WO1999011200A1 - Appareil de selection d'un epaulement de dimension appropriee pour une valvule mitrale - Google Patents

Appareil de selection d'un epaulement de dimension appropriee pour une valvule mitrale Download PDF

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Publication number
WO1999011200A1
WO1999011200A1 PCT/IE1998/000072 IE9800072W WO9911200A1 WO 1999011200 A1 WO1999011200 A1 WO 1999011200A1 IE 9800072 W IE9800072 W IE 9800072W WO 9911200 A1 WO9911200 A1 WO 9911200A1
Authority
WO
WIPO (PCT)
Prior art keywords
chord
buttress
shaped member
length
mitral
Prior art date
Application number
PCT/IE1998/000072
Other languages
English (en)
Inventor
Alfred Edward Wood
Original Assignee
Alfred Edward Wood
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 Alfred Edward Wood filed Critical Alfred Edward Wood
Priority to AU88822/98A priority Critical patent/AU8882298A/en
Publication of WO1999011200A1 publication Critical patent/WO1999011200A1/fr

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
    • A61F2/2496—Devices for determining the dimensions of the prosthetic valve to be implanted, e.g. templates, sizers
    • 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
    • A61F2/2445—Annuloplasty rings in direct contact with the valve annulus
    • A61F2/2448—D-shaped rings

Definitions

  • the present invention relates to an apparatus for selecting a suitably dimensioned buttress for reconstruction of the annulus of a mitral valve.
  • the mitral valve is located in the left atrioventricular opening of the heart and serves to prevent regurgitation of blood from the ventricle into the atrium when the ventricle contracts during systole.
  • the mitral valve which is surrounded by a dense fibrous ring known as the annulus, comprises two valve leaflets or cusps of unequal size, the large or anterior leaflet adjacent the aortic opening and the smaller posterior leaflet.
  • the line at which the leaflets come together is called the commissure.
  • annuloplasty The most common defect leading to mitral valve dysfunction is a dilation of the posterior two-thirds of the annulus which corresponds to the posterior leaflet.
  • annuloplasty it is sometimes necessary to repair the dilated posterior two-thirds of the mitral valve, by reducing the physiological dimensions of the annulus. This is known as annuloplasty .
  • annuloplasty buttress for mitral valve reconstruction, the buttress comprising an elongate member formed from a fabric bendable, in use, into an open substantially ring-shaped configuration dimensioned to fit against the base of the cusps of the mitral valve.
  • Such a buttress is normally offered to the mitral valve in an extended condition, as is taught in WO 97/03625, the whole contents of which are incorporated herein by reference.
  • an apparatus for selecting a suitably dimensioned buttress for reconstruction of an annulus of a mitral valve the mitral valve including an anterior mitral leaflet and a posterior mitral leaflet; the buttress being bendable, in use, into an open substantially ring-shaped configuration, the buttress being longitudinally extendable to no more than about 110% of its unextended length; and the buttress being offered to the mitral annulus, preferably in its extended condition, the apparatus comprising a segment member having a chord to arc length ratio of about 1:2, the chord length approximately relating to the maximum depth of the anterior mitral leaflet from its base to its commissure with the posterior mitral leaflet.
  • the length of the chord approximates twice the maximum depth of the anterior mitral leaflet from its base to its commissure with the posterior mitral leaflet and the length of the arc approximates the length of the buttress in its unextended condition.
  • the apparatus includes a substantially semi-circle-shaped member defined by a second arc and a second chord, the chord of the segment -shaped member and the second chord of the substantially semi-circle- shaped member being co- linear.
  • the substantially semi-circle-shaped member is substantially parallel to, and spaced-apart from, the segment -shaped member; and a flange is provided extending between the chord of the segment - shaped member and the second chord of the substantially semi-circle-shaped member, the chord, the flange and the second chord being coplanar.
  • a gripping means is provided, preferably on the substantially semi-circle-shaped member .
  • FIG. 1 is a plan view of an apparatus for selecting a suitably dimensioned buttress according to the present invention
  • Figure 2 is a side view of the apparatus of Figure 1 ;
  • Figure 3 is an isometric view of the apparatus of Figure 1.
  • FIG. 1 there is illustrated an apparatus for selecting a suitably dimensioned buttress for mitral valve reconstruction, the apparatus being generally indicated as 10.
  • the apparatus 10 comprises a segment -shaped member 12, defined by an arc 14 and a chord 16.
  • the chord 16 to arc 14 length ratio is about 1:2.
  • the apparatus 10 also comprises a substantially semicircle-shaped member 18, which is defined by a second arc 20 and a second chord 22.
  • the length of the chord 16 approximates the length of the second chord 22.
  • the substantially semi-circle-shaped member 18 is substantially parallel to, and spaced-apart from, the segment-shaped member 12.
  • a flange 24 is provided extending between the chord 16 of the segment -shaped member 12 and the second chord 22 of the substantially semi-circle-shaped member 18.
  • the chord 16, the flange 24 and the second chord 22 are coplanar.
  • substantially semicircle-shaped member 18 could, alternatively, be integral with the segment -shaped member 12 (not shown) and, in that event, the second arc 20 of the substantially semi-circle-shaped member 18 would be indicated on the surface of the segment -shaped member 12. In that event, the second chord 22 and the chord 16 would be co-linear.
  • a gripping means 26 in the form of a boss is provided on the substantially semi-circle-shaped member 18. It will of course be appreciated that, in the above- mentioned alternative embodiment (not shown) , the gripping means 26 would be provided on the segment - shaped member 12.
  • the apparatus 10 may be formed from any suitable bio- inert material such as, for example, polysuphone .
  • a series of apparatus 10 according to the invention will be provided as a kit of parts to a cardiac surgeon for use in selecting a suitably dimensioned buttress for mitral valve reconstruction for an individual patient.
  • the cardiac surgeon offers a series of apparatus 10 according to the invention, to the annulus of a particular patient, until he identifies the specific apparatus 10 according to the present invention, whose substantially semi-circle-shaped member 18 most closely approximates the dimensions of the anterior mitral leaflet of that particular patient.
  • the apparatus 10 is used to select an appropriately sized buttress.
  • the substantially semi- circle-shaped member 18 approximates the clear area of the anterior mitral leaflet, whilst the segment -shaped member 12 approximates the effect on mitral orifice area upon completion of mitral valve reconstruction.
  • the segment -shaped member 12 also approximates the total surface area of the anterior mitral leaflet which, in turn, approximates the area of the mitral valve during systole, that is, during dynamic contraction.
  • the length of the arc 14 is twice the length of the chord 16 and four times the radius of the substantially semi-circle-shaped member 18.
  • the apparatus 10 identifies a length of buttress proportional to a particular anterior mitral leaflet measured, in vivo , in a particular patient. It will, therefore, be appreciated that the apparatus 10 according to the present invention identifies a desired length of buttress for mitral valve reconstruction in a particular patient, the buttress being pre- formed using an apparatus for cardiac valve reconstruction as disclosed in WO 97/03625.
  • the cardiac surgeon then offers the annuloplasty buttress to the mitral annulus in an extended condition and sutures the annuloplasty buttress to the mitral annulus, preferably in the extended condition. If, as is preferred, the length of the chord 16 approximates twice the maximum depth of the anterior mitral leaflet so that the length of the arc 14 approximates the length of the buttress in its unextended condition, the cardiac surgeon can then re-offer the apparatus 10 to the mitral annulus, to confirm that the terminal sutures of the buttress have been correctly positioned.
  • a single buttress 10 according to the invention could be provided to the cardiac surgeon, provided that the arc 14 and chord 16 of the segment- shaped member 12 and the second arc 20 of the substantially semi-circle-shaped member 18 are suitably graduated.

Abstract

L'invention concerne un appareil de sélection d'un épaulement dimensionné de manière appropriée pour la reconstruction d'un espace annulaire d'une valvule mitrale. L'appareil comprend un élément de segment ayant un rapport de longueur de corde/arc d'environ 1:2, la longueur de corde étant approximativement rapportée à la profondeur maximale de la valve mitrale antérieure de sa base à sa commissure avec la valve mitrale postérieure. De préférence, la longueur de corde est à peu près deux fois égale à la profondeur maximale de la valve mitrale antérieure. On a prévu une série de ce type d'appareil, de longueur de corde graduée, ainsi qu'un ensemble de pièces qu'un chirurgien du coeur peut utiliser pour sélectionner un épaulement de dimension appropriée pour la reconstruction d'une valvule mitrale pour un patient particulier.
PCT/IE1998/000072 1997-08-28 1998-08-26 Appareil de selection d'un epaulement de dimension appropriee pour une valvule mitrale WO1999011200A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU88822/98A AU8882298A (en) 1997-08-28 1998-08-26 Apparatus for selecting a suitably dimensioned buttress for a mitral valve

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IES970642 1997-08-28
IE970642 1997-08-28

Publications (1)

Publication Number Publication Date
WO1999011200A1 true WO1999011200A1 (fr) 1999-03-11

Family

ID=11041582

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IE1998/000072 WO1999011200A1 (fr) 1997-08-28 1998-08-26 Appareil de selection d'un epaulement de dimension appropriee pour une valvule mitrale

Country Status (3)

Country Link
AU (1) AU8882298A (fr)
IE (1) IES80776B2 (fr)
WO (1) WO1999011200A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002017817A1 (fr) * 2000-08-31 2002-03-07 Edwards Lifesciences Corporation Dispositif de calibrage de valvule de coeur frais de donneur et procede d'utilisation
US10765517B2 (en) 2015-10-01 2020-09-08 Neochord, Inc. Ringless web for repair of heart valves

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996039942A1 (fr) * 1995-06-07 1996-12-19 Heartport, Inc. Dispositifs et procedes moins invasifs pour le traitement des valvules cardiaques
WO1997003625A1 (fr) 1995-07-17 1997-02-06 Alfred Edward Wood Piece d'appui pour la refection des valvules cardiaques

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996039942A1 (fr) * 1995-06-07 1996-12-19 Heartport, Inc. Dispositifs et procedes moins invasifs pour le traitement des valvules cardiaques
WO1997003625A1 (fr) 1995-07-17 1997-02-06 Alfred Edward Wood Piece d'appui pour la refection des valvules cardiaques

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
"CARPENTIER-EDWARDS ANNULOPLASTY RINGS., ANNOUNCEMENT", 1 January 1989, BAXTER, PAGE(S) 1/2, XP000319445 *

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2002017817A1 (fr) * 2000-08-31 2002-03-07 Edwards Lifesciences Corporation Dispositif de calibrage de valvule de coeur frais de donneur et procede d'utilisation
US6458155B1 (en) 2000-09-01 2002-10-01 Edwards Lifesciences Corporation Fresh donor heart valve sizer and method of use
US10765517B2 (en) 2015-10-01 2020-09-08 Neochord, Inc. Ringless web for repair of heart valves
US11484409B2 (en) 2015-10-01 2022-11-01 Neochord, Inc. Ringless web for repair of heart valves

Also Published As

Publication number Publication date
AU8882298A (en) 1999-03-22
IES980730A2 (en) 1999-01-10
IE980730L (en) 1999-02-10
IES80776B2 (en) 1999-02-10

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