JP7277436B2 - 心臓弁搬送装置用歯車駆動機構 - Google Patents
心臓弁搬送装置用歯車駆動機構 Download PDFInfo
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- 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
- A61F2/243—Deployment by mechanical expansion
-
- 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
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3468—Trocars; Puncturing needles for implanting or removing devices, e.g. prostheses, implants, seeds, wires
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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
- A61F2/2439—Expansion controlled by filaments
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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
- A61F2/2442—Annuloplasty rings or inserts for correcting the valve shape; Implants for improving the function of a native heart valve
- A61F2/2466—Delivery devices therefor
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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
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
- A61B2017/00389—Button or wheel for performing multiple functions, e.g. rotation of shaft and end effector
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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
- A61F2002/9511—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 the retaining means being filaments or wires
Description
開示された実施形態を、心臓の自然弁輪(たとえば、肺動脈弁輪、僧帽弁輪、および三尖弁輪)のいずれかに人工デバイスを搬送し移植するように適合することができ、かつ様々な搬送手法(たとえば、逆行性、順行性、経中隔、経心室、経心房)のいずれかとともに使用することができることを理解されたい。開示された実施形態は、人体の他の内腔にプロテーゼを移植するために使用することもできる。さらに、本明細書に記載された搬送アセンブリ実施形態を、人工弁に加えて、ステントおよび/または他の人工修復デバイスなどの様々な他の人工デバイスを搬送し移植するように適合することができる。
102 フレーム
104 流入端部
106 流出端部
108 ラティスストラット
110 弁構造
112 リーフレット
114 頂点
118 孔
122 留め具
124 流出端
130 アクチュエータ
132 ロッド
134 スリーブ
136 ナット
138 取付け部材
140 切欠き
142 突起
200 人工弁搬送装置
210 ハンドル
212 モータ
220 カテーテル
224 入力トルクシャフト
226 たわみ軸
230 ギアボックス
232 ギアボックスハウジング
234 駆動歯車
235 内歯
236 管状部分
238 近位プレート
239 遠位プレート
240 出力トルクシャフト
242 被駆動歯車
250 ノーズコーン
252 最内シャフト
254 遠位端部
256 近位開口部
258 遠位端部
260 中央開口部
264 開口部
266 遠位端部
268 突起
270 スリーブ
274 アイドラピニオン歯車
275 歯
278 ピニオン歯車
279 被駆動ピニオン歯車
280a、280b、282 ボタン
284 停止ボタン
286 ビジュアルディスプレイ
288a、288b ボタン
Claims (15)
- ハンドルと、
前記ハンドルの外部に配置されたギアボックスと、
前記ハンドルから遠位方向に延び、前記ギアボックスに動作可能に接続された遠位端部を有する入力トルクシャフトと、
前記ギアボックスに動作可能に接続され、前記ギアボックスから遠位方向に延びる複数の出力トルクシャフトであって、前記入力トルクシャフトを回転させると、前記ギアボックスを介して前記出力トルクシャフトが回転する、出力トルクシャフトと、
を備える、人工弁搬送装置。 - 前記ハンドル内に配置されたモータであって、前記モータは、前記入力トルクシャフトの近位端部に動作可能に接続され、前記モータを作動させると、前記入力トルクシャフトが回転する、モータをさらに備える、請求項1に記載の人工弁搬送装置。
- 前記ギアボックスは、
前記入力トルクシャフトに動作可能に接続され、前記入力トルクシャフトによって駆動される駆動歯車と、
前記駆動歯車によって駆動されるように構成された複数の被駆動歯車であって、各被駆動歯車は、前記出力トルクシャフトのうちの1つに動作可能に接続され、前記出力トルクシャフトのうちの1つを回転させる、被駆動歯車と、
を備える、請求項1または2に記載の人工弁搬送装置。 - 前記駆動歯車は内歯歯車を備え、前記被駆動歯車は、前記内歯歯車の内部に位置するピニオン歯車を備える、請求項3に記載の人工弁搬送装置。
- 前記駆動歯車は、前記入力トルクシャフトの前記遠位端部に取り付けられ、各被駆動歯車は、前記出力トルクシャフトのうちの1つに取り付けられる、請求項3または4に記載の人工弁搬送装置。
- 前記駆動歯車は、各被駆動歯車の歯と噛み合う歯を有する、請求項3から5のいずれか一項に記載の人工弁搬送装置。
- 前記ギアボックスは、前記駆動歯車から前記被駆動歯車のうちの1つに回転運動を伝達するように構成された少なくとも1つのアイドラ歯車をさらに備える、請求項3から6のいずれか一項に記載の人工弁搬送装置。
- 前記複数の出力トルクシャフトは3つの出力トルクシャフトを備える、請求項1から7のいずれか一項に記載の人工弁搬送装置。
- 各出力トルクシャフトは、人工心臓弁上のアクチュエータとの取外し可能な接続部を形成するように構成されたコネクタを出力トルクシャフトの遠位端に備える、請求項1から8のいずれか一項に記載の人工弁搬送装置。
- 前記入力トルクシャフトは、前記人工弁搬送装置の中央長手方向軸と同一線上の中央回転軸を画定し、各出力トルクシャフトは、前記人工弁搬送装置の前記中央長手方向軸からずれた回転軸を画定する、請求項1から9のいずれか一項に記載の人工弁搬送装置。
- 前記人工弁搬送装置が、半径方向に拡張可能および圧縮可能なフレームと、前記フレームを半径方向に拡張および圧縮するように構成された複数のアクチュエータと、を備える人工弁と組み合わされ、各出力トルクシャフトは、アクチュエータのねじに取外し可能に結合されて、回転運動を前記出力トルクシャフトから前記ねじに伝達し、それによって、前記ねじを回転させると、前記フレームが半径方向に拡張するかまたは圧縮される、請求項1から10のいずれか一項に記載の人工弁搬送装置。
- 前記入力トルクシャフトは、前記人工弁搬送装置の長さの少なくとも大部分にわたって延びる、請求項1から11のいずれか一項に記載の人工弁搬送装置。
- 人工弁搬送アセンブリであって、
半径方向に拡張可能および圧縮可能なフレームと、前記フレームを半径方向に拡張および圧縮するように構成された複数のアクチュエータと、を備える人工弁と、
ハンドルと、前記ハンドルから延びる入力トルクシャフトと、前記ハンドルの外部に配置されかつ前記入力トルクシャフトの遠位端部に結合された歯車機構と、前記歯車機構に結合され前記歯車機構から遠位方向に延びる複数の出力トルクシャフトと、を備える搬送装置と、
を備え、
前記歯車機構は、前記入力トルクシャフトの回転運動を前記出力トルクシャフトに伝達し、
各出力トルクシャフトは、前記アクチュエータのうちの1つに取外し可能に結合され、それにより、前記出力トルクシャフトの回転によって前記アクチュエータが前記人工弁を半径方向に拡張させるかまたは圧縮する、アセンブリ。 - 前記入力トルクシャフトの前記遠位端部、前記歯車機構、および前記出力トルクシャフトは、患者の血管系内に挿入されるように構成される、請求項13に記載のアセンブリ。
- 前記歯車機構は、前記入力トルクシャフトの前記遠位端部に動作可能に接続された駆動歯車と、前記駆動歯車によって駆動されるように構成された複数の被駆動歯車と、を備え、各被駆動歯車は、前記出力トルクシャフトのうちの1つに動作可能に接続される、請求項13または14に記載のアセンブリ。
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US62/548,855 | 2017-08-22 | ||
US16/105,353 US10806573B2 (en) | 2017-08-22 | 2018-08-20 | Gear drive mechanism for heart valve delivery apparatus |
US16/105,353 | 2018-08-20 | ||
PCT/US2018/047441 WO2019040571A1 (en) | 2017-08-22 | 2018-08-22 | GEAR DRIVE MECHANISM FOR CARDIAC VALVE DISTRIBUTION APPARATUS |
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US (3) | US10806573B2 (ja) |
EP (1) | EP3672531A4 (ja) |
JP (2) | JP7277436B2 (ja) |
KR (1) | KR102630581B1 (ja) |
CN (2) | CN111194192B (ja) |
AU (1) | AU2018320846B2 (ja) |
CA (1) | CA3072761A1 (ja) |
CR (1) | CR20200070A (ja) |
SG (1) | SG11202001493UA (ja) |
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CR20200070A (es) | 2020-07-11 |
US20230270545A1 (en) | 2023-08-31 |
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AU2018320846A1 (en) | 2020-02-27 |
WO2019040571A1 (en) | 2019-02-28 |
CA3072761A1 (en) | 2019-02-28 |
JP2020531162A (ja) | 2020-11-05 |
CN111194192B (zh) | 2023-05-26 |
US20190060057A1 (en) | 2019-02-28 |
EP3672531A1 (en) | 2020-07-01 |
US20210015606A1 (en) | 2021-01-21 |
KR102630581B1 (ko) | 2024-01-29 |
US11648113B2 (en) | 2023-05-16 |
KR20200035156A (ko) | 2020-04-01 |
JP2023101530A (ja) | 2023-07-21 |
CN116509600A (zh) | 2023-08-01 |
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SG11202001493UA (en) | 2020-03-30 |
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