WO2023175499A1 - Dispositif modifié destiné à une fermeture percutanée de dérivations intracardiaques - Google Patents

Dispositif modifié destiné à une fermeture percutanée de dérivations intracardiaques Download PDF

Info

Publication number
WO2023175499A1
WO2023175499A1 PCT/IB2023/052464 IB2023052464W WO2023175499A1 WO 2023175499 A1 WO2023175499 A1 WO 2023175499A1 IB 2023052464 W IB2023052464 W IB 2023052464W WO 2023175499 A1 WO2023175499 A1 WO 2023175499A1
Authority
WO
WIPO (PCT)
Prior art keywords
disc
semi
circular
guide wire
discs
Prior art date
Application number
PCT/IB2023/052464
Other languages
English (en)
Inventor
Alok RANJAN
Original Assignee
Ranjan Alok
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 Ranjan Alok filed Critical Ranjan Alok
Publication of WO2023175499A1 publication Critical patent/WO2023175499A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00243—Type of minimally invasive operation cardiac
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00592—Elastic or resilient implements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00606—Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/0057—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect
    • A61B2017/00575—Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect for closure at remote site, e.g. closing atrial septum defects
    • A61B2017/00623—Introducing or retrieving devices therefor

Definitions

  • the present technical invention relates to a medical device for intracardiac shunts. More particularly, the present technical invention relates to a device for percutaneous closure of intracardiac shunts.
  • Proximal disc refers to a right atrial disc in case of ASD occluders.
  • Eccentric waist refers to a part that occludes a device which has an eccentric shape.
  • Claw structure refers to a claw shaped attachment for fixing the device.
  • Occluder refers to an implement that is used to cover or stop up a hole in the heart.
  • Amplatzer Device refers to a percutaneous, transcatheter occlusion device intended for the nonsurgical closure of intracardiac shunts.
  • ASD atrial septal defect
  • VSD ventricular septal defect
  • PDA Patent ductus arteriosus
  • Figure 1 illustrates a prior art depicting a configuration of an Amplatzer series device (100).
  • Figure la illustrates a prior art depicting an Amplatzer Muscular VSD Occluder.
  • Figure lb illustrates a prior art depicting an Amplatzer Duct Occluder.
  • Figure 1c illustrates a prior art depicting an Amplatzer Vascular Plug III.
  • Figure Id illustrates a prior art depicting an Occlutech PLD (square-shaped design).
  • Figure le illustrates a prior art depicting an Amplatzer Septal Occluder.
  • Figure 1g illustrates a prior art depicting an Amplatzer Vascular Plug IV.
  • Figure Ih illustrates a prior art depicting an Occlutech PLD (rectangular-shaped design).
  • Figure 2 illustrates a prior art depicting a typical septal occluder (200).
  • Figure 2.1 illustrates a prior art depicting an Amplatzer septal Occluder.
  • Figure 2.1 (A) an Amplatzer septal occlude is shown.
  • Figure 2.1 (B) an Amplatzer septal occluder supported by septal tissue is shown.
  • Figure 2.2 illustrates a prior art depicting an Amplatzer septal occluder with different parts of septal occluder. In this, the circular device with no central lumen is shown.
  • Figure 2.3 illustrates a prior art depicting a Amplatzer septal occluder with delivery cable attached to connector.
  • Figure 3 illustrates prior art depicting a typical septal occluder (300).
  • Figure 3.1 illustrates a prior art depicting an Amplatzer Muscular VSD Occluder.
  • Figure 3.2 illustrates a prior art depicting different types of Amplatzer VSD occluders.
  • A shows a Symmetric Occluder
  • B shows an Eccentric Occluder
  • C shows a thin waist Occluder
  • D shows an Ampltzer Duct Occluder II.
  • L indicates a left disc and R indicates a right disc.
  • Figure 3.3 illustrates a prior art depicting a device with unequal margins.
  • FIG. 4 illustrates a prior art depicting a typical design of a PDA occluder (400).
  • the typical design of the PDA occlude shows a (A) Left ventricular retention disc diameter, (B) Left ventricular side diameter, (C) Right ventricular side diameter, (D) Device length, (E) Delivery cable, (F) Internal threat, where a cable connects to the device.
  • a typical septal occluder has a central waist which fits into the defect and has overhanging margins which takes support from surrounding tissue as per Figure 2.1(A), (B) and Figure 3.1.
  • the stability of the device is less if the surrounding rims are not adequate and can lead to embolization of the device. In the ASD and VSD, adequate rims all around the defect are preferred for proper placement of device.
  • the left retention disc is present, and stability of the device is provided by selecting a device size, at least 2 millimeters (mm) more than the narrowest diameter of the PDA as shown in Figure 4.
  • a device size at least 2 millimeters (mm) more than the narrowest diameter of the PDA as shown in Figure 4.
  • the ASD and VSD not only the size of the device but also the surrounding rims of tissue are important for device stability. Embolization of the device is a known complication of these devices. The device can embolize if the size of the device is smaller than the defect or if enough support is not provided by surrounding tissue. Role of rims of the surrounding tissue is crucial for the ASD and VSD. As adequate rims are not present in sinus venosus ASD and ostium primum ASD, surgery is the only option for such patients whereas devices are used in suitable ostium secundum ASDs with adequate rims.
  • Anatomical and device related limitations 1. There is a need to have surrounding 'walls' supporting their stability. These devices need more than 5-7 mm of sufficiently stable tissue to support device stability. Enough rims are necessary to avoid disks interference with atrioventricular valves and venous returns. However, isolated absence of aortic rim (in ASD) can be overcome and present generation of device can close such defects effectively. Occasionally, rims are well represented but are too floppy and flimsy. In these cases, the tissue of the rims is too compliant and does not assure stability of device.
  • ASA Atrial septal aneurysms
  • ASD closure devices The available waist diameter of ASD devices is 4 - 40 mm, so larger size of defect cannot be closed with these devices.
  • PDA closure devices Maximum available device size is A/ 2. mm, where a first number refers to diameter of the aortic end and a second number refers to the pulmonary end of a conical shaped device.
  • VSD closure device Available in sizes ranging from 4-16 mm and higher sizes are available in Post-infarct Muscular VSD Occluder (up to 24 mm).
  • a device for percutaneous closure of intra cardiac shunts has two semi-circular discs having a joint arrangement at the center of each disc as opposed to single circular disc in the present generation of devices.
  • Semicircular discs can be symmetrical (identical) or asymmetrical with inequal over hanging margins. Waist present on both semicircular discs should be equal or identical. It is the overhanging margins which are different of either disc.
  • One semicircular disc has normal (5-7 mm) or longer overhanging margins and the other disc has little or no overhanging margins.
  • Presence of 2 semicircular disc will create a space in center between these two discs to allow passage of guide wire called as a central lumen that is centrally placed between the two semi-circular discs.
  • a guide wire is placed in the central lumen, the guide wire can help to rotate device on the guidewire to align disc with little or no margins against the part of defect with deficient rims and other disc against adequate rims.
  • the guide wire is configured to rotate the device in one or more directions and align the semi-circular disc with little or no margins to the part of defect with deficient rim.
  • There is a delivery cable which is a hollow tube to accommodate the guide wire and it can be connected or disconnected from a device connector by clockwise or counterclockwise rotation respectively.
  • the delivery cable is configured to accommodate the guide wire inside the structure as well as the delivery cable is configured to help in aligning one of the semi-circular discs to the deficient rim.
  • the basic structures are same as in the previous embodiment as there are two semi-circular discs with two ends of each disc having a joint arrangement at the ends of each disc.
  • a central lumen is centrally placed between the two semi-circular discs.
  • a guide wire is placed in the central lumen of the device and the guide wire is configured to align device to the part of defect with deficient rim.
  • the guide wire is further configured to rotate the device in one or more directions and align the semi-circular disc with little or no margins to the deficient rim.
  • a delivery cable having a hollow tube structure is configured to accommodate the guide wire inside the structure and is also configured to help in alignment of semi-circular disc to the deficient rim.
  • fixation wires that are attached to proximal disc of semicircular disc with normal or longer overhanging margins and help to fix the device to an adjacent septal tissue which is configured to stabilize the device.
  • Fixation wires along with delivery cable can be delivered through delivery sheath. These fixation wires can be screwed on to adjacent tissue to stabilize the device.
  • the delivery cable and these fixation wires on the right disc can be within the delivery sheath to facilitate attachment to septal tissue.
  • Another way to stabilize the device will be to put claw like wires on septal tissue side of proximal disc.
  • a device with two semi-circular discs with two ends of each disc having a joint arrangement at the ends of each disc is shown.
  • a central lumen is present between the two semi-circular discs will facilitate the device to be delivered over the guidewire.
  • the guide wire is also configured to rotate the device in one or more directions and align the semi-circular disc with little or no margins to the deficient rim of the defect.
  • a delivery cable having a hollow tube structure which is configured to accommodate the guide wire inside the structure and to help in aligning the semi-circular disc to the deficient rim is also present.
  • a delivery sheath which is configured to accommodate the guide wire, the delivery cable along with a septal puncture needle, the septal puncture needle is configured to puncture the adjacent septal tissue through the semi-circular disc with normal or longer overhanging margins and enable a passage of a thin wire through the adjacent septal tissue.
  • the septal tissue can be punctured through this needle and a wire can be passed within the lumen of needle.
  • a catheter is used to snare the thin wire left atrium in the central lumen of the delivery cable and the device is fixed to the septal tissue by extreriotating, rotating and cutting the wire from outside to fix the device to the septal tissue.
  • the modified device where the discs are symmetrical can be used to occlude defects with sufficient rims all around as they are closed with prior art.
  • the presence of fixation wires, claws or fixation as explained with help of septal puncture needle can be accommodated on one of the symmetrical discs to minimize embolization of device.
  • Figure 1 illustrates a prior art depicting a configuration of an Amplatzer series device.
  • Figure 2 illustrates a prior art depicting a typical septal occluder.
  • Figure 3 illustrates a prior art depicting a typical septal occluder.
  • Figure 4 illustrates a prior art depicting a typical design of a PDA occluder.
  • Figure 5 illustrates a schematic diagram depicting a device for percutaneous closure of intracardiac shunts, according to an embodiment of the present technical invention.
  • Figure 6 illustrates a schematic diagram depicting a device for percutaneous closure of intracardiac shunts having delivery sheath and fixation wires, according to an embodiment of the present technical invention.
  • Figure 7 illustrates a schematic diagram depicting a device for percutaneous closure of intracardiac shunts having a septal puncture tool, according to an embodiment of the present technical invention.
  • the present invention provides a device for percutaneous closure of intracardiac shunts.
  • the present invention provides a device for percutaneous closure of intracardiac shunts to close defects with insufficient rims around the defect.
  • the present invention provides a device for percutaneous closure of intracardiac shunts to reduce the embolization of the devices.
  • the present invention provides a device for percutaneous closure of intracardiac shunts to eliminate and / or reduce the shortcomings and defects of the prior art.
  • the present invention provides a device for percutaneous closure of intracardiac shunts that closes defects with inadequate rims for which the present generations of devices are not recommended.
  • ASDs and VSDs it may be possible to close the defects which are contraindicated right now for device closure e.g., sinus venosus or septum primum ADSs.
  • the device of the present invention reduces the incidence of embolization and it may eliminate this complication seen in current generations of devices.
  • the higher sizes of defect can be closed with the present invention as risk of embolization will be near zero.
  • the incidences of obstruction to atrioventricular valves or venous returns can be reduced with the present invention.
  • the interference with other intracardiac structures and electrical conduction system can be reduced with the present invention.
  • the present invention makes no change in the nitinol framework of devices.
  • the device according to the present invention is made up of nitinol and has fabric mesh. There is no need to change the material as it is best suited for devices according to the present invention.
  • the present invention provides a modification in overhanging margins of the device.
  • most of the present set of devices has a 'central' waist with over hanging disc margins on both sides for support and to prevent embolization ( Figure 2.1 and Figure 3.1).
  • Typical PDA occluders (ADO I) have a slightly different design ( Figure lb and Figure 4).
  • ADO II ( Figure 3.2 D) has a central waist and symmetrical margins. In some occluders (for perimembranous and subarterial VSDs), the overhanging margins are unequal to accommodate the deficient rims (Fig 3.2 B and 3.3).
  • the waist of the device In order to close defects with inadequate or deficient rims (applicable for certain ASDs and VSDs), the waist of the device (part that occludes the defect) will remain the same but the overhanging margins should be modified to be eccentric.
  • the margins on one side should be negligible and the side opposite to it should have normal or longer overhanging margins.
  • the side without margins will face a defect with inadequate rims and the opposite side will continue to provide support.
  • a provision should be there to rotate the device once it is placed across the defect. Therefore, the modifications are required in the present invention: a) Eccentric margins with identical waist b) Rotation facility in device.
  • the device has two semi-circular discs with the two ends of each semi-circular disc having a joint arrangement at the ends of each disc.
  • One disc has normal or longer overhanging margins and the other disc has little or no margins.
  • the device can be delivered over the guidewire.
  • the guide wire is configured to rotate the device in one or more directions and help in aligning the semi-circular disc with little or no overhanging margins to the deficient rim.
  • a delivery cable which is a hollow tube to accommodate the guide wire and it can be connected or disconnected from a device connector by clockwise or counterclockwise rotation respectively.
  • the delivery cable is configured to accommodate the guide wire inside the structure as well as the delivery cable is configured to help in aligning the semi-circular disc to the deficient rim.
  • a first disc of the two semi-circular discs has longer and over hanging margins.
  • a second disc of the two semi-circular discs has shorter overhanging margins.
  • each disc from the at least two semicircular discs includes an identical waist.
  • the device is eccentric due to unequal overhanging margins but the waist is identical.
  • a device cable connector is configured to connect the one end of the delivery cable to the device.
  • the delivery cable is attached to the device by using a clockwise rotation of the device cable and detached the delivery cable by using a counterclockwise rotation of the device cable. This rotation is done from the end of delivery cable which is outside and under control of operator.
  • the first disc of the two semi-circular discs provides extra support to reduce embolization of device.
  • the second disc of the two semi-circular discs aligns with part of defect with deficient rims.
  • the device is made up of nitinol material having fabric mesh.
  • a central lumen is centrally placed between the two semi-circular discs.
  • a guide wire is placed in the central lumen of the device and the guide wire is configured to rotate the device in one or more directions and align the one semi-circular disc with little or no margins to the part of defect with deficient rim.
  • a delivery cable having a hollow tube structure is configured to accommodate the guide wire inside the structure and is also configured to help in aligning the semi-circular disc to the deficient rim.
  • fixation wires that are attached to proximal disc of semi-circular disc with normal or overhanging margins to fix the device on adjacent septal tissue which is configured to stabilize the device.
  • proximal disc of semi-circular disc with normal or overhanging margins to fix the device on adjacent septal tissue which is configured to stabilize the device.
  • delivery sheath which has the delivery cable, and the fixation wires which are further configured to facilitate an attachment to the adjacent septal tissue.
  • fixation wires can be screwed on to adjacent tissue to stabilize the device.
  • the delivery cable and these fixation wires on the proximal disc can be within the delivery sheath to facilitate attachment to septal tissue.
  • Another way to stabilize the device will be to put claw like wires on septal tissue side of proximal disc.
  • fixation wires are being fixed on to an adjacent septal tissue and are being screwed in or hooked up with an extension.
  • the semi-circular disc with normal or overhanging margins is having a screw in arrangement to actively fix the device to adjacent tissue.
  • the semi-circular disc with normal or overhanging margins is having a screw in arrangement to actively fix the device to adjacent tissue.
  • a device with two semi-circular discs with two ends of each disc having a joint arrangement at the ends of each disc is shown.
  • a central lumen is centrally placed between the two semi-circular discs with a guide wire placed in the central lumen, the guide wire is configured to rotate the device in one or more directions and align semicircular disc with little or no margins to the deficient rim of the defect.
  • a delivery cable has a hollow tube structure which is configured to accommodate the guide wire inside the structure and to help in aligning the semi-circular disc with little or no margins to the deficient rim is also present.
  • a delivery sheath which is configured to accommodate the guide wire, a delivery cable inside along with a septal puncture needle, the puncture needle is configured to puncture the adjacent septal tissue through the semi-circular disc with normal or over hanging margins and to enable passage of a thin wire through the adjacent septal tissue.
  • the septal tissue can be punctured through this needle and a wire can be passed within the lumen of needle.
  • a catheter is used to snare the thin wire from left atrium in the central lumen of the device and the device is fixed to the septal tissue by extreriotating, rotating and cutting the wire from outside.
  • a thin wire consists of rotating two ends of the thin wire thereby making a knot and cutting the thin wire to fix the device.
  • a device for percutaneous closure of intracardiac shunts (hereinafter referred to as "device") (500) includes two semi-circular discs (510,520), a central lumen (550), a guide wire (540), and a delivery cable (530).
  • a first disc (510) of the two semi-circular discs (510,520) is having longer over hanging margin.
  • a second disc (520) of the two semi-circular discs (510,520) has shorter overhanging margins.
  • each disc includes an identical waist.
  • the central lumen (550) is centrally placed between the two semi-circular discs (510,520).
  • the guide wire (540) is placed in the central lumen.
  • the guide wire (540) is configured to rotate the device (500) in one or more directions and align the semi-circular disc with little or no over hanging margins to the deficient rim.
  • the delivery cable (530) has a hollow tube structure.
  • the delivery cable (530) is configured to accommodate the guide wire (540) inside the structure and further help in aligning the semi-circular disc to the deficient rim.
  • the device (500) includes a device cable connector (560) which is configured to connect the one end of the delivery cable (530) to the device (500).
  • the device (500) has two semicircular discs (510,520) as opposed to a single circular disc.
  • One disc (510) has normal or longer overhanging margins and the other disc (520) has little or no margins.
  • the delivery cable (530) is a hollow tube to accommodate the guide wire (540) and it can be connected or disconnected from the device cable connector (560) by clockwise or counterclockwise rotation respectively. Due to this facility, the device (500) can be delivered over the guide wire (540).
  • the present invention facilitates help to rotate the device (500) in order to align the semi-circular disc (520) with little or no margins along the deficient rims.
  • Figure 6 illustrates a schematic diagram (600) depicting a device (500) for percutaneous closure of intracardiac shunts having delivery sheath and fixation wires, according to an embodiment of the present technical invention.
  • the device (500) also includes a set of fixation wires (610).
  • the set of the fixation wires (610) is attached to a proximal disc of semi-circular disc with normal or longer overhanging margins (510,520).
  • the fixation wires (610) are fixed to an adjacent septal tissue and configured to stabilize the device (500).
  • the delivery sheath (620) has the delivery cable (530) and the fixation wires (610), which is further configured to facilitate an attachment to the adjacent septal tissue.
  • a screw in or claw like extension to hook up the device (500) to underlying tissue is disclosed.
  • This mechanism can be understood with an active fixation method used in pacemaker leads.
  • the present generations of pacemaker leads have screw in facility to actively fix pacemaker lead to cardiac tissue.
  • a screw in mechanism can be added in the semi-circular disc with normal or longer over hanging margins (520) so that some of its struts can actively fix to adjacent septal tissue. It can be done by some separate fixation wires (610) on the device and wires can be fixed to underlying septal tissue by screw in mechanism. These wires may remain within the delivery sheath (620) of the device.
  • Figure 7 illustrates a schematic diagram (700) depicting a device (500) for percutaneous closure of intracardiac shunts having a puncture tool, according to an embodiment of the present technical invention.
  • a puncture needle and catheter from the septal puncture tool (710) have been disclosed.
  • the puncture needle (710) passes through the delivery sheath (620) to puncture an adjacent septal tissue through semi-circular disc with normal or longer overhanging margins and enable passage of a thin wire through the adjacent septal tissue.
  • the catheter (710) is configured to snare the thin wire from left atrium in the central lumen of the device (500) and to fix the device (500) to the septal tissue by extreriotating, rotating and cutting the wire from outside.
  • the puncture needle (710) can be passed within the delivery sheath (620) after device deployment.
  • the septal tissue can be punctured through the semi-circular disc with normal or longer over hanging margins (520) and a thin wire can be passed through it and snared through the central lumen of the device (500).
  • the two ends of the thin wire can be rotated to make a knot and cut so that the device (500) can remain fixed at its position.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Cardiology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention divulgue un dispositif (500) destiné à une fermeture percutanée de dérivations intracardiaques. Deux disques semi-circulaires (510, 520) présentant un agencement d'articulation doté d'un câble de pose (530) pour loger le fil de guidage (540) sont représentés. Des fils de fixation supplémentaires (610) sont fixés au disque proximal de premiers disques semi-circulaires (510) qui peuvent être vissés sur un tissu adjacent et qui demeurent à l'intérieur d'une gaine de pose (620) du dispositif (500). En variante, une aiguille de perforation (710) est amenée à passer à l'intérieur de la gaine de pose (620) après un déploiement de dispositif pour perforer le tissu septal et pour fermer les défauts présentant des rebords insuffisants, ce qui est actuellement contre-indiqué pour des dispositifs de fermeture de dispositif. Le dispositif (500) divulgué fermera les défauts présentant des rebords inadéquats et réduira l'incidence de l'embolisation du dispositif. Les tailles de défaut plus importantes peuvent également être fermées, et les complications observées dans les générations actuelles de dispositifs peuvent être éliminées.
PCT/IB2023/052464 2022-03-14 2023-03-14 Dispositif modifié destiné à une fermeture percutanée de dérivations intracardiaques WO2023175499A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IN202121058158 2022-03-14
IN202121058158 2022-03-14

Publications (1)

Publication Number Publication Date
WO2023175499A1 true WO2023175499A1 (fr) 2023-09-21

Family

ID=88024562

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2023/052464 WO2023175499A1 (fr) 2022-03-14 2023-03-14 Dispositif modifié destiné à une fermeture percutanée de dérivations intracardiaques

Country Status (1)

Country Link
WO (1) WO2023175499A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160317135A1 (en) * 2007-10-12 2016-11-03 St. Jude Medical, Cardiology Division, Inc. Multi-component vascular device
US20190274668A1 (en) * 2016-09-26 2019-09-12 St. Jude Medical, Cardiology Division, Inc. Percutaneous catheter directed intravascular occlusion devices with retractable stabilizing wires

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20160317135A1 (en) * 2007-10-12 2016-11-03 St. Jude Medical, Cardiology Division, Inc. Multi-component vascular device
US20190274668A1 (en) * 2016-09-26 2019-09-12 St. Jude Medical, Cardiology Division, Inc. Percutaneous catheter directed intravascular occlusion devices with retractable stabilizing wires

Similar Documents

Publication Publication Date Title
Lock et al. Transcatheter closure of ventricular septal defects.
US10213207B2 (en) Septal occlusion devices and methods
US7582104B2 (en) Daisy design for occlusion device
US7905901B2 (en) Self-centering occlusion device
US8409219B2 (en) Method and system for placement of electrical lead inside heart
EP1175867B1 (fr) Système de deliverance d'un occlusion
JP6042889B2 (ja) 心閉塞装置
Xing et al. Minimally invasive transthoracic device closure of isolated ventricular septal defects without cardiopulmonary bypass: long-term follow-up results
US20060116717A1 (en) Articulated center post
WO2022091018A1 (fr) Dispositif d'occlusion interseptal
WO2007064810A2 (fr) Procede et dispositif pour detecter et refermer un foramen ovale persistant
WO2014130535A1 (fr) Dispositifs d'occlusion cardiaque
US20220346869A1 (en) Medical implantable interatrial septal defect occlusion device
WO2023175499A1 (fr) Dispositif modifié destiné à une fermeture percutanée de dérivations intracardiaques
US20160100843A1 (en) Medical device for closing an opening or isolating a structure in the cardiovascular system
Guo et al. Off-pump occlusion of trans-thoracic minimal invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience
Pedra et al. Transcatheter closure of perimembranous ventricular septal defects
US20220346803A1 (en) Occluder, occluding system, and knotting method for tightening element in occluder
Ishikawa et al. Two-Port Robotic Cardiac Surgery (TROCS) for Atrial Septal Defect (ASD) Using Cross-Arm Technique–TROCS ASD Repair–
Yetkin et al. Emergency surgical approach to device emboli due to migration of the atrial septal defect occluder
Aggarwal et al. Gore Cardioform atrial septal occluder: deployment procedure and techniques for closing challenging secundum atrial septal defects
Kavurt et al. Transcatheter closure of post-operative type 1 Gerbode defect by Amplatzer Duct Occluder 2
US20220022935A1 (en) Transcatheter closure of patent foramen ovale with bipolar rf application
Gao et al. Totally endoscopic robotic correction of cor triatriatum sinister coexisting with atrial septal defect
Goonetilleke et al. Early clinical experience with the new Amplatzer Ductal Occluder II for closure of the Persistent Arterial Duct (PDA)

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 23769999

Country of ref document: EP

Kind code of ref document: A1