WO2009141286A1 - Méthode de traitement de pathologies cardiaques - Google Patents
Méthode de traitement de pathologies cardiaques Download PDFInfo
- Publication number
- WO2009141286A1 WO2009141286A1 PCT/EP2009/055957 EP2009055957W WO2009141286A1 WO 2009141286 A1 WO2009141286 A1 WO 2009141286A1 EP 2009055957 W EP2009055957 W EP 2009055957W WO 2009141286 A1 WO2009141286 A1 WO 2009141286A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- valve
- heart
- balloon
- diseases
- aorta
- Prior art date
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0003—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having an inflatable pocket filled with fluid, e.g. liquid or gas
-
- 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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
- A61F2250/0059—Additional features; Implant or prostheses properties not otherwise provided for temporary
Definitions
- the invention is in the field of methods for the treatment of heart failure of any origin with a substrate in the heart and devices used therein, in particular for the treatment of coronary diseases and/or arterial diseases. More in particular the invention provides artificial valves suitable for permanently or temporarily residing in an artery, more in particular the descending aorta, even more in particular the descending aorta just after branching of the left subclavian artery.
- a device according to the invention may be advantageously employed in the treatment of congestive heart failure or decompensatio cordis.
- a device according to the invention may be employed even if the arterial vessels are stiff.
- vascular valves for placement in smaller veins or arteries have been described.
- Vascular valves for placement in the descending aorta have also been described.
- Such valves have also been described mounted on stents, albeit for temporary placement in the patient's body to overcome a period of acute detonation of decompensted heart failure. They are all catheter mounted, so they are prone to infections and thrombosis, can only reside a very limited period and make the patient bedridden and to be bound to an intensive cardiac care unit.
- valves described in the prior art are all prone to substantial paravalvular leakage so they cannot be used for investigational purposes that look after the properties of the aorta. Hence, their use as a device to lower afterload for the Left Ventricle will be very limited. There remains a need for an improved method to treat heart diseases as well as devices for use therein.
- the invention relates to a method for the treatment of a disease selected from the group consisting of acute and chronic congestive heart failure, coronary diseases, arterial diseases, heart valve diseases, cardiomyopathic diseases, decompensatio cordis and asthma cardiale wherein an artificial valve is placed in the aorta descendens after the left subclavian artery.
- Such devices may be suitable for permanent placement in the patient.
- a temporarily device is inserted.
- the temporarily placed device may also be used to determine whether the patient may benefit from the placement of a permanent device.
- the invention also relates to an artificial valve mounted on a low gradient stent that can withstand the forces applied on it by the blood stream in the aorta descendens. When permanently placed, such a device may then be applied to a mobile patient and remain in the patient's body for a lifetime.
- a permanent device comprises a low gradient valve mounted on a stent equipped with means for anchoring the device at the appropriate place in the aorta descendens, such that it can withstand the blood pressure at that particular site.
- a particularly advantageous device is a stent comprising an outer surface as depicted in figure 1 . Such a device may be delivered percutaneously and transluminal ⁇ and is non thrombogenic. This device provides structures that anchor the stent in the aorta descendens and prevent its migration, for instance by the blood flow in the aorta while resulting in minimal discomfort and adverse effects for the patient..
- a temporary device may be designed as a balloon mounted on a catheter comprising a tricuspid valve. The balloon then anchors the device at the appropriate position, either for therapeutic or for diagnostic purposes.
- This invention relates to a method for the treatment of a disease selected from the group consisting of acute and chronic congestive heart failure, coronary diseases, arterial diseases, heart valve diseases, cardiomyopathic diseases, decompensatio cordis and asthma cardiale wherein an artificial valve is placed in the aorta descendens after the left subclavian artery.
- a disease selected from the group consisting of acute and chronic congestive heart failure, coronary diseases, arterial diseases, heart valve diseases, cardiomyopathic diseases, decompensatio cordis and asthma cardiale
- an artificial valve is used herein to indicate a valve from a different origin as the species wherein it is to be inserted.
- an artificial valve is a mechanical valve, i.e. not from a biological origin.
- a valve mounted in the aorta descendens shortly after branching of the left subclavian artery provides a means to reduce the intensity of reflection waves of the first and higher order reaching the aortic root. It also provides a means to reduce the intensity of aortic and distal arterial compliance effects reaching the aortic root and a means to reduce afterload and through that resulting in diminishing dyssynchrony within the left ventricle.
- the valve in the method according to the invention may advantageously be a tricuspid valve.
- the valve may be comprised in a temporary or a permanent device.
- a temporary device is characterized in that it contains elements for its removal from the human or animal body.
- a permanent device is characterized in that it consists of materials suitable for a long term stay in the human or animal body and/or the lack of means for its removal from the human or animal body.
- the permanent device is a cylindrical stent comprising a valve in its inner lumen whereas the temporary device is a hollow cylindrical balloon with a valve in its inner lumen.
- a balloon may be mounted on a catheter in any conventional way, for instance using wires.
- a balloon which comprises a valve can also be used to investigate the properties of the aorta as a whole or segment by segment.
- the invention also relates to a device that provides a mechanical support that may be used to treat congestive heart failure. Placement of the device at its intended location leaves the diseased structure of the existing heart untouched. It is a mechanical support, which does not need the addition of external energy and may be applied both in the chronic and acute setting.
- the device according to the invention may be applied under conditions of heart failure whereas a disfunctioning heart valve is not mandatory.
- the device may be applied to the human or animal body by percutaneous and transluminal insertion. It is also possible to implant the device using a surgical method.
- patients with severe chronic or acute heart failure are usually treated with drugs that may reduce the preload, reduce the afterload or strengthen the contraction force of the ventricle, without negatively influencing the coronary flow.
- preload is known in the art and is used herein to indicate end diastolic wall stress which is best measured by the end-diastolic volume.
- afterload indicates the wall stress during ejection which is best measured by the systolic pressure of the left ventricle which has systolic blood pressure s a good measurable surrogate.
- contraction force indicates contractility which is the intrinsic strength of the ventricle, best measured by the end systolic elastance (Ees), the slope of the end-systolic pressure-volume relation (in PV-loops for varying filling pressures).
- the preload depends on the filling pressure and the compliance of the ventricle in diastole.
- Drug therapy with reduction of blood volume ie diuretics, reducing pre-and afterload
- vasodilators reducing afterload
- Intravenous drugs such as catecholamines are usually supplied in order to influence the contraction force.
- Such treatment is only effective for a limited period of exacerbation, for instance during cardiac asthma.
- the mechanical interventions to change the mechanics of the heart can take place in the heart or in the large blood vessels outside the heart.
- the mechanical functioning of the heart can be changed by electrical add-ons inserting a pacemaker (PM) a PM and an implantable cardioverter defibrillator (ICD), biventricular pacing.
- PM pacemaker
- ICD implantable cardioverter defibrillator
- Atrial septal defect ASD
- VSD Ventricular septal defect
- obstructing structures eg subaortale membrane, Asymmetrical septal hypertrphy (ASH), coronary artery stenoses
- AVR Aortic valve replacement
- MVR Mtral valve replacement
- PVR Pulmonal valve replacement
- Mihaylov D Verkerke GJ, Blanksma PK, Elstrodt J, de Jong ED, Rakhorst G. Evaluation of the optimal driving mode during left ventricular assist with a pulsatile catheter pump in calves. Artif Organs 1999;23:1 1 17-22. 4. Mihaylov D, Rakhorst G, van der Plaats A, et al. In vivo and in vitro experience with the PUCA-II, a single valved pulsatile catheter pump, lnt J Artif Organs 2000;23:697-702.
- phlebotomizing bloodvein
- bloodvein is the most simple form, reducing pre-and afterload by decrease in circulating volume but is still effective, even though the method is somewhat obsolete.
- the use of a balloon pump is widespread and is still undergoing improvements.
- the coronary perfusion begin diastole by inflation of the balloon is increased while end-diastolic afterload is reduced by deflation.
- the Intra Aortic Balloon Pump (IABP) reduces especially afterload, but is only temporarily applicable, not in a serious sclerotic aorta and also requires energy administration from the outside (P. J Overwalder: Intra Aortic Balloon Pump (IABP) Counterpulsation . The Internet Journal of Thoracic and Cardiovascular Surgery. 1999. Volume 2 Number 2).
- the method wherein a valve is inserted in the aorta descendens shortly after branching of the left subclavian artery for the treatment of acute or chronic congestive heart failure is a unique solution for the problem to influence the defective mechanical functioning of the heart by an intervention outside the heart itself in the large vessels with the aim to relieve the heart by diminishing afterload.
- Hufnagel has implanted in patients with severe aortic insufficiency (Al) events a ball in a cage high in the aorta descendens, he estimated that 75% of the cardiac output flows through the valve. It is estimated that some 4000 Hufnagel valves were implanted but only 55 are described well in the literature (Hufnagel CA, Harvey WP: The surgical correction of aortic regurgitation, Preliminary report. Bull Georgetown Univ Med Center 6:60-61 , 1953 2 Hufnagel CA, Harvey WP, Rabil PJ, et al: Surgical correction of aortic insufficiency. Surgery 35:673-683, 1954 3 McKu. sick VA, Hahn DP, Brayshaw JR.
- Al severe aortic insufficiency
- Hufnagel describes the effects of the valve in case of Al are decrease in afterload, an increase of cardiac output (up to 75%), decrease of the Pulmonary artery pressure (PAP), a decline in Cor-thorax ratio (CTR), a reduction in New York Heart Association (NYHA) class and increase exercise tolerance.
- PAP Pulmonary artery pressure
- CTR Cor-thorax ratio
- NYHA New York Heart Association
- US2006074483 describes a method of treatment and devices for the treatment of left ventricular failure.
- US3671979 describes a catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve.
- US4056854 describes an aortic heart valve catheter. These are all catheter based mechanical techniques for treating the decompensated heart in the acute setting with temporary support, as far as we know these are the only three examples. The primary purpose of these three patented devices in the acute setting was to develop a cheaper solution than the IABP, with less monitoring needed. The entire expandable and impandable valves with mounting catheter remains in situ. The patient is bedridden and the valve must be removed after a short time.
- the current valves most used for PAVR are the Core Valve Revalving (18F) and the Edwards Sapien valve.
- stent-valves in development are the Bonhoefer valve, valve Aortech, Panagua valve, 3-F valve, Palmaz-Baily valve, Direct Flow valve, AorTx cover and Sadra Lotus valve.
- the invention is primarily aimed at intraluminal and percutaneous insertion of an organic 3-Strut self-expandable or balloon mounted artificial valve, with only flow possible in the blood flow direction, which is inserted in the aorta descendens, preferably positioned a few cm after the left subclavian artery and is called artificial valve in the aorta descendens (AVAD).
- AVAD artificial valve in the aorta descendens
- the valve can be delivered with a 24, 18 or less French catheter.
- the AVAD is a biological valve because this presents no resistance to blood flowing in the aorta (gradient over the valve 0 mm
- the primary function of the valve is in reducing afterload downstream of the valve, where estimated 75% of Cardiac Output flows through.
- the compliance of the vascular system after this valve makes that during diastole the pressures are conducted only to the periphery and that the reflected wave of the first and higher order from the periphery are at least partly, sometimes even completely stopped in diastole. This decrease in afterload has a positive effect so that the CO increases, the lower PAP will reduce the shortness of breath and the exercise tolerance increases.
- the valve of the invention (AVAD) will best the best solution nowadays available for treating pure Al in a patient that has an opreation indication for AVR but who has also too many contra-indications to perform this.
- Bicuspid or tricuspid artificial valves are both suitable for placement in the device. It should be noted however that incomplete closure of the bicuspid valve especially in aging of the valve, as usually some degeneration is seen, occurs less often with a tricuspid valve.
- the pull forces will in the tricuspidal case be more spread over the whole annulus of artificial valve and will thus be smaller per square mm of the aortic wall and thus beneficial in preventing stent migration.
- the forces on the AVAD will only occur in retrograde direction during diastole, in the target population and is estimated to remain below 100 mm Hg, such as 75 or 50 mm Hg.
- the fixation by means of an expandable stent in the aortic wall must resist these forces, it is therefore preferred that the valve is placed at the upsteam end of the stent and that the stent is at least 5 cm long.
- the downstream side is in particular the fixation side.
- the leaflets may comprise a drug eluting coating or equivalent means.
- the meshes in the stent should be large enough to maintain an unrestricted blood flow to the branching arteries.
- This invention is part of mechanical support techniques for a decompensated heart and is the only one which may be applied in the chronic setting even if the valves of the heart itself are intact. Patients suffering from chronic congestive heart failure class NYHA III or IV may particularly benefit from the present invention.
- the described invention is a simple outpatient applicable mechanical form of intervention that may be used for chronic heart failure in the mobile patient.
- the AVAD provides the advantage of allowing a reduced risk of the procedure due to the percutaneous transluminal placement. This provides a reduced invasiveness and reduced complexity of insertion. It is a prerequisite for this technique that the aorta descendens after the left subclavian artery is intact over about seven or more centimeters.
- a device according to the invention provides the advantage that the valve is able to sustain a backward pressure gradient of more than 100 mm Hg. Such is true even at an early stage, when the valve is still not covered with endothelium, without dislocation.
- the device according to the invention may be placed in a smooth as well as a sclerotic aorta. If properly placed, i.e. at a few cm from the subclavian left artery and with a max length of 7 cm, the device will not provide any problems with prior arteries. In a device according to the invention, the chances of valve degeneration are minimal. and the chances of endothelial growth on the valve leaflets are also minimal. Moreover, there is no antegrade gradient over the device according to the invention. If the device according to the invention comprises Dacron, endothelialization is facilitated and any micro-embolies may be prevented but this is not mandatory. A device according to the invention may be applied or delivered to a patient using a conventional balloon.
- a temporary valve is provided.
- a device may comprise a low gradient valve mounted on a catheter mounted within a cylindrical thin balloon that functions as its stent. This is herein further referenced as a balloon valve.
- the catheter contains at least a lumen for inflation of the balloon and a lumen for guiding a conductance catheter for measurement in the Left Ventricle and Aorta.
- the catheter is directly connected to the wall of the cylinder and may have connections from proximal and distal ends of the cylinder to several places on the edges of the cylinder.
- connections may be applied for stability and also to be able to deliver and to retrieve the balloon and valve as depicted in figures 3 and 4.
- Such a device may be delivered percutaneously and transluminal ⁇ and is non thrombogenic.
- This device provides properties that anchor the balloon in the aorta descendens and prevent its derealization by the blood flow in the aorta.
- the gradient of the device as a whole in the aorta in systole is not significantly different from zero.
- cylindrical balloon of the device can be inflated slightly oversized for better fixation in the aorta and to prevent a diameter step in the transition aorta cylinder.
- a temporary valve such as a balloon valve may be used for simulation of the permanent valve to investigate its applicability in selected patients but also for investigational purposes, to lower the afterload of the left ventricle i.e. the treatment of acute HF or for routine clinical use. It may be used to study the properties of the aorta such as stiffness, reflection waves, pulse wave velocity and elasticity.
- the Balloon Valve can be inflated shortly at different places in the aorta. When the time interval for the measurement remains short at each level there will be no damage as a consequence of occluding side branches during inflation. These measurements may lead to somewhat adjusted recommended optimal placement sites in the aorta in selected cases of aorta stiffness.
- the temporary valve can also be used to determine whether it makes sense to place a permanent device in order to treat the patient.
- the invention can be delivered with a 18 or less French catheter.
- the invention is a biological valve because this presents no resistance to blood flowing in the aorta (gradient over the valve O mm Hg).
- the primary function of the Balloon Valve, placed shortly after the left subclavian artery is in reducing afterload downstream of the valve, where estimated 75% of Cardiac Output flows through.
- the compliance of the vascular system after this valve makes that during diastole the pressures are conducted only to the periphery and that the reflected wave of the first and higher order from the periphery are completely stopped in diastole.
- the cylinder length of the balloon is at least 7 cm long.
- the balloon valve can also be produced for selected cases to withstand inflation pressures up to 22 atmosphere in order to obtain enough stability of the valved-balloon, the valve itself and or fixation in the aorta.
- This balloon valve is part of mechanical support techniques for a decompensated heart and is the only one which may be applied in the chronic setting even if the valves of the heart itself are intact.
- the described balloon valve is a simple applicable mechanical form of intervention that may be widely used for acute heart failure in the bedridden intensive care patient.
- the balloon valve provides the advantage of allowing a reduced risk of the procedure due to the percutaneous transluminal placement. This provides a reduced invasiveness and reduced complexity of insertion. It is a prerequisite for this technique that the aorta descendens after the left subclavian artery is intact over about seven or more centimeters.
- a balloon valve provides the advantage that the valve is able to sustain a backward pressure gradient of more than 100 mm Hg. Such is true even at an early stage, when the valve is still not covered with endothelium, without dislocation.
- the balloon valve may be placed in a smooth as well as a sclerotic aorta. If properly placed, i.e. at a few cm from the subclavian left artery and with a max length of 7 cm or, as is the case with aorta measurements, will be applied so shortly that the device will not provide any problems with prior arteries.
- valve comprises Dacron, endothelialization is facilitated and any micro-embolies may be prevented.
- a balloon Valve may be applied using a cylindrical balloon.
- the inserted valve and the balloon have a minimum diameter to be able to pass the femoral artery without much risk of damage.
- Figure 1 Pattern of the wall of a stent according to the invention
- Figure 2 Stent with valve placed in the aorta descendens
- Figure 3 Balloon valve.
- Reference signs indicate a thin cylindrical balloon 10, a hollow catheter 20, fixation wires 30 and a valve 40 comprising multiple leaflets .
- Figure 4 cross section of the hollow cylindrical balloon 10 showing fixation wires 30, a tricuspid valve 40 and the hollow catheter 20 with a lumen 21 .
- the lumen 21 of the catheter may be used to allow a measurement device to pass through the catheter along the balloon into the aorta at the cardiac site of the valve.
- Catheter 20 may also be placed through the lumen of the balloon in the axial direction of the cylinder.
- the lumen 21 of the balloon may also contain means for inflating the balloon, such as an air guide connected to a pump outside the patient. In that case, the support wires 30 then form a pyramid structure and the air connection is a separate connection to the inner side of the balloon.
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- External Artificial Organs (AREA)
Abstract
La présente invention concerne des dispositifs destinés au traitement d’une insuffisance cardiaque de toute origine avec un substrat dans le cœur, en particulier au traitement de maladies coronaires et/ou de maladies artérielles. Plus particulièrement, l’invention concerne une valvule artificielle appropriée pour rester temporairement ou définitivement dans une artère, plus particulièrement l’aorte descendante, plus particulièrement encore l’aorte descendante juste après la ramification de l’artère sous-clavière gauche. Un dispositif selon l’invention peut être utilisé de façon avantageuse dans le traitement de l’insuffisance cardiaque. Un dispositif selon l’invention peut être utilisé même si les vaisseaux artériels sont rigides.
Applications Claiming Priority (10)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
NL1035433A NL1035433C2 (nl) | 2008-05-19 | 2008-05-19 | Aorta descendens kunstklep implantatie (percutaan of operatief) als behandelingsmogelijkheid bij decompensatio cordis. |
NL1035433 | 2008-05-19 | ||
NL1036816 | 2009-04-04 | ||
NL1036816 | 2009-04-04 | ||
EP09158497A EP2243443A1 (fr) | 2009-04-22 | 2009-04-22 | Stent comportant une valvule tricuspide |
EP09158497.9 | 2009-04-22 | ||
US17569709P | 2009-05-05 | 2009-05-05 | |
US61/175,697 | 2009-05-05 | ||
US17689709P | 2009-05-09 | 2009-05-09 | |
US61/176,897 | 2009-05-09 |
Publications (1)
Publication Number | Publication Date |
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WO2009141286A1 true WO2009141286A1 (fr) | 2009-11-26 |
Family
ID=40933629
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/EP2009/055957 WO2009141286A1 (fr) | 2008-05-19 | 2009-05-15 | Méthode de traitement de pathologies cardiaques |
Country Status (1)
Country | Link |
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WO (1) | WO2009141286A1 (fr) |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2349097A4 (fr) * | 2008-10-10 | 2015-08-26 | Kirk Promotion Ltd | Valve artificielle améliorée |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1283027A2 (fr) * | 1991-07-16 | 2003-02-12 | Heartport, Inc. | remplacement de valves aortiques endovasculaires |
US20060020333A1 (en) * | 2004-05-05 | 2006-01-26 | Lashinski Randall T | Method of in situ formation of translumenally deployable heart valve support |
US20070005133A1 (en) * | 2005-06-07 | 2007-01-04 | Lashinski Randall T | Stentless aortic valve replacement with high radial strength |
US20070203561A1 (en) * | 2006-02-27 | 2007-08-30 | Cardiacmd, Inc. A California Corporation | Methods and devices for delivery of prosthetic heart valves and other prosthetics |
-
2009
- 2009-05-15 WO PCT/EP2009/055957 patent/WO2009141286A1/fr active Application Filing
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP1283027A2 (fr) * | 1991-07-16 | 2003-02-12 | Heartport, Inc. | remplacement de valves aortiques endovasculaires |
US20060020333A1 (en) * | 2004-05-05 | 2006-01-26 | Lashinski Randall T | Method of in situ formation of translumenally deployable heart valve support |
US20070005133A1 (en) * | 2005-06-07 | 2007-01-04 | Lashinski Randall T | Stentless aortic valve replacement with high radial strength |
US20070203561A1 (en) * | 2006-02-27 | 2007-08-30 | Cardiacmd, Inc. A California Corporation | Methods and devices for delivery of prosthetic heart valves and other prosthetics |
Cited By (1)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2349097A4 (fr) * | 2008-10-10 | 2015-08-26 | Kirk Promotion Ltd | Valve artificielle améliorée |
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