WO2006013234A1 - Vascular prosthesis for adapting diameter differences between two ends of a replaceable blood vessel segment - Google Patents

Vascular prosthesis for adapting diameter differences between two ends of a replaceable blood vessel segment

Info

Publication number
WO2006013234A1
WO2006013234A1 PCT/FR2004/001713 FR2004001713W WO2006013234A1 WO 2006013234 A1 WO2006013234 A1 WO 2006013234A1 FR 2004001713 W FR2004001713 W FR 2004001713W WO 2006013234 A1 WO2006013234 A1 WO 2006013234A1
Authority
WO
Grant status
Application
Patent type
Prior art keywords
prosthesis
diameter
vascular
tube
valve
Prior art date
Application number
PCT/FR2004/001713
Other languages
French (fr)
Inventor
Daniel Roux
Original Assignee
Daniel Roux
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

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2/064Blood vessels with special features to facilitate anastomotic coupling
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart 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
    • A61F2/2412Heart 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 with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2002/061Blood vessels provided with means for allowing access to secondary lumens
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2/00Filters 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
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06Blood vessels
    • A61F2002/065Y-shaped blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS 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
    • A61F2250/00Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2250/0014Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
    • A61F2250/0039Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter

Abstract

The invention relates to a vascular prosthesis which makes it possible to adapt diameter differences between two ends of a replaceable blood vessel. The inventive prosthesis consists of a prosthetic tube (1) provided with a flange (2) which is arranged on the end thereof, made of the material used for the prosthesis and whose diameter relatively greater than the diameter of the prosthetic tube in such a way that the prosthesis whose one end is perfectly adaptable to the blood vessel (3, 3') diameter is obtainable, wherein the flange is reshapable by a surgeon according to the need thereof. Said invention generally relates to vascular surgery and, in particular, to operations for replacing a part of aorta or an entire aorta by a prosthesis.

Description

VASCULAR PROSTHESIS FOR AN ADAPTATION

DIAMETER DIFFERENCES BETWEEN BOTH ENDS OF

SEGMENT BLOOD VESSEL TO REPLACE

The present invention relates to a vascular prosthesis to allow for adaptation to differences in diameter between the two ends of a blood vessel segment to be replaced.

It relates generally to the field of vascular surgery and in particular the interventions for the replacement by a prosthesis of a portion or all of the aorta.

Current vascular prostheses are made of synthetic textile-based polyester "Dacron" woven or knitted, or "Goretex" flexible inert material based on polytetra-fluoro-ethylene, totally compatible with biological tissues and used for surgery ( vessels and ligaments) and for aesthetics.

Their diameter varies from 4 mm to 40 mm and all known prostheses are cylindrical. But in many cases, the blood vessel diameter is not the same from one point to another. If this difference in diameter is very sensitive in small diameter, it may become important for the blood vessels of large diameter as the aorta for example.

This fact creates a difficulty for the surgeon. It will indeed choose a prosthesis whose diameter is an average of the large area and the small section of the blood vessel where it is going to intervene. Then, he will stitch, knitting to compensate the difference in diameter. Needless to follow, a waste of time a flight risk.

The device of the present invention aims to remedy this situation. It lets the surgeon, when there is a blood vessel segment to be replaced with an upstream diameter difference on downstream save time significantly, while achieving perfectly sealed at both ends sutures of the implant. It consists of a prosthetic tube equipped at the periphery of one of its ends with a collar of the same nature as the prosthesis and a relatively large diameter compared to that of the prosthetic tube, so as to obtain a prosthesis one of whose ends has a perfectly adaptable to the diameter of the blood vessel, the collar can be resized by the surgeon as desired.

In the accompanying drawings, given by way of nonlimiting examples of embodiments according to the present application: Figure 1 shows in perspective a vascular prosthesis according to the invention before implantation, Figure 2 shows the same prosthesis after positioning , figures 3 to 6 illustrate the use of the vascular prosthesis on an aorta,

7 shows a vascular prosthesis for replacement of the abdominal portion of the aorta and Figs 8 and 9 show a descending aorta prosthesis. associated with a heart valve, respectively before and after assembly of the prosthesis and of the valve.

The device, figures 1 to 9, is formed of a prosthetic tube 1 having at one of its ends, or close to this end, a flange 2 extending around the periphery of the prosthetic tube in a plane substantially perpendicular to the axis thereof.

The prosthetic tube 1, made of biocompatible material such as "Dacron" or "Goretex", is currently the standard type used in the replacement of segments of blood vessels 3, 3 '.

The flange 2 is a plane or conical member, the same material as the prosthetic tube 1, circular or semi-circular and having an opening whose edge is attached perfectly sealed to the tube wall. The diameter of the collar 2 will be considerably greater than that of the prosthetic tube 1 so as to cope with all cases that may arise, for example for an aortic prosthesis with a diameter of 4 cm higher than the prosthesis .

Thus when there is a segment of blood vessel 3, 3 'to be replaced with an upstream diameter difference and downstream, the surgeon chooses the diameter of the prosthesis equal to the small diameter of the vessel. He realizes the suture end to end perfectly congruently, since the diameter of the vessel and the prosthesis are identical.

As against the large diameter, it will suture the collar if its diameter is suitable if it can resize the chisel so as to give it a diameter exactly adapted to that of the blood vessel 3, 3 '(Figure 2). The surgeon will save time and Ia suture will be easier and waterproof. This device makes it easy to fit the shape of the vessel; Indeed, if it is not perfectly cylindrical as is often the case, the collar * will be cut to the shape of the section of the vessel.

The vascular prosthesis according to the invention is particularly suitable in the case of interventions on the aorta 4 and allows to intervene under very satisfactory conditions to handle specific situations such as those subject to the following examples:

- aortic dissection, the prosthesis preferably comprising a 5 infusion conduit for rapid connection with extracorporeal circulation (see patent N ° FR 01 12642 filed by the Applicant of the present application). Figures 3 and 4 show respectively the bottom part of an aorta 4 (side core 6) severed before implantation of the prosthesis and after placement of the latter.

- thoracic aortic aneurysm 7: the prosthesis includes not only 5, but also infusion conduit branches 8 for connection with the lead 9 constituting the brachiocephalic artery, the left carotid and left subclavian under (Figure 5).

The invention enables operation in two stages. First step: replacing the aortic arch 10; Second time: replacement of the thoracic aorta descending 7 (Figure 6).

- Aneurysm of the abdominal aorta 11: when the aneurysm interested in the abdominal aorta and the iliac arteries, the surgeon uses a bifurcated prosthesis herein, the invention may be adapted to the bifurcated prosthesis 12 so as to perform its attachment to the abdominal aorta (Figure 7).

When a leak of the aortic heart valve is associated with a pathological ascending aorta (aneurysm), change the valve and replace the ascending aorta with a vascular prosthesis. There are mechanical valves sutured on vascular prostheses. As against this device does not exist for Biological valves 13 (made from pork or veal tissues). Indeed, biological valves are kept in a liquid product called glutamaldehyde which alter the vascular prosthesis and that is why there is no valve tube with a bioprosthesis.

The vascular prosthesis according to the invention enables a tube- valve at the time of operation by the surgeon.

It takes a vascular prosthesis, the diameter of the prosthetic tube 1 is slightly greater than that of the biological valve (indicative requires a vascular prosthesis 26 mm diameter for a valve of 23 mm in diameter.) Thus the prosthetic tube 1 is cap on the biological valve 13 and the flange 2 is pressed against the suture cushion 14 of the valve consisting of a ring "dacron" (figures 8 and 9).

It remains the surgeon sutured to this set. There will be a separate packaging of the valve and the prosthesis collar, an assembly at the time of operation.

The collar may measure, for example 1 cm wide. After assembly of the tube and of the valve 13, the suture 6 on the heart is carried out so that the flange 2 of the vascular prosthesis and the suture cushion 14 of the biological valve 13 are interlocked when the son is knotted.

In general, the device according to the invention can be implemented on any vascular prosthesis so that the surgeon used if necessary otherwise do not use it. Indeed, this device does not interfere in any use of conventionally prosthesis.

The positioning of the various components gives the object of the invention a maximum of useful effects which had not been, to date, been obtained by similar devices.

Claims

1. vascular prosthesis for adaptation to differences in diameter between the two ends of a blood vessel segment to be replaced, in particular for interventions for the replacement by a prosthesis of a portion or all of the aorta, characterized by combination of a prosthetic tube (1) and a flange (2) of the material extending around the periphery of said prosthetic tube in a plane substantially perpendicular to the axis thereof, the flange being of a relatively large diameter compared to that of the prosthetic tube (1) and having an opening whose edge is attached perfectly sealed to the wall of the tube at one end thereof or near the end of so as to obtain a vascular prosthesis whose one end has a perfectly adaptable ceiui diameter of the blood vessel (3, 3 '), the collar can be resized ^ with scissors by the chir urgien.
2 °. Vascular prosthesis according to claim 1, characterized in that the collar (2) is a planar member.
3 °. Vascular prosthesis according to claim 1, characterized in that the collar (2) is a conical member.
4 °. Vascular prosthesis according to any one of the preceding claims characterized in that the collar (2) is of semicircular form.
5 °. Vascular prosthesis according to any one of the preceding claims characterized in that the prosthetic tube (1) and the flange (2) are made of biocompatible material such as synthetic fabric based on polyester
"Dacron" woven or knitted, or flexible inert material based on polytetra-fluoro-ethylene ( "Goretex"). 6 °. Vascular prosthesis according to any one of the preceding claims characterized in that it is designed for aortic dissection interventions and it comprises an infusion conduit (5) for rapid connection to the extracorporeal circulation.
7 °. Vascular prosthesis according to claim 6, characterized in that it comprises legs (8) for a connection- with the branch pipes (9) constituting the brachiocephalic artery, the left carotid and left subclavian under.
8 °. Vascular prosthesis according to any one of claims 1 to 5, being characterized by the fact that one end thereof is bifurcated so as to be used to connect the abdominal aorta (11) to the iliac arteries.
9 °. Vascular prosthesis according to any one of claims 1 to 5, characterized in that it is associated with a biological valve (13) and arranged to allow to carry out in a single operation the change of the heart valve and the replacement of the ascending aorta by a vascular prosthesis.
10 °. Vascular prosthesis as claimed in claim 9, being characterized in that the diameter of the prosthetic tube (1) is slightly greater than that of the biological valve (13) and is arranged for capping said valve so that the flange (2) is applied on the suture pad (14) of the valve to permit suturing the assembly on the core (6) ensuring the fastening of said flange and said cushion when the suture is knotted son.
PCT/FR2004/001713 2004-07-02 2004-07-02 Vascular prosthesis for adapting diameter differences between two ends of a replaceable blood vessel segment WO2006013234A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/FR2004/001713 WO2006013234A1 (en) 2004-07-02 2004-07-02 Vascular prosthesis for adapting diameter differences between two ends of a replaceable blood vessel segment

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/FR2004/001713 WO2006013234A1 (en) 2004-07-02 2004-07-02 Vascular prosthesis for adapting diameter differences between two ends of a replaceable blood vessel segment

Publications (1)

Publication Number Publication Date
WO2006013234A1 true true WO2006013234A1 (en) 2006-02-09

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Country Status (1)

Country Link
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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008042092A2 (en) 2006-10-03 2008-04-10 St. Jude Medical, Inc. Synthetic blood vessel grafts
WO2011108409A1 (en) * 2010-03-04 2011-09-09 テルモ株式会社 Artificial blood vessel
US9301835B2 (en) 2012-06-04 2016-04-05 Edwards Lifesciences Corporation Pre-assembled bioprosthetic valve and sealed conduit
US9585748B2 (en) 2012-09-25 2017-03-07 Edwards Lifesciences Corporation Methods for replacing a native heart valve and aorta with a prosthetic heart valve and conduit
US9844436B2 (en) 2012-10-26 2017-12-19 Edwards Lifesciences Corporation Aortic valve and conduit graft implant tool

Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) * 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
EP0269254A1 (en) * 1986-10-27 1988-06-01 Ethicon Inc. Improvements in synthetic vascular grafts
WO1998052495A1 (en) * 1997-05-17 1998-11-26 Vortex Innovation Limited Vascular prosthesis
US6090140A (en) * 1999-02-17 2000-07-18 Shelhigh, Inc. Extra-anatomic heart valve apparatus
US6136022A (en) * 1996-05-24 2000-10-24 Meadox Medicals, Inc. Shaped woven tubular soft-tissue prostheses and methods of manufacturing the same
US6187033B1 (en) * 1997-09-04 2001-02-13 Meadox Medicals, Inc. Aortic arch prosthetic graft
FR2799362A1 (en) * 1999-10-11 2001-04-13 Perouse Implant Lab Prosthesis for vascular surgery comprises a tubular body with an external flange at one end adapted to link the prosthesis to a tubular conduit with an opening
US6273912B1 (en) * 1996-02-28 2001-08-14 Impra, Inc. Flanged graft for end-to-side anastomosis
WO2002000273A2 (en) * 2000-06-26 2002-01-03 Thoratec Corporation Flared coronary artery bypass grafts
US6544285B1 (en) * 2000-01-17 2003-04-08 Heinemen Medical Research, Inc. Aortic root prosthesis with compliant sinuses
US20030139805A1 (en) * 2002-01-24 2003-07-24 Holmberg William R. Conduit for aorta or pulmonary artery replacement

Patent Citations (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2127903A (en) * 1936-05-05 1938-08-23 Davis & Geck Inc Tube for surgical purposes and method of preparing and using the same
EP0269254A1 (en) * 1986-10-27 1988-06-01 Ethicon Inc. Improvements in synthetic vascular grafts
US6273912B1 (en) * 1996-02-28 2001-08-14 Impra, Inc. Flanged graft for end-to-side anastomosis
US6136022A (en) * 1996-05-24 2000-10-24 Meadox Medicals, Inc. Shaped woven tubular soft-tissue prostheses and methods of manufacturing the same
WO1998052495A1 (en) * 1997-05-17 1998-11-26 Vortex Innovation Limited Vascular prosthesis
US6187033B1 (en) * 1997-09-04 2001-02-13 Meadox Medicals, Inc. Aortic arch prosthetic graft
US6090140A (en) * 1999-02-17 2000-07-18 Shelhigh, Inc. Extra-anatomic heart valve apparatus
FR2799362A1 (en) * 1999-10-11 2001-04-13 Perouse Implant Lab Prosthesis for vascular surgery comprises a tubular body with an external flange at one end adapted to link the prosthesis to a tubular conduit with an opening
US6544285B1 (en) * 2000-01-17 2003-04-08 Heinemen Medical Research, Inc. Aortic root prosthesis with compliant sinuses
WO2002000273A2 (en) * 2000-06-26 2002-01-03 Thoratec Corporation Flared coronary artery bypass grafts
US20030139805A1 (en) * 2002-01-24 2003-07-24 Holmberg William R. Conduit for aorta or pulmonary artery replacement

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2008042092A2 (en) 2006-10-03 2008-04-10 St. Jude Medical, Inc. Synthetic blood vessel grafts
WO2008042092A3 (en) * 2006-10-03 2008-07-24 St Jude Medical Synthetic blood vessel grafts
US7575592B2 (en) 2006-10-03 2009-08-18 St. Jude Medical, Inc. Synthetic blood vessel grafts
JP2010505515A (en) * 2006-10-03 2010-02-25 セント ジュード メディカル インコーポレイテッド Synthetic vascular graft
WO2011108409A1 (en) * 2010-03-04 2011-09-09 テルモ株式会社 Artificial blood vessel
US9301835B2 (en) 2012-06-04 2016-04-05 Edwards Lifesciences Corporation Pre-assembled bioprosthetic valve and sealed conduit
US9585748B2 (en) 2012-09-25 2017-03-07 Edwards Lifesciences Corporation Methods for replacing a native heart valve and aorta with a prosthetic heart valve and conduit
US9844436B2 (en) 2012-10-26 2017-12-19 Edwards Lifesciences Corporation Aortic valve and conduit graft implant tool

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