、該シースからの拡張可能な固定具の留置後に留置ツールによって拡張するようになされた、固定具と、
置換弁であって、心臓弁の近辺に送達するためにシース内に配置されるようになされた、置換弁と、
複数の固定具駆動要素は、拡張可能な固定具の先端側部分に基端方向の力を加えるようになされており、
拡張可能な固定具の先端側部分に取り付けられた複数の第1の部材であって、複数の第1の部材のそれぞれが、その基端側部分の内側に、1または複数の凹部を含むルーメンを有している、複数の第1の部材と、
複数の第1の部材のそれぞれに解放可能に取り付けられた複数の第2の部材であって、複数の第2の部材のそれぞれが、1または複数の突起を有しており、複数の第1の部材のそれぞれのルーメン内に解放可能に受承されると、1または複数の突起が第1の部材の1または複数の凹部と係合する、複数の第2の部材と、
複数の第2の部材のそれぞれは、1または複数の突起が第1の部材の1または複数の凹部から外れるのを防止する第1の状態と、1または複数の突起が第1の部材の1または複数の凹部から外れるのを許容する第2の状態とを有しており、
拡張可能な固定具の基端側部分に固着して取り付けられ、かつ、拡張可能な固定具を留置形状に錠止するために複数の第1の部材に係合するようになされた、複数の錠止要素と、
を備えており、
複数の第1の部材はそれぞれ、拡張可能な固定具の内側で置換弁を支持するようになされている、
装置。 - 複数の第2の部材のうちの1つの第2の部材が、留置ツールの複数の固定具駆動要素のうちの1つに取り付けられている、請求項1に記載の装置。
- 第2の部材の1または複数の突起が、径方向に外側に拡張して第1の部材の基端側部分の内側のルーメンの内側に備えられた1または複数の凹部に係合するように付勢された第1の突起を備えている、請求項1に記載の装置。
- 第2の部材の1または複数の突起が、径方向に外側に拡張して第1の部材の基端側部分の内側のルーメンの内側に備えられた1または複数の凹部に係合するように付勢された第2の突起をさらに備えている、請求項3に記載の装置。
- 第2の部材が、摺動可能な要素であって、第1の突起と第2の突起との間で第1の配置状態をとることにより第1の突起および第2の突起が第1の部材の基端側部分の内側のルーメンの内側に備えられた1または複数の凹部から引き抜かれるのを防止するようになされ、かつ、該摺動可能な要素が第1の突起と第2の突起との間にない第2の配置状態をとることにより第1の突起および第2の突起が第1の部材の基端側部分の内側のルーメンの内側に備えられた1または複数の凹部から引き抜かれるのを可能にするようになされた、摺動可能な要素を備えている、請求項4に記載の装置。
- 第2の部材の1または複数の突起が、第1の回転配置状態において第1の部材の基端側部分の内側のルーメンの内側に備えられた1または複数の凹部に係合するように、かつ、第2の回転配置状態において第1の部材の基端側部分のルーメンの内側に備えられた1または複数の凹部から離脱するようになされている、請求項1に記載の装置。
- 第2の部材が第1の部材の基端側部分の内側のルーメンから取り外されたときに錠止要素は拡張可能な固定具を留置形状に錠止する、請求項1に記載の装置。
- 複数の錠止要素がそれぞれ、複数の第1の部材のうち1つを受承することができるルーメンと、爪部であって、該ルーメンに入るように付勢され、かつ、受承された第1の部材の特徴に係合することによって第1の部材が錠止要素のルーメンの内側に受承されたときに第1の部材の錠止要素に対する先端側への移動を防止するようになされた爪部とを備えている、請求項1に記載の装置。
- 爪部が係合しうる第1の部材の特徴が爪部の一部を受承するようになされた凹部である、請求項8に記載の装置。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161577880P | 2011-12-20 | 2011-12-20 | |
US61/577,880 | 2011-12-20 | ||
PCT/US2012/070991 WO2013096644A1 (en) | 2011-12-20 | 2012-12-20 | Apparatus for endovascularly replacing a heart valve |
US13/721,466 | 2012-12-20 | ||
US13/721,466 US9393114B2 (en) | 2011-12-20 | 2012-12-20 | Apparatus for endovascularly replacing a heart valve |
Publications (2)
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JP2015506194A JP2015506194A (ja) | 2015-03-02 |
JP5978312B2 true JP5978312B2 (ja) | 2016-08-24 |
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JP2014548903A Expired - Fee Related JP5978312B2 (ja) | 2011-12-20 | 2012-12-20 | 心臓弁を血管内で置換するための装置 |
Country Status (6)
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US (1) | US9393114B2 (ja) |
EP (1) | EP2793748B1 (ja) |
JP (1) | JP5978312B2 (ja) |
CN (1) | CN104135967B (ja) |
CA (1) | CA2860225A1 (ja) |
WO (1) | WO2013096644A1 (ja) |
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CN104135967B (zh) | 2016-05-18 |
CN104135967A (zh) | 2014-11-05 |
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