JP6648196B2 - 人工心臓弁送達装置 - Google Patents
人工心臓弁送達装置 Download PDFInfo
- Publication number
- JP6648196B2 JP6648196B2 JP2018110963A JP2018110963A JP6648196B2 JP 6648196 B2 JP6648196 B2 JP 6648196B2 JP 2018110963 A JP2018110963 A JP 2018110963A JP 2018110963 A JP2018110963 A JP 2018110963A JP 6648196 B2 JP6648196 B2 JP 6648196B2
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- Prior art keywords
- shaft
- prosthetic valve
- delivery device
- sheath
- handle
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Active
Links
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Classifications
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Landscapes
- Health & Medical Sciences (AREA)
- Cardiology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Life Sciences & Earth Sciences (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
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Description
12 膨張性フレーム部材またはステント
14 可撓性尖部セクション
16 ストラット
18 ノード
20 一般的に円筒形の「上側」または流出端部分
22 外向きに弓なりに曲がるか、または膨らんだ中間セクション
24 内向きに弓なりに曲がる「下側」または流入端部分
26 流入端部
27 流出端部
28 大動脈弁輪
30 保持アーム、支柱
32 開口
34a、34b、34c 尖部
36 補強セクション
38 上側縁部分
42 弁輪補強スカート
44 縫合線
46 内部補強ストリップ
48 縫合糸
50 縫合糸
52 矢印
56 バルサルバ洞
58 自然尖部
60 流入端部分
62 流出端部分
100 送達装置
102 第1の、一番外側の、または主カテーテル
104 細長いシャフト
106 送達用シース
108 第2の中間カテーテル
110 細長いシャフト
112 細長いネジ
114 弁保持機構
118 第3のノーズコーンカテーテル
120 細長いシャフト
122 前金具またはノーズコーン
126 遠位セグメント
126' セグメント
128 リング
130 外フォーク
132 内フォーク
134 突起部
136 突起部
136a 遠位端部分
138 基部
140 開口部
150 ねじ切りしたナット
154 脚部
160 複数の相互接続された円形バンドもしくはリンク
162 プルワイヤ
164 位置
166 近位セグメント
168 屈曲制御機構
170 結合部材
172 開口部
174 近位端部分
176 中間セクション
178 縦溝、または陥凹部
180 近位端
186 回転可能なハウジング、またはハンドル部分
188 スライドナット
192 レール
202 ハンドル
204 カテーテルアセンブリ
212 環状溝
214 ラッチ機構
216 係合部分
218 ボタン
220 バネ
222 駆動されるナット
224 駆動シリンダー
226 電気モーター
228、230 歯車
232 電池コンパートメント
234 オペレータボタン
236 拡大された遠位端部分
238 取付具
240 近位端部分
242 可撓性側板
244 主ハウジング
246 Oリング
300 送達装置
302 第1の外側カテーテル
304 細長いシャフト
306 弁保持機構
308 ハンドル部分
310 第2のトルクカテーテル
312 細長いトルクシャフト
314 可撓性ネジ機構
316 可撓性シャフト
318 ネジ部材
320 制御つまみ
322 移動可能なシース
324 第3のノーズカテーテル
326 細長いシャフト
328 ノーズピース
330 外フォーク
332 内フォーク
334 ヘッド部分
336 細長い可撓性突起部
338 保持フランジ
340 ヘッド部分
342 突起部
344 開口
346 ハウジング
348 第1の歯車
350 第2の歯車
358 突起部
360 開口
362 フィンガー
402 シャフト
500 外フォーク
502 突起部
600 外フォーク
602 突起部
700 トルクシャフト
701 セクション
701a 遠位セグメント
701b 近位セグメント
702 輪状金属リンク
704 脚部
706 脚部
710 中間セクション
800 ローディングコーン
802 円錐状の第1のセクション
804 細長い円柱状の第2のセクション
806 比較的短い円錐状の第3のセクション
808 細長い円錐状の第4のセクション
810 可撓性脚部
814 リング
900 ローディングコーン
1000 シース
1002 可撓性フラップ
1004 補強リング
1100 シース
1102 可撓性ポリマースリーブ
1104 外側円柱状金属チューブ
1200 ローディングコーン
1202 プランジャ
1204 細長いシャフト
1206 ハンドル
1208 円錐状の第1のセクション
1210 円柱状の第2のセクション
1212 円柱状の第3のセクション
1214 円柱状の第4のセクション
1216 陥凹部
1218 リブ
1300 送達装置
1400 送達装置
1402 ネジ
1404 バネ
1406 近位端
1408 バネ
1500 送達装置
1502 トルクシャフト
1504 近位セグメント
1506 遠位セグメント
1508 リングもしくは固定円板
1512 バネ
1600 送達装置
1700 送達装置
1702 近位セグメント
1704 ネジ
1706 遠位セグメント
1708 バネ
2000 シース
2002 ハウジング、またはハブ
2004 スリーブ、またはカニューレ
2006 チューブ状層
2007 円形バンド
2008 開口部
2010 接続部分
2012 バンド
2014 開口部
2016 接続部分
2018 外層
2020 内層
2100 スリーブ
2102 円形バンド
2104 2つのリンク、または接続部分
2200 スリーブ
2202 円形のバンド
2204 リンク
2206 切欠、または開口
2300 コイル
2302 ワッシャ、またはブレード
2304 中心部の開口
2306 内歯
2308 陥凹部もしくは溝
2400 ステント
2402 第1の端部
2404 第2の端部
2406 保持アーム
2410 頂点
2412a、1412b ストラット
2412c 第3のストラット
2414 自由頂点
3000 保管用チューブアセンブリ
3002 前部保管部分
3004 後部保管用チューブ部分
3005 キャップ部分
3006 移送用チューブ
3007 延長部分
3008 アタッチメントスペーサー
3010 近位突起部、またはトライデント
3012 溝
3013 陥凹部分
3014 中間ハブ部分
3016 遠位突起部
3018 取付用工具
3019 端部
3020 ハウジング部分
3022 係止クリップ
3024 一般的に円柱状の近位部分
3026 一般的に円柱状の拡大された遠位部分
3028 開口、もしくはウィンドウ
3030 底部係止コンポーネント
3034 取付用プランジャ
3036 ガイドレール
3037 陥凹部
3038 スリーブ
3040 近位端部分
3042 係止アーム
3044 嵌合開口部
3046 係止爪
3050 弁捲縮機
3052 主シリンダー
3054 尖部たくし込みウィンドウ
3056 たくし込み工具
3060 係止爪
3062 溝
3064 テーパー付き表面
3066 内側ボア
3068 内側ボア
3070 輪状リップ部
Claims (16)
- 経血管人工心臓弁送達装置用の電動式のハンドルであって、前記ハンドルは、前記経血管人工心臓弁送達装置のカテーテルアセンブリの近位端に着脱可能に連結されるように構成され、前記カテーテルアセンブリは、外側シャフトと、前記外側シャフト内の内側トルクシャフトと、を有しており、前記ハンドルは、
使用者が手で保持するように構成されたハウジングを備え、前記ハウジングは;
遠位開口部;
前記内側トルクシャフトを回転させるために前記ハウジング内に取り付けられた電動機構;及び
前記カテーテルアセンブリと係合するためのハウジング内の保持機構;
を備え、
前記遠位開口部が、前記カテーテルアセンブリの前記近位端を受容するように構成され、これにより、前記内側トルクシャフトの近位端が前記ハンドル内に位置し、かつ、前記電動機構と着脱可能に連結し、これにより、前記保持機構が、前記外側シャフトの近位端を前記ハンドルに着脱可能に連結し、これにより、軸方向及び回転方向において固定された位置で前記外側シャフトを保持し、
前記ハンドルが前記カテーテルアセンブリに結合されると、前記電動機構が、作動すると、前記外側シャフトに対して前記内側トルクシャフトを回転させるように構成されることを特徴とするハンドル。 - 前記電動機構は、モーター、駆動シリンダー、及び、ギヤ、を備え、前記内側トルクシャフトは、前記駆動シリンダーに着脱可能に連結されており、前記駆動シリンダーは、前記ギヤを介して前記モーターに作動可能に結合されることを特徴とする請求項1に記載のハンドル。
- 前記電動機構は、シャフトを有するモーターを備え、前記内側トルクシャフトは、前記シャフトの端部に直接連結されることを特徴とする請求項1に記載のハンドル。
- 前記ギヤは、前記モーターに固定された第1のギヤと、前記駆動シリンダーに固定された第2のギヤと、を備え、前記第1のギヤは、前記モーターから前記駆動シリンダーに回転を伝達するように前記第2のギヤと噛合していることを特徴とする請求項2に記載のハンドル。
- 前記カテーテルアセンブリの前記内側トルクシャフトの近位端は、前記駆動シリンダーにより係合され、これにより、前記モーターが前記駆動シリンダーを回転させるように作動可能であり、これにより、前記内側トルクシャフトを回転させることを特徴とする請求項2または4に記載のハンドル。
- 前記モーターは、第1の回転軸を有し、前記駆動シリンダーは、前記第1の回転軸とは異なる第2の回転軸を有し、前記第1の回転軸は、前記第2の回転軸と平行であり、かつ、前記第2の回転軸から半径方向にオフセットされていることを特徴とする請求項2、4及び5のいずれか一項に記載のハンドル。
- 前記駆動シリンダーは、前記駆動シリンダーを貫通して延在する貫通開口部を有し、前記貫通開口部は、前記内側トルクシャフトの近位端の形状に対応する形状であり、これにより、前記駆動シリンダーの回転が、前記内側トルクシャフトを回転させることを特徴とする請求項2、及び4から6のいずれか一項に記載のハンドル。
- 前記駆動シリンダーの前記貫通開口部は、前記内側トルクシャフトの近位端のナットの平坦部に対応するように形状であることを特徴とする請求項7に記載のハンドル。
- 前記ハンドルが前記カテーテルアセンブリに結合された際に、前記内側トルクシャフトの近位端が、前記ハウジングの遠位開口部を貫通して挿入され、かつ、前記駆動シリンダーの前記貫通開口部に挿入され、前記保持機構は、前記ハンドルに対して軸方向の位置に前記カテーテルアセンブリを保持し、前記駆動シリンダーが回転する際に前記内側トルクシャフトの近位端が前記駆動シリンダーの前記貫通開口部内に保持されることを特徴とする請求項7または8に記載のハンドル。
- 前記保持機構は、前記外側シャフトが前記ハンドルに対して軸方向に移動することを防止するように前記外側シャフトの溝内に延在するラッチを備えることを特徴とする請求項1から9のいずれか一項に記載のハンドル。
- 前記保持機構が、前記保持機構を前記カテーテルアセンブリと係合する位置に付勢するバネを備えることを特徴とする請求項1から10のいずれか一項に記載のハンドル。
- 前記保持機構に連結された解放ボタンをさらに備え、前記解放ボタンを押すことによって、前記保持機構が前記カテーテルアセンブリから外れることを特徴とする請求項1から11のいずれか一項に記載のハンドル。
- 使用者が前記電動機構を作動させることを可能にするハンドル上のオペレータボタンをさらに備えることを特徴とする請求項1から12のいずれか一項に記載のハンドル。
- 請求項1から13のいずれか一項に記載のハンドルと、前記カテーテルアセンブリと、備えることを特徴とする経血管人工心臓弁送達装置。
- 前記カテーテルアセンブリ内の前記内側トルクシャフトの回転により、前記カテーテルアセンブリの送達シースを前記カテーテルアセンブリの遠位端に配置された人工心臓弁の軸方向外方に動かせることを特徴とする請求項14に記載の装置。
- 前記カテーテルアセンブリ内の前記内側トルクシャフトの回転は、前記カテーテルアセンブリの送達シースが、前記カテーテルアセンブリの遠位端に位置する人工心臓弁から離間して、または、人工心臓弁の上で軸方向に移動させる効果があり、前記モーターは一方向に回転させることにより、前記送達シースを引き、前記人工心臓弁を露出させることを可能にし、前記モーターを第2の反対方向に回転させることにより、前記送達シースが前記人工心臓弁を超えて遠位に移動することを可能にすることを特徴とする請求項2から9のいずれか一項に記載のハンドル。
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US201161446972P | 2011-02-25 | 2011-02-25 | |
US61/446,972 | 2011-02-25 | ||
US13/405,119 US9155619B2 (en) | 2011-02-25 | 2012-02-24 | Prosthetic heart valve delivery apparatus |
US13/405,119 | 2012-02-24 |
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EP (13) | EP4035625A1 (ja) |
JP (3) | JP6017460B2 (ja) |
CN (2) | CN105287052B (ja) |
AU (1) | AU2012222080B2 (ja) |
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