JP6515088B2 - 人工心臓弁送達装置 - Google Patents
人工心臓弁送達装置 Download PDFInfo
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- JP6515088B2 JP6515088B2 JP2016515032A JP2016515032A JP6515088B2 JP 6515088 B2 JP6515088 B2 JP 6515088B2 JP 2016515032 A JP2016515032 A JP 2016515032A JP 2016515032 A JP2016515032 A JP 2016515032A JP 6515088 B2 JP6515088 B2 JP 6515088B2
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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
-
- 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
-
- 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
- A61F2/2439—Expansion controlled by filaments
Description
一般的考慮事項
12 ステント
34a、34b、34c 尖部
42 スカート
100 送達装置
104 シャフト
126 遠位セグメント
134 突起部
202 ハンドル
300 ステント
302 頂点
304 開口
306 継ぎ目支柱
308 小穴
500、600 送達装置
502 主シャフト
504 シース
506 内側シャフト
508 ノーズコーン
509 ガイドワイヤ
510 縫合糸保持部材
512 近位円板部材
514 シャフト
516 遠位円板部材
518 開口部
520 縫合糸解放部材
522 縫合糸ループ
528 開口部
530 第5の開口部
600 送達装置
602 第1のカテーテル
604 第2のカテーテル
606 細長いシャフト
608 中間セクション
610 遠位端部分
612 送達シースまたはシリンダー
613 レール
614 細長いシャフト
616 結合部材
618 ネジ山付きネジ
620 ノーズコーン
622 ノーズコーンシャフト
626 縫合糸保持部材
628 解放部材部または解放ワイヤ
630 近位部分
632 遠位端部分
634 遠位端セグメント
636 遠位円板部材
638 近位円板部材
640 ナット
642 つまみ
644 窓部
648 外側スリーブ部分
650 環状隆起部
652 代替的溝付きチューブ
654 歯または突出部
656 縦方向開口部
658 レール
660 開口部
662 プルワイヤ
664 つまみ
666 環状陥凹部分
Claims (19)
- 人工弁送達アセンブリであって、
自己膨張型ステントを備え、前記自己膨張型ステントは前記自己膨張型ステントの第1の端部分の周上に相隔てて並ぶ複数の頂点を有し、各頂点は開口を有する、人工弁と、
前記人工弁の近位に配置された細長いシャフトと、
前記シャフトの遠位に配置された縫合糸保持部材であって、前記縫合糸保持部材は、近位部分と、前記近位部分から一定間隔で並ぶ遠位部分とを備え、前記近位部分は前記シャフトに結合される、縫合糸保持部材と、
前記縫合糸保持部材の前記近位部分および前記遠位部分を貫通して延在する少なくとも1つの摺動可能な解放部材と、
前記縫合糸保持部材の前記近位部分から、前記自己膨張型ステントの前記頂点内の前記開口を貫通し、前記縫合糸保持部材の前記近位部分と前記遠位部分との間の場所で前記解放部材の周りに延在する複数の縫合糸ループであって、すべての頂点の前記開口それぞれが、前記開口を貫通して延在する、少なくとも1つの前記縫合糸ループを含む、複数の縫合糸ループと、
前記自己膨張型ステントが前記縫合糸ループを介して前記縫合糸保持部材に接続されている間に、前記人工弁を径方向に圧縮された状態に保持するように前記人工弁の上で送られ、前記人工弁の径方向膨張を可能にするように前記人工弁に対して引っ込められうる、外側シースと、
を備え、
前記人工弁全体が前記外側シースの中から展開された後、前記縫合糸ループを介して前記縫合糸保持部材に接続されている間に、前記外側シースは、前記縫合糸ループにおける張力が増し、前記自己膨張型ステントの前記頂点を径方向につぶれるように、前記縫合糸ループの上で遠位方向に送られて戻され、これにより、前記外側シースが前記人工弁の上で遠位方向に送られて戻されることで、前記人工弁は、前記人工弁が前記外側シースによって再び取り込まれるときに径方向につぶれうる人工弁送達アセンブリ。 - 単一の縫合糸が、その長さに沿って複数回折り畳まれて前記縫合糸ループを形成する請求項1に記載の人工弁送達アセンブリ。
- 前記シャフトは第1のシャフトを備え、前記人工弁送達アセンブリは、少なくとも部分的に前記第1のシャフトを貫通して延在する第2のシャフトをさらに備え、前記外側シースは、軸方向に動くように前記第2のシャフトに動作可能に連結され、これにより、前記第1のシャフトに対する前記第2のシャフトの回転に応じて前記人工弁に対して送られるか、または引っ込められうる請求項1に記載の人工弁送達アセンブリ。
- 前記少なくとも1つの解放部材は、前記縫合糸保持部材に対して摺動可能であり、前記解放部材が、前記解放部材の遠位端が前記縫合糸保持部材の前記遠位端の近位に来るように近位に引っ込められるときに、前記縫合糸ループは、前記解放部材の前記遠位端から離れて摺動し、これによって、前記人工弁を前記縫合糸保持部材から解放することができる請求項1に記載の人工弁送達アセンブリ。
- 前記外側シースの少なくとも一部は、溝付き金属チューブを形成する複数の相互接続された円形バンドまたはリンクを備える請求項1に記載の人工弁送達アセンブリ。
- 前記外側シースの遠位端部分は、前記溝付き金属チューブの遠位端に接続された送達カプセルを備え、前記送達カプセルは前記人工弁の上に延在し、前記人工弁を前記径方向に圧縮された状態に保持するように構成される請求項5に記載の人工弁送達アセンブリ。
- 前記送達カプセルは、ポリマースリーブを備える請求項6に記載の人工弁送達アセンブリ。
- 前記外側シースは、長さが少なくとも約5cmであり、また長さは約40cm以下である請求項1に記載の人工弁送達アセンブリ。
- 前記縫合糸ループのうちの少なくとも1つの縫合糸ループは、前記縫合糸ループのうちの他の縫合糸ループよりも大きい太さを有する請求項1に記載の人工弁送達アセンブリ。
- 人工弁を埋め込むためのシステムであって、
自己膨張型ステントを備え、前記自己膨張型ステントは前記自己膨張型ステントの第1の端部分の周上に相隔てて並ぶ複数の頂点を有し、各頂点は開口を有する、人工弁と、
縫合糸保持部材から、前記自己膨張型ステントの前記頂点内の前記開口を貫通して延在する複数の縫合糸ループであって、すべての頂点の前記開口それぞれが、前記開口を貫通して延在する、前記複数の縫合糸ループの少なくとも1つを含む、複数の縫合糸ループと、
近位端部分および遠位端部分を有する細長い第1のシャフトと、
前記第1のシャフトを貫通して延在する細長い第2のシャフトであって、前記細長い第2のシャフトが近位端部分および遠位端部分を有し、前記第1のシャフトに対して回転可能であるが、前記第1のシャフトに対する軸方向移動に対抗するように固定された細長い第2のシャフトと、
人工弁を受け入れ、前記人工弁を圧縮された送達状態に保持するように構成された遠位端部分と、前記細長い第2のシャフトの前記遠位端部分に接続された近位端部分とを有する送達シースであって、前記近位端部分は、前記遠位端部分よりも高い可撓性を有し、前記送達シースは、長さが少なくとも約5cmであり、また長さは約40cm以下である、送達シースと、
を備え、
前記第2のシャフトは、前記第2のシャフトの回転によって前記送達シースが前記第1のシャフトおよび前記第2のシャフトに対して軸方向に移動するように前記第1のシャフトに対して回転可能であるように構成され、
前記人工弁全体が前記送達シースの中から展開された後、前記縫合糸ループを介して前記縫合糸保持部材に接続されている間に、前記送達シースは、前記縫合糸ループにおける張力が増し、前記自己膨張型ステントの前記頂点を径方向につぶれるように、前記縫合糸ループの上で遠位方向に送られて戻され、これにより、前記送達シースが前記人工弁の上で遠位方向に送られて戻されることで、前記人工弁は、前記人工弁が前記送達シースによって再び取り込まれるときに径方向につぶれうるシステム。 - 前記第2のシャフトの遠位端に接続されたネジと、
前記ネジに装着され、前記送達シースに接続されたナットであって、前記第2のシャフトおよび前記ネジの回転により前記ネジに対して前記ナットが軸方向に移動し、これによって前記送達シースの軸方向の移動が生じるようなナットと、
をさらに備える請求項10に記載のシステム。 - 前記送達シースの前記近位端部分は、長さが約2cmから約35cmまでの間である請求項10に記載のシステム。
- 前記第1のシャフトの前記遠位端部分は、前記送達シースを貫通して延在し、溝付き金属チューブを備える請求項10に記載のシステム。
- 前記第1のシャフトの前記遠位端部分に接続された縫合糸保持部材と、
前記縫合糸保持部材から延在する複数の縫合糸ループであって、前記人工弁のフレーム内の開口部を貫通して延在するように構成された複数の縫合糸ループと、
前記縫合糸保持部材および前記縫合糸ループを貫通して延在し、前記人工弁を前記縫合糸保持部材に解放可能に固定するように構成された少なくとも1つの摺動可能な解放部材と、
をさらに備える請求項10に記載のシステム。 - 前記縫合糸保持部材は、近位部分と、第1の部分から軸方向に隔てて並ぶ遠位部分とを備え、
前記解放部材は、前記縫合糸保持部材の前記近位部分および前記遠位部分を貫通して延在する第1の位置と前記解放部材が前記縫合糸保持部材の前記遠位部分の近位の場所まで引っ込められる第2の位置との間で、前記縫合糸保持部材に対して摺動可能であり、
前記解放部材が前記第1の位置にあり、前記縫合糸ループが前記フレームの前記開口部を貫通し、前記近位部分と前記遠位部分との間の場所で前記解放部材の周りに延在するときに、前記人工弁は、前記縫合糸保持部材に固定され、
前記解放部材が前記第2の位置にあるときに、前記縫合糸ループは、前記解放部材の遠位端から離れて摺動し、前記人工弁を前記縫合糸保持部材から解放することができる請求項14に記載のシステム。 - 前記少なくとも1つの解放部材は、前記縫合糸保持部材を貫通して延在する複数の解放部材を備える請求項14に記載のシステム。
- 外側シースの前記近位端部分は、溝付き金属チューブを備える請求項10に記載のシステム。
- 前記外側シースの前記遠位端部分は、前記溝付き金属チューブの遠位端に接続された送達カプセルを備え、前記送達カプセルは前記人工弁の上に延在し、前記人工弁を前記圧縮された送達状態に保持するように構成される請求項17に記載のシステム。
- 前記送達カプセルは、ポリマースリーブを備える請求項18に記載のシステム。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US201361825476P | 2013-05-20 | 2013-05-20 | |
US61/825,476 | 2013-05-20 | ||
PCT/US2014/038852 WO2014189977A1 (en) | 2013-05-20 | 2014-05-20 | Prosthetic heart valve delivery apparatus |
Publications (2)
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JP2016518948A JP2016518948A (ja) | 2016-06-30 |
JP6515088B2 true JP6515088B2 (ja) | 2019-05-15 |
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JP2016515032A Active JP6515088B2 (ja) | 2013-05-20 | 2014-05-20 | 人工心臓弁送達装置 |
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US (3) | US9867700B2 (ja) |
EP (3) | EP3326583B1 (ja) |
JP (1) | JP6515088B2 (ja) |
CN (2) | CN107334563B (ja) |
CA (3) | CA3134578C (ja) |
CR (1) | CR20150514A (ja) |
ES (2) | ES2699785T3 (ja) |
MX (1) | MX361339B (ja) |
SG (1) | SG11201508180PA (ja) |
TR (1) | TR201816620T4 (ja) |
WO (1) | WO2014189977A1 (ja) |
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CA2908342A1 (en) | 2014-11-27 |
EP3326583A1 (en) | 2018-05-30 |
CN105188612B (zh) | 2017-08-08 |
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US9867700B2 (en) | 2018-01-16 |
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CA3134578C (en) | 2024-01-02 |
EP3482718A1 (en) | 2019-05-15 |
EP2999436A1 (en) | 2016-03-30 |
CA3219973A1 (en) | 2014-11-27 |
SG11201508180PA (en) | 2015-12-30 |
CA2908342C (en) | 2021-11-30 |
CN107334563B (zh) | 2019-05-14 |
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EP2999436A4 (en) | 2017-05-17 |
EP3482718B1 (en) | 2021-12-01 |
MX2015013829A (es) | 2016-03-01 |
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