WO1983000617A1 - Leaflet attachment and method of attachment for prosthetic heart valves - Google Patents

Leaflet attachment and method of attachment for prosthetic heart valves Download PDF

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Publication number
WO1983000617A1
WO1983000617A1 PCT/US1982/001030 US8201030W WO8300617A1 WO 1983000617 A1 WO1983000617 A1 WO 1983000617A1 US 8201030 W US8201030 W US 8201030W WO 8300617 A1 WO8300617 A1 WO 8300617A1
Authority
WO
WIPO (PCT)
Prior art keywords
valve
frame
sections
supports
wire
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.)
Ceased
Application number
PCT/US1982/001030
Other languages
English (en)
French (fr)
Inventor
Hospital Supply Corporation American
Ernest Lane
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
American Hospital Supply Corp
Original Assignee
American Hospital Supply Corp
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by American Hospital Supply Corp filed Critical American Hospital Supply Corp
Priority to BR8207814A priority Critical patent/BR8207814A/pt
Priority to AT82902630T priority patent/ATE33342T1/de
Priority to DE8282902630T priority patent/DE3278310D1/de
Publication of WO1983000617A1 publication Critical patent/WO1983000617A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • 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
    • 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
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

Definitions

  • Prosthetic heart valves are used to replace diseased natural heart valves in the aortic, mitral, tri cuspid and pulmonary- positions in the heart. Exam- pies of three such valves are shown in Carpentier et al U.S. Patent No. 4,106,129, Ionescu et al U.S. Patent No. 4,084,268 and Davis et al U.S. Patent No. 4,192,020. As shown by these patents, a prosthetic heart valve typical- ly includes a frame formed of a wire or a shell and valve leaflets attached to the frame.
  • This invention provides a clamping action on
  • this invention utilizes the tensile force which tends to cause failure of the valve leaflet attachment means.
  • This tensile force reduces during valve opening, and this contributes to the variable nature of the clamping force.
  • the clamping force can be applied over a large area of the valve leaflet to further reduce the likelihood of damage to the leaflet.
  • This concept can be advantageously im lement- ed in a prosthetic heart valve which comprises a gener- ally annular frame having a plurality of commissure sup- ports, a resilient valve leaflet support attached to the frame adjacent a first frame section, and valve leaflet sheet material mounted on the frame to define a plural- ity of valve leaflets which are movable between open and closed positions.
  • the first of the valve leaflets is drivingly coupled to the resilient support so that a radial inward force on the first valve leaflet deflects the resilient support radially inwardly.
  • a region of the first valve leaflet extends between the resilient support and the first frame section.
  • the resilient sup- port and the first frame section are located so that the resilient support can deflect and press the region of the first valve leaflet against the first frame section in response to a- force which deflects the support ra- dially inwardly.
  • the resilient support and the frame cooperate to define a clamp which is operated by the tensile force which occurs during valve closure.
  • the valve leaflet sheet material includes a section of valve leaflet sheet material for each of the valve leaflets, and the valve leaflets are attached to each other.
  • the frame has two circu ferentially spac- ed frame sections defining an opening through which the valve leaflets extend, and each of the frame sections cooperates with the resilient support to clamp one of the valve leaflets during diastole.
  • the valve leaflets can be attached by sutures, and the clamp- ing substantially reduces the shearing stresses in the valve leaflets at the sutures.
  • Another advantage of this construction is that, when the valve leaflets open abruptly, e.g., systolic ejection through the aortic valve, the leaflet material can separate uniformly and closely simulate the ideal central flow orifice of a natural valve and distribute the stresses uniformly along the free edges of the valve leaflets. This is in contrast to valves which utilize a tuck stitch to hold the valve leaflets together radially inwardly of the frame at the commissures.
  • the tuck stitch which is eliminated by this invention, induces intensified stresses in the valve leaflet as the valve leaflets fully open. It has been postulated that these stresses can lead to early failure of the leaflet materia Broom, Neil D.
  • This invention also provides a resilient wire frame which maximizes the opening of the prosthetic heart valve and which has no sharp bends or kinks of the type which would reduce the valve opening or be in- compatible with the tissue with which it will be in contact during use.
  • the frame of this invention is con- structed of wire formed into an annular configuration and having a plurality of circumferentially spaced apic- al sections joined by curved sections, with each of the apical sections including a reverse bend. The apical sections extend in the same direction.
  • each of the curved sections is substantially elliptical as viewed in side elevation and forms a portion of an ellipse.
  • the frame can advantageously be constructed by a method which includes forming a wire into a gen- erally flat pattern, with the wire having a plurality of part-substantially elliptical sections joined by apical sections and with each of the apical sections including a reverse bend.
  • the apical sections extend in the same general direction, and the wire has oppo- site ends.
  • the flat pattern is then formed into an annu- lar configuration, and the opposite ends of the wire are joined to retain the wire in the annular configuration.
  • the means for joining the opposite ends of the wire inherently provide a discontinuity in the frame. To minimize the effect of this discontinuity, the wire terminates in straight, tangent sections of one of the apical sections, and the tangent sections are tangent to the associated reverse bend and the associated elliptical section, respectively.
  • the joining means can advantage- ously take the form of a splice which joins such tangent sections.
  • the valve of this invention has other advan- tageous features.
  • valve can be con- structed in two separate sub-assemblies, and then the two sub-assemblies are attached.
  • a fabric cover is attached to the wire frame to form one sub-assembly
  • valve leaflet sheet material is attached to valve leaflet supports to form a second sub-assembly.
  • the second sub-assembly is then inserted up into re- Steps formed by the first sub-assembly and attached in place.
  • Fig. 1 is a perspective view of a bioprosthe- tic heart valve constructed in accordance with the teach- ings of this invention.
  • Fig. 2 is a perspective view of a preferred form of wire frame, with the outline of the valve being shown in phantom lines.
  • Fig. 3 is a side elevational view of the wire formed into a flat pattern in the first step of making the wire frame.
  • Figs. 4-6 are line diagrams showing the center- line configuration of the wire frame in front elevation, side elevation and top plan, respectively.
  • Fig. 7 is a perspective view showing the co - pleted wire frame formed into an annular, frusto-conical configuration.
  • Fig. 1 is a perspective view of a bioprosthe- tic heart valve constructed in accordance with the teach- ings of this invention.
  • Fig. 2 is a perspective view of a preferred form of wire frame, with the outline of the valve being shown in phantom lines.
  • Fig. 3 is
  • Fig. 8 is a fragmentary view partially in sec- tion showing one form of splice for attaching the oppo- site ends of the wire together.
  • Fig. 9 is a perspective view similar to Fig. 7 showing a.subassembly which comprises the wire frame and a fabric cover.
  • Fig. 10 is a fragmentary perspective view with the fabric cover in section illustrating the fabric cov- er and frame at one of the commissure supports.
  • Fig. 11 is a plan view of one form of valve leaflet.
  • Fig. 12 is a perspective view of one form of resilient support.
  • Fig. 13 is a perspective view of the resil- ient support and a fabric skirt attached to the support.
  • Fig. 14 is a fragmentary perspective view of the resilient support-valve leaflet subassembly.
  • Fig. 15 is a fragmentary perspective view of the two subassemblies being stitched together, with portions of the fabric cover being broken away.
  • Fig. 16 is a perspective view illustrating the two subassemblies fully attached to each other.
  • Fig. 17 is a fragmentary sectional view taken generally along line 17-17 of Fig. 1, with the valve leaflets closed.
  • Fig. 18 is a fragmentary sectional view taken along line 17-17 of Fig. 1 with the valve leaflets open.
  • Fig. 1 shows a prosthetic heart valve 11 which generally comprises a frame 13 (Fig. 2) , three identical valve leaflets 15, 15a and 15b, and a suture ring 17.
  • the suture ring 17 is scalloped, and accordingly, the heart valve 11 is an aortic heart valve; however, this is merely illustrative inasmuch as the features of this invention are equally applicable to other heart valves which would employ suture rings of other configurations.
  • the valve leaflets 15, 15a and 15b may be tissue or be a synthetic material, such as film poly- tetrafluoroethylene.
  • the frame 13 is preferably constructed of a wire; however, certain features of this invention, such as the intermittent clamping feature, do not require that the frame be constructed of wire.
  • the frame may be constructed of various biocompatible materials, such as suitable metals, plastics or composite fibrous materials. For example, a suitable cobalt alloy, a polyolefin or a carbon reinforced, non-metallic material may be used.
  • the wire is formed into a flat pattern as shown in Fig. 3.
  • the wire has commissure supports 19, 21 and 23 integrally joined by curved sections 25, 27 and 29. Each of the commissure supports is identical and extends in the same direction.
  • Each of the commissure supports 19, 21 and 23 may be considered as forming, or includ- ing, an apical, section, each of which includes a reverse bend 31 and two tangents 33 joining the opposite ends of the associated reverse bend to the adjacent curved sec- tions.
  • the wire terminates at opposite ends 35 and 37 at one of the tangents 33 of the commissure support 19.
  • Each of the tangents 33 is linear, and the tangents 33 of each of the commissure supports diverge as they ex- tend away from the associated reverse bend 31.
  • each of the curved sections 25, 27 and 29 is identical and preferably forms a part of an ellipse.
  • each of the curved sections extends for 170 degrees
  • each of the reverse bends 31 is circular and also extends for 170 degrees.
  • the included angle formed by an extension of the axes of the tangents 33 of each of the commissure supports may be, for example, ten degrees. This speci- fie dimensional data is given by way of illustration only, and the concepts of this invention relating to the frame do not require these particular dimensions.
  • the flat pattern shown in Fig. 3 contains no kinks or sharp bends, and the tangents 33 blend smoothly into the adjacent reverse bends and curved sections.
  • the curved sections 25, 27 and 29 and the re- verse bends 31 provide no kinks or sharp corners.
  • the flat pattern of Fig. 3 is formed in- to an annular, cylindrical configuration, and the oppo- site ends 35 and 37 are joined together in any suitable manner, such as by splicing, using a sleeve 39 which is a cylindrical sleeve. Splicing together the opposite ends of a wire frame for a heart valve is shown in Carpentier et al U.S. Patent No. 4,106,129.
  • the frame of the present invention differs from the frame of the Carpentier et al patent in that the wire terminates in 12
  • the presence of the straight cylindrical sleeve 39 on the correspond- ingly straight tangent 33 for splicing the ends 35 and 37 does not alter the configuration of the wire or cause the wire to kink or form a sharp end.
  • the sleeve 39 would have to be care- fully correspondingly curved,and crimping of the curved sleeve to avoid kinks would be difficult. If a straight sleeve were used, it would cause kinks in the wire, which is undesirable.
  • the tangent 33 on which the sleeve 39 is carried may be considered as including tangent sections 41 and 43 which are splic- ed together by the sleeve 39.
  • the final step i " constructing the frame 13 is to form the cylin- drical annular configuration into a frusto-conical annu- lar configuration as shown in Figs. 2 and 7.
  • the commissure supports 19, 21 and 23 are inclined toward each other as they extend away from their associated curved sections 25, 27 and 29.
  • the configuration of the frame 13 in Fig. 2 is a frustum of a right circular cone with each of the commis- sure supports 19 being inclined radially inwardly at 13
  • the wire is formed from the flat configuration of Fig. 3 to the frusto-conical configuration of Fig. 2 (or Fig. 7) , the curved sec- tions 25, 27 and 29 remain in an elliptical configura- tion as viewed in side elevation, the tangents 33 remain straight and the reverse bends 31 remain part circular.
  • the aspect ratio of the partial ellipses form- ed by the curved sections 25, 27 and 29 is altered sorae- what.
  • the frame 13, including the commissure supports 19, 21 and 23, is resiliently flexible and can better
  • Figs. 4-6 illustrate how the wire frame 13 pro- vides a smoothly curved contour at all locations along the frame, and in particular, along and adjacent the •commissure support 23, it being understood that the com- missure supports 19 and 21 are identical to the commis- sure support 23.
  • Figs. 4-6 show the center line of the wire in line diagram form, and it can be seen that smooth curves exist in all three views.
  • Fig. 4 which is a sid elevational view, illustrates one half of the part ellip- tical configuration of the curved section 29.
  • the frame 13 is covered with a fabric cover 43, and the cover is attached to the frame in any suitable manner, such as by sutures 45.
  • the cover 43 completely encloses the wire frame 13 and has a pair of flaps 48 which extend radially outwardly of the frame.
  • the preferred method also includes forming a second subassembly as shown in Fig. 14 and attaching the two subassemblies as shown in Fig. 15.
  • This latter subassembly includes a plurality of identical, resil- ient, valve leaflet supports 49 (Fig. 12) .
  • the resilient support 49 is provided for each of the com- missure supports 19, 21 and 23, and accordingly, in the, embodiment illustrated, there are three of the resilient supports 49.
  • the resilient support 49 may be of various different constructions provided that it is resilient and that the valve leaflets 15-15b can be attached there- to.
  • the resilient support 49 is constructed of a suitable plastic material, such as Mylar, and it is elongated.
  • the resilient support 49 is of integral construction and has a relatively wide base 51, an elongated shank 53 with a curved upper end 55 and suture holes 57, 59 and 61. As shown in Fig. 12, the resilient support 49 is in the form of a relatively flat sheet, with side edges 60 and a radial outer face 62. 15
  • Each of the resilient supports 49 is then cov- ered with a fabric skirt 63, and the fabric skirt is at- tached to the support in any suitable manner, such as by a suture 65 which extends through the skirt 63 and one or more of the suture holes 57, 59 and 61 to define a seam 66 on the outer face 62.
  • the valve leaflets 15, 15a and 15b are formed of suitable valve leaflet sheet material. In the embodi ment illustrated, each of the valve leaflets 15, 15a and 15b is made up from an individual section of the valve sheet leaflet sheet material.
  • Fig. 11 shows one form that the valve leaflet 15 might assume when laid out flat, it being understood that the other valve leaflets may be identical. In the form shown in Fig.
  • the valve leaflet 15 has attaching tabs 67, an elliptical edge 69 extending between the tabs 67 and an edge 71 forming a shallow trough and extending from a lower (as viewed in Fig. 11) , central region outwardly to the tabs 67.
  • the dashed line in Fig. 11 shows the original con- figuration of the edge 71 before cutting.
  • the valve leaflets 15, 15a and 15b are attached to the resilient supports 49.
  • the valve leaflets 15 and 15a are attached to one of the resilient supports 49. In the embodiment illustrated, this is ac- complished by wrapping one of the tabs 67 of each of 16
  • these two leaflets part-way around the resilient support 49 and then attaching these tabs to the support 49 in any suitable manner, such as by sewing utilizing a su- ture 73.
  • the suture 73 extends through the tab 67, the skirt 63 and the suture holes 57 and 59. This forms a seam 75 which extends along the seam 66 on the outer face 62 of the resilient support 49.
  • the edges 71 extend radially inwardly from a location adjacent the upper end 55 of the support 49 to define commissures.
  • the elliptical edges 69 are draped over the side edges 60 of the support 49 and overlie portions of the outer face 62 of the support 49.
  • the construction shown in Fig. 14 is typical for the other two supports 49.
  • the other tab 67 of the valve leaflet 15 is attached to a tab 67 of the valve leaflet 15b at a second of the supports 49, and the other tabs 67 of the valve leaflets 15a and 15b are attached to the third resilient support 49.
  • the next step in the construction of the heart valve 11 is the insertion of the subassembly of Fig. 14 into the recesses 47 of the subassembly of Fig. 9 as shown in Figs. . 15 and 16. Specifically, the supports 49 are inserted into the recesses 47, respectively, to a location closely adjacent the reverse bends 31, with the 17
  • the valve leaflets 15 and 15a extend from the support 49 to which they are attached radially inwardly through the recess 47 and into the interior of the frame 13. With the two subassemblies in the position shown in Fig. 15, they are attached to each other, and this is preferably carried out in two stages. In the first stage, the supports 49 are attached to the asso- ciated commissure supports 19, 21 and 23 in any suitable manner, such as by a suture 76 ' which is passed through the tab 67 of the valve leaflets 15, 15a,the skirt 63, the suture holes 57 and 59, and passed over the reverse bend 31. This is done several times, and the suture is then suitably tied off.
  • This initial attachment step holds the two subassemblies together in the. proper orien- tation so that a marginal portion of the valve leaflets 15, 15a and 15b lying along the elliptical edges 69 can be attached to the cover 43 as by sewing utilizing a su- ture 77 as shown in Fig. 16.
  • the suture ring 17 is then attached to the frame 13 in any suitable manner, such as by sewing it to the cover 43, the flaps 48 are sewed closed, and woven cloth 78 (Fig. 16) is sewed to the out- side faces of the flaps to form the configuration of Fig. 1. 18
  • Figs. 17 and 18 further show the structural ori entation of the support 49 and the segments or tangents 33 of the frame and how they cooperate to provide a clamp- ing force on the valve leaflets.
  • the tangents 33 and the surrounding portions of the cover 43 are spaced circumfer- entially to define an opening which is a portion of the recess 47.
  • the support 49 is located radially outwardly of the opening and the tangents.
  • the seams 66 and 75 lie radially outwardly of the support 49 along the outer face 62. Regions of the leaflets 15 and 15a extend from the support 49 along a path which extends between the support and the segments 33 and through the opening to the inter- ior of the frame. Figs.
  • the clamping force on the leaflets also varies as the clamping force is a function of whatever forces act on the segments 33 and the support 49 to move them to clamp or unclamp the leaflet.
  • the ten ⁇ sile force F reduces, and the resilient support 49 resil ⁇ iently moves toward its normal position in which there is sufficient space between it and the tangents 33 to reduce the clamping force and, if desired, by appropriately selec ing the resilience of the supports 49 and the commissure supports, the clamping force can be periodically reduced to zero.
  • the clamping force provided is variable and can be made intermittent if desired.
  • the leaflets 15 and 15a separate uniformly and closely simulat the ideal central flow orifice of a natural valve and dis ⁇ tribute the stresses uniformly along the free edges of the $JSI

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • External Artificial Organs (AREA)
  • Compressor (AREA)
  • Materials For Medical Uses (AREA)
PCT/US1982/001030 1981-08-17 1982-07-29 Leaflet attachment and method of attachment for prosthetic heart valves Ceased WO1983000617A1 (en)

Priority Applications (3)

Application Number Priority Date Filing Date Title
BR8207814A BR8207814A (pt) 1981-08-17 1982-07-29 Processo de fixacao de folheto para valvulas de coracao proteticas
AT82902630T ATE33342T1 (de) 1981-08-17 1982-07-29 Befestigung der taschen an kuenstlichen herztaschenklappen.
DE8282902630T DE3278310D1 (en) 1981-08-17 1982-07-29 Leaflet attachment and method of attachment for prosthetic heart valves

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US293,667810817 1981-08-17
US06/293,667 US4501030A (en) 1981-08-17 1981-08-17 Method of leaflet attachment for prosthetic heart valves

Publications (1)

Publication Number Publication Date
WO1983000617A1 true WO1983000617A1 (en) 1983-03-03

Family

ID=23130033

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1982/001030 Ceased WO1983000617A1 (en) 1981-08-17 1982-07-29 Leaflet attachment and method of attachment for prosthetic heart valves

Country Status (10)

Country Link
US (1) US4501030A (enExample)
EP (2) EP0196116B1 (enExample)
JP (2) JPS58501263A (enExample)
AT (1) ATE49702T1 (enExample)
AU (2) AU562543B2 (enExample)
BR (1) BR8207814A (enExample)
CA (1) CA1186453A (enExample)
DE (2) DE3280091D1 (enExample)
MX (1) MX156341A (enExample)
WO (1) WO1983000617A1 (enExample)

Cited By (9)

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Publication number Priority date Publication date Assignee Title
US5258021A (en) * 1992-01-27 1993-11-02 Duran Carlos G Sigmoid valve annuloplasty ring
US5489297A (en) * 1992-01-27 1996-02-06 Duran; Carlos M. G. Bioprosthetic heart valve with absorbable stent
US5549665A (en) * 1993-06-18 1996-08-27 London Health Association Bioprostethic valve
WO1998043556A1 (en) * 1997-03-27 1998-10-08 Baxter International Inc. Natural tissue heart valves and methods of making same
US5861028A (en) * 1996-09-09 1999-01-19 Shelhigh Inc Natural tissue heart valve and stent prosthesis and method for making the same
AU774750B2 (en) * 1997-03-27 2004-07-08 Edwards Lifesciences Corporation Natural tissue heart valves and methods of making same
EP3009105A1 (en) * 2004-01-23 2016-04-20 Edwards Lifesciences Corporation Anatomically approximate prosthetic mitral heart valve
US9629717B2 (en) 2001-10-11 2017-04-25 Edwards Lifesciences Pvt, Inc. Prosthetic heart valve and method
US10022220B2 (en) 2000-04-06 2018-07-17 Edwards Lifesciences Corporation Methods of implanting minimally-invasive prosthetic heart valves

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IT1156682B (it) * 1982-10-14 1987-02-04 Pro Bio Spe Produz Biolog Spec Valvola biologica bicuspide a basso profilo
IT1208326B (it) * 1984-03-16 1989-06-12 Sorin Biomedica Spa Protesi valvolare cardiaca provvista di lembi valvolari di tessuto biologico
US4851000A (en) * 1987-07-31 1989-07-25 Pacific Biomedical Holdings, Ltd. Bioprosthetic valve stent
DE3834545A1 (de) * 1988-10-11 1990-04-12 Rau Guenter Flexibles schliessorgan, insbesondere herzklappe, und verfahren zur herstellung desselben
US5147391A (en) * 1990-04-11 1992-09-15 Carbomedics, Inc. Bioprosthetic heart valve with semi-permeable commissure posts and deformable leaflets
US5163955A (en) * 1991-01-24 1992-11-17 Autogenics Rapid assembly, concentric mating stent, tissue heart valve with enhanced clamping and tissue alignment
US5489298A (en) * 1991-01-24 1996-02-06 Autogenics Rapid assembly concentric mating stent, tissue heart valve with enhanced clamping and tissue exposure
US5755782A (en) * 1991-01-24 1998-05-26 Autogenics Stents for autologous tissue heart valve
US5258023A (en) * 1992-02-12 1993-11-02 Reger Medical Development, Inc. Prosthetic heart valve
US5713950A (en) 1993-11-01 1998-02-03 Cox; James L. Method of replacing heart valves using flexible tubes
US5425741A (en) * 1993-12-17 1995-06-20 Autogenics Tissue cutting die
US5522885A (en) * 1994-05-05 1996-06-04 Autogenics Assembly tooling for an autologous tissue heart valve
US5562729A (en) * 1994-11-01 1996-10-08 Biocontrol Technology, Inc. Heart valve
EP0813398A4 (en) * 1996-01-04 1999-11-17 Shelhigh Inc COMPOSITE HEART VALVE PROSTHESIS AND MANUFACTURING METHOD THEREOF
US6006134A (en) * 1998-04-30 1999-12-21 Medtronic, Inc. Method and device for electronically controlling the beating of a heart using venous electrical stimulation of nerve fibers
US5800531A (en) 1996-09-30 1998-09-01 Baxter International Inc. Bioprosthetic heart valve implantation device
US5910170A (en) * 1997-12-17 1999-06-08 St. Jude Medical, Inc. Prosthetic heart valve stent utilizing mounting clips
US6530952B2 (en) 1997-12-29 2003-03-11 The Cleveland Clinic Foundation Bioprosthetic cardiovascular valve system
US6334873B1 (en) 1998-09-28 2002-01-01 Autogenics Heart valve having tissue retention with anchors and an outer sheath
US6338740B1 (en) * 1999-01-26 2002-01-15 Edwards Lifesciences Corporation Flexible heart valve leaflets
US6558418B2 (en) * 1999-01-26 2003-05-06 Edwards Lifesciences Corporation Flexible heart valve
US6736845B2 (en) 1999-01-26 2004-05-18 Edwards Lifesciences Corporation Holder for flexible heart valve
US6231602B1 (en) 1999-04-16 2001-05-15 Edwards Lifesciences Corporation Aortic annuloplasty ring
US6296662B1 (en) 1999-05-26 2001-10-02 Sulzer Carbiomedics Inc. Bioprosthetic heart valve with balanced stent post deflection
US6478819B2 (en) * 1999-05-27 2002-11-12 Sulzer Carbomedics Inc. Prosthetic heart valves with flexible post geometry
US20020055773A1 (en) 1999-07-12 2002-05-09 Louis A. Campbell Polymer heart valve with insert molded fabric sewing cuff
US6348068B1 (en) 1999-07-23 2002-02-19 Sulzer Carbomedics Inc. Multi-filament valve stent for a cardisc valvular prosthesis
US8016877B2 (en) * 1999-11-17 2011-09-13 Medtronic Corevalve Llc Prosthetic valve for transluminal delivery
US7018406B2 (en) 1999-11-17 2006-03-28 Corevalve Sa Prosthetic valve for transluminal delivery
US20070043435A1 (en) * 1999-11-17 2007-02-22 Jacques Seguin Non-cylindrical prosthetic valve system for transluminal delivery
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AU8821782A (en) 1983-03-08
JPS58501263A (ja) 1983-08-04
EP0196116B1 (en) 1990-01-24
AU562543B2 (en) 1987-06-11
US4501030A (en) 1985-02-26
EP0086213B1 (en) 1988-04-06
EP0086213A1 (en) 1983-08-24
MX156341A (es) 1988-08-10
EP0196116A3 (en) 1986-12-10
BR8207814A (pt) 1983-07-19
AU570589B2 (en) 1988-03-17
EP0086213A4 (en) 1984-11-07
ATE49702T1 (de) 1990-02-15
DE3278310D1 (en) 1988-05-11
JPS6139820B2 (enExample) 1986-09-05
EP0196116A2 (en) 1986-10-01
CA1186453A (en) 1985-05-07
JPS61122857A (ja) 1986-06-10
DE3280091D1 (de) 1990-03-01
JPS6221540B2 (enExample) 1987-05-13
AU5765886A (en) 1986-10-09

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