JP7431459B2 - 心臓弁膜置換システムおよびその方法 - Google Patents
心臓弁膜置換システムおよびその方法 Download PDFInfo
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- JP7431459B2 JP7431459B2 JP2022004461A JP2022004461A JP7431459B2 JP 7431459 B2 JP7431459 B2 JP 7431459B2 JP 2022004461 A JP2022004461 A JP 2022004461A JP 2022004461 A JP2022004461 A JP 2022004461A JP 7431459 B2 JP7431459 B2 JP 7431459B2
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Description
Claims (20)
- 病的な心臓弁の生来の弁尖を置き換えるための人工心臓弁であって、前記人工心臓弁は、
ステントであって、当該ステントはフレームを含み、当該フレームは、
動作位置で病的な心臓弁の生来の弁輪の少なくとも一部に及ぶように構成される上部のフレア状の部分と、
生来の弁輪のほんの一部にまたがり、動作位置で少なくとも1つの生来の弁尖の動的な運動を可能にするように構成される、前記フレームの周囲に部分的にのみ伸びる下部の心室部分とを含む、
フレームを含む、ステントと、
前記フレームの内側表面に取り付けられ、当該内側表面から放射状に内側へ伸長する少なくとも1つの人工弁尖であって、当該少なくとも1つの人工弁尖は動作位置で心周期中に開口位置から閉鎖位置まで可動であるように構成される、少なくとも1つの人工弁尖と、
前記フレームの少なくとも一部に取り付けられるシーリングスカート、および、
少なくとも1つの誘導と固定の二重式の部材であって、当該少なくとも1つの誘導と固定の二重式の部材は、少なくとも一部を生来の組織に植え込むように構成され、かつ、少なくとも一部に前記フレームを選択的に係合して生来の弁輪に誘導し、前記フレームを動作位置で生来の弁輪に対して固定するように構成される、少なくとも1つの誘導と固定の二重式の部材と、
を含む、人工心臓弁。 - 病的な心臓弁の生来の弁尖を置き換えるための人工心臓弁であって、前記人工心臓弁は、
病的な心臓弁の生来の弁尖内に展開される時、送達中に圧縮位置に圧縮可能であり動作位置に拡張可能なステントであって、当該ステントは動作位置で生来の弁尖の円周の周辺に完全に伸長するように構成される上部のフレア状の部分、および生来の弁尖の円周の周辺に部分的にのみ伸長し、動作位置で少なくとも1つの生来の弁尖の動的な運動を可能にするように構成される下部の心室部分を含むフレームを含む、ステント、
前記フレームの内側表面に取り付けられ、当該フレームの内側表面から放射状に内側へ伸長する少なくとも1つの人工弁尖であって、当該少なくとも1つの人工弁尖は動作位置で心周期中に開口位置から閉鎖位置まで可動であるように構成される、少なくとも1つの人工弁尖、
前記フレームの少なくとも一部に取り付けられるシーリングスカート、および、
複数の細長い誘導と固定の二重式の部材であって、各部材は生来の弁輪上または生来の弁輪周辺の生来の組織に植え込むように構成される第1の部分、送達中に生来の弁輪へとフレームを誘導するように構成される第2の部分、および生来の弁輪に対して前記フレームを固定する第3の部分を含む、複数の細長い誘導と固定の二重式の部材、
を含む、人工心臓弁。 - 病的な心臓弁の生来の弁尖を置き換えるための人工心臓弁であって、前記人工心臓弁は、
病的な心臓弁の生来の弁尖内に配置される時、送達中に圧縮位置に圧縮可能であり動作位置に拡張可能なステントであって、当該ステントは動作位置で生来の弁尖の円周の周辺に完全に伸長するように構成される上部のフレア状の部分、および少なくとも1つの生来の弁尖をカバーするために生来の弁尖の円周の周辺に部分的にのみ伸長し、動作位置で少なくとも1つの他の生来の弁尖の動的な運動を可能にするように構成される下部の心室部分を含むフレームを含む、ステント、
前記フレームの内側表面に取り付けられ、当該フレームの内側表面から放射状に内側へ伸長する少なくとも1つの人工弁尖であって、当該少なくとも1つの人工弁尖は動作位置で心周期中に開口位置から閉鎖位置まで可動であるように構成される、少なくとも1つの人工弁尖、
前記フレームの少なくとも一部に取り付けられるシーリングスカート、および、
複数の細長い誘導と固定の二重式の部材であって、各部材は生来の弁輪上または生来の弁輪周辺の生来の組織に植え込むように構成される第1の部分、送達中に生来の弁輪へとフレームを誘導するように構成される第2の部分、および生来の弁輪に対して前記フレームを固定する第3の部分を含む、複数の細長い誘導と固定の二重式の部材、
を含む、人工心臓弁。 - 前記ステントは圧縮位置から伸長された動作位置まで選択的に伸長可能である、請求項1または2に記載の人工心臓弁。
- 動作位置で、前記上部のフレア状の部分は病的な心臓弁の生来の弁輪の全円周をカバーする、請求項1に記載の人工心臓弁。
- 前記上部のフレア状の部分は、展開中に前記人工心臓弁を誘導し、および/または上部のフレア状の部分を生来の弁輪に固定するために少なくとも1つのアンカーテザーの少なくとも一部が通過できるように構成される上部のフレア状の部分を通って伸長する少なくとも1つの開口部を含む、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記少なくとも1つの誘導と固定の二重式の部材は、複数の誘導と固定の二重式の部材を含み、前記上部のフレア状の部分は、展開中に前記人工心臓弁を誘導し、および/または前記上部のフレア状の部分を生来の弁輪に固定するために、前記誘導と固定の二重式の部材のそれぞれのアンカーテザーの少なくとも一部が通過できるように構成される上部のフレア状の部分を通って伸長する少なくとも複数の開口部を含む、請求項1に記載の人工心臓弁。
- 前記上部のフレア状の部分は、展開中に前記人工心臓弁を誘導し、および/または前記上部のフレア状の部分を生来の弁輪に固定するために、前記誘導と固定の二重式の部材のそれぞれのアンカーテザーの少なくとも一部が通過できるように構成される上部のフレア状の部分を通って伸長する少なくとも複数の開口部を含む、請求項2または3に記載の人工心臓弁。
- 前記開口部の各々は円形、正方形、菱形、三角形または非対称の形状のうちの1つを含む、請求項7または8に記載の人工心臓弁。
- 前記開口部の各々は約0.2mm2~2mm2の間の開口区域を有する、請求項7または8に記載の人工心臓弁。
- 前記フレームの前記上部のフレア状の部分は前記フレームの環状寸法を縮小するための機構を含む、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記フレームは当該フレームの対向端の間を伸長する長手方向軸を画定し、前記上部のフレア状の部分は長手方向軸に沿って前記ステントの前記下部の心室部分に対する角度を90度と150度(90~150度)の間で画定する、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記フレームの前記下部の心室部分の円周領域はその円周に沿って異なる長さを有する、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記フレームの前記下部の心室部分は、前記ステントが生来の弁輪に対して動作可能に位置づけられた時、病的な心臓弁の生来の弁尖を捕らえるように構成される1つ以上の特徴を含む、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記1つ以上の特徴は病的な心臓弁の生来の弁尖を捕らえるように構成される1つ以上のフランジ、フック、コイル、またはクリップを含む、請求項14に記載の人工心臓弁。
- 前記少なくとも1つの人工弁尖は少なくとも1つの突起構造で構成される、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記少なくとも1つの突起構造は複数の突起構造を含む、請求項16に記載の人工心臓弁。
- 前記フレームの周囲に部分的にのみ伸びる前記下部の心室部分は部分的な円柱形状または部分的な円錐形状を含む、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記少なくとも1つの人工弁尖が、前記フレームの前記下部の心室部分の内側表面に据え付けられ、そこから半径方向内側に延びる、請求項1から3のいずれか1つに記載の人工心臓弁。
- 前記フレームの前記下部の心室部分が、第1の生来の弁尖のみを捕捉し、第2の生来の弁尖は自由に動けるままであるように構成され、
前記少なくとも1つの人工弁尖は、前記フレームの前記下部の心室部分の内部表面に取り付けられ、当該内部表面から半径方向内側に延びて、前記第1の生来の弁尖のみを置換する、
請求項1から3のいずれか1つに記載の人工心臓弁。
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CN113331997A (zh) | 2021-09-03 |
US20210275305A1 (en) | 2021-09-09 |
US20170258589A1 (en) | 2017-09-14 |
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EP3426195A4 (en) | 2019-11-20 |
CN109069273A (zh) | 2018-12-21 |
EP3426195A1 (en) | 2019-01-16 |
JP7015609B2 (ja) | 2022-02-03 |
JP2019507664A (ja) | 2019-03-22 |
WO2017156133A1 (en) | 2017-09-14 |
US11007057B2 (en) | 2021-05-18 |
CN109069273B (zh) | 2021-06-29 |
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